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The world is becoming increasingly complex and concerned about the resources that compose it, the current COVID-19 pandemic shows that not only companies but also countries are involved in a competition at all levels to become a reference impacting on the 3 dimensions (economic, social and environmental). The purpose of this research was to analyze the main motivations of B-certified companies in Latin America. The methodology was qualitative under the grounded theory method, the unit of analysis was 183 companies under exclusion criteria such as: Belonging to the industries of education, tourism and hospitality, and support for entrepreneurship, belonging to only Latin American countries and having the B certification. The main findings were that responsible B companies develop a more inclusive, sustainable and environmentally friendly economy for the benefit of society, that they go beyond the notion of Corporate Social Responsibility. The conclusions show that these companies move away from traditional companies, as they combine social development and economic growth, positioning the countries that have these types of companies as benchmarks. © 2023,Revista de Ciencias Sociales. All Rights Reserved.
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Introduction: The risk of complications and death related to difficult airway (DA) in critically ill patients is higher than in controlled settings such as the operating room. Statistics on DA in intensive care in Colombia are scarce, as are the intervention data and resources available in the units. The main objective was to determine the prevalence and characteristics of anatomical and physiological difficult airway. Methods: An observational, cross-sectional, multicentre study was conducted in adult Intensive Care Units (ICU) in Quindío. Links to two Google® forms were sent to the Coordinating Intensivists, one general and one specific related to DA anatomical factors (Mallampati, obstructive apnoea, stiff cervical spine, obesity, external appearance, Cormack-Lehane > 2, etc.) and physiological (oxygenation disorder, state of collapse, anaemia, etc.). Results: Four units participated, with 62 beds (83.9% of the beds in the department);56 hospitalized patients were found, 38 patients (67.8%) were intubated. Of the patients, 29% had some type of difficult airway. Of the patients with difficult airway, 100% had physiological DA parameters and 27.3% anatomical difficult airway: 18.2% Cormack-Lehane (CL) > 2, and 9.1% subglottic stenosis. Obesity was the best predictor of CL > 2. LR+: 4.5, LR−:. 001. Conclusions: Physiological DA is highly prevalent in the adult ICU, which represents a challenge for the intensivist, and a high risk of complications for patients. In this study, obesity was the main predictor of anatomical DA in critically ill patients. Intensive care units must have sufficient resources and personnel trained in the management of difficult airway. © 2022 Asociación Colombiana de Medicina Crítica y Cuidado lntensivo
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Graphical Introduction Since the beginning of the pandemic, morbidity and mortality in emergency care of surgical patients have been the subject of several studies. However, most of these have compared this variable with that of the pre-COVID period, ignoring its evolution during the pandemic itself. In order to analyze this possible change, we performed a comparative study of morbidity and mortality in emergency surgery between the first and second waves of the pandemic in our center. Methods Retrospective longitudinal study including all patients over the age of 18 admitted and/or operated in the emergency setting in the two maximum incidence periods (MIP) of COVID-19 infection (1st MIP: 22/03/2020-31/05/2020;2nd MIP: 26/08/2020-30/11/2020). The incidence of SARS-CoV-2 infection, treatment received, early morbidity and mortality and possible risk factors for complications were analyzed. Results A total of 173 patients were analyzed (1st MIP: 66;2nd MIP: 107). The incidence of COVID-19 was higher in the second period (14.95% vs. 4.54%). SARS-CoV-2 infection was associated with a higher rate of complications;however, no statistically significant differences were observed in morbimortality rate, either in the total sample (P = .746) or in patients with a positive COVID-19 test (P = .582) between both periods. Surgical treatment was found to be associated with a lower complication rate in both the first (P = .006) and second waves (P = .014), and it was more frequent in the second MIP (70.1% vs 57.6%), although statistical significance was not reached (P = .065). Conclusions No significant differences were observed in morbidity and mortality of patients admitted and/or operated in the emergency setting in the two periods of maximum incidence of SARS-CoV-2 at our center. Surgical treatment was associated with lower morbidity and mortality rates, and it was more frequent in the second MIP.
