Browsing by Subject "Safety"
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- PublicationEmbargoA Comprehensive Review of the State-of-the-Art on Security and Privacy Issues in Healthcare(2023-03-28) López Martínez, Antonio; Gil Pérez, Manuel; Ruiz-Martínez, Antonio; Ingeniería de la Información y las ComunicacionesCurrently, healthcare is critical environment in our society, which attracts attention tomalicious activities and has caused an important number of damaging attacks. In parallel, the recent advancements in technologies, computing systems, and wireless communications are changing healthcare environment by adding different improvements and complexity to it. This article reviews the current state of the literature and provides a holistic view of cybersecurity in healthcare. With this purpose in mind, the article enumerates the main stakeholders and architecture implemented in the healthcare environment, as well as the main security issues (threats, attacks, etc.) produced in healthcare. In this context, this work maps the threats collected with a widely used knowledge-based framework, MITRE ATT&CK, building a contribution not seen so far. This article also enumerates the security mechanisms created to protect healthcare, identifying the principal research lines addressed in the literature, and listing the available public security-focused datasets used in machine-learning to provide security in the medical domain. To conclude, the research challenges that need to be addressed for future research works in this area are presented.
- PublicationOpen AccessAnálisis Semántico-Cuantitativo de conceptos de Educación Moral(Universidad de Zaragoza, Asociación Universitaria de Formación del Profesorado (AUFOP), 2001) Peirón Barber, Gema; Vicén Ferrando, María JesúsEste artículo se ha elaborado como consecuencia de una investigación enmarcada en el tema «educación en valores», una de cuyas partes se ha llevado a cabo con estudiantes de Magisterio. También se elaboraron materiales con la consiguiente aplicación en educación infantil y educación primaria en colegios de la ciudad. El estudio que presentamos se desarrolló a partir de unas actividades de clarificación de valores. La dinámica didáctica llevada a cabo se basó en un clima de participación igualitaria, por medio del diálogo, el debate, sin imposición de opiniones. El hecho de generar discusión conlleva a reflexionar acerca de las posiciones personales que se enriquecen con los puntos de vista de los demás.
- PublicationOpen AccessAnalysis of obligatory measures against anthropic risks in spanish football stadiums(Murcia: Servicio de Publicaciones de la Universidad de Murcia, 2016) López Fernández, J.; García Unanue, J.; Luis Felipe, J.; Burillo, Pablo; Sánchez Sánchez, J.; Gallardo, L.ABSTRACT: Objectives: a) To develop a tool to check the level of compliance of Spanish football stadiums for the obligatory security measures against anthropic risk. b) To analyse and describe the current security state of six football stadiums (two per division). Methods: A dichotomic tool composed by 150 items divided in 10 categories was performed to analyse the situation of Spanish football stadiums. Results: There is a big heterogeneity in the percentage of compliance of the obligatory security measures among the stadiums analysed,from 2ª division B (52%) to those of 2nd Division (85%) and 1st Division (97%). The lower categories implemented are security plans (71%), high risk measures (69%), security documentation (67%) and technological means (61%). Conclusions: None of the sisx studied cases performed the 100% of the obligatory security measures. The tool used in this study can be useful for them to perform all the obligatory security measures.
- PublicationOpen AccessChecklist para el transporte intrahospitalario seguro del paciente crítico: A scoping review(Universidad de Murcia. Servicio de publicaciones, 2020) Canellas, Madalena; Palma, Isabel; Pontífice-Sousa, Patrícia; Rabiais, IsabelTransportar a un paciente crítico conlleva una serie de riesgos que pueden poner en peligro su seguridad. Conocer los riesgos asociados con el transporte intrahospitalario es esencial para mejorar su seguridad. Elegimos estudiar la lista de verificación de transporte intrahospitalario, ya que la literatura los describe como una forma práctica y simple de aumentar la seguridad. Objetivo: Mapear la envidencia científica existente sobre los aspectos del check list o lista de verificación garantizando la seguridad del paciente crítico en el transporte intrahospitalario. Material y método: Se realizó un scoping review através de la metodologia The Joanna Briggs Institute, utilizando los motores de búsqueda EBSCOhost y B-on. La investigación fue realizada en portugués, inglés y español. Fueron seleccionados artículos con texto libre, sin límite de tiempo. Los criterios incluídos: el paciente crítico adulto/anciano, transporte intrahospitalario, la lista de verificación y la seguridad del paciente. Resultados: Se incluyeron 7 artículos. La mayoría de los aspectos de la lista de verificación se enfoca en la preparación del transporte, el aspecto que más se menciona es la monitorización del paciente. La parte después del transporte, aspectos de la lista de verificación solo es mencionada en 3 de los 7 artículos. Conclusión: Todos los estudios constatan aspectos que pueden incluírse en una lista de verificación y que mejoran la seguridad de los pacientes críticos en el transporte intrahospitalario. No hay unanimidad en cuanto a qué aspectos incluir en la lista de verificación.
