Trabajo Decente en el siglo XVI: Vasco de Quiroga y el Hospital de Santa Fe

En el presente estudio, basado parcialmente en el análisis de expedientes judiciales del siglo XVI, se plantea que la labor realizada por el Obispo Vasco de Quiroga en el Pueblo-Hospital de Santa Fe, constituye un antecedente de lo que se conoce como Trabajo Decente, en el marco de las teorías desarrolladas por el filósofo Avishai Margalit en su obra “Sociedad Decente”

Perspectivas del Derecho a la Ciudad en Puebla

The so-called Right to the City, starts from the premise that the population can recover the urban spaces that originally corresponded to them and make them part of their own culture again, independently of the interests of savage capitalism. From the point of view of this right, a study of the City of Puebla is proposed, showing how since its foundation, it has been part of an elite plan in which the population has been directed to a very specific territorial planning, of the which now give rise to many of the problems of violence and social conflicts that are experienced within it. Inductive, historical, and analytical methods were used, using national and international instruments, with special emphasis on the latter. Among the main conclusions reached, we should highlight the need to apply a protocol that contributes to the development of the Right to the City in Puebla, covering three aspects: community, crime and environment.El denominado Derecho a la Ciudad, parte de la premisa de que la población pueda recuperar los espacios urbanos que originalmente les corresponden y hacerlos nuevamente parte de su propia cultura, independientemente de los intereses del capitalismo salvaje. Desde el punto de vista de este derecho, se propuso un estudio de la Ciudad de Puebla, analizando su fundación, y la manera en que la población ha sufrido una planificación territorial muy específica, de la cual se desprenden ahora muchos de los problemas de violencia y conflictos sociales que se viven al interior de esta.  Se utilizaron los métodos inductivo, histórico y analítico, recurriendo a instrumentos nacionales e internacionales, con especial énfasis en estos últimos. Dentro de las principales conclusiones que se obtuvieron se debe destacar la necesidad de aplicar un protocolo para coadyuvar con el desarrollo del Derecho a la Ciudad en Puebla, que abarque tres aspectos: comunidad, delincuencia y ambiente

Trabajo Decente en el siglo XVI: Vasco de Quiroga y el Hospital de Santa Fe

En el presente estudio, basado parcialmente en el análisis de expedientes judiciales del siglo XVI, se plantea que la labor realizada por el Obispo Vasco de Quiroga en el Pueblo-Hospital de Santa Fe, constituye un antecedente de lo que se conoce como Trabajo Decente, en el marco de las teorías desarrolladas por el filósofo Avishai Margalit en su obra “Sociedad Decente”

Canagliflozin and renal outcomes in type 2 diabetes and nephropathy

BACKGROUND Type 2 diabetes mellitus is the leading cause of kidney failure worldwide, but few effective long-term treatments are available. In cardiovascular trials of inhibitors of sodium–glucose cotransporter 2 (SGLT2), exploratory results have suggested that such drugs may improve renal outcomes in patients with type 2 diabetes. METHODS In this double-blind, randomized trial, we assigned patients with type 2 diabetes and albuminuric chronic kidney disease to receive canagliflozin, an oral SGLT2 inhibitor, at a dose of 100 mg daily or placebo. All the patients had an estimated glomerular filtration rate (GFR) of 30 to <90 ml per minute per 1.73 m2 of body-surface area and albuminuria (ratio of albumin [mg] to creatinine [g], >300 to 5000) and were treated with renin–angiotensin system blockade. The primary outcome was a composite of end-stage kidney disease (dialysis, transplantation, or a sustained estimated GFR of <15 ml per minute per 1.73 m2), a doubling of the serum creatinine level, or death from renal or cardiovascular causes. Prespecified secondary outcomes were tested hierarchically. RESULTS The trial was stopped early after a planned interim analysis on the recommendation of the data and safety monitoring committee. At that time, 4401 patients had undergone randomization, with a median follow-up of 2.62 years. The relative risk of the primary outcome was 30% lower in the canagliflozin group than in the placebo group, with event rates of 43.2 and 61.2 per 1000 patient-years, respectively (hazard ratio, 0.70; 95% confidence interval [CI], 0.59 to 0.82; P=0.00001). The relative risk of the renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes was lower by 34% (hazard ratio, 0.66; 95% CI, 0.53 to 0.81; P<0.001), and the relative risk of end-stage kidney disease was lower by 32% (hazard ratio, 0.68; 95% CI, 0.54 to 0.86; P=0.002). The canagliflozin group also had a lower risk of cardiovascular death, myocardial infarction, or stroke (hazard ratio, 0.80; 95% CI, 0.67 to 0.95; P=0.01) and hospitalization for heart failure (hazard ratio, 0.61; 95% CI, 0.47 to 0.80; P<0.001). There were no significant differences in rates of amputation or fracture. CONCLUSIONS In patients with type 2 diabetes and kidney disease, the risk of kidney failure and cardiovascular events was lower in the canagliflozin group than in the placebo group at a median follow-up of 2.62 years

Procesos de precarización laboral de los trabajadores de servicios de intendencia del hospital general de zona 20 del Instituto Mexicano del Seguro Social: protección de la ley, desamparo de hecho

"La presente investigación pretende interpretar, mediante un estudio de caso, la precarización laboral que existe en el mercado de trabajo; cuestión que empeora cada día, en todos los Estados del globo. Específicamente, se analizan los mecanismos de política laboral que, el Instituto Mexicano del Seguro Social (IMSS) ha implementado en el hospital general de zona 20, dándose a conocer las principales características de los procesos de precarización laboral, que viven cotidianamente los trabajadores de servicios básicos de intendencia, por medio del análisis de trayectorias laborales, siendo éstas, las que permiten construir las experiencias de estos trabajadores, relacionadas directamente con categorías como flexibilización laboral y trabajo decente. Finalmente, se entrelazan los indicadores del trabajo decente y la precarización laboral, con las normas imperantes relativas al IMSS, primordialmente, el “contrato colectivo de trabajo”, donde derivado de su análisis, no se observaron modificaciones a su contenido en el sentido de la Reforma Laboral del 2012; no obstante, sí existe precarización laboral en la cotidianidad de los trabajadores; llegando a la conclusión de que existe una protección de la ley y desamparo de hecho.

El Instituto Mexicano del Seguro Social: fundación y reformas al Contrato Colectivo del Trabajo

This article describes how social security has developed in order to become the actual Mexican Institute of Social Security (IMSS). First of all, the historical framework and emergence of the Institution is stablished, as nucleus of social security and how it is properly applied. Secondly, The Collective Work Contract (CCT) is analyzed. It is considered as one of the great achievements of the workers’ social struggle. This research paper analyzes in detail the contract carried out by IMSS and the Social Security Workers Union (SNTSS). The changes that have taken place and what has been the worker´s position on such matters. The research provides some answers to the question: What have been the results in Mexico based on the implementation of the new reforms?El presente artículo se enmarca en el desarrollo que ha tenido la seguridad social en México hasta el nacimiento del Instituto Mexicano del Seguro Social (IMSS); en el primer apartado se muestra el entramado histórico y surgimiento de dicha Institución, como la principal encargada de la aplicación adecuada de la seguridad social; posteriormente, se analiza el contrato colectivo de trabajo (CCT), como uno de los grandes logros alcanzados por la lucha social de los trabajadores; en específico, se estudia el CCT celebrado entre el IMSS y el Sindicato de Trabajadores del Seguro Social (SNTSS), los cambios que ha sufrido y las posiciones que han tenido los trabajadores al respecto, a raíz de las reformas en materia laboral que se han implementado en México

Kidney and Cardiovascular Effects of Canagliflozin According to Age and Sex: A Post Hoc Analysis of the CREDENCE Randomized Clinical Trial

