ADMINISTRACIÓN PARA EL DESARROLLO LOCAL: EXPERIENCIAS DE PRODUCTORES DE HORTALIZAS EN LA REGIÓN III FRONTERIZA DE CHIAPAS

This paper is meant to share results with the academic community, specialists and agricultural management experts, this results are related to the Project “Análisis y Propuestas para el Desarrollo Organizacional de la Integradora de la Frontera Sur, S.A. de C.V.†(Analysis and proposals for the Organization Development of Integradora de la Frontera Sur, S.A. de C.V.). This project was sponsored by Universidad Autónoma de Chiapas and by Campesinos Unidos de Comitán, which is a private association of producers. This borderland is located in southern Mexico in the State of Chiapas and specifically in the municipalities of Tzimol, La Trinitaria, Comitán y La Independencia, where the producers organization has its own greenhouses and commercialization places. The project focused on analysing and studying the specific business activities that some companies develop in order to generate business management knowledge. There were involved activities related to research, teaching and entailment. This means; research activity was of main interest, but the team also promoted teaching and entailment activities. In this sense, the general objective, which guided the work, it was analyzed the management status of La Integradora de la Frontera Sur, S.A. de C.V. This analysis took place in the light of the theories related to Business Administration to generate tangible proposals to improve it. Particular objectives were to propose specific management strategies and to develop a short training program. The scheme of work was raised from the participant focus; this means the owners were given a relevant participant role during the process. This way they could promote and include their point of view regarding tangible proposals. This is relevant in the light of the actor oriented development theory. In the process of diagnosis, the company defined as a priority for the current stage of its organizational development topics regarding human resources (especially about new personnel), control sales and advertising their products. This document focuses on the two first topics that have been developed at this point of the first stage of the research work.Control for sales, human resources, induction, Chiapas, vegetable producers, local development, actor oriented development, social capital., Agribusiness,

Brotes de gastroenteritis aguda vírica en residencias de ancianos. Sistema de detección por umbral de prevalencia (SiDUP)

Javier Buesa Gómez ([email protected])Se describen las intervenciones llevadas a cabo en una unidad de epidemiología local, durante varios años, relacionadas con la epidemiología de la gastroenteritis por norovirus en residencias de ancianos de Castellón. Desde varios brotes acaecidos en un mismo geriátrico, hasta el estudio de los casos esporádicos que determinan la situación endémica en varias residencias. Este trabajo se centra en el análisis de esa situación endémica de síntomas digestivos en periodos de silencio epidémico y la propuesta de un método sencillo para detectar el inicio de brotes de GEA de transmisión progresiva (persona-persona) que hemos denominado Sistema de Detección por Umbral de Prevalencia (SiDUP). Se discute el espectro epidemiológico de la gastroenteritis por norovirus en estas instituciones para personas mayores.We describe the interventions carried out in a local epidemiology unit related to the epidemiology of gastroenteritis due to norovirus in geriatric homes in Castellón (Spain) during several years. These range from various outbreaks in the same geriatric home to the study of sporadic cases which determine the endemic situation. This study focuses on the analysis of this endemic situation of digestive symptoms in silent epidemic periods and proposes a simple method to detect the initiation of GEA of progressive transmission (person-person) which we call System of Detection by Prevalence Threshold (SiDUP). The epidemiological spectrum of gastroenteritis due to norovirus in geriatric homes is discussed

Violencia de género durante la gestación: asociación con la interrupción voluntaria del embarazo y complicaciones de salud neonatales

Objetivo: Evaluar si la exposición a la violencia de género durante la gestación se relaciona con la interrupción voluntaria del embarazo y las complicaciones de salud neonatales que conlleven el ingreso en una Unidad de Cuidados Neonatales. Metodología: Estudio observacional, descriptivo y prospectivo, llevado a cabo en los dos centros de Atención a la Salud Sexual y eproductiva de L'Hospitalet de Llobregat (Barcelona). Cumplimentaron el cuestionario validado de detección de violencia de género Index of Spouse Abuse las mujeres gestantes asistidas por matronas de los centros participantes. Conjuntamente, se recogieron variables sociodemográficas y obstétricas. Se realizó un análisis descriptivo, bivariante y multivariante de los datos. Resultados: Se obtuvo una muestra de 120 mujeres que solicitaron una interrupción voluntaria del embarazo y 381 que continuaron con la gestación. La prevalencia de violencia de género en el último año fue significativamente mayor (p <0,001) entre las mujeres gestantes que decidieron interrumpir el embarazo (25%) que entre las que decidieron continuar con el mismo (8,92%). La exposición a la violencia de género se asocia, después de ajustar otros factores explicativos, con un mayor riesgo de solicitar una interrupción voluntaria del embarazo (odds ratio [OR]= 4,06; intervalo de confianza [IC] del 95%: 2,23-7,48; p <0,001), y con un mayor riesgo de complicaciones neonatales (OR= 2,68; IC del 95%: 1,02-6,48). Conclusiones: La exposición a la violencia de género durante la gestación se relaciona con la interrupción voluntaria del embarazo y los ingresos del recién nacido por complicaciones de salud. Por ello, es necesario preguntar sobre violencia de género durante la asistencia sanitaria, tanto a las mujeres que continúan con el embarazo como a las que deciden interrumpirlo

