Propuesta estratégica de mejora en la implementación de los estándares mínimos del Sistema de Gestión de la Seguridad y Salud en el Trabajo (SG- SST) en la empresa Fondar para el segundo semestre del 2019 y principios del 2020

Matriz de evaluación del sistema de gestión de seguridad y salud en el trabajo, diagrama de GanttEl presente proyecto comprende el estudio del decreto 1443 del 31 de julio de 2014; que ordeno las directrices de obligatorio cumplimiento para implementar el Sistema de Gestión de la Seguridad y Salud en el Trabajo (SG-SST) el cual debe cumplir la empresa de economía solidaria FONDAR, a partir de ese momento el Fondo de Empleados direcciono un trabajo detallado para cumplir con lo ordenado por el gobierno; teniendo en cuenta la actualización de los estándares mínimos de acuerdo a la resolución No. 0312 del 13 de febrero de 2019, sin embargo al revisar en la práctica el desarrollo de los estándares mínimos que debe cumplir, se evidencio que FONDAR no ha trabajado de la manera correcta el ítem de capacitación en SST y por ende está fallando en el ítem que detalla su plan anual de trabajo. Es por ello que buscamos guiar a la empresa FONDAR para que logre realizar una buena implementación de estos estándares y de esta manera evitar sanciones en la inspección, vigilancia y control que realizará el Ministerio de Trabajo a partir del mes de Noviembre de 2019; aunque la empresa ya tiene un gran porcentaje del trabajo realizado, es importante en este momento hacer un proceso de seguimiento y plan de mejora de acuerdo a lo que ellos ya tienen planteado, proceso que se ha llevado a cabo generando una autoevaluación conforme a los estándares mínimos y en el cual se observó la problemática anteriormente descrita y de acuerdo a esta misma se generará un plan de mejora para solventar esta situación, es muy importante para la consecución de esta actividad poder contar con todos los colaboradores de FONDAR y para ello se elaborará una propuesta que brinde un cronograma de capacitación el cual se pueda ejecutar y que permita cumplir con el plan anual del Sistema de Gestión de SST. Para alcanzar este proyecto es necesario plantear el problema observado, revisar sus antecedentes y analizar de forma cualitativa que está generando esta falencia, así como también analizar el marco teórico y legal, mostrando una metodología de investigación cualitativa la cual se llevara a cabo de acuerdo al análisis que se realizó de la implementación inicial del SG - SST en la empresa, la implementación de la tabla de valores y calificación de los estándares mínimos de SG -SST, de acuerdo a la matriz utilizada para tal fin logrando describir como fue la transición de la empresa desde el decreto 1443 a la nueva resolución 0312, obteniendo de esta manera un análisis detallado de los resultados obtenidos y generando con estos un plan de mejora y los diferentes cronogramas con los que debe trabajar la empresa para alcanzar a un 100% la implementación y evaluación de su Sistema de Gestión de la Seguridad y Salud en el Trabajo (SG-SST) para ser aplicado a partir del mes de Noviembre, evitando sanciones y demás perjuicios para la organización.This project includes the study of Decree 1443 of July 31, 2014; I order the mandatory compliance guidelines to implement the Occupational Health and Safety Management System (SG-SST) which must be met by the solidarity economy company FONDAR, from that moment the Employee Fund directed a detailed work to comply with the orders of the government; taking into account the update of the minimum standards according to resolution No. 0312 of February 13, 2019, however, when reviewing in practice the development of the minimum standards that must be met, it was evidenced that FONDAR has not worked on the Correctly, the training item in OSH and therefore is failing in the item that details your annual work plan. That is why we seek to guide the company FONDAR to achieve a good implementation of these standards and thus avoid sanctions in the inspection, surveillance and control that will be carried out by the Ministry of Labor from the month of November 2019; Although the company already has a large percentage of the work done, it is important at this time to carry out a monitoring process and improvement plan according to what they have already proposed, a process that has been carried out generating a self-assessment according to the standards minimum and in which the above-described problem was observed and according to this one an improvement plan will be generated to solve this situation, it is very important for the achievement of this activity to be able to count on all the employees of FONDAR and for this it will be prepared a proposal that provides a training schedule which can be executed and that allows to comply with the annual plan of the OSH Management System. To achieve this project it is necessary to raise the observed problem, review its background and analyze in a qualitative way that this flaw is generating, as well as analyze the theoretical and legal framework, showing a qualitative research methodology which will be carried out according to the analysis that was carried out of the initial implementation of the SG-SST in the company, the implementation of the table of values ​​and qualification of the minimum standards of SG-SST, according to the matrix used for this purpose managing to describe how the transition of the company from decree 1443 to the new resolution 0312, thus obtaining a detailed analysis of the results obtained and generating with them an improvement plan and the different schedules with which the company must work to achieve 100% implementation and evaluation of its Occupational Health and Safety Management System (SG-SST) to be applied as of the month November, avoiding penalties and other damages for the organization

Covid-19: consecuencias y desafíos en la economía colombiana. Una mirada desde las universidades

