THE RED FLAG OF EMERGENCY USE AUTHORIZATION (EUA)

The Emergency Use Authorization (EUA) policy, a representative biodefense policy, was legislated in the United States in 2001 based on lessons learned from Amerithrax, whereas Korea's EUA policy was based on lessons learned from the Middle East Respiratory Syndrome outbreak in 2015. Due to these divergent origins, the U.S. EUA's homeland security objectives were specialized to deal with highly pathogenic biological agents that could be exploited for bioterrorism, whereas the Korean EUA pursues disease containment purposes to strengthen mass-testing practices. During the early phase of the COVID-19 pandemic, the U.S. EUA revealed limitations in its integration with public health surveillance, laboratory partnerships, and insurance systems, which hampered the rapid expansion of testing capacities. Thereafter, once the limitations of the EUA were circumvented, the testing capacity of the United States began to catch up with that of South Korea, and later skyrocketed after solving these issues. (English) [ FROM AUTHOR] La política de autorización de uso de emergencia (EUA), una política representativa de biodefensa, se legisló en los Estados Unidos en 2001 en base a las lecciones aprendidas de Amerithrax, mientras que la política de EUA de Corea se basó en las lecciones aprendidas del brote del síndrome respiratorio de Oriente Medio (MERS) en 2015 Debido a estos orígenes divergentes, los objetivos de seguridad nacional de la EUA EUA se especializaron para tratar con agentes biológicos altamente patógenos que podrían explotarse para el bioterrorismo, mientras que la EUA coreana persigue propósitos de contención de enfermedades para fortalecer las prácticas de pruebas masivas. Durante la fase inicial de la pandemia de COVID-19, la EUA EUA reveló limitaciones en su integración con la vigilancia de la salud pública, las asociaciones de laboratorios y los sistemas de seguros, lo que obstaculizó la rápida expansión de las capacidades de prueba. A partir de entonces, una vez que se eludieron las limitaciones de la EUA, la capacidad de prueba de los Estados Unidos comenzó a alcanzar a la de Corea del Sur y luego se disparó después de resolver estos problemas. (Spanish) [ FROM AUTHOR] 美国在2001年根据炭疽攻击事件(Amerithrax)的经验教训制定了一项具有代表性的生物防卫政策，即紧急使用授权(EUA)政策，而韩国的EUA政策则基于2015年爆发的中东呼吸综合征(MERS)的经验教训。鉴于这些不同的起源，美国EUA的国土安全目标专门应对可能被用于生物恐怖主义的高致病性生物制剂，而韩国EUA则追求疾病遏制目的，以加强大规模检测实践。在2019冠状病毒病(COVID-19)大流行的早期阶段，美国EUA在与公共卫生监测、实验室合作伙伴关系和保险系统的整合方面存在局限性，这阻碍了检测能力的快速扩展。此后，当绕过EUA的限制后，美国的检测能力开始赶上韩国，并在解决这些问题后，检测能力直线上升。 (Chinese) [ FROM AUTHOR] Copyright of World Affairs is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Reflexiones necesarias sobre seguridad alimentaria en Cuba

Cuba exhibe indicadores promedio de consumo aparente diario de alimentos que rebasan las recomendaciones nutricionales diarias. Sin embargo, este consumo depende en gran medida de importaciones de alimentos, ya que los esfuerzos de política por reactivar el sector agropecuario aún no se revierten en incrementos de la producción doméstica. Esta situación se ha acrecentado en años recientes, marcados por la pandemia de la Covid-19 y el recrudecimiento del bloqueo estadounidense. Como resultado, se evidencia una contracción de la disponibilidad de alimentos como resultado de las caídas en la producción nacional y en las importaciones. Ello, junto a otros factores, dificultan el acceso a los alimentos. Por demás, el gasto en alimentación sigue siendo el más importante dentro del gasto familiar, limitando las posibilidades de otros consumos igualmente relevantes. Este artículo examina en mayor profundidad la problemática que significa para las familias cubanas alcanzar la seguridad alimentaria en el contexto actual. [ FROM AUTHOR] Copyright of International Journal of Cuban Studies is the property of Pluto Journals and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Diagnóstico situacional de seguridad alimentaria en Argentina, Brazil, Colombia e Inglaterra post Covid-19

O artigo analisa as iniciativas de promoção da segurança alimentar na Argentina, Brasil, Colômbia e Inglaterra a partir do desenho de um diagnóstico situacional dos países em questão, no período pós-Covid-19. São dados secundários recentes de agências de pesquisa locais e multilaterais que questionam a gama de indicadores de riqueza e pobreza versus insegurança alimentar entre a população mais vulnerável. Avança também no modo de produzir alimentos em larga escala, principalmente a economia baseada em commodities, questionando a soberania na produção de alimentos e a contradição com as premissas do desenvolvimento sustentável. Busca evidenciar a implementação de alguns programas e políticas sociais. Nesses países, para cuidar de famílias em situação de vulnerabilidade social.Alternate :El artículo analiza iniciativas para promover la seguridad alimentaria en Argentina, Brazil, Colombia e Inglaterra a partir del diseño de un diagnóstico situacional de los países en mención, en el periodo post-Covid-19. Se trata de datos secundarios recientes de agencias de investigación locales y multilaterales que cuestionan la gama de indicadores de riqueza y pobreza frente a la inseguridad alimentaria entre la población más vulnerable. También avanza sobre la forma de producir alimentos a gran escala, en especial la economía basada en commodities, cuestionando la soberanía en la producción de alimentos y la contradicción frente a las premisas para el desarrollo sostenible. Busca evidenciar sobre la implementación de algunos programas y políticas sociales. En los referidos países, para atender a las familias en situación de vulnerabilidad social.Alternate :The article analyzes the initiatives to promote food security in Argentina, Brazil, Colombia and England based on the design of a situational diagnosis of the countries in question, in the post-Covid-19 period. These are recent secondary data from local and multilateral research agencies that question the range of indicators of wealth and poverty versus food insecurity among the most vulnerable population. It also advances in the way of producing food on a large scale, mainly the economy based on commodities, questioning the sovereignty in food production and the contradiction with the premises of sustainable development. It seeks to highlight the implementation of some social programs and policies. In these countries, to care for families in situations of social vulnerability.

