Derechos sociales fundamentales y bienes jurídicos protegidos en el código : el caso de la vivienda

En los siguientes apartados analizaremos en términos generales la manera en que la reforma del Código Civil y Comercial lleva adelante este cambio de paradigma en relación con ciertos bienes jurídicos básicos relativos a los derechos sociales, para detendremos en particular en la regulación realizada sobre la “vivienda”. Como se podrá apreciar, nuestro juicio sobre el tema llega a la conclusión de que en este valioso camino, el proyecto ha avanzado menos de lo posible y deseable en la materia, con una tutela relativamente parcial y menos robusta de lo que demandaría el compromiso contitucionalmente asumido por nuestro país. 1 Las referencias de

Democracia, derechos y control judicial: Versiones de Carlos Nino

The paper analyzes the deliberative justification of judicial review centered on the original contribution of Carlos Nino’s work. It proposes that deliberativism can only defend, consistently, a role for judicial review in a democracy if the institution is radically oriented to the justificatory and deliberative conditions of public policies, practices and decisions, abandoning any substantive evaluation of their consistency with fundamental rights, even those that are considered as democratic preconditions. The paper argues that the most known version of Carlos Nino’s thesis on the subject was partially inconsistent –while trying to preserve some room for substantive judicial review related to a priori rights– and considers an alternative and less known version, presented in one of Nino’s last books, where judicial review is constructed with that radically procedimental-justificatory approach.El artículo analiza la justificación deliberativa de la revisión judicial a partir los originales aportes de la obra de Carlos Nino. Propone que el deliberativismo solo puede defender consistentemente un rol para la revisión judicial si esta se orienta radicalmente a las condiciones justificatorias y deliberativas de las decisiones, prácticas y políticas públicas, y no a la evaluación sustantiva de su consistencia con los derechos fundamentales, incluso los que sean considerados precondiciones democráticas. Argumenta que la versión más difundida de las tesis de Carlos Nino caía en una inconsistencia –al tratar de preservar un ámbito sustantivo para la revisión judicial relacionado con los derechos a priori– y reconstruye una versión alternativa y menos conocida, articulada en uno de sus últimos libros, en la que la revisión judicial es articulada en clave radicalmente procedimental-justificatoria

Herding: a new phenomenon affecting medical decision-making in multiple sclerosis care? Lessons learned from DIScUTIR MS

Abstract Purpose Herding is a phenomenon by which individuals follow the behavior of others rather than deciding independently on the basis of their own private information. A herding-like phenomenon can occur in multiple sclerosis (MS) when a neurologist follows a therapeutic recommendation by a colleague even though it is not supported by best practice clinical guidelines. Limited information is currently available on the role of herding in medical care. The objective of this study was to determine the prevalence (and its associated factors) of herding in the management of MS. Methods We conducted a study among neurologists with expertise in MS care throughout Spain. Participants answered questions regarding the management of 20 case scenarios commonly encountered in clinical practice and completed 3 surveys and 4 experimental paradigms based on behavioral economics. The herding experiment consisted of a case scenario of a 40-year-old woman who has been stable for 3 years on subcutaneous interferon and developed a self-limited neurological event. There were no new magnetic resonance imaging (MRI) lesions. Her neurological examination and disability scores were unchanged. She was advised by an MS neurologist to switch from interferon to fingolimod against best practice guidelines. Multivariable logistic regression analysis was conducted to evaluate factors associated with herding. Results Out of 161 neurologists who were invited to participate, 96 completed the study (response rate: 60%). Herding was present in 75 (78.1%), having a similar prevalence in MS experts and general neurologists (68.8% vs 82.8%; P=0.12). In multivariate analyses, the number of MS patients seen per week was positively associated with herding (odds ratio [OR] 1.08, 95% CI 1.01–1.14). Conversely, physician’s age, gender, years of practice, setting of practice, or risk preferences were not associated with herding. Conclusion Herding was a common phenomenon affecting nearly 8 out of 10 neurologists caring for MS patients. Herding may affect medical decisions and lead to poorer outcomes in the management of MS

Overcoming Therapeutic Inertia in Multiple Sclerosis Care: A Pilot Randomized Trial Applying the Traffic Light System in Medical Education

Overcoming Therapeutic Inertia in Multiple Sclerosis Care: A Pilot Randomized Trial Applying the Traffic Light System in Medical Educatio

Does attendance at the ECTRIMS congress impact on therapeutic decisions in multiple sclerosis care?

