Protocolo de adaptación gradual y progresiva al puesto de trabajo después de un periodo de baja de muy alta duración

The reincorporation of these people being away from work a long time produces a series of concerns, both for the affected person and for the company or organization. To solve this or other situations and to reduce the impact, return to work programs are arising. In Spain, programs of this kind are very few. In this context, a pioneering program of return to work is presented; people who have overcome oncological processes inspire its structure and basic design, but it is not limited only to this type of case. With this breadth of scope, always avoiding referring to the process cause and possible stigmatization, the «Protocol of gradual and progressive adaptation to the workplace after a period of very high duration» was elaborated. This is a proactive adaptation program; the third version is presented as the fruit of the several years experience analysis.Actualmente en España existen alrededor de un millón y medio de personas supervivientes de cáncer. Estas personas necesitan reincorporarse a su vida cotidiana y, por ende, a su actividad laboral, con necesidades particulares. La reincorporación de este personal que ha estado durante mucho tiempo alejado del trabajo produce una serie de preocupaciones, tanto para el afectado como para la empresa u organización en la que trabaja. Para resolver esta u otras situaciones y reducir el impacto, surgen los programas de retorno o vuelta al trabajo. En España apenas existen este tipo de programas. En este contexto se presenta un programa pionero de retorno al trabajo, cuya estructura y diseño de base están inspirados en personas que han superado procesos oncológicos, pero no se circunscribe únicamente a este tipo de casos. Con esta amplitud de alcance, evitando en todo momento hacer referencia a la causa del proceso y a una posible estigmatización, se elaboró el «Protocolo de adaptación gradual y progresiva al puesto de trabajo después de un periodo de baja de muy alta duración». Este es un programa de adaptación proactivo, del que se presenta la tercera versión, fruto del análisis de la experiencia de estos años

Gestión de la calidad total y recursos humanos. Implantación en las pequeñas y medianas empresas

La presente monografía pretende divulgar la filosofía de la gestión de la calidad total, especialmente en el ámbito de las PYMES, sirviendo como guía de apoyo tanto para los gerentes como para los profesionales dedicados a los Recursos Humanos. La gestión de la calidad total representa un modelo de gestión global de la empresa, conllevando procesos de cambio y de mejora continua. Desde estas páginas se introducen y clarifican conceptos y técnicas, se tratan aspectos relacionados con la gestión de los Recursos Humanos, de cómo afectan a las PYMES, de cómo debe implantarse la calidad en dichas empresas, y qué otros sistemas de calidad existen. En resumen, representa una aproximación y reflexión hacia esta filosofía de entender la empresa

Complementary music therapy for cancer patients in at-home palliative care and their caregivers: protocol for a multicentre randomised controlled trial

Background Patients with advanced cancer, receiving at-home palliative care, are subject to numerous symptoms that are changeable and often require attention, a stressful situation that also impacts on the family caregiver. It has been suggested that music therapy may benefit both the patient and the caregiver. We propose a study to analyse the efficacy and cost utility of a music intervention programme, applied as complementary therapy, for cancer patients in palliative care and for their at-home caregivers, compared to usual treatment. Method A randomised, double-blind, multicentre clinical trial will be performed in cancer patients in at-home palliative care and their family caregivers. The study population will include two samples of 40 patients and two samples of 41 caregivers. Participants will be randomly assigned either to the intervention group or to the control group. The intervention group will receive a seven-day programme including music sessions, while the control group will receive seven sessions of (spoken word) therapeutic education. In this study, the primary outcome measure is the assessment of patients' symptoms, according to the Edmonton Symptom Assessment System, and of the overload experienced by family caregivers, measured by the Caregiver Strain Index. The secondary outcomes considered will be the participants' health-related quality of life, their satisfaction with the intervention, and an economic valuation. Discussion This study is expected to enhance our understanding of the efficacy and cost-utility of music therapy for cancer patients in palliative care and for their family caregivers. The results of this project are expected to be applicable and transferrable to usual clinical practice for patients in home palliative care and for their caregivers. The approach described can be incorporated as an additional therapeutic resource within comprehensive palliative care. To our knowledge, no previous high quality studies, based on a double-blind clinical trial, have been undertaken to evaluate the cost-effectiveness of music therapy. The cost-effectiveness of the project will provide information to support decision making, thereby improving the management of health resources and their use within the health system