'Against everything that got you into the job': experiences of potentially morally injurious events among Canadian public safety personnel.

Background: Moral injury (MI) has become a research and organizational priority as frontline personnel have, both during and in the years preceding the COVID-19 pandemic, raised concerns about repeated expectations to make choices that transgress their deeply held morals, values, and beliefs. As awareness of MI grows, so, too, does attention on its presence and impacts in related occupations such as those in public safety, given that codes of conduct, morally and ethically complex decisions, and high-stakes situations are inherent features of such occupations.Objective: This paper shares the results of a study of the presence of potentially morally injurious events (PMIEs) in the lived experiences of 38 public safety personnel (PSP) in Ontario, Canada.Method: Through qualitative interviews, this study explored the types of events PSP identify as PMIEs, how PSP make sense of these events, and the psychological, professional, and interpersonal impacts of these events. Thematic analysis supported the interpretation of PSP descriptions of events and experiences.Results: PMIEs do arise in the context of PSP work, namely during the performance of role-specific responsibilities, within the organizational climate, and because of inadequacies in the broader healthcare system. PMIEs are as such because they violate core beliefs commonly held by PSP and compromise their ability to act in accordance with the principles that motivate them in their work. PSP associate PMIEs, in combination with traumatic experiences and routine stress, with adverse psychological, professional and personal outcomes.Conclusion: The findings provide additional empirical evidence to the growing literature on MI in PSP, offering insight into the contextual dimensions that contribute to the sources and effects of PMIEs in diverse frontline populations as well as support for the continued application and exploration of MI in the PSP context.

The objective of this study was to understand the types of events that Canadian public safety personnel (PSP) experience as potentially morally injurious events (PMIEs) as well as the impacts that they associate with these events.The findings illuminate that contextual dimensions are significant in the origin of PMIEs, which PSP experience in the completion of routine duties, because of the organizational culture, or as a result of issues in the broader healthcare system, which led to many negative consequences in their personal and professional lives.PMIEs reduced the trust PSP had in their leadership and the healthcare system to protect the public and themselves, were associated with feelings of anger, frustration, resignation, and helplessness, and connected to internal struggles marked by inner conflict and the erosion of self-concept.

Food Safety: A Critical Review Based on SDG 2.

This paper aims to analyze the issue of food security, articulating it with the relevance of achieving SDG 2, as one of the fundamental objectives set by the United Nations Organization for Sustainable Development (2015). To achieve this end, the research focuses on four fundamental aspects: 1. The relevance of food security in the global context and the need for timely access to food for individuals, without neglecting the asymmetric structural contexts on the planet, such as hunger and poverty, which limit the conditions for development (FAO, 2009). 2. The relevance of SDG 2 for food security, the production of goods and food effectively, preventing actions that threaten life on the planet (Cóndor et. al, 2022). 3. The presence of people who suffer from hunger in the Latin American and Caribbean region, which has been on the rise since the 2010s and which limits the possibilities of access to sustainability and better living conditions (ECLAC, 2019), a fact that has been intensified with the presence of the COVID-19 pandemic (FAO, 2021). 4. The COVID-19 pandemic that has given rise to new vulnerabilities and conditions for access to food, resulting, among other things, in the stunted growth of infants under five years of age. The method used is documentary review. It concludes on the relevance of food security for the achievement of sustainable development, for the reduction of poverty and structural asymmetric conditions, without failing to recognize the distance that exists to reach the fulfillment of these objectives, especially in convulsive scenarios such as those of the global South. (English) [ FROM AUTHOR] El artículo tiene por objetivo analizar el tema de la seguridad alimentaria, articulándolo con la pertinencia de alcanzar el ODS 2, como uno de los objetivos fundamentales planteados por la Organización de las Naciones Unidas para el desarrollo sostenible (2015). Para lograr tal fin, la investigación se centra en cuatro aspectos fundamentales: 1. La relevancia de la seguridad alimentaria en el contexto global y la necesidad del oportuno acceso a la alimentación de los individuos, sin dejar de lado los contextos asimétricos estructurales en el planeta, como el hambre y la pobreza, que limitan las condiciones para el desarrollo (FAO, 2009). 2. La pertinencia del ODS 2 para la seguridad alimentaria, la producción de bienes y alimentos de forma efectiva, evitando acciones que atenten contra la vida en el planeta (Cóndor et. al, 2022). 3. La presencia de personas que padecen hambre en la región latinoamericana y caribeña, que viene en ascenso desde la década del 2010 y que limita las posibilidades de acceso a la sostenibilidad y mejores condiciones de vida (CEPAL, 2019), hecho que se ha intensificado con la presencia de la pandemia COVID-19 (FAO, 2021). 4. La pandemia COVID-19 que ha dado lugar a nuevas vulnerabilidades y condicionamientos para el acceso a la alimentación, resultando, entre otras cosas, en el retraso de crecimiento de infantes menores de cinco años. El método utilizado es la revisión documental. Se concluye en la relevancia de la seguridad alimentaria para el logro del desarrollo sostenible, para la disminución de la pobreza y de condiciones asimétricas estructurales, sin dejar de reconocer la distancia que existe para llegar al cumplimiento de estos objetivos, especialmente en escenarios convulsos como los del Sur global. (Spanish) [ FROM AUTHOR] Copyright of Revista de Filosofía is the property of Revista de Filosofia-Universidad del Zulia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Seguridad de los profesionales de enfermería y del paciente ante la pandemia de COVID-19 en unidades críticas