Continuing medical education; ECTRIMS; Behavioral economicsEducació mèdica continuada; ECTRIMS; Economia del comportamentEducación médica continuada; ECTRIMS; Economía del comportamientoConferences traditionally play an important role in the ongoing medical education of healthcare professionals. We assessed the influence of attending the ECTRIMS congress on therapeutic decision-making in multiple sclerosis (MS) care. A non-interventional, cross-sectional study involving 96 neurologists was conducted. Treatment escalation when therapeutic goals were unmet and management errors related to tolerability and safety scenarios of MS therapies were tested using different case-scenarios. Attendance at ECTRIMS was associated with an increase likelihood of treatment escalation in the presence of clinical progression (cognitive decline) and radiological activity (OR 2.44; 95% CI 1.06-5.82) and lower number of management errors (OR 0.26; 95% CI 0.07-0.98). Attendance at ECTRIMS may facilitate therapeutic decisions and reduction in management errors in MS care

Caracterización de la lana de ovejas criollas en seis provincias de Argentina

From the sheep introduced by the conquerors, belonging to the Spanish Churras and Montañesas breed and also to Merino specimens, the Argentine Creole sheep breed was formed. This breed has had an enormous social and economic importance throughout our national territory for the formation and development of the first human populations. The objective of this work was to compare characteristics of the wool of Creole sheep in flocks located in different Argentine provinces. Exclusive producers of Creole sheep flocks from six provinces were selected (Salta, Buenos Aires, Santiago del Estero, La Pampa, Chaco and Jujuy). Wool samples were taken, and weight and body condition were recorded. With the wool, five variables were determined by which the wool quality is established: Average fiber diameter, Curl of curvature, Comfort factor, Yield to wash and Fiber length. Creole sheep have an important phenotypic variability, both in the characteristics related to weight and body condition, and in those of wool quality. This difference is associated to the different environments where the flocks have been developed.A partir de los ovinos introducidos por los conquistadores, pertenecientes a las Razas Churras y Montañesas Españolas y también a ejemplares de Merino, se formó la raza ovina criolla argentina. Esta raza ha tenido una enorme importancia social y económica en todo nuestro territorio nacional para la formación y el desarrollo de las primeras poblaciones humanas. El objetivo del trabajo fue comparar características de la lana de ovejas criollas en majadas ubicadas en seis provincias argentinas. Se seleccionaron productores exclusivos de majadas ovinas criollas de seis provincias (Salta; Buenos Aires; Santiago del Estero; La Pampa; Chaco y Jujuy). Se tomaron muestras de lana, y se registró el peso y la condición corporal. Con la lana se determinaron cinco variables mediante las cuales se establece la calidad de la lana: Diámetro medio de fibra, Curvatura de ondulación, Factor de confort, Rinde al lavado y Largo de Mecha. Las ovejas criollas presentan una importante variabilidad fenotípica, tanto en las características relacionadas al peso y a la condición corporal, como en aquellas de la calidad de la lana. Esta diferencia está asociada a los distintos ambientes donde se han desarrollado las majadas

Behavioral aspects of nurse practitioners associated with optimal multiple sclerosis care in Spain

Background Nurse practitioners (NPs) play a critical role in the multidisciplinary management of patients with multiple sclerosis (MS). Neurologists´ behavioral characteristics have been associated with suboptimal clinical decisions. However, limited information is available on their impact among NPs involved in MS care. The aim of this study was to assess nurses´ therapeutic choices to understand behavioral factors influencing their decision making process. Methods A non-interventional, cross-sectional, web-based study was conducted. NPs actively involved in the care of patients with MS were invited to participate in the study by the Spanish Society of Neurology Nursing. Participants answered questions regarding their standard practice and therapeutic management of seven simulated relapsing-remitting MS (RRMS) case scenarios. A behavioral battery was used to measure participants´ life satisfaction, mood, positive social behaviors, feeling of helpfulness, attitudes toward adoption of evidence- based innovations, occupational burnout, and healthcare-related regret. The outcome of interest was therapeutic inertia (TI), defined as the lack of treatment escalation when there is clinical and radiological evidence of disease activity. A score to quantify TI was created based on the number of simulated scenarios where treatment intensification was warranted. Results Overall, 331 NPs were invited to participate, 130 initiated the study, and 96 (29%) completed the study. The mean age (SD) was 44.6 (9.8) years and 91.7% were female. Seventy-three participants (76.0%) felt their opinions had a significant influence on neurologists´ therapeutic decisions. Sixteen NPs (16.5%) showed severe emotional exhaustion related to work and 13 (13.5%) had depressive symptoms. The mean (SD) TI score was 0.97 (1.1). Fifty-six of NPs showed TI in at least one case scenario. Higher years of nursing experience (p = 0.014), feeling of helpfulness (p = 0.014), positive attitudes toward innovations (p = 0.046), and a higher intensity of care-related regret (p = 0.021) were associated with a lower risk of TI (adjusted R2 = 0.28). Burnout was associated with higher risk of TI (p = 0.001). Conclusions Although NPs cannot prescribe MS treatments in Spain, their behavioral characteristics may influence the management of patients with RRMS. Continuing education and specific strategies for reducing occupational burnout may lead to better management skills and improve MS care