- PublicationOpen AccessGrado de percepción sobre el conocimiento, las habilidades y la seguridad antes y después de un programa de entrenamiento con videolaringoscopia y mecanismo de protección Intubox® en el manejo de la vía aérea de pacientes con COVID-19.(Sociedad Española de Medicina de Urgencias y Emergencias, 2020-12-16) Adánez Martínez, María Gracia; Leal Costa, César; García López, José Antonio; Torres Ganfornina, Máximo; Ramos Morcillo, Antonio Jesús; Hernández Ruipérez, Tomás; García Palenciano, Carlos; Díaz Agea, José Luis; EnfermeríaObjetivos. El objetivo principal fue describir el grado de percepción sobre el conocimiento, las habilidades y la seguridad antes y después de un programa de entrenamiento con videolaringoscopia y mecanismo de protección Intubox® en el manejo de la vía aérea de pacientes con COVID-19. El objetivo secundario fue evaluar la seguridad de los dispositivos de barrera en la intubación a través de un análisis visual de dispersión de partículas. Método. Ensayo clínico de un solo brazo basado en simulación. Los participantes fueron médicos que realizaron un programa de formación mediante simulación clínica de baja y alta fidelidad. Se usó un instrumento diseñado y validado específico para evaluar la percepción sobre el conocimiento, las habilidades y la seguridad antes y después del programa. Se realizó un análisis visual de la contaminación por gotas. Resultados. La muestra final estuvo compuesta por 27 médicos, con una edad media de 40 (DE 10,8) años y el 63% mujeres. Se obtuvo un incremento estadísticamente significativo en las dimensiones conocimiento, habilidad y seguridad tras el entrenamiento. Se observó una menor contaminación cuando se realizaron las técnicas de manejo de vía aérea con urna protectora. Conclusiones. Los urgenciólogos incrementaron su percepción sobre los conocimientos, habilidades y seguridad en el manejo de la vía aérea en pacientes con COVID-19 tras un programa de formación con simulación. El uso combinado de laringoscopia y dispositivo de barrera Intubox® causó menor dispersión de partículas durante la intubación.
- PublicationEmbargoInfluence of a multiple intervention program for hand hygiene compliance in an ICU(Elsevier Doyma, 2012-05-10) García-Vázquez, Elisa; Murcia-Payá, J.; Allegue, J.M.; Canteras, M.; Gómez, J.; MedicinaABSTRACT: Objective: To assess compliance with hand hygiene (HH) in ICU workers before (P1) and after (P2) implementation of a HH promotion program and distribution of an alcoholic solution for HH, and to analyze factors independently associated to HH before and after patients care. Design: Observational evaluation for 50 h of was carried out during each period of the study (P1 and P2); the number of opportunities for HH (before and after patients care) was registered. Educational program (6 months): poster campaign, educational meetings with staff about HH, and the provision of alcohol hand rubs. Setting: ICU in a secondary level hospital. Participants: Healthcare workers in the ICU. Interventions: A quasi-experimental design was used to evaluate compliance with HH before and after implementation of the educational program. Variables: Dependent variable: HH compliance before---after patients care; independent variables that might be associated to compliance (including the educational program). Results: In P1, there were 338 opportunities for HH both before and after patients care, versus 355 in P2 (before and after patients care). The hand-washing rate was significantly higher in P2 than in P1 (prior to patient care: 45.3% and 34.9%, respectively, and after patient care: 63% and 51.7%, respectively). In the multivariate analysis, the educational program, together with other variables, was significantly associated to HH before and after patients care. Conclusion: There was a significant increase in compliance with hand hygiene among the ICU personnel during the educational phase, both before and after patients care
- PublicationEmbargoPharmacokinetics of tildipirosin in horses after intravenous and intramuscular administration and its potential muscle damage(Elsevier, 2022-07-23) Galecio Naranjo, Juan Sebastian; Escudero Pastor, Elisa; Badillo Puerta, Elena; Marín Carrillo, Pedro; FarmacologíaTildipirosin is a novel semisynthetic macrolide antibiotic exclusively used in veterinary practice to treat respiratory infections. There are no pharmacokinetic or safety information available regarding the use of tildipirosin after intramuscular administration in horses. Thus, the objective of this work was to determine the disposition kinetics of tildipirosin after intravenous (IV) and intramuscular (IM) administration in horses and its potential muscle damage and cardiotoxicity. Six mature, Spanish-breed horses were used in a crossover study with a washout period of 30 days. Tildipirosin (18%) was administered at single doses by IV (2 mg/kg) and IM (4 mg/kg) routes. Tildipirosin plasma concentrations were determined by HPLC assay with ultraviolet detection. Muscle damage and inflammation were assessed by creatine kinase (CK) and haptoglobin (Hp), respectively. Creatine kinase myocardial band (CK-MB) and troponin (Tn) were used to evaluate cardiotoxicity. Tildipirosin in horses reached peak concentrations (Cmax = 1.13 μg/mL) at 0.60 h (tmax) after IM administration with an absolute bioavailability of 109.2%. Steady-state volume of distribution and clearance were 3.31 ± 0.57 L/kg and 0.22 ± 0.02 L/h/kg, respectively. Tildipirosin did not cause cardiotoxicity since CK-MB and Tn basal levels were not significantly different from those obtained after several days post-administration. Mild local reactions were observed after IM administration. This local inflammation was associated with mild myolysis (CK 239–837 UI/L), which was detectable for 48 h. In brief, tildipirosin could help to treat respiratory infections in horses because it showed extensive distribution, high bioavailability and did not provoke general adverse reactions.