Objetivo: evaluar la seguridad de los profesionales de enfermería y la cultura de seguridad del paciente durante su actuación profesional en el cuidado de pacientes sospechosos o con COVID-19. Método: estudio transversal realizado con 90 profesionales de unidades críticas de dos hospitales universitarios. Se utilizó un instrumento de caracterización sociodemográfica y de condiciones de salud, además de los constructos "Seguridad del profesional y del paciente” y Hospital Survey on Patient Safety Culture. Se realizaron análisis univariados entre el diagnóstico de COVID-19 y las características de los profesionales y se aplicó la correlación de Kendell entre los constructos. Resultados: el diagnóstico de COVID-19 mostró diferencia estadísticamente significativa entre los profesionales que actuaron por más de seis años en la unidad (p=0,020) y los ítems del constructo "Seguridad del profesional y del paciente” referentes a dudas sobre cómo retirar el Equipo de Protección Personal (p=0,013) y flujo seguro (p=0,021). Las dimensiones 2 (p=0,003), 3 (p=0,009), 4 (p=0,013), 6 (p<0,001) y 9 (p=0,024) del Hospital Survey on Patient Safety Culture se asociaron a la realización de formación. Conclusión: mayor tiempo de experiencia profesional de enfermería se asoció con la no infección por COVID-19. La percepción de la cultura de seguridad del paciente se relacionó con la realización de entrenamiento.Alternate : Objective: to evaluate nursing professionals and patient safety culture during the professional performance in the care of suspected or infected patients with COVID-19. Method: a cross-sectional study carried out with 90 professionals from critical care units of two teaching hospitals. An instrument for sociodemographic characterization and health conditions was used, in addition to the constructs "Nursing professional and patient safety” and the Hospital Survey on Patient Safety Culture. Univariate analyzes were performed between the diagnosis of COVID-19 and the characteristics of Nursing professionals, applying Kendell's correlation between the constructs. Results: the COVID-19 diagnosis presented a significant statistical difference between nursing professionals that worked for more than six years at the critical care unit (p=0.020) and the items of the construct "Nursing professional and patient safety” regarding the doubts about how to remove the personal protective equipment (p=0.013) and safety flow (p=0,021). The dimensions 2 (p=0.003), 3 (p=0.009), 4 (p=0.013), 6 (p<0.001), and 9 (p=0.024) of the Hospital Survey on Patient Safety Culture were associated with the accomplishment of training. Conclusion: a higher professional nursing experience time was associated with non-infection by COVID-19. The perception of the safety culture of the patient was related to the accomplishment of training.

Security analysis of sports competition under the influence of covid-19 / Análise de segurança da competição esportiva sob a influência da covid-19 / Análisis de seguridad de la competición deportiva bajo la influencia del covid-19

ABSTRACT Introduction The continuous growth of COVID-19 has harmed sports competitions. Although the existing method of non-opening to spectators is very effective for preventing and controlling COVID-19, it will also seriously blow the sports economy's development. Objective Explore the safety of sports competition under the influence of COVID-19 to realize sports practice in a safe and regulated condition. Methods Firstly, the current public's willingness to participate in the competition was analyzed by questionnaire survey. Then, using the literature search method, this paper discusses the safety needs of sports competitions under the normalization of the prevention and control of COVID-19 in the research area at the present stage. Results By completely controlling the crowd shift rule and skillfully controlling the crowd pace, the transmission risk in the competition process can be effectively reduced. Conclusion The relevant departments and stadium managers should fully analyze the current epidemic prevention and control needs and strengthen spectator safety management in the study area in combination with regional characteristics and the actual spectator situation. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O crescimento contínuo da COVID-19 tem tido um impacto negativo sobre as competições esportivas. Embora o método existente de não-abertura aos espectadores seja muito eficaz para a prevenção e controle da COVID-19, ele também trará um sério golpe ao desenvolvimento da economia esportiva. Objetivo Explorar a segurança da competição esportiva sob a influência da COVID-19, de forma a realizar a prática esportiva em uma condição segura e regulamentada. Métodos Primeiramente, a disposição do público atual para participar da competição foi analisada por meio de pesquisa por questionário. Em seguida, utilizando o método de pesquisa bibliográfica, este trabalho discute as necessidades de segurança das competições esportivas sob a normalização da prevenção e controle da COVID-19 na área de pesquisa na presente fase. Resultados Controlando completamente a regra do deslocamento da multidão e controlando habilmente o ritmo da multidão, o risco de transmissão no processo de competição pode ser efetivamente reduzido. Conclusão Os departamentos e gerentes de estádios pertinentes devem analisar plenamente as necessidades atuais de prevenção e controle de epidemias e fortalecer a gestão da segurança dos espectadores na área de estudo em combinação com as características regionais e a situação real dos espectadores. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El continuo crecimiento del COVID-19 ha tenido un impacto negativo en las competiciones deportivas. Aunque el método actual de no abrir para los espectadores es muy eficaz para la prevención y el control del COVID-19, también supondrá un duro golpe para el desarrollo de la economía deportiva. Objetivo Explorar la seguridad de la competición deportiva bajo la influencia del COVID-19, para llevar a cabo la práctica deportiva en condiciones seguras y reguladas. Métodos En primer lugar, se analizó la disposición del público actual a participar en el concurso mediante una encuesta por cuestionario. A continuación, utilizando el método de búsqueda bibliográfica, este trabajo analiza las necesidades de seguridad de las competiciones deportivas en el marco de la normalización de la prevención y el control del COVID-19 en el ámbito de la investigación en la etapa actual. Resultados Si se controla completamente la regla de desplazamiento de la multitud y se controla hábilmente el ritmo de la multitud, se puede reducir eficazmente el riesgo de transmisión en el proceso de competición. Conclusión Los departamentos competentes y los gestores de los estadios deben analizar a fondo las necesidades actuales de prevención y control de epidemias y reforzar la gestión de la seguridad de los espectadores en la zona de estudio en combinación con las características regionales y la situación real de los espectadores. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Security analysis of sports competition under the influence of covid-19 / Análise de segurança da competição esportiva sob a influência da covid-19 / Análisis de seguridad de la competición deportiva bajo la influencia del covid-19

