La perspectiva de género en los presupuestos de la comunidad autónoma de Andalucía

El Presupuesto de la Comunidad Autónoma de Andalucía para el año 2006 fue el primero que incluyó un Informe de Evaluación de Impacto de Género. El objetivo que nos proponemos a la hora de acometer la elaboración de este trabajo es hacer una comparativa de estos Informes de Evaluación desde su implantación en el Presupuesto para el ejercicio 2006 hasta el Presupuesto para el ejercicio 2010, último aprobado por el Parlamento Andaluz. Se hace una especial incidencia en la evolución de la metodología utilizada para la elaboración de los Informes de Evaluación de Impacto de Género, en el estudio sociodemográfico que incluyen estos, en la evolución de la representación por sexo del personal al servicio de la Administración General de la Junta de Andalucía, y del análisis desde la perspectiva de género de los créditos contenidos en los presupuestos, así como en la evolución de los indicadores utilizados. Por último, hemos querido finalizar este trabajo exponiendo algunas propuestas que entendemos podrían suponer una mejora de los Informes de Evaluación de Impacto de Género (IEIG) del Presupuesto de la Comunidad Autónoma de Andalucía para los ejercicios futuros.The budget of the Autonomous Community of Andalusia to the year 2006 was the first report included a Gender Impact Assessment. The objective that we intend to go ahead when this work is to make a comparative assessment of these reports since its introduction in the Budget for 2006 to the Budget for the financial year 2010, last approved by the Andalusian Parliament. It makes a special impact on the evolution of the methodology used for the preparation of reports Gender Impact Assessment, the socio-demographic study include, the evolution of gender representation of staff serving in the administration General of the Government of Andalusia, and analysis from a gender perspective of the appropriations contained in the budgets and the evolution of the indicators used. Finally, we wanted to finish this work showing some proposals that could lead to a better understand of the Reports of Gender Impact Assessment (IEIG) of the Budget of the Autonomous Community of Andalusia future periods

Toward Sustainable Adoption of Integrated Care for Prevention of Unplanned Hospitalizations: A Qualitative Analysis

Introduction: Complex chronic patients are prone to unplanned hospitalizations leading to a high burden on healthcare systems. To date, interventions to prevent unplanned admissions show inconclusive results. We report a qualitative analysis performed into the EU initiative JADECARE (2020-2023) to design a digitally enabled integrated care program aiming at preventing unplanned hospitalizations. Methods: A two-phase process with four design thinking (DT) sessions was conducted to analyse the management of complex chronic patients in the region of Catalonia (ES). In Phase I, Discovery, two DT sessions, October 2021 and February 2022, were done using as background information: i) the results of twenty structured interviews (five patients and fifteen professionals), ii) two governmental documents on regional deployment of integrated care and on the Catalan digital health strategy, respectively, and iii) the results of a cluster analysis of 761 hospitalizations. In Phase II, Confirmation, we examined the 30- and 90 -day post -discharge periods of 49,604 hospitalizations as input for two additional DT sessions conducted in November and December 2022. Discussion: The qualitative analysis identified poor personalization of the interventions, the need for organizational changes, immature digitalization, and suboptimal services evaluation as main explanatory factors of the observed efficacyeffectiveness gap. Additionally, a program for prevention of unplanned hospitalizations, to be evaluated during the period 2024-2025, was generated. Conclusions: A digitally enabled adaptive case management approach to foster collaborative work and personalization of care, as well as organizational re -engineering, are endorsed for value -based prevention of unplanned hospitalizations

