Evolución del comportamiento estratégico de las cooperativas versus empresas capitalistas: una aproximación descriptiva al efecto crisis

Since 2008 the economic situation in Spain has undergone a process of deterioration. The situation is so complex that it is necessary to study it of numerous perspectives because it is very important to know the factors that are enabling firms survive. In this regard, two key factors in this topic are the ability to export and innovation. The aim of the paper it is to analyse both phenomena in Social Firms Spain, comparing their situation with capitalist enterprises, in order to get a picture of the position of Social Economy Enterprises in these areas. The data used for the study come from the Survey on Business Strategies (ESEE) for the period 2005-2010.Desde el año 2008 la situación económica en España ha sufrido un proceso de deterioro que no se había conocido en otros periodos. La situación es tan compleja que es necesario abordar el estudio de numerosas cuestiones a nivel macroeconómico, microeconómico, del sector financiero y de la economía real para comprender y, especialmente, para reconocer qué factores están permitiendo sobrevivir a los proyectos empresariales. En este sentido, dos factores fundamentales para la supervivencia de las organizaciones económicas en la crisis actual son la capacidad de exportación y de innovación. El objetivo de la investigación es ambos fenómenos de las sociedades cooperativas de trabajo y las sociedades laborales en España, comparando su situación con las empresas capitalistas, con el fin de obtener una imagen real del posicionamiento de las Empresas de Economía Social en estos ámbitos. Los datos utilizados para realizar el estudio proceden de la Encuesta sobre Estrategias Empresariales (ESEE) para el periodo 2005-2010, y se realiza atendiendo especialmente a los sectores

Evolución del comportamiento estratégico de las cooperativas versus empresas capitalistas: una aproximación descriptiva al efecto crisis

Desde el año 2008 la situación económica en España ha sufrido un proceso de deterioro que no se había conocido en otros periodos. La situación es tan compleja que es necesario abordar el estudio de numerosas cuestiones a nivel macroeconómico, microeconómico, del sector financiero y de la economía real para comprender y, especialmente, para reconocer qué factores están permitiendo sobrevivir a los proyectos empresariales. En este sentido, dos factores fundamentales para la supervivencia de las organizaciones económicas en la crisis actual son la capacidad de exportación y de innovación. El objetivo de la investigación es ambos fenómenos de las sociedades cooperativas de trabajo y las sociedades laborales en España, comparando su situación con las empresas capitalistas, con el fin de obtener una imagen real del posicionamiento de las Empresas de Economía Social en estos ámbitos. Los datos utilizados para realizar el estudio proceden de la Encuesta sobre Estrategias Empresariales (ESEE) para el periodo 2005-2010, y se realiza atendiendo especialmente a los sectores

Predictors of clozapine discontinuation at 2 years in treatment-resistant schizophrenia

Introduction: Little is known about predictors of clinical response to clozapine treatment in treatment-resistant psychosis. Most published cohorts are small, providing inconsistent results. We aimed to identify baseline clinical predictors of future clinical response in patients who initiate clozapine treatment, mainly focusing on the effect of age, duration of illness, baseline clinical symptoms and homelessness. Methodology: Retrospective cohort of patients with treatment-resistant schizophrenia, aged between 15 and 60 years, that initiated clozapine between 2014 and 2017. Sociodemographic characteristics, years from illness diagnosis, and clinical presentation before the initiation of clozapine were collected and analyzed. All-cause discontinuation at two years follow-up was used as the primary measure of clozapine response. Results: 261 patients were included with a median age at illness diagnosis of 23 years old (IQR 19-29) and a median age at clozapine initiation of 25 (IQR: 21–33). 72.33% (183/253) continued clozapine after two years follow-up. Being homeless was associated to higher clozapine non-adherence, with an OR of 2.78 (95%CI 1.051–7.38) (p = 0.039, controlled by gender). Older age at clozapine initiation and longer delay from first schizophrenia diagnosis to clozapine initiation were also associated with higher clozapine non-adherence, with each year increasing the odds of discontinuation by 1.044 (95%CI 1.018–1.071; p = 0.001) and OR 1.093 (95%CI 1.008–1.19;p = 0.032) respectively. Conclusion: Starting clozapine in younger patients or shortly after schizophrenia diagnosis were associated with better adherence.</p

Longitudinal changes in striatocortical connectivity in first-episode psychosis associated with the emergence of treatment resistance

Treatment resistance affects up to one in four individuals with psychosis in the first few years of illness. However, there is limited information about the brain changes associated with treatment resistance, restricting our ability to develop effective prognostic biomarkers or new treatments. Using resting-state functional MRI, we examined striatocortical connectivity in 87 patients who presented a non-affective first-episode of psychosis and 118 healthy controls, with follow-up imaging on more than half of the participants in the next 6 years, totaling 361 images. Crucially, we identified 30 patients who presented treatment-resistant psychosis in this follow-up period. Thus, we examined baseline (at first episode) and longitudinal striatocortical differences within psychosis subgroups (treatment-responsive and treatment-resistant psychosis), and between patients subgroups and healthy controls. Compared to healthy controls, participants with treatment-responsive psychosis presented baseline differences in functional connectivity of ventral striatal systems, without changes over time; whereas patients with treatment-resistant psychosis showed both baseline and longitudinal differences in ventral striatal systems, compared to healthy controls. Treatment-responsive and treatment-resistant psychosis groups differed in longitudinal changes in connectivity between ventral striatal and temporal cortical regions. This is one of the circuits which has been previously related to symptom improvements in patients with first-episode of psychosis. No baseline differences were observed between the two psychosis groups. Overall, treatment-resistant psychosis is characterized by longitudinal changes in striatal systems in early psychosis, which might be used as the basis of future prognostic biomarkers

Effectiveness of a transition plan at discharge of patients hospitalized with heart failure: a before-and-after study.

We evaluated the effectiveness of a multidisciplinary transition plan to reduce early readmission among heart failure patients. We conducted a before-and-after study in a tertiary internal medicine department, comparing 3 years of retrospective data (pre-intervention) and 13 months of prospective data (intervention period). Intervention was the introduction in 2013 of a transition plan performed by a multidisciplinary team. We included all consecutive patients hospitalized with symptomatic heart failure and discharged to home. The outcomes were the fraction of days spent in hospital because of readmission, based on the sum of all days spent in hospital, and the rate of readmission. The same measurements were used for those with potentially avoidable readmissions. Four hundred thirty-one patients were included and compared with 1441 patients in the pre-intervention period. Of the 431 patients, 138 received the transition plan while 293 were non-completers. Neither the fraction of days spent for readmissions nor the rate of readmission decreased during the intervention period. However, non-completers had a higher rate of the fraction of days spent for 30 day readmission (19.2% vs. 16.1%, P = 0.002) and for potentially avoidable readmission (9.8% vs. 13.2%, P = 0.001). The rate of potentially avoidable readmission decreased from 11.3% (before) to 9.9% (non-completers) and 8.7% (completers), reaching the adjusted expected range given by SQLape® (7.7-9.1%). A transition plan, requiring many resources, could decrease potentially avoidable readmission but shows no benefit on overall readmission. Future research should focus on potentially avoidable readmissions and other indicators such as patient satisfaction, adverse drug events, or adherence

Ready for Qualified Practice? A Comparative Study of Capability for Critical Reflection and Analysis of MA Social Work and MA Step Up to Social Work Students at the End of Second Placement

Social Work education is faced with substantial changes. New programmes like Step Up to Social Work have emerged and were evaluated in relation to intake, programme development and subjective student experiences. The lack of evidence on outcomes of such programmes was addressed in this study. In a comparative study of a MA in Social Work and a MA in Step Up to Social Work, the authors analysed students' capability to critically reflect on and analyse social work practice scenarios at the end of their final placement at one university. The PCF domain ‘Critical Reflection and Analysis’ was operationalised and the study design employed qualitative and quantitative data analysis. Demographic data, academic marks achieved during social work education and written reflections on case vignettes from the two programmes were analysed statistically. The findings suggest that, while there are some differences in outcomes between the programmes, they are not statistically significant. However, reflections on children and family vignettes were significantly better (U = 185, p=0.008). Thematic analysis revealed considerable variation in the levels of curiosity and critical thinking and that respondents who framed their answers with reference to policy guidance, theory and research often extended their critical thinking

Le bon moment pour un médicament: comment faire passer la pilule ? [The best time for a medication: how to sweeten the pill ?]

Is it worth improving the effectiveness of a treatment by modulating the prescription schedule? Data show that the preferred administration timing depends on biological rhythms. Taking this into consideration can improve efficiency or reduce side effects. Food also plays a role. However, for most medications, setting a schedule that is too strict in relation to meals may not be clinically relevant and can lead to « therapeutic weariness ». To ensure effectiveness, tolerance and economy of a treatment, it is more important to ask patients about their habits and to define with them the best schedule