ABSTRACT Introduction The continuous growth of COVID-19 has harmed sports competitions. Although the existing method of non-opening to spectators is very effective for preventing and controlling COVID-19, it will also seriously blow the sports economy's development. Objective Explore the safety of sports competition under the influence of COVID-19 to realize sports practice in a safe and regulated condition. Methods Firstly, the current public's willingness to participate in the competition was analyzed by questionnaire survey. Then, using the literature search method, this paper discusses the safety needs of sports competitions under the normalization of the prevention and control of COVID-19 in the research area at the present stage. Results By completely controlling the crowd shift rule and skillfully controlling the crowd pace, the transmission risk in the competition process can be effectively reduced. Conclusion The relevant departments and stadium managers should fully analyze the current epidemic prevention and control needs and strengthen spectator safety management in the study area in combination with regional characteristics and the actual spectator situation. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O crescimento contínuo da COVID-19 tem tido um impacto negativo sobre as competições esportivas. Embora o método existente de não-abertura aos espectadores seja muito eficaz para a prevenção e controle da COVID-19, ele também trará um sério golpe ao desenvolvimento da economia esportiva. Objetivo Explorar a segurança da competição esportiva sob a influência da COVID-19, de forma a realizar a prática esportiva em uma condição segura e regulamentada. Métodos Primeiramente, a disposição do público atual para participar da competição foi analisada por meio de pesquisa por questionário. Em seguida, utilizando o método de pesquisa bibliográfica, este trabalho discute as necessidades de segurança das competições esportivas sob a normalização da prevenção e controle da COVID-19 na área de pesquisa na presente fase. Resultados Controlando completamente a regra do deslocamento da multidão e controlando habilmente o ritmo da multidão, o risco de transmissão no processo de competição pode ser efetivamente reduzido. Conclusão Os departamentos e gerentes de estádios pertinentes devem analisar plenamente as necessidades atuais de prevenção e controle de epidemias e fortalecer a gestão da segurança dos espectadores na área de estudo em combinação com as características regionais e a situação real dos espectadores. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El continuo crecimiento del COVID-19 ha tenido un impacto negativo en las competiciones deportivas. Aunque el método actual de no abrir para los espectadores es muy eficaz para la prevención y el control del COVID-19, también supondrá un duro golpe para el desarrollo de la economía deportiva. Objetivo Explorar la seguridad de la competición deportiva bajo la influencia del COVID-19, para llevar a cabo la práctica deportiva en condiciones seguras y reguladas. Métodos En primer lugar, se analizó la disposición del público actual a participar en el concurso mediante una encuesta por cuestionario. A continuación, utilizando el método de búsqueda bibliográfica, este trabajo analiza las necesidades de seguridad de las competiciones deportivas en el marco de la normalización de la prevención y el control del COVID-19 en el ámbito de la investigación en la etapa actual. Resultados Si se controla completamente la regla de desplazamiento de la multitud y se controla hábilmente el ritmo de la multitud, se puede reducir eficazmente el riesgo de transmisión en el proceso de competición. Conclusión Los departamentos competentes y los gestores de los estadios deben analizar a fondo las necesidades actuales de prevención y control de epidemias y reforzar la gestión de la seguridad de los espectadores en la zona de estudio en combinación con las características regionales y la situación real de los espectadores. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Assessment of the patient safety culture in the ICU of a second level hospital at the end of the third COVID-19 wave.

INTRODUCTION: Current healthcare settings and ICUs especially are complex, highly technical, and multidisciplinary, with interactions between healthcare professionals and users, in which there may be errors at different levels. Our objective was to assess the perception of patient safety in our unit at the end of the third wave of the COVID pandemic, with the intention of conducting subsequent improvement actions. METHODS: Observational, cross-sectional, and descriptive study. The perception of Safety Culture was estimated using the HSOPS questionnaire translated into Spanish. Some questions were posed in a positive sense, and others in a negative sense. The response was also rated as positive, negative, or neutral. Our findings were compared visually, not mathematically, with those found in the previous national study «Analysis of the culture on patient safety in the hospital setting of the Spanish National Health System¼ published in 2009. A subgroup analysis was performed according to professional group and seniority as a health worker. The Student's t, χ2 and ANOVA tests were used. RESULTS: Sixty-two professionals responded to the questionnaire, 73.90% of the total. The median time working in ICU 2 years (interquartile range 2-4.5 years). The rating for the degree of safety was 8.06 (SD 1.16). The majority (91.20%) had not reported any adverse event in the last year. A total of 30.90% had recently received patient safety training. The dimensions considered as weaknesses were 9 ("Staffing", with 27.57% of positive responses) and 10 ("Support of the hospital management in safety", with 17.64% of positive responses). The dimensions considered as strengths were 3 ("Expectation of actions by management/supervision of the service") with 85.29% of positive responses, and 5 ("Teamwork") with 95.58% of positive responses. The Cronbach's alpha index values suggest that the questionnaire has adequate internal consistency. In general, our data are more positive than those collected in the 2011 national survey, although the 2 dimensions considered weaknesses were already considered such in the previous work. CONCLUSIONS: The perception of patient safety in the ICU of our hospital after the end of the third wave of the COVID pandemic is adequate, with a more positive rating than that of the national study on safety culture at the hospital level carried out in 2009. The constant quest for patient safety should prioritize activity in the 2 dimensions considered weaknesses: staffing, and support from hospital management in everything related to patient safety.

Neurological manifestations associated with COVID-19 vaccine.

INTRODUCTION: Coronavirus disease 2019 (COVID-19) has spread rapidly, giving rise to a pandemic, causing significant morbidity and mortality. In this context, many vaccines have emerged to try to deal with this disease. OBJECTIVE: To review the reported cases of neurological manifestations after the application of COVID-19 vaccines, describing clinical, analytical and neuroimaging findings and health outcomes. METHODS: We carried out a review through bibliographic searches in PubMed. RESULTS: We found 86 articles, including 13 809 patients with a wide spectrum of neurological manifestations temporally associated with COVID-19 vaccination. Most occurred in women (63.89%), with a median age of 50 years. The most frequently reported adverse events were Bell's palsy 4936/13 809 (35.7%), headache (4067/13 809), cerebrovascular events 2412/13 809 (17.47%), Guillain-Barré syndrome 868/13 809 (6.28%), central nervous system demyelination 258/13 809 (1.86%) and functional neurological disorder 398/13 809 (2.88%). Most of the published cases occurred in temporal association with the Pfizer vaccine (BNT162b2), followed by the AstraZeneca vaccine (ChAdOX1-S). CONCLUSIONS: It is not possible to establish a causal relationship between these adverse events and COVID-19 vaccines with the currently existing data, nor to calculate the frequency of appearance of these disorders. However, it is necessary for health professionals to be familiar with these events, facilitating their early diagnosis and treatment. Large controlled epidemiological studies are necessary to establish a possible causal relationship between vaccination against COVID-19 and neurological adverse events.