Processos clau o operatius de la fase d'estudi

El document té tres parts més: Primera entrevista i exploració diagnòstica [http://hdl.handle.net/11703/106734], Anàlisi, valoració i pronòstic [http://hdl.handle.net/11703/106735] i Pla d’intervenció (pla de millora/acords COSE) i devolució a la família [http://hdl.handle.net/11703/106736

Registro español de nutrición enteral domiciliaria del año 2009; Grupo NADYA-SENPE

Objetivo: Describir las características de la Nutrición Enteral Domiciliaria (NED) en España, registrada por el grupo NADYA-SENPE durante el año 2009. Material y métodos: Recopilación y análisis descriptivo de los datos del registro de NED del grupo NADYASENPE desde el 1 de enero al 31 de diciembre de 2009. Resultados: Se registraron 6.540 pacientes, 5,11% más que en el año anterior y 6.649 episodios de NED (3.135 en mujeres, 47,93%) pertenecientes a 32 centros hospitalarios. Siendo 6.238 (95,38%) mayores de 14 años. La edad media en los menores de 14 años fue de 3,67 ± 2,86 y de 72,10 ± 16,89 en los mayores de 14 años. La enfermedad de base que se registró con más frecuencia fue la neurológica en 2.732 (41,77%) ocasiones, seguida de la neoplasia en 1838; 28,10%. La vía de acceso se registró en 1.123 (17,17%) de los episodios, siendo más frecuente la administración por sonda nasogástrica 562 (50,04%). El tiempo medio de tratamiento nutricional fue de 323 días (10,77 meses). Finalizaron 606 episodios de NED, siendo el motivo más frecuentes el fallecimiento del enfermo, lo que aconteció en 295 (48,68%) ocasiones y el paso a alimentación oral en 219 (36,14%). Los pacientes mantenían una actividad normal en 2162 episodios de NED (32,55%) y en 2468 (37,13%) hacían vida “cama-sillón”. El grado de dependencia fue “total” en 2598 (39,07%) de los episodios registrado. El suministro de la fórmula nutricional se realizó desde el hospital en 4.183 (62,91%) casos y por la farmacia de referencia en 2.262 (el 34,02%) y el material fungible se suministró desde el hospital en 3.531 (53,11%) de los casos. Conclusiones: El número de pacientes con NED registrados es superior al del año 2008, continuando con el incremento progresivo desde el inicio del registro. Las características de los mismos mantiene el mismo perfil que en años anteriores con pequeñas variaciones.Objective: To describe the Home Enteral Nutrition Characteristics (HEN) recorded by the group NADYASENPE during 2009. Material and methods: collection and analysis of the data voluntary recorded in the HEN registry from the NADYASENPE group from January 1st to December 31st. Results: 6.540 HEN patients were registered, 5.11% more than the previous year and 6,649 episodes (3,135 in women, 47,93%) from 32 different hospitals. 6,238 of them (95,38%) were over 14 years. The mean age of the patients under 14 yr was 3,67 ± 2,86 and it was 72,10 ± 16,89 in those over 14 yr group. The base illness registered more frequently was the neurological disorders in 2,732 (41,77%) patients, followed by cancer patients in 1,838; 28,10%. The enteral access route was registered in 1,123 (17,17%) of the episodes, being more frequent the administration by nasogastric tube 562 (50,04%). The mean length of nutritional treatment by episode was 323 days (10,77 months). 606 episodes of HEN ended, being the principal reasons for discontinuing treatment the patient death in 295 (48,68%) occasions. The transition to oral feeding occurred in 219 (36,14%) cases. Patients maintained normal activity in 2162 (32,55%) HEN episodes and 2,468 (37,13%) cases were living “bedcouch”. The level of dependence was “total” in 2,598 (39,07%) of the episodes recorded. The nutritional formula was provided by the hospital in 4,183 (62,91%) cases and by the reference pharmacy in 2,262 (el 34,02%). Consumables were provided by the hospital in 3,531 (53,11%) cases. Conclusions: The number of HEN patients recorded increased from the year 2008, continuing the gradual growth increase since the start of registration. The characteristics of the patients remain in the same profile as in previous years

A picture of medically assisted reproduction activities during the COVID-19 pandemic in Europe

