ABSTRACT
The Cuban economy is performing weaker than expected due to the coronavirus and prolonged supply chain disruptions. The problem is global, causing serious problems in the entire Central American and Caribbean region. The good news is that the COVID-19 restrictions are being lifted more and more, and the Cuban government has allowed the creation of SMEs, for which interest is very high, but if the supply chain problems are prolonged, the hoped positive effects may be overshadowed. The Covid-19 pandemic adversely affected the entire global supply chain in terms of both manufacturing and logistics processes, as well as a significant shift in demand. The pandemic has highlighted the need to address three key areas to increase the adaptability of supply chains: risk and resilience, global transparency, and rapid response and decision-making. In our research, we determine the directions for the development of supply chains, as well as the current supply chain problems in Cuba. We are preparing a solution proposal, which can be used to deal with the supply chain bottlenecks in the region by implementing commission sales with the involvement of SMEs. © 2022 Editura Politechnica. All rights reserved.
ABSTRACT
Background: Cardiac Rehabilitation (CR) is a multidisciplinary approach involving exercise training and health-related education routinely available to cardiac patients, but rarely offered to people with stroke. We have shown people with stroke can be integrated into centre-based CR, but due to access difficulties, opportunities for people with stroke to participate in centre-based CR are limited. Home-based CR is well-established for people with heart disease and offers an alternative for people with stroke who are unable to access centre-based rehabilitation. Aim(s): Investigate the safety and feasibility of home-based, telehealthdelivered, stroke-adapted CR. Method(s): A single-site, prospective-cohort safety and feasibility trial. People with ischaemic stroke were screened for eligibility and invited to participate in a six-week program of exercise and education delivered via telehealth to the participant in their own home following discharge from inpatient rehabilitation (i.e. <6-weeks post-stroke). Safety and feasibility were assessed by incidence of adverse events and measures of participant recruitment, retention, and adherence. Result(s): Ninety-five people with stroke were screened, 67 (70%) were eligible to participate, and 19 (28%) consented. Of the 28 that were ineligible to participate, the main reasons for exclusion were haemorrhagic stroke (53%), nil medical clearance (18%), and nil acute stroke (14%). Of the 48 eligible participants that did not consent, 45% were not included due to the impact of COVID-19, 20% were discharged prior to being approached to participate, and 12% did not consent due to a lack of time. Three participants dropped out of the study prior to commencing the outpatient intervention. The remaining 16 participants completed the six-week intervention. Positive written and verbal feedback was received from participants on the appropriateness of the intervention. Conclusion(s): COVID-19 significantly impacted our capacity to recruit participants to this trial. Preliminary data suggests home-based, telehealthdelivered, stroke-adapted CR is safe and potentially feasible in early subacute stroke.
ABSTRACT
This manuscript presents a model and the methodology to understand and define the ethical management of the large-scale implementation of ICT solutions for Active and Healthy Ageing. Based on project expertise, including experience from the Pharaon project Horizon 2020, this model includes an understanding of the main ethical challenges and the development of the necessary guidelines, measures, and tools for different stakeholder profiles. This model extends beyond conventional ethical guidelines, providing a methodology to actively discuss ethical and societal challenges within a project based on interactive and iterative dialogue between the entire value-chain of stakeholders. One of the cornerstones in the analysis of challenges is focused attention on policy and societal issues that emerge during a project. Accordingly, the model includes targeted reflections and tools delivered in the context of the recent Covid-19 pandemic. The tools developed in this process are organised in a guide that can be actively used throughout large-scale implementation projects related to ICT solutions.
ABSTRACT
AIMS & OBJECTIVES: With the atual coronavirus disease 2019 (COVID-2019) pandemic, pediatrics societies have been discrebing many manifestation and complications of this virus. One of then is the multissytem inflammatory syndrome that we observed in a 10-year-ond boy and pretend to report. METHODS: Report a multisystem syndrome COVID-19 associated case, in a terciary public hospital in São Paulo, Brazil, during the pandemic (may, 2020). The follow-up was based on papers published by the Brazilian Pediatric Society in May 2020, about to the diagnosis and treatment in question, as well British Pediatric society Guidelines (April, 2020), and WHO reports (May, 2020) RESULTS: As the mentioned studies, in the begining patient had persistent fever, abdominal pain and rash mimetizing Kawasaki's Disease. He went through apendicectomy due to suspected appendicitis and lymph nodes with inflammatory signs were removed. On the second postoperative day, he presented respiratory distress, cardiogenic shock, kidney injury, coagulation disorder, miocardiac disfunction, hypersignal in coronary artery. As the most cases reported, PCR for SARS-COV-2 was negative, however serology for COVID-19 positive. This patient received mechanical ventilation, vasoactive drugs, high spectre antibiotic therapy and as suggested on the new guidelines: two days of immunoglobulin and iniciatede long therapy with Acetyl Salicylic Acid. CONCLUSIONS: In the middle of a disease pandemic with worldwide repercussions, when pediatric patients are less affected than adults, this case report contributes to Pediatric Societies being alert and knowing how to recognize cases with serious and lethal possibilities in relation to COVID-19 and iniciate the right treatment, decreasing the complications associated.