Medidas de controlo vetorial de mosquitos em caso de surtos de arboviroses

This paper proposes developing monitoring and control strategies with regard to various species of mosquitoes well- established in the Iberian Peninsula based on their ecological characteristics for two different scenarios of arbovirus outbreaks: One for controlling Aedes albopictus as a vector transmitting dengue, zika and chikungunya in urban environments and the other for keeping in check the Culicinae species linked to the transmission of the West Nile virus in rural and peri-urban environments. These entomological monitoring and control plans are based on experiments conducted in different Spanish provinces over the past few years. The results of the control treatments carried out and the relevance of the coordination and cooperation among public and private entities are discussed herein in detail.En el presente artículo se plantea el desarrollo de estrategias de vigilancia y control de diversas especies de mosquitos asentados en la Península Ibérica, basados en sus características ecológicas, para dos escenarios diferenciados de brotes de arbovirosis: fundamentalmente para el control de Aedes albopictus como vector transmisor en entornos urbanos (dengue, zika y chikungunya) y, en segundo lugar, el control de especies de culicinos ligados al medio rural y periurbano (virus West Nile). Estos planes de vigilancia y control entomológico se basan en experiencias llevadas a cabo en diferentes provincias españolas a lo largo de los últimos años. El resultado de los tratamientos de control realizados y la relevancia de la coordinación y cooperación entre entidades públicas y privadas, se discuten con detalle en el presente artículo.Este artigo propõe o desenvolvimento de estratégias de vigilância e controlo de várias espécies de mosquitos instaladas na Península Ibérica, com base nas suas características ecológicas, para dois cenários distintos de surto de arboviroses: fundamentalmente para o controle de Aedes albopictus como vetor transmissor em ambientes urbanos (dengue, zika e chikungunya) e, em segundo lugar, o controlo de espécies de culicídeos ligados aos meios rurais e periurbanos (vírus do Nilo Ocidental). Estes planos de vigilância e controle entomológico baseiam-se em experiências realizadas em diferentes províncias espanholas nos últimos anos. O resultado dos tratamentos de controlo efetuados e a relevância da coordenação e cooperação entre entidades públicas e privadas são discutidos em pormenor neste artigo

Análisis del juego de ataque en balonmano femenino

.- This study focuses on the specific organization of the attacking strategies in women's handball. In particular, we explore the specific weight of the two possible modalities of attack: positional and counterattack. To do so, during the 2008/2009 season, we have analyzed through a systematic observation methodology, direct and non-participant, the matches of a team that plays in the First Division of Women's Handball. To determine the rates of effectiveness, we have studied more than 2000 attacks and 900 throws on goal. Statistical analysis revealed that counterattack is more effective than positional play, and that it has a closer relationship with victory.Este estudio examinó la específica organización del juego de ataque en balonmano femenino. En concreto, hemos explorando el peso específico de los dos posibles tipos de ataque: posicional y contraataque. Para ello, hemos analizado los partidos de un mismo equipo de División de Honor Femenina durante la temporada 2008/2009 mediante metodología de la observación sistemática, directa y no participante. Hemos estudiado más de 2000 jugadas de ataque y 900 lanzamientos a portería, determinando de esta manera los índices de efectividad. El análisis estadístico reveló que existe una mayor eficacia del contraataque frente al juego posicional, además de una mayor relación con la victoria final

Prevention of Unplanned Hospital Admissions in Multimorbid Patients Using Computational Modeling: Observational Retrospective Cohort Study

Background: Enhanced management of multimorbidity constitutes a major clinical challenge. Multimorbidity shows well-established causal relationships with the high use of health care resources and, specifically, with unplanned hospital admissions. Enhanced patient stratification is vital for achieving effectiveness through personalized postdischarge service selection. Objective: The study has a 2-fold aim: (1) generation and assessment of predictive models of mortality and readmission at 90 days after discharge; and (2) characterization of patients' profiles for personalized service selection purposes. Methods: Gradient boosting techniques were used to generate predictive models based on multisource data (registries, clinical/functional and social support) from 761 nonsurgical patients admitted in a tertiary hospital over 12 months (October 2017 to November 2018). K-means clustering was used to characterize patient profiles. Results: Performance (area under the receiver operating characteristic curve, sensitivity, and specificity) of the predictive models was 0.82, 0.78, and 0.70 and 0.72, 0.70, and 0.63 for mortality and readmissions, respectively. A total of 4 patients' profiles were identified. In brief, the reference patients (cluster 1; 281/761, 36.9%), 53.7% (151/281) men and mean age of 71 (SD 16) years, showed 3.6% (10/281) mortality and 15.7% (44/281) readmissions at 90 days following discharge. The unhealthy lifestyle habit profile (cluster 2; 179/761, 23.5%) predominantly comprised males (137/179, 76.5%) with similar age, mean 70 (SD 13) years, but showed slightly higher mortality (10/179, 5.6%) and markedly higher readmission rate (49/179, 27.4%). Patients in the frailty profile (cluster 3; 152/761, 19.9%) were older (mean 81 years, SD 13 years) and predominantly female (63/152, 41.4%, males). They showed medical complexity with a high level of social vulnerability and the highest mortality rate (23/152, 15.1%), but with a similar hospitalization rate (39/152, 25.7%) compared with cluster 2. Finally, the medical complexity profile (cluster 4; 149/761, 19.6%), mean age 83 (SD 9) years, 55.7% (83/149) males, showed the highest clinical complexity resulting in 12.8% (19/149) mortality and the highest readmission rate (56/149, 37.6%). Conclusions: The results indicated the potential to predict mortality and morbidity-related adverse events leading to unplanned hospital readmissions. The resulting patient profiles fostered recommendations for personalized service selection with the capacity for value generation