- PublicationOpen AccessSafeMan: a unified framework to manage cybersecurity and safety in manufacturing industry(Wiley, 2020-08-06) Perales Gómez, Ángel Luis; Fernández Maimó, Lorenzo; Huertas Celdrán, Alberto; García Clemente, Félix J.; Gil Pérez, Manuel; Martínez Pére, Gregorio; Ingeniería y Tecnología de ComputadoresIndustrial control systems (ICS) are considered cyber-physical systems that join both cyber and physical worlds. Due to their tight interaction, where humans and robots co-work and co-inhabit in the same workspaces and production lines, cyber-attacks targeting ICS can alter production processes and even bypass safety procedures. As an example, these cyber-attacks could interrupt physical industrial processes and cause potential injuries to workers. In this article, we present SafeMan, a unified management framework based on the Edge Computing paradigm that provides high-performance applications for the detection and mitigation of both cyber-attacks and safety threats in industrial scenarios. Three use cases show specific threats in manufacturing as well as the SafeMan actions carried out to detect and mitigate them. In order to validate our proposal, a pool of experiments was performed with Electra, an industrial dataset with normal network traffic and different cyber-attacks by using a given number of Modbus TCP and S7Comm devices. The experiments measured the runtime performance of anomaly detection techniques based on machine learning and deep learning to detect cyber-attacks in control networks. The experimental results show that Neural Networks report the best performance, being able to examine 217 feature vectors per second over Electra, and therefore demonstrating that it can be used as detection model for SafeMan in real scenarios.
- PublicationOpen AccessSeguimiento del paciente crónico durante la pandemia COVID-19 en la farmacia comunitaria: caso clínico(Sociedad Española de Farmacia Comunitaria (SEFAC), 2022-04-26) García Navarro, Caridad; Rodríguez Arcas, María Jesús; Ortiz Sánchez, Juana; Sanidad AnimalLa pandemia COVID-19 ha sido especialmente perjudicial en el control del paciente crónico y las farmacias han sido el centro sanitario de referencia para estos pacientes. Del mismo modo, han seguido ofreciendo formación a los estudiantes, con el fin de obtener el mayor número de profesionales formados para las necesidades sanitarias del momento. Durante el período de prácticas tuteladas se detecta un paciente crónico de 75 años con sintomatología abdominal, valores de hemoglobina glicosilada 7,7 % y triglicéridos 309 mg/dl, ambos superiores al rango de normalidad. Se observa una interacción farmacológica entre metformina e inhibidores del transportador OCT1, como posible causa de la sintomatología intestinal. También se detecta un problema relacionado con prednisona debido a su efecto hiperglucémico, y una posible interacción entre repaglinida y clopidogrel a través del CYP2C8. Se notifican al médico los distintos resultados negativos asociados a la medicación (RNM) detectados en un informe escrito. El médico acepta la intervención farmacéutica y modifica la medicación. A los tres meses el paciente presenta unos valores de hemoglobina glicosilada de 6,8 % y triglicéridos 122 mg/dl dentro del rango de valores óptimos y su sintomatología abdominal se ha reducido considerablemente. El seguimiento farmacoterapéutico es una herramienta para detectar problemas de efectividad y seguridad, y así conseguir mejorar el control del paciente crónico en colaboración con el médico.
- PublicationOpen AccessLa seguridad del parto planificado en casa: algunas consideraciones a partir de un estudio cualitativo(2022) Rico Becerra, Juan Ignacio; Sánchez Navarro, María del Carmen; Atención SociosanitariaIntroduction: The search for safety also involves risks caused by the devices that are created to anticipate and control them. This is the case of unnecessary interventionism in hospital births in relation to planned home deliveries. Objectives: To explore the relationship between physiological delivery and obstetric interventionism, and to examine the debate on the safety of home delivery and its main repercussions. Methodology: Qualitative research. Collection of information with a questionnaire of open questions completed in writing by 45 women who gave birth at home in the province of Murcia between 2008 and 2017. For its analysis MAXQDA qualitative data analysis software was used. Results: obstetric interventionism hinders the physiological delivery process; The debate over the safety of planned home birth is polarized, causing various repercussions for those involved. Conclusions: planned home birth in low-risk women favors the development of physiological delivery, which avoids many of the unnecessary obstetric interventions associated in hospitals; Likewise, the polarized debate on the safety of childbirth at home does not provide consensual information, which has repercussions on the different positioning of the two health groups that take care of childbirth (gynecologists and midwives), and on the fact that women who decide to perform the home births are pressurized by multiple sources (health system, family members, friends ...) that come face to face with the relevant information available to them about home birth and the support of the professional who accompanies them in the birth.