Clima laboral y empresa

Los autores han observado en su experiencia profesional que los estudios de «clima laboral» son uno de los aspectos que la empresa más demanda a los consultores externos y que más preocupan a los Departamentos de Recursos Humanos. Esto no es extraño si consideramos el «clima laboral» como un reflejo de la «salud organizativa» de la empresa, estrechamente ligada a la «cultura empresarial». Este concepto justifica la importancia estratégica de esta variable y la necesidad de gestionarla eficazmente para asegurar la adaptación de la empresa a las, cada vez mayores, exigencias del entorno competitivo

Representaciones Sociales Sobre La Práctica Odontológica En Un Grupo De Profesionistas De La Salud En Guadalajara (México)

Objetivo: Reconocer las representaciones sociales que un grupo de profesionistas tiene sobre la práctica profesional del odontólogo. Material y métodos: La metodología empleada fue de tipo cualitativa, con apoyo de técnicas etnográficas; se realizaron entrevistas en profundidad a 29 profesionistas de la salud, de ambos sexos, durante el periodo 2010-2011. El análisis de la información obtenida se realizó mediante codificación abierta, axial y selectiva. Resultados: Se identificó las categorías de miedo al dolor y mala relación entre paciente-dentista como parte de la representación social de la práctica dental. Conclusiones: Los resultados muestran que el dolor y los miedos a la asistencia odontológica afectan negativamente a la viabilidad del tratamiento y, por ende, repercute de forma desfavorable en la salud dental de los entrevistados

Intervention to improve quality of sleep of palliative patient carers in the community: protocol for a multicentre randomised controlled trial

Background: Sleep disorders are commonly experienced by community caregivers for persons with cancer, with at least 72% reporting moderate to severe disorders. A consequence of this condition, which is associated with the presence of overload in the caregiver, is the increased risk of clinical depression. The aim of this study is to evaluate the effects of music on the sleep quality achieved by informal caregivers for cancer patients receiving home palliative care. In addition, we will assess the influence of specific variables that could modify these effects, analyse the correlates related to nocturnal wakefulness and consider the diurnal consequences according to the sleep characteristics identified. Methods: This single-blind, multicentre, randomised clinical trial will focus on informal providers of care for cancer patients. Two samples of 40 caregivers will be recruited. The first, intervention, group will receive seven music-based sessions. The control group will be masked with seven sessions of therapeutic education (reinforcing previous sessions). Outcomes will be evaluated using the Pittsburgh Sleep Quality Index, a triaxial accelerometer, EuroQol-5D-5L, the Caregiver Strain Index, the Epworth Sleepiness Scale and the Client Satisfaction Questionnaire. The caregivers' satisfaction with the intervention performed will also be examined. Discussion: This study is expected to extend our understanding of the efficacy of music therapy in enhancing the sleep quality of caregivers for patients receiving home palliative care. To our knowledge, no reliable scientific investigations of this subject have previously been undertaken. Music is believed to benefit certain aspects of sleep, but this has yet to be proven and, according to a Cochrane review, high-quality research in this field is necessary. One of the main strengths of our study, which heightens the quality of the randomised clinical trial design, is the objective assessment of physical activity by accelerometry and the use of both objective and subjective measures of sleep in caregivers. Music therapy for the caregivers addressed in this study is complementary, readily applicable, provokes no harmful side effects and may produce significant benefits

Optimizando la Transmisión de Datos Ip Mediante la Conmutación de Etiquetas Multiprotocolo

