Madurez ciudadana. Requisito para la consolidación de una democracia ética

La ciudadanía, decían los filósofos griegos, es la condición por la que el hombre puede, en lugar de limitarse a vivir, aspirar a una vida buena. La teoría política enseña que los ciudadanos son importantes sencillamente porque son la esencia y existencia de todo Estado. Sin ciudadanos no hay Estado. ¿Cuál es la situación del ciudadano en la actualidad? ¿Cuál es su nivel de participación y compromiso con los fines del Estado? Ser ciudadano supone desarrollar el sentido de identidad y pertenencia en el lugar en el que se interactúa socialmente; implica desenvolverse con responsabilidad, lo cual nos conduce al meollo de la ciudadanía: la participación política. La participación ciudadana en política se asocia estrechamente al concepto de democracia, la cual se caracteriza por la necesidad de conciliar las exigencias de la participación con la gobernabilidad. Pero para lograr una actitud de compromiso y participación se requiere de una ciudadanía madura. En la antigüedad se decía que el “ciudadano virtuoso” era aquel ciudadano libre y bien formado, con capacidad crítica, que actuaba con ética y responsabilidad, participando en la decisión sobre los derroteros de su comunidad. Para volver a ese ciudadano virtuoso, libre y activo, que se evocaba en la antigüedad, es necesario desenmarañar el entramado actual y salir del laberinto creado por la sociedad de consumo. Indudablemente, es fundamental que cada individuo encuentre o recupere su libertad. Quienes participamos en la obra Madurez ciudadana y gobernanza para la consolidación de una democracia ética invitamos a la ciudadanía a caminar en ese sentido

La lógica neoliberal y su impacto en el Estado mexicano. Un enfoque multidisciplinario

La Constitución escrita de 1917, nació como resultado de la Convención de Aguascalientes, en ella, participaron diferentes grupos que lucharon en la Revuelta mexicana iniciada en 1910 encabezada por Francisco I. Madero. En dicha Constitución se plasmaron diversas aspiraciones sociales de los grupos revolucionarios que se tornaron principios y que marcaron el eje de un nuevo régimen político. A un siglo de la creación de dicha constitución, es un buen momento para reflexionar, ¿qué ha pasado con las instituciones y fines del Estado mexicano? ¿De qué manera las nuevas teorías y modelos económicos de carácter neoliberal han influido en la estructura en la estructura estatal? ¿Cómo han impactado estos modelos en los representantes públicos de México? Hay dos variables que marcan los ejes de las investigaciones, por un lado, hacer una reflexión sobre la configuración del Estado mexicano tomando como elemento clave para su análisis la Constitución Política de los Estados Unidos Mexicanos (CPEUM) creada en 1917, también denominada Constitución del 17. Por otro lado, se pretende analizar la llegada de la globalización y el modelo neoliberal al Estado mexicano desde la década de los ochenta del siglo XX y cómo éste se ha mantenido hasta hoy en día (2017). Sobre éstas variables se hace un análisis de la realidad mexicana sin olvidar la retrospectiva histórica. Un interés manifiesto en este proyecto es analizar si el modelo de Constitución política original se mantiene bajo los principios plasmados en la constitución original o se ha desviado, en las últimas décadas, con la llegada de las políticas neoliberales y la globalización

Ética pública frente a corrupción. Instrumentos éticos de aplicación práctica

La corrupción en los albores del siglo XXI es una característica generalizada en distintos gobiernos y administraciones públicas. México no está exento de esta lacra. Casos escandalosos protagonizados por servidores públicos sin escrúpulos salen a la luz cotidianamente. Dichas conductas desgastan la confianza ciudadana, aumentando el desprestigio de las instituciones públicas

Modelling of the long-term evolution and performance of engineered barrier system

Components of the so-called “multiple-barrier system” from the waste form to the biosphere include a combination of waste containers, engineered barriers, and natural barriers. The Engineered Barrier System (EBS) is crucial for containment and isolation in a radioactive waste disposal system. The number, types, and assigned safety functions of the various engineered barriers depend on the chosen repository concept, the waste form, the radionuclides waste inventory, the selected host rock, and the hydrogeological and geochemical settings of the repository site, among others. EBS properties will evolve with time in response to the thermal, hydraulic, mechanical, radiological, and chemical gradients and interactions between the various constituents of the barriers and the host rock. Therefore, assessing how these properties evolve over long time frames is highly relevant for evaluating the performance of a repository system and safety function evaluations in a safety case. For this purpose, mechanistic numerical models are increasingly used. Such models provide an excellent way for integrating into a coherent framework a scientific understanding of coupled processes and their consequences on different properties of the materials in the EBS. Their development and validation are supported by R&D actions at the European level. For example, within the HORIZON 2020 project BEACON (Bentonite mechanical evolution), the development, test, and validation of numerical models against experimental results have been carried out in order to predict the evolution of the hydromechanical properties of bentonite during the saturation process. Also, in relation to the coupling with mechanics, WP16 MAGIC (chemo Mechanical AGIng of Cementitious materials) of the EURAD Joint Programming Initiative focuses on multi-scale chemo-mechanical modeling of cementitious-based materials that evolve under chemical perturbation. Integration of chemical evolution in models of varying complexity is a major issue tackled in the WP2 ACED (Assessment of Chemical Evolution of ILW and HLW Disposal cells) of EURAD. WP4 DONUT (Development and improvement of numerical methods and tools for modeling coupled processes) of EURAD aims at developing and improving numerical models and tools to integrate more complexity and coupling between processes. The combined progress of those projects at a pan-European level definitively improves the understanding of and the capabilities for assessing the long-term evolution of engineered barrier systems

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Production of He-4 and (4) in Pb-Pb collisions at root(NN)-N-S=2.76 TeV at the LHC

Results on the production of He-4 and (4) nuclei in Pb-Pb collisions at root(NN)-N-S = 2.76 TeV in the rapidity range vertical bar y vertical bar <1, using the ALICE detector, are presented in this paper. The rapidity densities corresponding to 0-10% central events are found to be dN/dy4(He) = (0.8 +/- 0.4 (stat) +/- 0.3 (syst)) x 10(-6) and dN/dy4 = (1.1 +/- 0.4 (stat) +/- 0.2 (syst)) x 10(-6), respectively. This is in agreement with the statistical thermal model expectation assuming the same chemical freeze-out temperature (T-chem = 156 MeV) as for light hadrons. The measured ratio of (4)/He-4 is 1.4 +/- 0.8 (stat) +/- 0.5 (syst). (C) 2018 Published by Elsevier B.V.Peer reviewe

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries