Definición, dinámica y alcance de la eco-innovación.

Actualmente la mayoría de las empresas cumplen los requisitos ambientales que exigen los clientes y la legislación vigente. Sin embargo, no es fácil ir más allá y alcanzar la excelencia ambiental. Es aquí donde entra el concepto de eco-innovación. Todavía no existe una definición clara de este concepto y es importante aclarar su significado para poder avanzar. Por lo tanto, a través de una investigación exploratoria, este artículo expone los diferentes enfoques de eco-innovación y aclara el concepto, dándole una perspectiva dinámica. Es importante destacar, que la ecoinnovación no tiene por qué tener como objetivo inicial la mejora ambiental; sino que puede partir de innovaciones que se realizan en los productos, procesos o servicios de la empresa. Esta definición se debe enmarcar en un campo de mejora continua, de tal forma que se busque de manera incremental, nuevos márgenes de mejora; ya sea en los productos, procesos y/o servicios y como consecuencia en el medio ambiente; o por el contrario, en aspectos ambientales y como consecuencia en los productos, procesos y/o servicios. Por otro lado, la eco-innovación está muy ligada al eco-diseño y a la eco-eficiencia. A través del eco-diseño se puede llegar a la eco-innovación, pero hay que tener en cuenta que para que el producto/servicio sea rentable hay que analizar la eco-eficiencia que se centra en el diseño de los procesos

Evolución de la gestión ambiental a través de estados de madurez.

A primera vista, la gestión ambiental puede parecer diferente en cada empresa. Sin embargo, esta investigación ha demostrado que la evolución de la gestión ambiental es similar en todas las organizaciones; es decir, cada compañía pasa por análogos estados de madurez. A través de entrevistas y workshops con expertos en gestión ambiental, se ha definido esta evolución y se ha desarrollado una clasificación de estos estados de madurez: Cumplimiento de la Legislación, Formación, Sistematización, ECO2, Eco-Innovación y Empresa Líder en Gestión Ambiental. Esta clasificación ayuda a comprender con mayor precisión la evolución de la gestión del medio ambiente y la estructura que representa a esta evolución

Estudio de la evolución de la gestión ambiental en empresas industriales.

La gestión ambiental se ha convertido en un aspecto esencial en todas las empresas. Sin embargo, no todas han alcanzado el mismo nivel de madurez. A través de una serie de workshops con expertos en el campo ambiental, se ha recogido información referente a aquellos aspectos que afectan a la gestión ambiental de todas las empresas para lograr demostrar que la evolución de la gestión ambiental a lo largo del tiempo es similar en todas ellas. Se ha definido una serie de factores, políticas, indicadores y comportamientos que intervienen en la gestión ambiental a lo largo del tiempo. Este estudio permite a las empresas identificar en qué estado de madurez se encuentran y qué pasos tienen que ir dando hacia la excelencia ambiental

Environmental Management Maturity: The Role of Dynamic Validation.

Maturity models enhance the performance of companies by prescribing a trajectory through stages of increasing capability. However, a recent review of maturity models concludes that current maturity models hardly meet the design principles required for prescriptive use. To address this deficiency, we conducted semistructured interviews and a Group Model Building study with industrial companies in Spain in which we studied the progression toward a Leading Green Company as the highest maturity stage of environmental management. The findings from the study were tested using surveys with enterprises in Spain, Italy, and the United Kingdom, semistructured interviews in the United Kingdom and case studies in Spain. Using these data sources, we develop a causal model that captures an idealized environmental management maturity dynamic progression though stages. By mapping maturity stages to feedback loops connected to actions to improve those maturity levels, system dynamics can help companies articulate policies for transitioning toward higher maturity stages

Environmental Management Evolution Framework: Maturity Stages and Causal Loops.

Environmental management has become a fundamental concern for organizations, customers, and citizens, yet there are few environmental management metrics that guide toward environmental excellence. This research presents a detailed qualitative model of the evolution of environmental management of a firm through the definition of maturity stages and causal influences. The model provides a technique for assessing maturity stages as well as steps that can assist or negate their ecological advancement. The causal-based classification helps companies to understand the need for nontechnical elements in the process, such as top management commitment. This article also contributes to the literature on integrative multimethod research, as it brings together several approaches to environmental management

2016 Expert consensus document on prevention, diagnosis and treatment of short-term peripheral venous catheter-related infections in adults

AbstractThe use of endovascular catheters is a routine practice in secondary and tertiary care level hospitals. The short-term use of peripheral catheters has been found to be associated with the risk of nosocomial bacteraemia, resulting in morbidity and mortality. Staphylococcus aureus is mostly associated with peripheral catheter insertion. This Consensus Document has been prepared by a panel of experts of the Spanish Society of Cardiovascular Infections, in cooperation with experts from the Spanish Society of Internal Medicine, Spanish Society of Chemotherapy, and the Spanish Society of Thoracic-Cardiovascular Surgery, and aims to define and establish guidelines for the management of short duration peripheral vascular catheters. The document addresses the indications for insertion, catheter maintenance, registering, diagnosis and treatment of infection, indications for removal, as well as placing an emphasis on continuous education as a drive toward quality. Implementation of these guidelines will allow uniformity in use, thus minimizing the risk of infections and their complications

2016 Expert consensus document on prevention, diagnosis and treatment of short-term peripheral venous catheter-related infections in adult.