This document shows the data transmission study results with different characterization (better effort, better effort with high priority, as well as two types of real time traffic), made through the use of label commutation multiprotol in IP nets, compared to the IP data transmission using Asynchronous Transfer Mode, the study illustrates the best performance that MPLS presents in network cogestion states. The discret events simulator NS_2, was used as the experimentation tool running on Linux operative system.El presente artículo muestar los resultdos del estudio de transmisión de datos con diferente caracterización (mejir esfuerzo, mejor esfuerzo con alta prioridad así como dos tipos de trafico de tiempo real) mediante el protocolo de conmutación de etiquetas multi-protocolo en redes IP, comparado con la transmisión de datos IP utilizando el Modo de Transferencia Asincrónico, el estudio ilustra el mejor rendimiento que presenta MPLS en condiciones de congestión de la red. Como herramienta de experimentación se utilizo el simulador de eventos discretos NS_2 sobre sistema operativo Linux

Influence of negative factors in the context of work in psychological exhaustion of workers in Colombia

Objetivo: Identificar la influencia que la percepción sobre los factores de contexto de trabajo tiene sobre desgaste psíquico en trabajadores de Centro Oriente y Suroccidente en Colombia en 2013. Materiales y Métodos: Diseño no experimental, transversal, cuantitativo. Muestra no probabilística, seleccionada por conveniencia, 193 trabajadores de población laboral de diversos sectores empresariales. Instrumento: batería para estudio de condiciones de trabajo de carácter psicosocial "CTCPS-MAC" validada para población iberoamericana, evalúa cuatro dimensiones: contexto de trabajo, contenido de trabajo, factores individuales y desgaste psíquico e incluye 14 factores psicosociales. El tipo de investigación es descriptivo, comparativo y correlacional de tipo multivariante. El análisis de datos y los resultados de los instrumentos se hicieron en el programa IBM SPSS Statistics 21. Resultados: cultura organizacional [p = 0,000 Exp (B) = 9,300] y formación técnica o superior [p = 0,001 Exp (B) = 5,600] infieren mayor riesgo para provocar desgaste psíquico cognitivo-emocional. A nivel conductual el rol [p = 0,000 Exp (B) = 30,714] y las relaciones interpersonales en el trabajo [p = 0,001 Exp (B) = 16,381]. El trabajador con formación técnica o superior y percepción nociva de cultura de empresa tiene una probabilidad del 70,70% de desgaste psíquico cognitivo-emocional. Una mala percepción de rol y de las relaciones interpersonales una probabilidad del 35,10% de desgaste psíquico conductual. Conclusiones: El estudio permite profundizar en el conocimiento de factores psicosociales de contexto de trabajo y muestran la importancia que, una buena cultura de organización y gestión, adecuado papel o rol en la organización y buenas relaciones interpersonales en el trabajo, tienen en la consecución de una organización saludable, promotora de salud y bienestar en todos sus integrantes.Objective: To identify the influence that the perception on the factors of work context have on the psychological exhaustion of workers in Central East and South-Western Colombia in 2013. Materials and Methods: Non-experimental, cross-sectional and quantitative design. Non-probabilistic sample, selected for convenience, 193 workers from the working population of various business sectors. Instruments: battery for the study of working conditions of psychosocial character "CTCPS-MAC" validated for Iberoamerican population. It evaluates four dimensions: work context, work content, individual factors and psychological exhaustion, and includes 14 psychosocial factors. The research is descriptive, comparative and co-relational of multivariate type. Data analysis and results of the instruments were analyzed through IBM SPSS Statistics 21. Results: The organizational culture [p = 0.000 Exp (B) = 9.300] and technical training or higher education [p = 0.001 Exp (B) = 5.600] cause higher risk to end up in psychological cognitive-emotional exhaustion. At the behavioral level, the role [p = 0.000 Exp (B) = 30.714] and the interpersonal relationships at work [p = 0.001 Exp (B) = 16.381] are the exhaustion cause. The workers with technical training or higher education and a harmful perception of the company culture has a 70.70% chance of psychological cognitive-emotional exhaustion. A bad perception of the role and of interpersonal relationships represent a 35.10% possibility of psychological behavioral exhaustion. Conclusions: This study allows deeper understanding of psychosocial factors of work context and shows the importance that a good organizational culture and management, an appropriate role in the organization and good interpersonal relationships at work, have in achieving a healthy organization that promotes health and wellness in all its members

Predicting the distribution of canine leishmaniasis in western Europe based on environmental variables.