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INTRODUCTION: Since the beginning of the pandemic, morbidity and mortality in emergency care of surgical patients have been the subject of several studies. However, most of these have compared this variable with that of the pre-COVID period, ignoring its evolution during the pandemic itself. In order to analyze this possible change, we performed a comparative study of morbidity and mortality in emergency surgery between the first and second waves of the pandemic in our center. METHODS: Retrospective longitudinal study including all patients over the age of 18 admitted and/or operated in the emergency setting in the two maximum incidence periods (MIP) of COVID-19 infection (1st MIP: 22/03/2020-31/05/2020; 2nd MIP: 26/08/2020-30/11/2020). The incidence of SARS-CoV-2 infection, treatment received, early morbidity and mortality and possible risk factors for complications were analyzed. RESULTS: A total of 173 patients were analyzed (1st MIP: 66; 2nd MIP: 107). The incidence of COVID-19 was higher in the second period (14.95% vs. 4.54%). SARS-CoV-2 infection was associated with a higher rate of complications; however, no statistically significant differences were observed in morbimortality rate, either in the total sample (P = .746) or in patients with a positive COVID-19 test (P = .582) between both periods. Surgical treatment was found to be associated with a lower complication rate in both the first (P = .006) and second waves (P = .014), and it was more frequent in the second MIP (70.1% vs 57.6%), although statistical significance was not reached (P = .065). CONCLUSIONS: No significant differences were observed in morbidity and mortality of patients admitted and/or operated in the emergency setting in the two periods of maximum incidence of SARS-CoV-2 at our center. Surgical treatment was associated with lower morbidity and mortality rates, and it was more frequent in the second MIP.
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Introducción: Desde el comienzo de la pandemia, la morbimortalidad en la atención urgente al paciente quirúrgico ha sido objeto de estudio. Sin embargo, la mayoría de los estudios compararon dicha variable con la propia de la época pre-COVID, obviando la evolución de la misma durante la propia pandemia. Con el objetivo de analizar este posible cambio, realizamos un estudio comparativo de morbimortalidad en cirugía de urgencias entre la primera y segunda ola de la pandemia en nuestro centro. Material y Métodos: Estudio retrospectivo longitudinal que incluyó a todos los pacientes mayores de 18 años ingresados y/o intervenidos quirúrgicamente de forma urgente en los dos períodos de máxima incidencia (PMI) de infección por COVID-19 (1ºPMI: 22/03/2020-31/05/2020;2ªPMI: 26/08/2020-30/11/2020). Se analizó la incidencia de infección por SARS-CoV2, el tratamiento recibido, la morbimortalidad precoz y los posibles factores de riesgo de complicaciones. Resultados: Se analizaron 173 pacientes (1ºPMI: 66;2ºPMI: 107). La incidencia de COVID-19 fue mayor en el segundo periodo (14,95% vs. 4,54%). La infección por SARS-CoV-2 se asoció a una mayor tasa de complicaciones, sin embargo, no se observaron diferencias estadísticamente significativas en la morbimortalidad general (p=0,746) ni en la de los pacientes COVID positivos (p=0,582) entre ambos períodos. El tratamiento quirúrgico se asoció con una menor tasa de complicaciones tanto en la primera (p=0,006) como en la segunda ola (p=0,014). Dicho tratamiento quirúrgico fue más frecuente en el segundo PMI (70,1% vs 57,6%) aunque no se alcanzó la significación estadística al respecto de esta afirmación (p=0,065). Conclusiones: No se observaron diferencias significativas en la morbimortalidad de los pacientes ingresados y/o intervenidos quirúrgicamente de urgencias en los dos períodos de máxima incidencia de SARS-CoV-2 en nuestro centro. El tratamiento quirúrgico se asoció con una menor morbimortalidad, siendo este más frecuente en el segundo PMI.
