770 research outputs found

    Sistema de gestión de la calidad con gobernanza e interculturalidad en Ecotur Yahuiche, Oaxaca

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    The innovation of administrative processes responds to one of the challenges of community tourism companies for the conciliation between community organization and business operation. The objective of this study is to analyze the process of implementing a quality management system (QMS) in Ecotur Yahuiche S.P.R. by R.I. from a community governance and intercultural approach. The participatory action research methodology and participant observation were used in a transversal way in the application of the PDCA method (Deming cycle) to implement the QMS and adapt the ISO 9001-2008 standard to the characteristics of governance and interculturality. The results show that Ecotur Yahuiche strengthened the provision of ecotourism services with the implementation of the SGC, while upholding community values and visitor-host interculturality.La innovación de procesos administrativos responde a uno de los retos de las empresas de turismo comunitario para la conciliación entre la organización comunitaria y el funcionamiento empresarial. El objetivo de este estudio es analizar el proceso de implementación de un sistema de gestión de la calidad (SGC) en Ecotur Yahuiche S. P. R. de R. I. desde un enfoque de gobernanza comunitaria e interculturalidad. Se empleó la metodología de investigación acción participativa y observación participante de manera transversal en la aplicación del método PHVA (ciclo Deming) para poner en marcha el SGC y adecuar la norma ISO 9001-2008 a las características de gobernanza e interculturalidad. Los resultados muestran que Ecotur Yahuiche fortaleció la prestación de servicios ecoturísticos con la implementación del SGC, a la vez que sostuvo los valores comunitarios e interculturalidad visitante-anfitrión

    Sistema de gestión de la calidad con gobernanza e interculturalidad en Ecotur Yahuiche, Oaxaca

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    La innovación de procesos administrativos responde a uno de los retos de las empresas de turismo comunitario para la conciliación entre la organización comunitaria y el funcionamiento empresarial. El objetivo de este estudio es analizar el proceso de implementación de un sistema de gestión de la calidad (SGC) en Ecotur Yahuiche S. P. R. de R. I. desde un enfoque de gobernanza comunitaria e interculturalidad. Se empleó la metodología de investigación acción participativa y observación participante de manera transversal en la aplicación del método PHVA (ciclo Deming) para poner en marcha el SGC y adecuar la norma ISO 9001-2008 a las características de gobernanza e interculturalidad. Los resultados muestran que Ecotur Yahuiche fortaleció la prestación de servicios ecoturísticos con la implementación del SGC, a la vez que sostuvo los valores comunitarios e interculturalidad visitante-anfitrión

    I.amAble: la ciencia (química) al alcance de toda la sociedad

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    En este proyecto de innovación, que nace con vocación de continuar en años sucesivos, se persigue mejorar la calidad de la formación de los estudiantes de la Facultad de Ciencias Químicas (F. CC.QQ.) en el ámbito de la docencia teórico-práctica y de la divulgación científica. El trabajo ha consistido en la preparación de unos experimentos prácticos para llevarlos a cabo en centros educativos no universitarios en los que se ha tenido en cuenta la participación conjunta de personas con y sin diversidad funcional, desde una perspectiva inclusiva colaborativa. Estas actividades las han realizado los estudiantes bajo la supervisión de profesores (PDI) y personal de administración y servicios (PAS). Los experimentos se han recogido en fichas didácticas para facilitar su desarrollo y aplicación por parte de otros usuarios. En estas fichas se explica detalladamente cómo realizar las experiencias en formato de taller. Las fichas de los talleres realizados están disponibles en una página web vinculada a la Universidad Complutense bajo el título I.amAble (iamable.ucm.es). Está página ha sido construida por un estudiante de la Facultad de Informática , bajo la supervisión de profesionales, tanto de esa facultad como del Instituto de Tecnología del Conocimiento, y está abierta a contribuciones similares de otras facultades y otras instituciones. La página web está diseñada de manera que resulte lo más intuitiva y accesible posible para todo tipo de público. Entre todos los experimentos se han elegido cuatro para llevarlos a la práctica en centros educativos como actividades inclusivas en las que han participado conjuntamente personas con y sin discapacidad. Con este proyecto se pretende mejorar la calidad docente al ofrecer a los estudiantes la posibilidad de aprender enseñando mediante una actividad semipresencial. El desarrollo por parte de los estudiantes de competencias transversales en educación y en divulgación de la ciencia facilitarán algunas salidas profesionales en el ámbito educativo formal (centros de enseñanza) o informal (museos, animación sociocultural). Otro aspecto importante a resaltar es la potenciación de la colaboración entre todos los miembros de la institución universitaria. Este proyecto pretende contribuir a la mejora de la cultura científica, así como al establecimiento de puentes entre la UCM y la sociedad a la que debe servir. Finalmente, es importante subrayar que incidirá en la inclusión de las personas con discapacidad como parte de la sociedad, a través del acercamiento compartido a la ciencia (Dimensiones de inclusión social y derechos de Schalock; NAVAS MACHO, P. y otros, 2012. Derechos de las personas con discapacidad intelectual: implicaciones de la Convención de Naciones Unidas. Siglo Cero. 43 (243): 7-28.)