Aquest document també està publicat a: 'Cirugía Cardiovascular' http://dx.doi.org/10.1016/j.circv.2016.06.001The use of endovascular catheters is a routine practice in secondary and tertiary care level hospitals. Short peripheral catheters have been found to be associated with the risk of nosocomial bacteremia resulting in morbidity and mortality. Staphyloccus aureus is mostly associated with peripheral catheter insertion. This Consensus Document has been elaborated by a panel of experts of the Spanish Society of Cardiovascular Infections in cooperation with experts from the Spanish Society of Internal Medicine, Spanish Society of Chemotherapy and Spanish Society of Thoracic-Cardiovascular Surgery and aims at define and establish the norm for management of short duration peripheral vascular catheters. The document addresses the indications for insertion, catheter maintenance and registry, diagnosis and treatment of infection, indications for removal and stresses on continuous education as a driver for quality. Implementation of this norm will allow uniformity in usage thus minimizing the risk of infection and its complications

Characteristics and outcome of Streptococcus pneumoniae endocarditis in the XXI Century: a systematic review of 111 cases (2000-2013)

Streptococcus pneumoniae is an infrequent cause of severe infectious endocarditis (IE). The aim of our study was to describe the epidemiology, clinical and microbiological characteristics, and outcome of a series of cases of S. pneumoniae IE diagnosed in Spain and in a series of cases published since 2000 in the medical literature. We prospectively collected all cases of IE diagnosed in a multicenter cohort of patients from 27 Spanish hospitals (n = 2539). We also performed a systematic review of the literature since 2000 and retrieved all cases with complete clinical data using a pre-established protocol. Predictors of mortality were identified using a logistic regression model. We collected 111 cases of pneumococcal IE: 24 patients from the Spanish cohort and 87 cases from the literature review. Median age was 51 years, and 23 patients (20.7%) were under 15 years. Men accounted for 64% of patients, and infection was community-acquired in 96.4% of cases. The most important underlying conditions were liver disease (27.9%) and immunosuppression (10.8%). A predisposing heart condition was present in only 18 patients (16.2%). Pneumococcal IE affected a native valve in 93.7% of patients. Left-sided endocarditis predominated (aortic valve 53.2% and mitral valve 40.5%). The microbiological diagnosis was obtained from blood cultures in 84.7% of cases. In the Spanish cohort, nonsusceptibility to penicillin was detected in 4.2%. The most common clinical manifestations included fever (71.2%), a new heart murmur (55%), pneumonia (45.9%), meningitis (40.5%), and Austrian syndrome (26.1%). Cardiac surgery was performed in 47.7% of patients. The in-hospital mortality rate was 20.7%. The multivariate analysis revealed the independent risk factors for mortality to be meningitis (OR, 4.3; 95% CI, 1.4-12.9; P < 0.01). Valve surgery was protective (OR, 0.1; 95% CI, 0.04-0.4; P < 0.01). Streptococcus pneumoniae IE is a community-acquired disease that mainly affects native aortic valves. Half of the cases in the present study had concomitant pneumonia, and a considerable number developed meningitis. Mortality was high, mainly in patients with central nervous system (CNS) involvement. Surgery was protective

Prevention, Diagnosis and Management of Post-Surgical Mediastinitis in Adults Consensus Guidelines of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES)

Prevention, Diagnosis and Management of Post-Surgical Mediastinitis in Adults Consensus Guidelines of the Spanish Society of Cardiovascular Infections (SEICAV), the Spanish Society of Thoracic and Cardiovascular Surgery (SECTCV) and the Biomedical Research Centre Network for Respiratory Diseases (CIBERES) doctors and radiologists. Despite the clinical and economic consequences of sternal wound infections, to date, there are no specific guidelines for the prevention, diagnosis and management of mediastinitis based on a multidisciplinary consensus. The purpose of the present document is to provide evidencebased guidance on the most effective diagnosis and management of patients who have experienced or are at risk of developing a post-surgical mediastinitis infection in order to optimise patient outcomes and the process of care. The intended users of the document are health care providers who help patients make decisions regarding their treatment, aiming to optimise the benefits and minimise any harm as well as the workload.Funding: J.M. Miró was a recipient of a personal 80:20 research grant from IDIBAPS during the period 2017–2021

Multivalvular Endocarditis: A Rare Condition with Poor Prognosis.

Background. Infective endocarditis (IE) is a severe condition. Our aim was to describe the profile and prognosis of patients with multivalvular infective endocarditis (MIE) and compare them to single-valve IE (SIE). Methods. We used a retrospective analysis of the Spanish IE Registry (2008−2020). Results. From 4064 definite cases of valvular IE, 577 (14.2%) had MIE. In patients with MIE, the most common locations were mitral (552, 95.7%) and aortic (550, 95.3%), with mitral-aortic involvement present in 507 patients (87.9%). The most common etiologies were S. viridans (192, 33.3%) and S. aureus (113, 19.6%). MIE involved only native valves in 450 patients (78.0%). Compared with patients with SIE, patients with MIE had a similar age (69 vs. 67 years, respectively, p = 0.27) and similar baseline characteristics, but were more frequently men (67.1% vs. 72.9%, p = 0.005) and had a higher incidence of intracardiac complications (36.2% vs. 50.4%, p < 0.001), heart failure (42.7% vs. 52.9%, p < 0.001), surgical indication (67.7 vs. 85.1%, p < 0.001), surgery (46.3% vs. 56.3%), and in-hospital mortality (26.9% vs. 34.3%, p < 0.001). MIE was an independent predictor of in-hospital mortality (odds ratio (OR) 1.3, 95% confidence interval (CI) 1.1−1.7, p = 0.004) but did not have an independent association with 1-year mortality (OR 1.1, 95% CI 0.9−1.4, p = 0.43). Conclusions. About one-seventh of the valvular IE patients had MIE, mainly due to mitral-aortic involvement. MIE is associated with a poor in-hospital prognosis. An early diagnosis and treatment of IE might avoid its spread to a second valve