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Purpose: There is limited evidence describing burnout among graduate health professions students, including pharmacy students, and there is a need for educational institutions to mitigate burnout and promote future healthcare provider wellness. Methods: A burnout prevention elective course was developed within an accelerated Doctor of Pharmacy program. Course faculty transitioned from live to fully remote instruction in April 2020. The modified course format combined discussion-based lectures, burnout self-assessments, reflective writing assignments, and applications-based presentations. Results: Twentyone second-year pharmacy students completed the elective, and 13 completed post-course evaluations (61.9% response rate). Evaluations indicated substantial student support, with 92.3% "strongly agree" and 7.7% "agree" responses for all questions. Students suggested incorporating this course into the core didactic curriculum rather than offering it as an elective. Conclusion: Pharmacy programs considering piloting similar courses may effectively implement them even under the modified learning conditions imposed by COVID-19.
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Although the pandemic is still with us and COVID-19 continues to saturate the news, everyone has abundant reasons to travel, whether it be physical and mental exhaustion from prolonged shutdowns, vaccine tourism, family reunions, long-awaited vacations, summer in the southern hemisphere, school break or year-end holidays. The main purpose of this research was to examine and understand the main motivations that lead consumers to attend national events as part of their local tourism activities. Through interviews, we have therefore collected the complementary experiences of specialists who work day-in-day-out to encourage local, quality and sustainable tourism. Using a naturalistic qualitative methodology, our hermeneutic analysis is structured in five phases and based on data-of a social nature-from public and private institutions which believe in endurable tourism. In order to validate these results and for them to be considered by other institutions and other countries when modifying and proposing activities to maintain sustainable tourism, the interviewees had to be representatives of public and private institutions and national tourists who have worked and attended the celebrations of the end of the year 2021 in this region of Chile. Our main conclusions from the analyzed units show that these types of local events enhance local tourism and lead to sustainable political, economic, social, and ecological activities.
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Introduction. The socio-health and economic consequences of COVID-19 led countries to adopt preventive communication strategies, broadcasted on social media to enhance their exposure. This research examines Spanish and Latin American spots (N=100) that aim at raising awareness among young people about COVID-19 and that were published between 1 September 2020 and 10 January 2021 on YouTube. Methodology. The methodology is mixed: qualitative, by analysing communicative, technical-narrative and affective-emotional variables;and quantitative, with a descriptive analysis of the data followed by variance analysis to identify differences in both contents. Results. Sixty-nine percent of the spots magnify the risks, 49% foster the subjects' identification with what is being told, 33% encourage reflection when faced with a critical situation, and 31% frighten them with the death of relatives. Spanish stories seek to avoid events/parties, promote the use of masks and comply with all health regulations. Latin American ones emphasise social distance, hygiene habits and adherence to quarantine rules. Spain prioritises attitude-based stories aimed at modifying behaviours, while Latin America prioritises procedure-based stories by showing healthy practices. Anonymous citizens, people affected by the virus, singers or health professionals, aged 18 to 35, starred in the Spanish stories, while communicators, footballers or famous personalities, aged 35 to 65, starred in the Latin American ones. Conclusions. The cultural factors shared between Spain and Latin America are reflected in the homogeneity of the narratives regarding affective-emotional variables. Youth portrayal is polarized: either positive models are emphasised, or rule-breakers are highlighted.
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One hundred spots aimed at sensitizing young Spaniards and Latin Americans to the coronavirus crisis are analyzed, relating female narratives with their objectives, character, emotions aroused and images, profiles and ages of the protagonists. Thus, proactive storytelling prevails, presented by subjects aged 18-35 years and intergenerational groups to persuade the audience to comply with health regulations, appealing to solidarity and empathy.