Developtment of a software tool for the analysis and verification of emergency operating procedures through the integrated simulation of plant and operators actions

Probabilistic safety assessment (PSA) includes operator actions as elements in the set of the considered protection performances during accident sequences. Nevertheless, its impact throughout a sequence is not usually analyzed dynamically. In this sense, it is convenient to make a more detailed analysis about its importance in the dynamics of the sequences, allowing for sensitivity studies with respect to human reliability and response times. For this reason, new developments in simulation software must be able to incorporate operator actions in conventional thermalhydraulic simulations. In this paper, we present one of these new tools, the TRETA/TIZONA–COPMA III coupled codes, which can be used for evaluating the impact in the final plant state of the execution by operators of procedures and the evaluation of the available times for the manual actions of the operators. This software tool consists of a closed-loop plant/operator simulator: a thermalhydraulic code for simulating the plant transient (TRETA for PWR NPPs and TIZONA for BWR NPPs) and the procedures processor (COPMA III) to simulate the operator actions requested by the procedures, both coupled by a data communication system which allows the information exchange (SWBus). The first pilot cases have been performed in order to analyze sequences initiated by secondary side breaks leading to loss of heat sink sequences in a PWR plant. These tests have been carried out using the real plant EOPs for COPMA-III and a PWR plant model for TRETA code. The results of these simulations are presented in this paper

Reducing non-attendance in outpatient appointments: predictive model development, validation, and clinical assessment

Background Non-attendance to scheduled hospital outpatient appointments may compromise healthcare resource planning, which ultimately reduces the quality of healthcare provision by delaying assessments and increasing waiting lists. We developed a model for predicting non-attendance and assessed the effectiveness of an intervention for reducing non-attendance based on the model. Methods The study was conducted in three stages: (1) model development, (2) prospective validation of the model with new data, and (3) a clinical assessment with a pilot study that included the model as a stratification tool to select the patients in the intervention. Candidate models were built using retrospective data from appointments scheduled between January 1, 2015, and November 30, 2018, in the dermatology and pneumology outpatient services of the Hospital Municipal de Badalona (Spain). The predictive capacity of the selected model was then validated prospectively with appointments scheduled between January 7 and February 8, 2019. The effectiveness of selective phone call reminders to patients at high risk of non-attendance according to the model was assessed on all consecutive patients with at least one appointment scheduled between February 25 and April 19, 2019. We finally conducted a pilot study in which all patients identified by the model as high risk of non-attendance were randomly assigned to either a control (no intervention) or intervention group, the last receiving phone call reminders one week before the appointment. Results Decision trees were selected for model development. Models were trained and selected using 33,329 appointments in the dermatology service and 21,050 in the pneumology service. Specificity, sensitivity, and accuracy for the prediction of non-attendance were 79.90%, 67.09%, and 73.49% for dermatology, and 71.38%, 57.84%, and 64.61% for pneumology outpatient services. The prospective validation showed a specificity of 78.34% (95%CI 71.07, 84.51) and balanced accuracy of 70.45% for dermatology; and 69.83% (95%CI 60.61, 78.00) for pneumology, respectively. The effectiveness of the intervention was assessed on 1,311 individuals identified as high risk of non-attendance according to the selected model. Overall, the intervention resulted in a significant reduction in the non-attendance rate to both the dermatology and pneumology services, with a decrease of 50.61% (p<0.001) and 39.33% (p=0.048), respectively. Conclusions The risk of non-attendance can be adequately estimated using patient information stored in medical records. The patient stratification according to the non-attendance risk allows prioritizing interventions, such as phone call reminders, to effectively reduce non-attendance rates