Enhancing solidarity among Europeans: Toward a political reappraisal of the EU and its citizenship

Related Articles In recent years, the EU's ability to mobilize European citizens in its favor and counteract such phenomena as nationalism, populism, and “sovereignism” has significantly decreased. Consequently, the suggestion has been made that the EU's social dimension should be enhanced and its citizenship be made more salient in that regard. Such a suggestion has become even more topical after the COVID‐19 outbreak and the strain it has placed on the health‐care systems and economies of EU member states. Starting from a debate which addresses that suggestion, in this article I argue that, before attempting to enhance its social dimension, the EU should first try to strengthen its still weak political foundations in order to cope with its predicament. The article also shows that this move would be consistent with the rationale behind the European integration process, where economic issues were originally regarded as only means to achieve an ever‐closer political union.Barrault‐Stella, Lorenzo, and Thomas Douniès. 2021. “Introduction to the Special Issue: Citizenship as a Tool of Government in Europe.” Politics & Policy 49(4): 824–41. https://doi.org/10.1111/polp.12423.Ewert, Benjamin. 2021. “Citizenship as a Form of Anticipatory Obedience? Implications of Preventive Health Policy in Germany.” Politics & Policy 49(4): 891–912. https://doi.org/10.1111/polp.12421.McBeth, Mark K., Donna L. Lybecker, and Kacee A. Garner. 2010. “The Story of Good Citizenship: Framing Public Policy in the Context of Duty‐Based versus Engaged Citizenship.” Politics & Policy 38(1): 1–23. https://doi.org/10.1111/j.1747‐1346.2009.00226.x. (English) [ FROM AUTHOR] Mejorar la solidaridad entre los europeos: hacia una reevaluación política de la UE y su ciudadanía En los últimos años, la capacidad de la UE para movilizar a los ciudadanos europeos a su favor y contrarrestar fenómenos como el nacionalismo, el populismo y el “soberanismo” ha disminuido significativamente. En consecuencia, se ha sugerido que se mejore la dimensión social de la UE y que su ciudadanía se haga más prominente en ese sentido. Tal sugerencia se ha vuelto aún más actual después del brote de COVID‐19 y la presión que ha ejercido sobre los sistemas de salud y las economías de los estados miembros de la UE. Partiendo de un debate que aborda esa sugerencia, en este artículo sostengo que antes de intentar mejorar su dimensión social, la UE primero debería tratar de fortalecer sus bases políticas aún débiles para hacer frente a su predicamento. El artículo también muestra que esta medida sería coherente con la lógica detrás del proceso de integración europea, donde los asuntos económicos se consideraron originalmente como el único medio para lograr una unión política cada vez más estrecha. (Spanish) [ FROM AUTHOR] 加强欧洲人之间的团结:对欧盟及其公民身份进行政治重估 近年来，欧盟在动员欧洲公民的支持，并抵制民族主义、民粹主义和“主权主义”等现象方面的能力明显下降。因此，有人建议加强欧盟的社会维度，并在这方面使其公民身份更加突出。在新冠疫情爆发及其对欧盟成员国的医疗保健系统和经济造成压力之后，这样的建议变得更加热门。以针对该建议的辩论为出发点，我论证认为，在试图增强其社会维度之前，欧盟应首先尝试加强其仍然薄弱的政治基础，以应对其困境。本文还表明，这一举措与欧洲一体化进程背后的基本原理是一致的，在欧洲一体化进程中，经济问题最初被视为实现更紧密的政治联盟的唯一手段。 (Chinese) [ FROM AUTHOR] Copyright of Politics & Policy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Quality of hospital emergency department care for patients with COVID-19 during the first wave in 2020: the CALUR-COVID-19 study. / Estudio CALUR-COVID-19: calidad asistencial en urgencias del proceso de atención a pacientes con COVID-19 durante el primer pico pandémico de 2020.

OBJECTIVES: To define quality of care indicators and care process standards for treating patients with COVID-19 in hospital emergency departments (EDs), to determine the level of adherence to standards during the first wave in 2020, and to detect factors associated with different levels of adherence. MATERIAL AND METHODS: We selected care indicators and standards by applying the Delphi method. We then analyzed the level of adherence in the SIESTA cohort (registered by the Spanish Investigators in Emergency Situations Team). This cohort was comprised of patients with COVID-19 treated in 62 Spanish hospitals in March and April 2020. Adherence was compared according to pandemic-related ED caseload pressure, time periods during the wave (earlier and later), and age groups. RESULTS: Fourteen quality indicators were identified. Three were adhered to in less than 50% of the patients. Polymerase chain reaction testing for SARS-CoV-2 infection was the indicator most often disregarded, in 29% of patients when the caseload was high vs 40% at other times (P .001) and in 30% of patients in the later period vs 37% in the earlier period (P = .04). Adherence to the following indicators was better in the later part of the wave: monitoring of oxygen saturation (100% vs 99%, P = .035), electrocardiogram monitoring in patients treated with hydroxychloroquine (87% vs 65%, P .001), and avoiding of lopinavir/ritonavir treatment in patients with diarrhea (79% vs 53%, P .001). No differences related to age groups were found. CONCLUSION: Adherence to certain quality indicators deteriorated during ED treatment of patients with COVID-19 during the first wave of the pandemic. Pressure from high caseloads may have exacerbated this deterioration. A learning effect led to improvement. No differences related to patient age were detected.