The domestic dog is the reservoir host of Leishmania infantum, the causative agent of zoonotic visceral leishmaniasis endemic in Mediterranean Europe. Targeted control requires predictive risk maps of canine leishmaniasis (CanL), which are now explored. We databased 2187 published and unpublished surveys of CanL in southern Europe. A total of 947 western surveys met inclusion criteria for analysis, including serological identification of infection (504, 369 dogs tested 1971-2006). Seroprevalence was 23 2% overall (median 10%). Logistic regression models within a GIS framework identified the main environmental predictors of CanL seroprevalence in Portugal, Spain, France and Italy, or in France alone. A 10-fold cross-validation approach determined model capacity to predict point-values of seroprevalence and the correct seroprevalence class (20%). Both the four-country and France-only models performed reasonably well for predicting correctly the 20% seroprevalence classes (AUC >0 70). However, the France-only model performed much better for France than the four-country model. The four-country model adequately predicted regions of CanL emergence in northern Italy (<5% seroprevalence). Both models poorly predicted intermediate point seroprevalences (5-20%) within regional foci, because surveys were biased towards known rural foci and Mediterranean bioclimates. Our recommendations for standardizing surveys would permit higher-resolution risk mapping

Ethnicity and Clinical Outcomes in Patients Hospitalized for COVID-19 in Spain: Results from the Multicenter SEMI-COVID-19 Registry

Background: This work aims to analyze clinical outcomes according to ethnic groups in patients hospitalized for COVID-19 in Spain. (2) Methods: This nationwide, retrospective, multicenter, observational study analyzed hospitalized patients with confirmed COVID-19 in 150 Spanish hospitals (SEMI-COVID-19 Registry) from 1 March 2020 to 31 December 2021. Clinical outcomes were assessed according to ethnicity (Latin Americans, Sub-Saharan Africans, Asians, North Africans, Europeans). The outcomes were in-hospital mortality (IHM), intensive care unit (ICU) admission, and the use of invasive mechanical ventilation (IMV). Associations between ethnic groups and clinical outcomes adjusted for patient characteristics and baseline Charlson Comorbidity Index values and wave were evaluated using logistic regression. (3) Results: Of 23,953 patients (median age 69.5 years, 42.9% women), 7.0% were Latin American, 1.2% were North African, 0.5% were Asian, 0.5% were Sub-Saharan African, and 89.7% were European. Ethnic minority patients were significantly younger than European patients (median (IQR) age 49.1 (40.5-58.9) to 57.1 (44.1-67.1) vs. 71.5 (59.5-81.4) years, p < 0.001). The unadjusted IHM was higher in European (21.6%) versus North African (11.4%), Asian (10.9%), Latin American (7.1%), and Sub-Saharan African (3.2%) patients. After further adjustment, the IHM was lower in Sub-Saharan African (OR 0.28 (0.10-0.79), p = 0.017) versus European patients, while ICU admission rates were higher in Latin American and North African versus European patients (OR (95%CI) 1.37 (1.17-1.60), p < 0.001) and (OR (95%CI) 1.74 (1.26-2.41), p < 0.001). Moreover, Latin American patients were 39% more likely than European patients to use IMV (OR (95%CI) 1.43 (1.21-1.71), p < 0.001). (4) Conclusion: The adjusted IHM was similar in all groups except for Sub-Saharan Africans, who had lower IHM. Latin American patients were admitted to the ICU and required IMV more often