Cultura politica y participación en España

En este artículo examinaré en qué medida la cultura política de España, las actitudes del ciudadano ante el sistema político y ante su papel como actor político, han evolucionado a lo largo de su trayectoria democrática , y cuál es su situación dentro de las tendencias experimentadas por los diversos países de la Unión Europea. A su vez, llevaré a cabo una revisión en la sociedad de estudio de las diversas formas de participación utilizadas, las cuales pueden encontrarse determinadas directamente por los rasgos de su cultura política

New perspectives on participatory budgeting: the results of participation from a political and technical perspective

Durante esta década la realización de experiencias de presupuestos participativos se ha visto consolidada en España, con un avance progresivo de las redes de investigación y la literatura al respecto, y con la necesidad creciente de contar con evaluaciones de tales experiencias que permitan progresar en el conocimiento de las mismas. El objetivo de este artículo es contribuir al análisis de los efectos que este mecanismo puede provocar en el personal técnico y político implicado. Consideramos que se trata de un enfoque necesario, ya que son muy escasos los estudios existentes al respecto, siendo más habituales las investigaciones sobre los impactos en la ciudadanía participante. En este trabajo se han analizado concretamente los indicadores para las dimensiones de resultados sobre políticas, resultados sobre relación con la ciudadanía y aprendizajes. Los efectos son analizados desde el punto de vista de la información cualitativa que se ha recogido a partir de la técnica de la entrevista semiestructurada.During this decade the realization of participatory budgeting experiences has been consolidated in Spain, with a progressive advance of the research networks and the literature in this regard, and with the growing need for evaluations of such experiences that allow progress in knowledge. The aim of this article is to contribute to the analysis of the effects that this mechanism can have on the technical and political personnel involved. We believe that this is a necessary approach, since there are very few studies on this issue, with more common research on the impacts on participating citizens. In this paper, indicators for the dimensions of results on policies, results on relation to citizenship and learning were specifically analyzed. The effects, both of the learning part and of the results on policy and relations, are analyzed from the point of view of the qualitative information that has been collected from the technique of the semi-structured interview.Investigación financiada por el Ayuntamiento de Las Torres de Cotillas (Murcia

La política pública de transporte de viajeros: el caso de la Entidad Pública del Transporte de la Región de Murcia

The Intergovernmental Relations are a constitutive factor of the majority of the public policies, also in case of the politics of the transport, and his analysis has allowed to integrate the institutional and territorial pluralism in the study of the processes of decision and implementation of public policies, in order to analyze the paper of the different actors and of his existing mechanisms of interaction and joint. The aim of this article is to analyze the reasons that influenced the creation of the Public Entity of the Transport and to evaluate his functioning to know the reasons that explain his disappearance paying particular attention to the influence of the Intergovernmental Relations.Las Relaciones Intergubernamentales son un factor constitutivo de la mayoría de las políticas públicas, también en el caso de la política del transporte, y su análisis ha permitido integrar el pluralismo institucional y territorial en el estudio de los procesos de decisión e implementación de políticas públicas, con el objeto de analizar el papel de los distintos actores y de sus mecanismos de interacción y articulación existentes. El objetivo de este artículo es analizar las causas que influyeron en la creación de la Entidad Pública del Transporte y evaluar su funcionamiento para conocer las razones que expliquen su desaparición prestando especial atención a la influencia de las Relaciones Intergubernamentales

¿Cómo mejorar la calidad de la democracia local? Analizando el funcionamiento de las juntas municipales en Murcia

No cabe duda de que el ámbito local es el escenario más propicio para atender las demandas y canalizar las propuestas de los ciudadanos, y que las Juntas Municipales, como órganos de gestión desconcentrada del municipio de Murcia, suponen un cauce prioritario para la participación ciudadana. La estructura y la composición de estos órganos de representación local juegan un papel fundamental en el desempeño de las funciones que tienen encomendadas. El compromiso de los actores implicados en este espacio institucional puede marcar el rumbo de estos órganos de participación. Hay que tener en cuenta que en los últimos años se ha registrado una baja actividad de las Juntas Municipales. Tan sólo se han convocado el 66 % de los plenos ordinarios que correspondían normativamente. Esta disfunción supone una merma en la calidad democrática municipal. A través del presente estudio queremos ofrecer una visión panorámica del funcionamiento de las Juntas Municipales en términos de calidad democrática para ofrecer propuestas de mejora para conseguir una mayor fortaleza y representación institucional