OBJETIVO: Definir indicadores de calidad y sus estándares para el proceso asistencial del paciente con COVID-19 en servicios de urgencias hospitalarios (SUH), así como determinar su grado de cumplimiento durante el primer pico pandémico e investigar si existieron diferencias en relación con diferentes factores. METODO: Siguiendo la metodología del Delphi, los autores seleccionaron los indicadores y sus estándares. Posteriormente, se analizó el grado de cumplimiento en la cohorte SIESTA, formada por pacientes COVID-19 de 62 SUH españoles atendidos en marzo y abril de 2020. Se comparó el cumplimiento de los indicadores según la presión asistencial generada por la pandemia en el SUH, el periodo asistencial y el grupo etario. RESULTADOS: Se definieron 14 indicadores. Tres de ellos se cumplieron en 50% de los pacientes. La realización de la reacción en cadena de la polimerasa (PCR) para el SARS-CoV-2 tuvo peor cumplimiento en SUH con alta presión (29% frente a 40%, p 0,001) y durante el periodo tardío (30% frente a 37%, p = 0,04). Durante el periodo tardío, mejoró la medida de saturación de oxígeno (100% frente a 99%, p = 0,035), la realización de electrocardiograma en pacientes tratados con hidroxicloroquina (87% frente a 65%, p 0,001) y la no administración de lopinavir-ritonavir en pacientes con diarrea (79% frente a 53%, p 0,001). No hubo diferencias en relación con el grupo etario. CONCLUSIONES: Durante el primer pico pandémico, diversos aspectos de la calidad de la atención a pacientes COVID-19 en los SUH españoles se vieron deteriorados. La presión asistencial pudo incrementar este deterioro. Hubo un efecto de aprendizaje que condicionó una mejora, pero no se observaron diferencias según la edad de los pacientes.

Impact of the COVID-19 pandemic in the lipid control of the patients that start PCSK9 inhibitors

Objectives MEMOGAL study (NCT04319081) is aimed at evaluating changes in cognitive function in patients treated with PCSK9 inhibitors (PCSK9i). This is the first analysis: (1) discussion about the role of the Hospital Pharmacists during the pandemic, and also the assessment of the impact of COVID-19 in the lipid control;(2) descriptive analysis;(3) effectiveness in LDL cholesterol (LDL-c) reduction of alirocumab and evolocumab;(4) communicate PCSK9i safety. Material and methods It is a prospective Real-World Evidence analysis of patients that take PCSK9i for the first time in the usual clinical practice, and they are included after the first dispensation in the public pharmacy consultations of 12 Hospitals in Galicia from May 2020 to April 2021. Baseline values of LDL-c are the previous values before taking PCSK9 and the follow-up values are in 6 months time. Results 89 patients were included. 86.5% with cardiovascular disease and 53.9% with statin intolerances. 78.8% of the patients were treated with high intensity statins. Statins most used were rosuvastatin (34.1%) and atorvastatin (20.5%). Baseline value of LDL-c was 148 mg/dL and the follow-up value was 71 mg/dL. The baseline value of patients treated with alirocumab (N = 43) was 144 mg/dL and 73 mg/dL in the follow-up. With evolocumab (N = 46) was 151 mg/dL in basaline and 69 mg/dL in follow-up. The LDLc- reduction was 51.21% with evolocumab and 51.05% with alirocumab. 43.1% of the patients showed values >70 mg/dL in six month time;19.4% between 69 mg/dl and 55 mg/dL and 37.5% <55 mg/dL. 58.3% of the patients achieved a reduction >50% of LDL-c. The adverse events were: injection point reaction (N = 2), myalgias (N = 1), flu-like symptoms (N = 1) and neurocognitive worsening (N = 1). Conclusions (1) Despite the number of prescriptions was reduced because of the pandemic, the lipid control was not affected. (2) Half of the patients treated with PSCK9i is due to statins intolerance and the 86% is for secondary prevention. (2) The reduction results were similar to pivotal clinical trials. Despite this, 39% of the total of the patients and 60% of patients with dual teraphy did not reach the goal of ESC/EAS guidelines (< 55 mg/dL and/or reduction > 50%). There were not significant differences between evolocumab and alirocumab: 51.21% vs 51.05% (P = .972). (3) There were not any adverse events of special interest. The possible neurocognitive worsening will be studied as the primary endpoint once the MEMOGAL study has been completed. Resumen Objetivos El estudio MEMOGAL (NCT04319081) está dirigido a evaluar cambios en la función cognitiva en pacientes tratados con inhibidores de la PCSK9 (iPCSK9). Se realiza primer análisis: 1) discutir el papel de los farmacéuticos hospitalarios durante de la pandemia, así como evaluar el impacto de la misma en el control lipídico;2) análisis descriptivo;3) eficacia en reducción de colesterol-LDL (c-LDL) de alirocumab y v;y 4) reportar seguridad de los iPCSK9. Material y métodos Se trata de un análisis prospectivo en vida real de pacientes tratados por primera vez con iPCSK9 en la práctica clínica habitual e incluidos en su primera dispensación en las consultas de farmacia de 12 hospitales de Galicia desde mayo de 2020-abril de 2021. Los valores basales de c-LDL son los previos al inicio del tratamiento con iPCSK9 y como seguimiento los valores a los 6 meses. Resultados Se incluyeron 89 pacientes. El 86,5% con enfermedad cardiovascular y un 53,9% intolerancia a las estatinas. Un 78,8% de los pacientes fueron tratados con estatinas de alta intensidad. Las estatinas más usadas fueron rosuvastatina (34,1%) y atorvastatina (20,5%). El nivel basal de c-LDL fue 148 mg/dl y de 71 mg/dl al seguimiento. Los pacientes tratados con alirocumab (n = 43) presentaban valores basales de 144 mg/dl y de 73 mg/dl al seguimiento y con evolocumab (n = 46) de 151 mg/dl basal y 69 mg/dl al seguimiento. La reducción de c-LDL fue para evolocumab 51,21% y alirocumab 51,05%. El 43,1% presentaba a los 6 meses valores > 70 mg/dl, el 19,4% entre 55 y 69 mg/dl y el 37,5% < 55 mg/dl. Los pacientes que obtuvieron una reducción > 50% de c-LDL fueron el 58,3%. Los eventos adversos presentados fueron: reacción en el lugar de inyección (n = 2), mialgias (n = 1), síntomas pseudogripales (n = 1) y deterioro neurocognitivo (n = 1). Conclusiones 1) A pesar de haber disminuido el número de prescripciones de iPCSK9 durante la pandemia, el control lipídico de estos pacientes no se ha visto afectado;2) la mitad de los pacientes tratados con iPSCK9 se debe a intolerancia a estatinas y el 86% es en prevención secundaria;3) se presentaron valores de reducción similares a los ensayos clínicos pivotales. A pesar de esto, un 39% del total y un 60% en doble terapia no alcanzaron las recomendaciones de las guías ESC/EAS (< 55 mg/dl y/o reducción > 50%). No hubo diferencias significativas entre evolocumab y alirocumab: 51,21% vs. 51,05% (p = 0,972);y 4) no se observaron eventos de especial interés con el uso de estos fármacos. El posible deterioro cognitivo será analizado como variable principal una vez completado el estudio MEMOGAL.