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This article presents an analysis of the degree of intrinsic alignment with the strategy as a source of business sustainability in the SMEs dedicated to the manufacturing sector in the region of Tacna, Peru. It was framed in a non-experimental research design of fieldtransaction, a survey was applied (questionnaire with 32 items with a Likert scale validated in the opinion of 3 experts with an Alpha Cronbach coefficient of 0.95(Excellent) to a random sample of 247 directors and managers. The data were analyzed through the descriptive statistics (SPSS25) to know the behaviour of the variables under study. In order to test hypotheses, the chi-square statistic was applied (categorical variables, ordinals and unit of analysis greater than 30 subjects). The main findings show that the degree of intra-strategy alignment is 4.46 (excellent alignment of the Intrinsic with the strategy) and business sustainability resulted in 4.23 (high business sustainability). In conclusion, there is a relationship between the intrategy alignment and business sustainability in the SMEs of the manufacturing sector of the Tacna-Peru Region with a strength of 0.691 (strong relationship).
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Introduction: Coronavirus Disease 2019 (COVID-19) is transmitted at an exceptionally high rate with a much higher mortality rate than the seasonal influenza. It is difficult for the mildly symptomatic or asymptomatic patients to know when to quarantine as the evidence suggest that patients are most contagious before symptoms. Testing is at the forefront of combating COVID-19 but it is difficult to find a fast and reliable test that does not require sophisticated laboratories. Research Question or Hypothesis: How accurate are the current COVID-19 qualitative rapid tests in detecting the virus compared to the quantitative molecular assays? Study Design: Literature Review Methods: This literature review compares eight different rapid (minutes/hours) real time reverse transcription-polymerase chain reaction (RT-PCR) or antigen tests with laboratory-controlled RTPCR quantitative assays (days) to determine positive predictive agreement (PPA) and negative predictive agreement (NPA) through studies found on PubMed using keywords. The laboratorycontrolled RT-PCR tests were used as a reference because of their quantitative accurate approach. The RT-PCR-based Abbott ID NOW® was the most featured rapid test because it is used at several rapid testing sites. Results: Over 1300 tests conducted with the Abbott ID NOW® showed 78.7% PPA and almost 100% NPA with an average test time of 13 minutes. The Cepheid Xpert Xpress®, another RT-PCR-based rapid qualitative test, had a much higher PPA of 98% but had only 96% NPA with 45-minute test time. Among the antigen tests, the immunofluorescence-based Bioeasy test had the most accuracy with 93.9% PPA and 100% NPA but the median cycle threshold was 17.1. Conclusion: With the most commonly used rapid test having <80% PPA, there is room for improvement in COVID-19 point-of-care testing;however, other rapid tests have the drawbacks of longer wait time or inability to detect low viral load. Thus, patients receiving a negative result on a rapid COVID-19 test, may follow-up with a quantitative test to confirm.
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It is the higher education center that governs the task of knowledge management and promotion, in order to develop professionals, which is why the work of the teacher is prevalent in their training. This article analyzes the competencies of teachers, their own or acquired in the digital field, for the use of educational platforms and resources such as learning and content management systems and incorporating others such as instant messaging and videoconferencing that have not been created for this purpose. Using a quantitative methodology, the variables of the research carried out by the National Autonomous University of Honduras are described and related;on the needs and approach of teaching-learning methods used by teachers in the first period of classes during the pandemic declared by the World Health Organization. The results reflect the conversion of a classroom environment to a digital one in this period of emergency worldwide by the teachers of this institution, showing resilience and adaptability to change. It is concluded that university teachers develop their digital skills and adapt their generic skills in a satisfactory way to the new world educational scenario. © 2020. All Rights Reserved.
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This study aimed to analyse the spatial-temporal distribution of COVID-19 mortality in Sergipe, Northeast, Brazil. It was an ecological study utilising spatiotemporal analysis techniques that included all deaths confirmed by COVID-19 in Sergipe, from 2 April to 14 June 2020. Mortality rates were calculated per 100 000 inhabitants and the temporal trends were analysed using a segmented log-linear model. For spatial analysis, the Kernel estimator was used and the crude mortality rates were smoothed by the empirical Bayesian method. The space-time prospective scan statistics applied the Poisson's probability distribution model. There were 391 COVID-19 registered deaths, with the majority among ⩾60 years old (62%) and males (53%). The most prevalent comorbidities were hypertension (40%), diabetes (31%) and cardiovascular disease (15%). An increasing mortality trend across the state was observed, with a higher increase in the countryside. An active spatiotemporal cluster of mortality comprising the metropolitan area and neighbouring cities was identified. The trend of COVID-19 mortality in Sergipe was increasing and the spatial distribution of deaths was heterogeneous with progression towards the countryside. Therefore, the use of spatial analysis techniques may contribute to surveillance and control of COVID-19 pandemic.