¿Cómo mejorar la calidad de la democracia local? Analizando el funcionamiento de las juntas municipales en Murcia

No cabe duda de que el ámbito local es el escenario más propicio para atender las demandas y canalizar las propuestas de los ciudadanos, y que las Juntas Municipales, como órganos de gestión desconcentrada del municipio de Murcia, suponen un cauce prioritario para la participación ciudadana. La estructura y la composición de estos órganos de representación local juegan un papel fundamental en el desempeño de las funciones que tienen encomendadas. El compromiso de los actores implicados en este espacio institucional puede marcar el rumbo de estos órganos de participación. Hay que tener en cuenta que en los últimos años se ha registrado una baja actividad de las Juntas Municipales. Tan sólo se han convocado el 66 % de los plenos ordinarios que correspondían normativamente. Esta disfunción supone una merma en la calidad democrática municipal. A través del presente estudio queremos ofrecer una visión panorámica del funcionamiento de las Juntas Municipales en términos de calidad democrática para ofrecer propuestas de mejora para conseguir una mayor fortaleza y representación institucional

Effectiveness of an intervention for improving drug prescription in primary care patients with multimorbidity and polypharmacy:Study protocol of a cluster randomized clinical trial (Multi-PAP project)

This study was funded by the Fondo de Investigaciones Sanitarias ISCIII (Grant Numbers PI15/00276, PI15/00572, PI15/00996), REDISSEC (Project Numbers RD12/0001/0012, RD16/0001/0005), and the European Regional Development Fund ("A way to build Europe").Background: Multimorbidity is associated with negative effects both on people's health and on healthcare systems. A key problem linked to multimorbidity is polypharmacy, which in turn is associated with increased risk of partly preventable adverse effects, including mortality. The Ariadne principles describe a model of care based on a thorough assessment of diseases, treatments (and potential interactions), clinical status, context and preferences of patients with multimorbidity, with the aim of prioritizing and sharing realistic treatment goals that guide an individualized management. The aim of this study is to evaluate the effectiveness of a complex intervention that implements the Ariadne principles in a population of young-old patients with multimorbidity and polypharmacy. The intervention seeks to improve the appropriateness of prescribing in primary care (PC), as measured by the medication appropriateness index (MAI) score at 6 and 12months, as compared with usual care. Methods/Design: Design:pragmatic cluster randomized clinical trial. Unit of randomization: family physician (FP). Unit of analysis: patient. Scope: PC health centres in three autonomous communities: Aragon, Madrid, and Andalusia (Spain). Population: patients aged 65-74years with multimorbidity (≥3 chronic diseases) and polypharmacy (≥5 drugs prescribed in ≥3months). Sample size: n=400 (200 per study arm). Intervention: complex intervention based on the implementation of the Ariadne principles with two components: (1) FP training and (2) FP-patient interview. Outcomes: MAI score, health services use, quality of life (Euroqol 5D-5L), pharmacotherapy and adherence to treatment (Morisky-Green, Haynes-Sackett), and clinical and socio-demographic variables. Statistical analysis: primary outcome is the difference in MAI score between T0 and T1 and corresponding 95% confidence interval. Adjustment for confounding factors will be performed by multilevel analysis. All analyses will be carried out in accordance with the intention-to-treat principle. Discussion: It is essential to provide evidence concerning interventions on PC patients with polypharmacy and multimorbidity, conducted in the context of routine clinical practice, and involving young-old patients with significant potential for preventing negative health outcomes. Trial registration: Clinicaltrials.gov, NCT02866799Publisher PDFPeer reviewe

Retrospective evaluation of whole exome and genome mutation calls in 746 cancer samples

Funder: NCI U24CA211006Abstract: The Cancer Genome Atlas (TCGA) and International Cancer Genome Consortium (ICGC) curated consensus somatic mutation calls using whole exome sequencing (WES) and whole genome sequencing (WGS), respectively. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2,658 cancers across 38 tumour types, we compare WES and WGS side-by-side from 746 TCGA samples, finding that ~80% of mutations overlap in covered exonic regions. We estimate that low variant allele fraction (VAF < 15%) and clonal heterogeneity contribute up to 68% of private WGS mutations and 71% of private WES mutations. We observe that ~30% of private WGS mutations trace to mutations identified by a single variant caller in WES consensus efforts. WGS captures both ~50% more variation in exonic regions and un-observed mutations in loci with variable GC-content. Together, our analysis highlights technological divergences between two reproducible somatic variant detection efforts

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat