ABSTRACT
Globally, the tourism industry has been devastated by the COVID-19 pandemic and associated changes in international travel. This paper draws on interviews with 51 women working in the tourism sector in Tanzania and examines gendered impacts of the pandemic on their welfare, which instigated or accelerated entrepreneurial activities as an attempt to protect women's incomes and security. Women in the study adopted one of three entrepreneurial strategies: they (re)committed to the tourism industry, working on developing their own skills and business ideas;they diversified their business interests to have a ‘Plan B' in addition to tourism to safeguard against future crises;or they moved away from tourism altogether, focusing instead on other less volatile sectors. The crisis caused by the pandemic exposed tourism as a risky business and a gamble for many women, who are considering leaving the sector. This represents a significant obstacle for the tourism industry's recovery and sustainability and illustrates some of the limitations of tourism entrepreneurship for supporting and empowering women in the Global South. Priority policy areas for supporting women to remain within tourism are identified to help support women entrepreneurs and ensure their skills and enthusiasm contribute to rebuilding and reshaping the sector. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
ABSTRACT
The objective of this study was to prepare a copper-coated rubber surface using cold spray technology with improved virucidal and antimicrobial properties to fight against highly transmissible viruses and bacteria. A successful cold spray coating was produced using irregular-shaped pure Cu powder on an escalator handrail rubber. The powder particles and the deposited coatings (single and double pass) were characterized in terms of particle morphology and size distribution, coating surface and coat/substrate cross-section properties. The bonding between powder and rubber surfaces was purely mechanical interlocking. The Cu powder penetration depth within the rubber surface increases with a number of depositions pass. The virucidal properties of the coated surface were tested utilizing surrogates for SARS-CoV-2: HCoV-229E, a seasonal human coronavirus, and baculovirus, a high-titer enveloped insect cell virus. A double-pass coated surface showed significant baculovirus inactivation relative to a bare rubber control surface after 2-h (approximately 1.7-log) and 4-h (approximately 6.2-log), while a 4-h exposure reduced HCoV-229E titer to below the limit of detection. A similar microbial test was performed using E. coli, showing a 4-log microbial reduction after 2-h exposure relative to the bare rubber. These promising results open a new application for cold spray in the health sector. Supplementary Information The online version contains supplementary material available at 10.1007/s11666-023-01553-x.
ABSTRACT
Background. Studies have shown the proportion of critically ill patients with COVID-19 receiving empiric antibiotics (ABX) greatly exceeds those with culture-proven bacterial co-infections. However, the benefits of continuing ABX in culture-negative (CxN) cases is unknown;this practice may increase the risks associated with ABX overuse. The purpose of this study was to evaluate outcomes and antibiotic use (AU) in intensive care unit (ICU) patients with COVID-19 based on culture results. Methods. This was a multicenter, retrospective cohort study evaluating adults in an ICU for the first episode of ABX initiated following a confirmed COVID-19 diagnosis between September to December 2020. Blood and/or respiratory cultures must have been obtained within 24 hours (h) of ABX initiation. Patients were categorized into three groups: 1) CxN, ABX discontinued ≤ 72 h, 2) CxN, ABX continued > 72 h, or 3) Culturepositive (CxP). Data on AU was obtained from electronic medication administration records. The primary outcome was clinical success, defined as being discharged alive or > 2-point decrease in the World Health Organization Clinical Progression Scale score from day of ABX initiation to day 30. Results. A total of 65 patients were included with 35.4% being CxP. ABX were discontinued ≤ 72 h in 23.8% of CxN patients. Methicillin-susceptible Staphylococcus aureus was the most common organism in 52.2% of CxP patients (66.7% respiratory;16.7% blood;16.7% both). Anti-methicillin-resistant Staphylococcus aureus and anti-pseudomonal antibiotics were the most prescribed for the initial regimen (Table 1). ABX de-escalation occurred in 58.5% of patients. Initial ABX duration was significantly longer in the CxP group (P < 0.01). No significant difference in clinical success was observed (Table 2). Although not significantly different, the highest rate of adverse events occurred in the CxN and ABX continued > 72 h group (40.6%). Conclusion. In ICU patients with COVID-19, empiric broad-spectrum ABX are often overutilized with an inertia to de-escalate despite negative culture results, potentially increasing the risk of adverse events. This remains an important area for focused antimicrobial stewardship efforts to mitigate the development of multidrug resistance.
ABSTRACT
Introduction and Objectives On March 1st 2020 the World Health Organisation dashboard had recorded 1 897 cases of COVID-19, rising to 75 008 by April 1st 2020. In this time, there were rapidly emerging changes in clinical knowledge and management, challenging the work of hospital teams caring for these patients. This project specifically aimed to rapidly bring together cross-speciality medical trainees in teams to develop a distanced weekly education update to help manage this 'infodemic', including real-time audit and quality improvement projects, local case reports, and a virtual journal club. Method Initial opportunities were created for trainees to join projects including: Rapid follow up of local admissions examining demographics and clinical outcomes;anti-microbial audit;bi-weekly oxygen usage audit, and thrombosis prophylaxis. These were carried out in a quality improvement style with education and re-evaluation. Cases and journal articles were selected for educational interest. A weekly update was sent online to those working within the COVID-19 inpatient departments. There was input from over 35 individuals. Results The overall data collection ran for 7 weeks, from March 13th to May 1st, rapidly assessing 874 patient presentations and tracking the progress of 329 COVID-19 positive patients. 42 patients were admitted to level 2 care, with positive outcomes similar to national data associating with shorter lengths of stay, female gender, younger age, and lower peak CRP. An antimicrobial audit on 2 occasions found 100% adherence to local guidance. Prevalence of antimicrobial use did not differ from a concurrent audit in non covid wards (31%). Oxygen usage work showed the majority of our patients had stepwise improvement in adherence to saturation targets by week 5, in keeping with NHS England guideline of 92-96%. The thrombosis prophylaxis project found an improvement in adherence from 88% to 100% as evidence emerged of a possible increased risk of pulmonary vascular complications. A total of 5 cases of complex COVID-19 were presented during this period. Outcomes This cross-department education process allowed for multiple trainee-led projects and presentations to guide local education, and ensured that our clinical practices were reviewed and in line with evolving national guidance during a pandemic.
ABSTRACT
Comparing historical perceptions of three epidemics in the Philippines and the responses they elicited allows us to see how these disease outbreaks were conceived in terms of configuration, whether ecological or sociological, and contamination. Cholera in 1902, influenza in 1918– 1919, and Covid-19 in 2020 each open up revealing cross sections through Philippine social life, culture, and governance. Furthermore, simplistic assumptions of contamination or pollution—in contrast to more complexly structured configurational models—are correlated with coercive or militaristic reactions to pandemics, including social distancing, lockdowns, curfews, and suppression of dissent. © Ateneo de Manila University.