Rationale & Objective: It is unclear whether the effect of canagliflozin on adverse kidney and cardiovascular events in those with diabetic kid-ney disease varies by age and sex. We assessed the effects of canagliflozin among age group categories and between sexes in the Canagli-flozin and Renal Endpoints in Diabetes with Established Nephropathy Clinical Evaluation (CREDENCE) study.Study Design: Secondary analysis of a random-ized controlled trial. Setting & Participants: Participants in the CREDENCE trial. Intervention: Participants were randomly assigned to receive canagliflozin 100 mg/d or placebo.Outcomes: Primary composite outcome of kid-ney failure, doubling of serum creatinine con-centration, or death due to kidney or cardiovascular disease. Prespecified secondary and safety outcomes were also analyzed. Out-comes were evaluated by age at baseline (<60, 60-69, and >_70 years) and sex in the intention-to-treat population using Cox regression models.Results: The mean age of the cohort was 63.0 & PLUSMN; 9.2 years, and 34% were female. Older age and female sex were independently associ-ated with a lower risk of the composite of adverse kidney outcomes. There was no evidence that the effect of canagliflozin on the primary outcome (acomposite of kidney failure, a doubling of serum creatinine concentration, or death from kidney or cardiovascular causes) differed between age groups (HRs, 0.67 [95% CI, 0.52-0.87], 0.63 [0.4 8-0.82], and 0.89 [0.61-1.29] for ages <60, 60-69, and >_70 years, respectively; P = 0.3 for interaction) or sexes (HRs, 0.71 [95% CI, 0.5 4-0.95] and 0.69 [0.56-0.8 4] in women and men, respectively; P = 0.8 for interaction). No differences in safety outcomes by age group or sex were observed.Limitations: This was a post hoc analysis with multiple comparisons.Conclusions: Canagliflozin consistently reduced the relative risk of kidney events in people with diabetic kidney disease in both sexes and across age subgroups. As a result of greater background risk, the absolute reduction in adverse kidney outcomes was greater in younger participants.Funding: This post hoc analysis of the CREDENCE trial was not funded. The CREDENCE study was sponsored by Janssen Research and Development and was conducted collaboratively by the sponsor, an academic-led steering committee, and an academic research organization, George Clinical.Trial Registration: The original CREDENCE trial was registered at ClinicalTrials.gov with study number NCT02065791

Effect of SGLT2 Inhibitors on Stroke and Atrial Fibrillation in Diabetic Kidney Disease: Results From the CREDENCE Trial and Meta-Analysis

BACKGROUND AND PURPOSE: Chronic kidney disease with reduced estimated glomerular filtration rate or elevated albuminuria increases risk for ischemic and hemorrhagic stroke. This study assessed the effects of sodium glucose cotransporter 2 inhibitors (SGLT2i) on stroke and atrial fibrillation/flutter (AF/AFL) from CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation) and a meta-analysis of large cardiovascular outcome trials (CVOTs) of SGLT2i in type 2 diabetes mellitus.METHODS: CREDENCE randomized 4401 participants with type 2 diabetes mellitus and chronic kidney disease to canagliflozin or placebo. Post hoc, we estimated effects on fatal or nonfatal stroke, stroke subtypes, and intermediate markers of stroke risk including AF/AFL. Stroke and AF/AFL data from 3 other completed large CVOTs and CREDENCE were pooled using random-effects meta-analysis.RESULTS: In CREDENCE, 142 participants experienced a stroke during follow-up (10.9/1000 patient-years with canagliflozin, 14.2/1000 patient-years with placebo; hazard ratio [HR], 0.77 [95% CI, 0.55-1.08]). Effects by stroke subtypes were: ischemic (HR, 0.88 [95% CI, 0.61-1.28]; n=111), hemorrhagic (HR, 0.50 [95% CI, 0.19-1.32]; n=18), and undetermined (HR, 0.54 [95% CI, 0.20-1.46]; n=17). There was no clear effect on AF/AFL (HR, 0.76 [95% CI, 0.53-1.10]; n=115). The overall effects in the 4 CVOTs combined were: total stroke (HRpooled, 0.96 [95% CI, 0.82-1.12]), ischemic stroke (HRpooled, 1.01 [95% CI, 0.89-1.14]), hemorrhagic stroke (HRpooled, 0.50 [95% CI, 0.30-0.83]), undetermined stroke (HRpooled, 0.86 [95% CI, 0.49-1.51]), and AF/AFL (HRpooled, 0.81 [95% CI, 0.71-0.93]). There was evidence that SGLT2i effects on total stroke varied by baseline estimated glomerular filtration rate (P=0.01), with protection in the lowest estimated glomerular filtration rate (<45 mL/min/1.73 m2]) subgroup (HRpooled, 0.50 [95% CI, 0.31-0.79]).CONCLUSIONS: Although we found no clear effect of SGLT2i on total stroke in CREDENCE or across trials combined, there was some evidence of benefit in preventing hemorrhagic stroke and AF/AFL, as well as total stroke for those with lowest estimated glomerular filtration rate. Future research should focus on confirming these data and exploring potential mechanisms. Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT02065791