STUDY QUESTION: How did coronavirus disease 2019 (COVID-19) impact on medically assisted reproduction (MAR) services in Europe during the COVID-19 pandemic (March to May 2020)? SUMMARY ANSWER: MAR services, and hence treatments for infertile couples, were stopped in most European countries for a mean of 7 weeks. WHAT IS KNOWN ALREADY: With the outbreak of COVID-19 in Europe, non-urgent medical care was reduced by local authorities to preserve health resources and maintain social distancing. Furthermore, ESHRE and other societies recommended to postpone ART pregnancies as of 14 March 2020. STUDY DESIGN, SIZE, DURATION: A structured questionnaire was distributed in April among the ESHRE Committee of National Representatives, followed by further information collection through email. PARTICIPANTS/MATERIALS, SETTING, METHODS: The information was collected through the questionnaire and afterwards summarised and aligned with data from the European Centre for Disease Control on the number of COVID-19 cases per country. MAIN RESULTS AND THE ROLE OF CHANCE: By aligning the data for each country with respective epidemiological data, we show a large variation in the time and the phase in the epidemic in the curve when MAR/ART treatments were suspended and restarted. Similarly, the duration of interruption varied. Fertility preservation treatments and patient supportive care for patients remained available during the pandemic. LARGE SCALE DATA: N/A. LIMITATIONS, REASONS FOR CAUTION: Data collection was prone to misinterpretation of the questions and replies, and required further follow-up to check the accuracy. Some representatives reported that they, themselves, were not always aware of the situation throughout the country or reported difficulties with providing single generalised replies, for instance when there were regional differences within their country. WIDER IMPLICATIONS OF THE FINDINGS: The current article provides a basis for further research of the different strategies developed in response to the COVID-19 crisis. Such conclusions will be invaluable for health authorities and healthcare professionals with respect to future similar situations.peer-reviewe

CARB-ES-19 Multicenter Study of Carbapenemase-Producing Klebsiella pneumoniae and Escherichia coli From All Spanish Provinces Reveals Interregional Spread of High-Risk Clones Such as ST307/OXA-48 and ST512/KPC-3

ObjectivesCARB-ES-19 is a comprehensive, multicenter, nationwide study integrating whole-genome sequencing (WGS) in the surveillance of carbapenemase-producing K. pneumoniae (CP-Kpn) and E. coli (CP-Eco) to determine their incidence, geographical distribution, phylogeny, and resistance mechanisms in Spain.MethodsIn total, 71 hospitals, representing all 50 Spanish provinces, collected the first 10 isolates per hospital (February to May 2019); CPE isolates were first identified according to EUCAST (meropenem MIC &gt; 0.12 mg/L with immunochromatography, colorimetric tests, carbapenem inactivation, or carbapenem hydrolysis with MALDI-TOF). Prevalence and incidence were calculated according to population denominators. Antibiotic susceptibility testing was performed using the microdilution method (EUCAST). All 403 isolates collected were sequenced for high-resolution single-nucleotide polymorphism (SNP) typing, core genome multilocus sequence typing (cgMLST), and resistome analysis.ResultsIn total, 377 (93.5%) CP-Kpn and 26 (6.5%) CP-Eco isolates were collected from 62 (87.3%) hospitals in 46 (92%) provinces. CP-Kpn was more prevalent in the blood (5.8%, 50/853) than in the urine (1.4%, 201/14,464). The cumulative incidence for both CP-Kpn and CP-Eco was 0.05 per 100 admitted patients. The main carbapenemase genes identified in CP-Kpn were blaOXA–48 (263/377), blaKPC–3 (62/377), blaVIM–1 (28/377), and blaNDM–1 (12/377). All isolates were susceptible to at least two antibiotics. Interregional dissemination of eight high-risk CP-Kpn clones was detected, mainly ST307/OXA-48 (16.4%), ST11/OXA-48 (16.4%), and ST512-ST258/KPC (13.8%). ST512/KPC and ST15/OXA-48 were the most frequent bacteremia-causative clones. The average number of acquired resistance genes was higher in CP-Kpn (7.9) than in CP-Eco (5.5).ConclusionThis study serves as a first step toward WGS integration in the surveillance of carbapenemase-producing Enterobacterales in Spain. We detected important epidemiological changes, including increased CP-Kpn and CP-Eco prevalence and incidence compared to previous studies, wide interregional dissemination, and increased dissemination of high-risk clones, such as ST307/OXA-48 and ST512/KPC-3

Diseño e implantación de un sistema de gestión medioambiental en una empresa consultora y de mantenimiento industrial según la norma UNE-EN-ISO 14001

Proyecto ConfidencialSánchez Vidal, C. (2005). Diseño e implantación de un sistema de gestión medioambiental en una empresa consultora y de mantenimiento industrial según la norma UNE-EN-ISO 14001. http://hdl.handle.net/10251/37693.Archivo delegad