    Creación del primer Grupo iGEM (Competición Internacional de Biología Sintética) de Madrid: Facultad de Biología-UCM

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    En este Trabajo se describe la creación del primer Grupo iGEM de Madrid así como la elaboración de un biosensor que permite la detección de polen de olivo a tiempo real empleando metodos de ingeniería genética y robótica

    Post-Hospital Syndrome and Hyponatremia

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    Introduction: Post-hospital syndrome (PHS) is defined as a period of vulnerability during the first 30 days after a patient is discharged from hospital, in which multiple factors come into play. Hyponatremia is the most frequent hydroelectrolytic disorder in hospitalized patients and may be related to the appearance of PHS. Objective: The objective is to estimate the prevalence of PHS that is assessed as the rate of readmissions in the first 30 days after discharge, in patients with hyponatremia. Material and Methods: It is a descriptive observational study of patients with hyponatremia who were discharged from 1 September 2010 to 2 February 2020 at the Internal Medicine Service of the Hospital University of San Juan (Alicante, Spain). Results: Of the 25 included patients, 5 (20%) were readmitted within a month of discharge, after a mean of 11.4 days (standard deviation [SD] 5.1). The overall mortality of the study was 20% (n = 5), with one case of death in the first 30 days post-hospitalization (4%). In 12 patients (48%) the origin of the hyponatremia was undetermined. The most frequently recorded etiology for the condition was pharmacological (n = 7, 28%), and there was pronounced variability in its clinical and laboratory study. The most widely used corrective measure was drug withdrawal, in 16 patients (64%). Water intake restriction was the most common treatment after discharge (5 patients, 20%), followed by urea (2 patients, 8%), while tolvaptan was not used. Conclusion: Hyponatremia may be the cause of PHS, which could increase the rate of early readmission. Hyponatremia is an underdiagnosed and undertreated entity, so it is necessary to apply an appropriate system to optimize its management and, in future studies, to assess its impact on PHS

    Multicentre, randomised, single-blind, parallel group trial to compare the effectiveness of a Holter for Parkinson's symptoms against other clinical monitoring methods: study protocol

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    Introduction In recent years, multiple studies have aimed to develop and validate portable technological devices capable of monitoring the motor complications of Parkinson's disease patients (Parkinson's Holter). The effectiveness of these monitoring devices for improving clinical control is not known. Methods and analysis This is a single-blind, cluster-randomised controlled clinical trial. Neurologists from Spanish health centres will be randomly assigned to one of three study arms (1:1:1): (a) therapeutic adjustment using information from a Parkinson?s Holter that will be worn by their patients for 7 days, (b) therapeutic adjustment using information from a diary of motor fluctuations that will be completed by their patients for 7 days and (c) therapeutic adjustment using clinical information collected during consultation. It is expected that 162 consecutive patients will be included over a period of 6 months. The primary outcome is the efficiency of the Parkinson?s Holter compared with traditional clinical practice in terms of Off time reduction with respect to the baseline (recorded through a diary of motor fluctuations, which will be completed by all patients). As secondary outcomes, changes in variables related to other motor complications (dyskinesia and freezing of gait), quality of life, autonomy in activities of daily living, adherence to the monitoring system and number of doctor?patient contacts will be analysed. The noninferiority of the Parkinson's Holter against the diary of motor fluctuations in terms of Off time reduction will be studied as the exploratory objective. Ethics and dissemination approval for this study has been obtained from the Hospital Universitari de Bellvitge Ethics Committee. The results of this study will inform the practical utility of the objective information provided by a Parkinson's Holter and, therefore, the convenience of adopting this technology in clinical practice and in future clinical trials. We expect public dissemination of the results in 2022.Funding This work is supported by AbbVie S.L.U, the Instituto de Salud Carlos III [DTS17/00195] and the European Fund for Regional Development, 'A way to make Europe'

    Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry

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    Aim To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW). Methods Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20-65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality. Results As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067-0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001). Conclusions Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality

    Treatment with tocilizumab or corticosteroids for COVID-19 patients with hyperinflammatory state: a multicentre cohort study (SAM-COVID-19)

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    Objectives: The objective of this study was to estimate the association between tocilizumab or corticosteroids and the risk of intubation or death in patients with coronavirus disease 19 (COVID-19) with a hyperinflammatory state according to clinical and laboratory parameters. Methods: A cohort study was performed in 60 Spanish hospitals including 778 patients with COVID-19 and clinical and laboratory data indicative of a hyperinflammatory state. Treatment was mainly with tocilizumab, an intermediate-high dose of corticosteroids (IHDC), a pulse dose of corticosteroids (PDC), combination therapy, or no treatment. Primary outcome was intubation or death; follow-up was 21 days. Propensity score-adjusted estimations using Cox regression (logistic regression if needed) were calculated. Propensity scores were used as confounders, matching variables and for the inverse probability of treatment weights (IPTWs). Results: In all, 88, 117, 78 and 151 patients treated with tocilizumab, IHDC, PDC, and combination therapy, respectively, were compared with 344 untreated patients. The primary endpoint occurred in 10 (11.4%), 27 (23.1%), 12 (15.4%), 40 (25.6%) and 69 (21.1%), respectively. The IPTW-based hazard ratios (odds ratio for combination therapy) for the primary endpoint were 0.32 (95%CI 0.22-0.47; p < 0.001) for tocilizumab, 0.82 (0.71-1.30; p 0.82) for IHDC, 0.61 (0.43-0.86; p 0.006) for PDC, and 1.17 (0.86-1.58; p 0.30) for combination therapy. Other applications of the propensity score provided similar results, but were not significant for PDC. Tocilizumab was also associated with lower hazard of death alone in IPTW analysis (0.07; 0.02-0.17; p < 0.001). Conclusions: Tocilizumab might be useful in COVID-19 patients with a hyperinflammatory state and should be prioritized for randomized trials in this situatio

    Vocabulario de la sociedad civil, la ruralidad y los movimientos sociales en América Latina

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    El Vocabulario de la Sociedad Civil, la Ruralidad y los Movimientos Sociales en América Latina tiene como objetivo desarrollar vocablos relacionados con temas de gran trascendencia para la vida colectiva de la población Latinoamericana; pretende introducir a estudiantes, personas del ámbito académico y activistas en la comprensión de estas categorías de análisis. A través de la mirada de 70 especialistas que participaron en este vocabulario, es posible comprender muchos de los términos que se utilizan dentro de la investigación social y áreas relacionadas con las ciencias políticas, ambientales y rurales, a partir de una mayor explicación y detalle. Es por ello que se inserta este trabajo desde una mirada colectiva y amplia de los conceptos que se exponen. En este libro podrá encontrar las ideas de varios autores y autoras de distintas universidades, con una visión multi, inter y transdisciplinaria. El esfuerzo que se realizó para conjuntar varios términos y analizar su compleja red de interpretaciones, permitirá que este manuscrito pueda ser consultado por estudiantes, personas del ámbito científico-académico, y ciudadanía; porque contiene el estado del arte, la historia del paulatino avance de múltiples conceptos y su vigencia en el contexto actual

    Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

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    The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality
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