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COVID-19/mortality , Age Factors , Aged , Bayes Theorem , Brazil/epidemiology , COVID-19/complications , Cardiovascular Diseases/complications , Cardiovascular Diseases/epidemiology , Cities , Cluster Analysis , Comorbidity , Diabetes Complications/epidemiology , Educational Status , Female , Humans , Hypertension/complications , Hypertension/epidemiology , Linear Models , Male , Middle Aged , Monte Carlo Method , Race Factors , Risk Factors , Rural Health , Sex Factors , Spatial Analysis , Spatio-Temporal Analysis , Time FactorsABSTRACT
This study aimed to analyse the trend and spatial-temporal clusters of risk of transmission of COVID-19 in northeastern Brazil. We conducted an ecological study using spatial and temporal trend analysis. All confirmed cases of COVID-19 in the Northeast region of Brazil were included, from 7 March to 22 May 2020. We used the segmented log-linear regression model to assess time trends, and the local empirical Bayesian estimator, the global and local Moran indexes for spatial analysis. The prospective space-time scan statistic was performed using the Poisson probability distribution model. There were 113 951 confirmed cases of COVID-19. The average incidence rate was 199.73 cases/100 000 inhabitants. We observed an increasing trend in the incidence rate in all states. Spatial autocorrelation was reported in metropolitan areas, and 178 municipalities were considered a priority, especially in the states of Ceará and Maranhão. We identified 11 spatiotemporal clusters of COVID-19 cases; the primary cluster included 70 municipalities from Ceará state. COVID-19 epidemic is increasing rapidly throughout the Northeast region of Brazil, with dispersion towards countryside. It was identified high risk clusters for COVID-19, especially in the coastal side.
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Coronavirus Infections/epidemiology , Coronavirus Infections/transmission , Pneumonia, Viral/epidemiology , Pneumonia, Viral/transmission , Spatio-Temporal Analysis , Betacoronavirus , Brazil/epidemiology , COVID-19 , Cities , Humans , Linear Models , Pandemics , SARS-CoV-2ABSTRACT
By November 2021, at the time of preparing this article, the disease caused by the new coronavirus (Coronavirus Disease 2019 - COVID-19), declared as a pandemic by the World Health Organization (WHO) on March 11, 2020, had affected more than 128 million people and claimed upwards of 5 million lives. Many of the patients who suffered from this disease will need elective procedures, and this will require knowledge on how to perform the surgery, what tests to order and the extent of preoperative optimization. The objective of this work was to conduct a narrative review of the current evidence regarding time to the performance of an elective procedure in a patient who suffered from COVID-19, the preoperative tests that need to be ordered, and the degree of clinical optimization required according to the complexity of the surgery and individual patient clinical condition. A search was conducted in the Pubmed/Medline, Science Direct, OVID and SciELO databases, as well as in the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) web-based platforms. Although the evidence is still limited, different scientific societies have issued relevant guidelines pertaining to the timing of an elective procedure after COVID-19 infection. For patients who were asymptomatic, the time is 4 weeks after the initial diagnosis of SARS-CoV-2, whereas for symptomatic patients with a mild to moderate course, the time is at least 7 weeks, and 12 weeks if ICU admission was required. There are no guidelines pertaining to preoperative tests or the degree of clinical optimization, although institutional protocols have been developed based on expert consensus on the topic. Copyright © 2022 Lippincott Williams and Wilkins. All rights reserved.