Comparación de características de la lana en ovinos criollos de Argentina

La raza ovina criolla está distribuida en la mayoría de las provincias argentinas. Generalmente, mediante observación visual se puede distinguir la existencia de dos tipos de vellones, uno compacto, cerrado y corto, así como otro más abierto, con la presencia de fibras largas, siendo común que los productores de las provincias de Chaco y Santiago del Estero denominen al primero como tipo Cerdón y al segundo como tipo Merino. El objetivo del presente trabajo fue evaluar si entre los dos tipos de vellón mencionados existen diferencias en cuanto a sus características de calidad de lana. En cuatro provincias de Argentina se eligieron en forma aleatoria ovejas adultas para obtener muestras de lana. Mediante la observación se distinguieron ovejas con el biotipo Cerdón y el biotipo Merino. Se obtuvo lana de la parte media lateral, con un crecimiento entre 11 y 12 meses. Las muestras fueron evaluadas en el INTA Bariloche, determinando cuatro variables mediante las cuales se establece la calidad de la lana: diámetro medio de fibra, factor de confort, largo de mecha y rendimiento al lavado. Para el análisis se aplicó estadística descriptiva y ANVA individuales. Para las variables diámetro medio de fibra, factor de confort y largo de mecha sólo se encuentran diferencias entre ambos biotipos en la provincia de Chaco. En rinde al lavado no se detectó interacción, ni diferencias entre provincias ni entre biotipos. Cuando se analizaron los biotipos por provincia encontramos que Salta presenta menor diámetro de fibra y mayor factor de confort en ambos biotipos.The creole sheep breed is distributed in almost all Argentinean provinces. Generally, by visual appreciation we can distinguish the existence of two types of fleece, one of them compact, close and short, and the other one more open, with presence of long fibres, being more common that the producers from Chaco and Corrientes provinces named the first one as Cerdon type, and the second one as Merino type. The objective of the present work was to evaluate if there were differences between both types of fleece. In four provinces from Argentina, adult female sheep were chosen to obtain samples of wool. By means of observation we distinguished sheep with Cerdon type and those of Merino type. We obtained wool from the mid-lateral side of the body, which has grown between 11 and 12 months. The samples were evaluated at INTA Bariloche, where they analysed four variables by which they establish wool quality: mean diameter of fibre, comfort factor, length of fibre and yield after wool scouring. For the analysis, we applied descriptive statistics and individual ANVA. For the variables mean diameter of fibre, comfort factor and fibre length there were only differences between both biotype in the province of Chaco. The yield after wool scouring has no interaction nor differences between neither provinces nor biotypes. When the biotypes per province were analysed, we find that Salta presents minor shorter diameter of fibre and larger comfort factor in both biotypes

Assessing care-related regret among nurses specialized in multiple sclerosis: A psychometric analysis of a new assessment battery

Experiences of regret associated with caring for patients with multiple sclerosis (MS) can affect medical decisions. A non-interventional study was conducted to assess the dimensionality and item characteristics of a battery including the Regret Intensity Scale (RIS-10) and 15 items evaluating common situations experienced by nurses in MS care. A total of 97 nurses were included. The RIS-10 showed good internal reliability and a unidimensional structure according to Mokken analysis. All-item homogeneity coefficients exceeded 0.30, whereas scalability for the overall RIS-10 was 0.66, indicating a strong scale. This battery showed adequate psychometric properties to evaluate regret among MS nurseThe author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was funded by the Medical Department of Roche Farma Spain (SL42129)

Psychometric Properties of the SymptoMScreen Questionnaire in a Mild Disability Population of Patients with Relapsing–Remitting Multiple Sclerosis: Quantifying the Patient’s Perspective

Crucial elements for achieving optimal long-term outcomes in multiple sclerosis (MS) are patient confidence and effective physician-patient communication. Patient-reported instruments may provide the means to fill the gap in currently available clinician-rated measures. The SymptoMScreen (SMSS) is a brief self-assessment tool for measuring symptom severity in 12 neurologic domains commonly affected by MS. We conducted a non-interventional study to assess the dimensional structure and item characteristics of the SMSS. A total of 218 patients with relapsing-remitting MS and mild disability (median Expanded Disability Status Scale score 2.0) were studied. Symptom severity was low (SMSS score 13.5, interquartile range 4.2-27), fatigue being the domain with the highest impact. A non-parametric item response theory, i.e., Mokken analysis, found that the SMSS is a robust one-dimensional scale (overall scalability index H 0.60) with high reliability (Cronbach's alpha 0.94). The confirmatory factor analysis model confirmed the unidimensional structure (comparative fit index 1.0, root-mean-square error of approximation 0.001). Samejima's model fitted well an unconstrained model with different item difficulties. The SMSS shows appropriate psychometric characteristics and may constitute a valuable and easy-to-implement addition to measure the symptom severity in clinical practice.This study was funded by the Medical Department of Roche Farma Spain. The sponsor also funded the journals Rapid Service fe