Este libro reúne diferentes hallazgos, perspectivas y efectos ante un fenómeno que, más de un año después, todavía representa un reto científico, médico y social para todos. Igualmente, esta obra representa el objetivo de la Red Investigadores de Economía: aunar esfuerzos para encontrar respuestas y para fortalecer la investigación en el país, aumentar la difusión de trabajos de calidad y propiciar el encuentro entre académicos, universidades y el Banco de la República. Las investigaciones expuestas en este libro pasaron por un proceso de selección por parte del comité científico, asegurando que hubiese una pluralidad de miradas y de instituciones educativas, además del Banco, donde se relacionaran los efectos de la pandemia y la actividad económica en el país, las consecuencias sociales y regionales. El texto está dividido en cuatro partes. En la primera se hace un análisis macroeconómico de los efectos de la pandemia; para ello se examinan los efectos de la emergencia sanitaria a nivel nacional y regional mediante modelos macroeconómicos que permiten obtener respuestas ante preguntas muy relevantes. La segunda sección trata sobre el impacto en el mercado laboral, el efecto del Covid-19 en la distribución del ingreso y el efecto de corto plazo en el mercado urbano. La tercera parte aborda los efectos de la pandemia en los agentes económicos y en otros mercados. Ello incluye la exposición del empleo al Covid-19, la vulnerabilidad económica de los hogares en el país y su respuesta en el consumo, patrones de actividad laboral y salud mental, efectos en la educación, inseguridad alimentaria de la población migrante, entre otros. Por último, el cuarto segmento hace un énfasis especial en los efectos diferenciales entre las regiones del país y la heterogeneidad de dicho impacto; para ello se analizan temas de informalidad, vulnerabilidad, fuerza de trabajo disponible, entre otros, en distintas regiones del país

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

Liver injury in hospitalized patients with COVID-19: An International observational cohort study

Background: Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes.MethodsWe included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component & GE;3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).ResultsOf 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37-1.71]; OR 2.50 [2.10-2.96]), ICU admission (OR 1.63 [1.48-1.79]; OR 1.90 [1.62-2.23]), and invasive mechanical ventilation (OR 1.43 [1.27-1.70]; OR 1.95 (1.55-2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27-1.50]; OR 1.46 [1.25-1.70]), acute kidney injury (OR 1.13 [1.00-1.27]; OR 1.59 [1.32-1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22-1.55]; OR 1.80 [1.49-2.17]).ConclusionsLiver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes

The value of open-source clinical science in pandemic response: lessons from ISARIC

International audienc

At-admission prediction of mortality and pulmonary embolism in an international cohort of hospitalised patients with COVID-19 using statistical and machine learning methods

By September 2022, more than 600 million cases of SARS-CoV-2 infection have been reported globally, resulting in over 6.5 million deaths. COVID-19 mortality risk estimators are often, however, developed with small unrepresentative samples and with methodological limitations. It is highly important to develop predictive tools for pulmonary embolism (PE) in COVID-19 patients as one of the most severe preventable complications of COVID-19. Early recognition can help provide life-saving targeted anti-coagulation therapy right at admission. Using a dataset of more than 800,000 COVID-19 patients from an international cohort, we propose a cost-sensitive gradient-boosted machine learning model that predicts occurrence of PE and death at admission. Logistic regression, Cox proportional hazards models, and Shapley values were used to identify key predictors for PE and death. Our prediction model had a test AUROC of 75.9% and 74.2%, and sensitivities of 67.5% and 72.7% for PE and all-cause mortality respectively on a highly diverse and held-out test set. The PE prediction model was also evaluated on patients in UK and Spain separately with test results of 74.5% AUROC, 63.5% sensitivity and 78.9% AUROC, 95.7% sensitivity. Age, sex, region of admission, comorbidities (chronic cardiac and pulmonary disease, dementia, diabetes, hypertension, cancer, obesity, smoking), and symptoms (any, confusion, chest pain, fatigue, headache, fever, muscle or joint pain, shortness of breath) were the most important clinical predictors at admission. Age, overall presence of symptoms, shortness of breath, and hypertension were found to be key predictors for PE using our extreme gradient boosted model. This analysis based on the, until now, largest global dataset for this set of problems can inform hospital prioritisation policy and guide long term clinical research and decision-making for COVID-19 patients globally. Our machine learning model developed from an international cohort can serve to better regulate hospital risk prioritisation of at-risk patients

ISARIC-COVID-19 dataset: A Prospective, Standardized, Global Dataset of Patients Hospitalized with COVID-19

The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC) COVID-19 dataset is one of the largest international databases of prospectively collected clinical data on people hospitalized with COVID-19. This dataset was compiled during the COVID-19 pandemic by a network of hospitals that collect data using the ISARIC-World Health Organization Clinical Characterization Protocol and data tools. The database includes data from more than 705,000 patients, collected in more than 60 countries and 1,500 centres worldwide. Patient data are available from acute hospital admissions with COVID-19 and outpatient follow-ups. The data include signs and symptoms, pre-existing comorbidities, vital signs, chronic and acute treatments, complications, dates of hospitalization and discharge, mortality, viral strains, vaccination status, and other data. Here, we present the dataset characteristics, explain its architecture and how to gain access, and provide tools to facilitate its use