Cuestiones institucionales en e! Acuerdo de 1994 relativo la parte XI de la Convención sobre el Derecho del Mar

The Agreement of July 1994 introduced profound changes in the rules of Part XI of the Convention on the Law of the Sea that regulate the procedures for the adoption of decisions in the Assembly and the Council, the composition of the latter and the distribution of powers between the two organs. As a result of these changes, the supremacy that the Council in fact had over the Assembly (only formally "the supreme organ" in the Convention system) is accentuated and the position within the first of the industrialized countries is strengthened, which have now with the possibility of controlling and guiding the management of the Authority.El Acuerdo de julio de 1994 introdujo profundos cambios en las normas de la Parte XI de la Convención sobre el Derecho del Mar que regulan los procedimientos para la adopción de decisiones en la Asamblea y el Consejo, la composición de este último y la distribución de competencias entre los dos órganos. Como resultado de dichos cambios se acentúa la supremacía que de hecho tenía el Consejo sobre la Asamblea (solo formalmente “el órgano supremo” en el sistema de la Convención) y se fortalece la posición dentro del primero de los países industrializados, que se encuentran ahora con posibilidad de poder controlar y orientar la gestión de la Autoridad

El impacto del nuevo derecho del mar en la evolución de la organización internacional

In recent years, the literature on the law of the sea has been so prolific that it is almost impossible to try to know everything that has been written on the subject. It is striking, however, that the development of the institutional aspects of the new law of the sea, which introduces numerous and profound changes in the existing order, has not attracted the interest of the authors. We are on the threshold of a revolutionary change in the history of the international organization. Some of the institutional aspects of the new legal order of the sea will undoubtedly have great repercussions on the future evolution of the organization of the international community. This study examines some of these aspects as reflected in the text of the recently adopted Convention on the Law of the Sea.En los últimos años la literatura sobre el derecho del mar ha sido tan prolífera que es casi imposible intentar conocer todo lo que se ha escrito sobre el tema. Llama la atención, sin embargo, que el desarrollo los aspectos institucionales del nuevo derecho del mar, que introduce numerosos y profundos cambios en el orden existente, no haya atraído el interés de los autores. Estamos en los umbrales de un cambio revolucionario en la historia de la organización internacional. Algunos de los aspectos institucionales del nuevo orden jurídico del mar tendrán, sin duda, grandes repercusiones en la evolución futura de la organización de la comunidad internacional. En este estudio se examinan algunos de esos aspectos tal como ellos se reflejan en el texto de la Convención sobre el Derecho de la Mar recientemente adoptada

Surgeons' perspectives on artificial intelligence to support clinical decision-making in trauma and emergency contexts: results from an international survey

Background: Artificial intelligence (AI) is gaining traction in medicine and surgery. AI-based applications can offer tools to examine high-volume data to inform predictive analytics that supports complex decision-making processes. Time-sensitive trauma and emergency contexts are often challenging. The study aims to investigate trauma and emergency surgeons' knowledge and perception of using AI-based tools in clinical decision-making processes. Methods: An online survey grounded on literature regarding AI-enabled surgical decision-making aids was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was advertised to 917 WSES members through the society's website and Twitter profile. Results: 650 surgeons from 71 countries in five continents participated in the survey. Results depict the presence of technology enthusiasts and skeptics and surgeons' preference toward more classical decision-making aids like clinical guidelines, traditional training, and the support of their multidisciplinary colleagues. A lack of knowledge about several AI-related aspects emerges and is associated with mistrust. Discussion: The trauma and emergency surgical community is divided into those who firmly believe in the potential of AI and those who do not understand or trust AI-enabled surgical decision-making aids. Academic societies and surgical training programs should promote a foundational, working knowledge of clinical AI

Time for a paradigm shift in shared decision-making in trauma and emergency surgery? Results from an international survey

Background Shared decision-making (SDM) between clinicians and patients is one of the pillars of the modern patient-centric philosophy of care. This study aims to explore SDM in the discipline of trauma and emergency surgery, investigating its interpretation as well as the barriers and facilitators for its implementation among surgeons. Methods Grounding on the literature on the topics of the understanding, barriers, and facilitators of SDM in trauma and emergency surgery, a survey was created by a multidisciplinary committee and endorsed by the World Society of Emergency Surgery (WSES). The survey was sent to all 917 WSES members, advertised through the society’s website, and shared on the society’s Twitter profile. Results A total of 650 trauma and emergency surgeons from 71 countries in five continents participated in the initiative. Less than half of the surgeons understood SDM, and 30% still saw the value in exclusively engaging multidisciplinary provider teams without involving the patient. Several barriers to effectively partnering with the patient in the decision-making process were identified, such as the lack of time and the need to concentrate on making medical teams work smoothly. Discussion Our investigation underlines how only a minority of trauma and emergency surgeons understand SDM, and perhaps, the value of SDM is not fully accepted in trauma and emergency situations. The inclusion of SDM practices in clinical guidelines may represent the most feasible and advocated solutions