El poder del bloque de constitucionalidad sin límite

El problema jurídico planteado en el trabajo denominado “El poder del bloque de constitucionalidad sin límite”, consistió en determinar si los Tratados Internacionales de Derechos Humanos que integran el bloque de constitucionalidad en sentido estricto, modifican el texto de la Constitución Política de 1991 Para tal efecto se procedió a identificar los antecedentes del bloque en Francia y España, países pioneros en aplicar este modelo de interpretación e integración normativa, para posteriormente, señalar las diferencias con el modelo de bloque de constitucionalidad adoptado en Colombia, en el que se integran no solo normas Internacionales con rango constitucional, sino que adicionalmente se incorporan normas con rango supralegal. Posteriormente se analizaron los antecedentes jurisprudenciales relevantes sobre el bloque de constitucionalidad en Colombia, proferidos por la Corte Constitucional, máximo Tribunal Judicial en materia constitucional en el país, que a través de sus pronunciamientos ha señalado criterios que permiten identificar si una norma forma parte del bloque de constitucionalidad en sentido estricto o en sentido lato, en otras ocasiones, de manera expresa ha identificado a cuál de las categorías mencionadas corresponde una norma específica. En et mencionado trabajo se identificaron veintiocho (28) instrumentos Internacionales sobre Derechos Humanos que la Corte Constitucional ha introducirlo en sentido estricto al bloque de constitucionalidad, atendiendo al contenido de sus disposiciones y a su ámbito de aplicación, fenómeno con el cual se amplía el texto constitucional, a través de la inclusión de otras normas jurídicas que permiten lograr una mayor garantía y reconocimiento de Derechos Humanos de la población.In the work called Uglimited Unwritten Constitutional Principies (El poder del bloque de constitucionalidad sin limite, in Spanish), the juridical problem that was posed consisted of determining whether International Human Rights Treaties that are a part of unwitten constitutional principies sensu stricto modify the text of the 1991 Constitution of Colombia. To this end, we proceeded to identify the precedents of unwritten constitutional principies in France and Spain, which are the countries that pioneered the application of this interpretation and legal normative integration model. After that. we indicate the differences with the model of unwrittenMagíster en Derecho ConstitucionalMaestrí

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P < 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)