Standardized System for the Optimization of Scanning, Digitization and Reverse Engineering Processes

La presente investigación tiene como estudio el tema de escaneo y digitalización en materia de procesos para la ingeniería inversa y la inspección&nbsp;&nbsp; de piezas mecanizadas, estas actividades resultan esenciales en los trabajos relacionados con la liberación de producto terminado, ya que nos permiten visualizar en primer instancia y de manera real objetos por medio de modelos 3D virtuales, para poder analizarlos, dimensionarlos e incluso reproducirlos (Quintanilla, 2017)&nbsp; estos procesos&nbsp; serán descritos como parte del desarrollo de este artículo. El plus a esta presente investigación es cuando se realizan actividades para la obtención de un producto final a partir de piezas físicas; lo cual no siempre resulta fácil, ya que no se cuenta con plano alguno de fabricación, y es donde se recurre al proceso que se denomina Ingeniera Inversa (Reversing). En donde Reversing se refiere a dar la vuelta al proceso de elaboración de un producto final, y la principal motivación es obtener el conocimiento suficiente sobre un producto final para poder reproducir de manera total o parcial el objeto analizado de manera más fiel posible&nbsp;(Garrote , 2018).&nbsp; El origen de esta tecnología no es nuevo, ya que se ha usado desde las primeras civilizaciones, cuando se comenzaron a replicar herramientas y maquinas, teniendo como auge el periodo de la segunda guerra mundial, y hoy en día su campo de aplicación se ha centrado en la industria moderna y en la recuperación del patrimonio cultural de la humanidad.The purpose of this research is to study the scanning and digitalization, aimed to process in reverse engineering, as well as the inspection of machined pieces. These activities are essential in different tasks related to the release of the final product, since they allow us to visualize the objects, by using virtual 3D models, and at the same time analyze them, sizing them and even replicate them. (Quintanilla, 2017) These processes will be described as part of the development of this article. The importance of this investigation is when a final product is obtained from physical pieces, which is not an easy process, because there is not a manufacturing plane, there is when the reverse engineering process is needed. (Reversing) The principal motivation of this process is to obtain enough knowledge about a final product, and then replicated it as similar as possible. (Garrote, 2018). The origin of this technology is not new, due to it has been used since the very first civilizations, when the replicas of tools and machines started, being the Second World War the boom of this technology. Now a days the range of application has been focused on the modern industry and the recovery of the world cultural heritage

Relación entre metodologías de control de la carga en el baloncesto profesional

[ES] El objetivo de este trabajo fue determinar la relación existente entre diferentes metodologías de medición de la carga de entrenamiento en un equipo profesional de baloncesto. 12 jugadores de un mismo equipo fueron sometidos a estructuras de entrenamiento iguales en cuanto a diseño y fueron monitorizados diariamentecon frecuencia cardiaca, GPS y percepción subjetiva de esfuerzo. Los resultados indicaron diferencias significativas entre todas las metodologías de control utilizadas. RPE (x2=12.4; P=.015), sRPE (x2=21.5; P<.001), TRIMP (x2=23.5; P<.001), SHRZ (x2=19.3; P<.001) y distancia (x2=21.7; P<.001). Se observó una correlación entre todas ellas exceptuando la variable distancia recorrida; Borg (p=.19; P=79), sRPE (p=.14; P=.299) y sHR-Z (p=.17; P=.197). Estos resultados sugieren que los diferentes métodos de evaluación utilizados para el control de la carga de entrenamiento determinan resultados variables en un equipo de baloncesto profesional. Se consideró que el ratio de esfuerzo percibido por sesión resulta el instrumento más eficaz para el control de la carga de entrenamiento.S