Análisis de los principales riesgos de trabajo que se presentan en el área administrativa de la clínica hospital b 00521 del instituto de seguridad y servicios sociales de los trabajadores del estado

This scientific research work frames the importance of knowing and preventing work risks that can happen in an office area and can lead to short term, medium term or long term effects on employees. The research was carried out at the Institute of Social Security and Services for Workers of the State of Delicias Chihuahua (ISSSTE), specifically focused on administrative staff, physical risk factors (lighting, ventilation, ergonomics of furniture and equipment) and mental risk factors were analyzed. -emotional (stress, workday, organizational climate). For the evaluation we use as a measurement instrument, a questionnaire of 18 items and 5 open questions to find out and synthesize information provided by the administrative staff. At the end of the investigation, it was possible to show low risk index within the facilities, because facilities are recently built. and of first level, the furniture and equipment is new and ergonomic and the only and main long-term affectation is manifested in complications visuals from the use of electronic devices.El presente trabajo de investigación enmarca la importancia de conocer y prevenir los diversos riesgos de trabajo que pueden presentarse en una oficina y pueden derivarse en afectaciones a corto, mediano o largo plazo en los colaboradores. La investigación se realizó en el Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado de Cd. Delicias Chihuahua, específicamente enfocado en el personal administrativo, se analizaron factores de riesgo físicos, (iluminación, ventilación, ergonomía del mobiliario y equipo) y mentales-emocionales (estrés, jornada laboral, clima organizacional). Para la evaluación utilizamos como instrumento de medición, un cuestionario de 18 items y 5 preguntas abiertas para poder conocer y sintetizar la información brindada por el personal administrativo. Al finalizar la investigación se pudo evidenciar que el índice de riesgos dentro de las instalaciones es bajo dado que las instalaciones son recientes y de primer nivel, el mobiliario y equipo es nuevo y ergonómico y la única y principal afectación a largo plazo se manifiesta en complicaciones visuales por el uso de dispositivos electrónicos

Controller-observer design and dynamic parameter identification for model-based control of an electromechanical lower-limb rehabilitation system

[EN] Rehabilitation is a hazardous task for a mechanical system, since the device has to interact with the human extremities without the hands-on experience the physiotherapist acquires over time. A gap needs to be filled in terms of designing effective controllers for this type of devices. In this respect, the paper describes the design of a model-based control for an electromechanical lower-limb rehabilitation system based on a parallel kinematic mechanism. A controller-observer was designed for estimating joint velocities, which are then used in a hybrid position/force control scheme. The model parameters are identified by customising an approach based on identifying only the relevant system dynamics parameters. Findings obtained through simulations show evidence of improvement in tracking performance compared with those where the velocity was estimated by numerical differentiation. The controller is also implemented in an actual electromechanical system for lower-limb rehabilitation tasks. Findings based on rehabilitation tasks confirm the findings from simulations.This work was partially financed by the Plan Nacional de I+D, Comision Interministerial de Ciencia y Tecnologia (FEDERCICYT) under the project DPI2013-44227-R and by the Instituto U. de Automatica e Informatica Industrial (ai2) of the Universitat Politecnica de Valencia.Valera Fernández, Á.; Díaz-Rodríguez, M.; Vallés Miquel, M.; Oliver, E.; Mata Amela, V.; Page Del Pozo, AF. (2017). Controller-observer design and dynamic parameter identification for model-based control of an electromechanical lower-limb rehabilitation system. International Journal of Control. 90(4):702-714. https://doi.org/10.1080/00207179.2016.1215529S702714904Åström, K. J., & Murray, R. M. (2010). Feedback Systems. doi:10.2307/j.ctvcm4gdkAtkeson, C. G., An, C. H., & Hollerbach, J. M. (1986). 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Analysis of the Adherence and Safety of Second Oral Glucose-Lowering Therapy in Routine Practice From the Mediterranean Area: A Retrospective Cohort Study

The aims of our study was compare adherence measured by the medical possession ratio (MPR), time until discontinuation and describe adverse events after adding a DPP-4i, SGLT-2i, or sulfonylureas (SU) to metformin in a primary care population with insufficient glycemic control. We used routinely-collected health data from the SIDIAP database. The included subjects were matched by propensity score. The follow-up period was up to 24 months or premature discontinuation. The primary outcomes were the percentage of subjects with good adherence, treatment discontinuation and adverse events among treatment groups. The proportion of patients with good adherence (MPR> 0.8) after the addition of DPP-4i, SGLT-2i or SU was 53.6%, 68.7%, and 43.0%, respectively. SGLT-2i users were 1.7 times more likely to achieve good adherence compared with DPP-4i users (odds ratio [OR]:1.72, 98% confidence interval [CI]:1.51, 1.96), and 2.8 times more likely compared with SU users (OR: 0.35, 98% CI: 0.07, 0.29). The discontinuation hazard ratios were 1.43 (98%CI: 1.26; 1.62) and 1.60 (98%CI: 1.42; 1.81) times higher among SGLT-2i and SU users than DPP-4i users during the follow-up period. No differences were observed for adverse events among the treatment groups. In conclusion, in our real-world setting, the combination of SGLT-2i with metformin was associated with better adherence. The mean time until discontinuation was longer in the SGLT-2i group in comparison with the DPP-4i or SU groups