¿Cómo hemos adaptado las recomendaciones de los Proyectos Zero durante la pandemia?

Resumen El impacto negativo de la pandemia sobre las tasas de infecciones controladas ha evidenciado la necesidad de reanudar la aplicación de las recomendaciones de los Proyectos Zero (PZ). En este artículo, en primer lugar, se realiza un análisis de la situación de las unidades de cuidados intensivos de España durante la pandemia. A continuación se presenta la adaptación de las recomendaciones de cada uno de los cuatro PZ y su grado de cumplimiento y riesgo de que existan infecciones relacionadas con dispositivos invasivos y/o bacteriemias multirresistentes. Para ello, se han tenido en cuenta: 1)el documento publicado en octubre de 2020 por el Consejo Asesor del Programa de Seguridad de pacientes críticos, y 2)el estudio exploratorio realizado, un año después, por el Consejo Asesor de los PZ, junto con los líderes de los proyectos de las unidades participantes del registro ENVIN. Por último, y en base a los hallazgos encontrados, se formulan cinco recomendaciones tentativas y prioritarias. The negative impact of the pandemic on infection control rates has highlighted the need to resume the implementation of Project Zero (PZ) recommendations. This article first analyses the situation of intensive care units in Spain during the pandemic. Subsequently, it presents the adaptation of the recommendations of each of the four PZs and their degree of compliance and the risk of invasive device-related infections and/or multidrug-resistant bacteraemias. For this purpose, we have taken into account: (i)the document published in October 2020 by the Advisory Board of the Critical Patient Safety Programme, and (ii)the exploratory study conducted, one year later, by the Advisory Board of the PZs, on the leaders of the Projects of the units participating in the ENVIN registry. Finally, based on the findings, five tentative and priority recommendations are formulated.

[Impact of the COVID-19 pandemic on patient safety incident and medication error reporting systems]. / Impacto de la pandemia COVID-19 en los sistemas de notificación de incidentes de seguridad del paciente y errores de medicación.

BACKGROUND AND AIM: To determine the impact of the COVID-19 pandemic on the epidemiology of safety incidents (SI) and medication errors (ME) reported to the CISEMadrid notification system in the hospital and primary care settings of the Madrid Health Service (SERMAS). MATERIALS AND METHODS: Observational and descriptive study with a retrospective analysis of data including all CISEMadrid notifications from 01-Jan-2018 to 31-Dec-2020, from 33 hospitals and 262 health care centres of the SERMAS. The two periods in 2020 with the greatest increase in COVID-19 cases were identified to compare incidents reported in the pre-pandemic and pandemic periods. RESULTS: 36,494 incidents were reported. Comparing both periods, an overall decrease in pandemic notifications of 60.7% was observed, being higher in primary care, falling to 33% of previous levels. The reduction in notifications was similar in the peaks and valleys of the waves. The three most frequent SIs in both periods and care settings were: diagnostic tests, medical devices/equipment/clinical furniture and organisational management/citations. In ME, dose failure and inappropriate selection were the most frequent in both settings and periods. There were no relevant differences in patient consequences in both periods. CONCLUSIONS: During the pandemic, patient safety notifications decreased although the most frequent types remained the same, as did their impact on the patient, both in hospitals and in primary care. The safety culture of organisations is a critical aspect for the maintenance of reporting systems.

Integrated supply chain security risk management with a focus on customer service

The management of supply chains in the new time that will open once the coronavirus SARS-CoV-2 (COVID-19) pandemic is overcome will tend to give a key importance to risk management. It will mean greater chain visibility, and greater collaboration momentum will be needed, in order to diligently take consensual action. The objective of this article is to provide a theoretical approach to the integration of supply chain security risk management to the organizational system with a focus on customer service as a key logistics activity. For this, theoretical modeling was used with a systemic, structural approach with logical consistency adapted to elements of logistics and internal control. Links are established between the supply chain security system and the internal control system, focused on logistics flows in an organization. It is determined that, in terms of supply chains, it will be effective to manage risks with a focus on customer service, from the reduction of the five existing gaps in this environment. It is concluded that the integration of supply chain security risk management is a quality that seeks the effectiveness of these systems in organizations with a focus on customer service, integrated with internal control, thus achieving a better capacity of immediate response to the demands of the supply networks. (English) [ FROM AUTHOR] La gestión de las cadenas de suministro, en la actualidad, una vez se supere la pandemia de coronavirus SARS-CoV-2 (COVID-19) tenderán a dar una importancia clave a la gestión de los riesgos. Va a implicar una mayor visibilidad de la cadena, y se necesitarán un mayor impulso de la colaboración, con el fin de tomar medidas consensuadas con diligencia. El objetivo de este artículo es ofrecer una aproximación teórica de la integración de la gestión de riesgos de la seguridad de las cadenas de suministros al sistema organizacional con un enfoque en el servicio al cliente como actividad clave de la logística. Para esto se utilizó la modelación teórica con un enfoque sistémico-estructural con consistencia lógica, adaptado a elementos de la logística y el control interno. Se establecen los nexos entre el sistema de seguridad de las cadenas de suministros y el sistema de control interno, enfocados en los flujos logísticos en una organización. Se determina que, en materia de cadenas de suministros, será efectivo gestionar los riesgos con un enfoque al servicio al cliente, a partir de la reducción de los cincos brechas existente en este entorno. Se concluye que la integración de la gestión de riesgos de la seguridad de las cadenas de suministros es una cualidad que busca la efectividad de estos sistemas en las organizaciones con un enfoque al servicio al cliente, integrado al control interno, se logrará así una mejor capacidad de respuesta inmediata a las demandas de las redes de suministros. (Spanish) [ FROM AUTHOR] Copyright of Ingeniería y Competitividad is the property of Universidad del Valle and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

COVID-19 from the lens of Global International Relations

Although the initiation of COVID-19 vaccination brought hope, IFM forecasts that the main fault line to global recovery is access to vaccines, an argument that reinforces the idea that COVID-19 is a syndemic and not a pandemic. This article argues that from the lens of Global International Relations three elements impact vaccine access and affordability: human security, global governance, and International Law. First, the health emergency requires rethinking security considering the multiple risks and threats centred on the human being. Second, inefficiency of global governance led to the success of vaccine diplomacy over Covax Facility, as well as India and South Africa's long and uncertain struggle for a waiver in the World Trade Organisation. Finally, although Law plays an essential role in building resilience in situations of vulnerability, the international legal system lacks treaties that rule pandemics or establish limits to intellectual property if the immunity of herd requires it. (English) [ FROM AUTHOR] Aunque el inicio de la vacunación contra la covid-19 trajo esperanza, el Fondo Monetario Internacional pronostica que la principal falla en la recuperación global es el acceso a las vacunas, argumento que refuerza la idea de que la covid-19 es una sindemia y no una pandemia. Este artículo sostiene que, desde la perspectiva de las relaciones internacionales globales, tres elementos impactan en el acceso y asequibilidad de la vacuna: la seguridad humana, la gobernanza global y el derecho internacional. En primer lugar, la emergencia sanitaria requiere repensar la seguridad considerando múltiples riesgos y amenazas centrados en el ser humano. Asimismo, la ineficacia de la gobernanza global condujo al éxito de la diplomacia de las vacunas sobre el Mecanismo Covax, así como a una larga e incierta lucha de India y Sudáfrica por una suspensión temporal de las patentes en la Organización Mundial del Comercio. Finalmente, si bien el derecho juega un papel fundamental en la construcción de resiliencia en situaciones de vulnerabilidad, el sistema internacional carece de tratados sobre pandemias o que establezcan límites a la propiedad intelectual si la inmunidad de rebaño así lo requiere. (Spanish) [ FROM AUTHOR] Copyright of OASIS - Observatorio de Análisis de los Sistemas Internacionales is the property of Universidad Externado de Colombia, Centro de Investigaciones y Proyectos Especiales (CIPE) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Retos de seguridad y salud en el trabajo para la gente de mar en actividades esenciales durante la pandemia mundial de COVID-19

Resumen La pandemia de COVID-19 ha transformado el mundo del trabajo, pero el comercio mundial sigue considerándose una esfera de actividad esencial y el transporte marítimo, como motor de la globalización, no puede detenerse. En este contexto, pocos Gobiernos han permitido a la gente de mar ?que transporta más del 90 por ciento de las mercancías mundiales? abandonar sus barcos y regresar a casa. Las restricciones de viaje relacionadas con la COVID-19 han provocado una crisis de seguridad y salud en el trabajo marítimo. Este artículo, basado en 29 entrevistas, explora los retos de SST que ha afrontado la gente de mar de todo el mundo durante la pandemia.

Moral Panics, Viral Subjects: Black Women's Bodies on the Line during Cuba's 2020 Pandemic Lockdowns.

While Cuba was in a COVID-19-induced lockdown, coleras, women who wait in hours-long colas (lines) to purchase scarce goods to resell, emerged in online state media as "folk devils" responsible for the acute shortages of basic goods. Using an intersection lens, we combine fieldwork in lines and content analysis of online media to examine the creation and policing of the colera threat during the summer of 2020. Coleras were framed as immoral subjects, gendered and racialized, and often depicted as a virus that threatened the nation's health. The colera moral panic attempted to obscure class, race, and gender inequalities and structures that have made certain citizens vulnerable in the aftermath of successive waves of Cuban economic reforms. Understanding this moral panic allows us to appreciate the material scarcities and indignities to which poor Black women have been subjected, and widespread concerns about the state's failure to protect society's most vulnerable.

Durante el encierro inducido por el COVID­19 en Cuba, las coleras, mujeres que esperan horas en colas (filas) para comprar bienes escasos para revenderlos, surgieron en los medios estatales en línea como "diablas populares", responsables de la aguda escasez de bienes básicos. Usando una lente interseccional, combinamos trabajo de campo en líneas y análisis de contenido de medios en línea para examinar la creación y vigilancia de la amenaza colera durante el verano de 2020. Las coleras fueron enmarcadas como sujetas inmorales, generizadas y racializadas, y a menudo representadas como un virus que amenazaba la salud de la nación. El pánico moral sobre la colera intentó oscurecer la clase, la raza y las desigualdades y estructuras de género que han hecho vulnerables a determinados ciudadanos tras las sucesivas oleadas de reformas económicas en Cuba. Entender este pánico moral nos permite apreciar las carencias materiales y las indignidades a las que las mujeres pobres negras han sido sometidas, así como las preocupaciones generalizadas sobre la falta de protección del Estado hacia los más vulnerables de la sociedad.

[Medication safety during the COVID-19 pandemic in primary care nurses]. / Seguridad de medicamentos durante la pandemia COVID-19 en las enfermeras de atención primaria.

OBJECTIVE: To know the perception of nurses about the factors that influence the safe administration of medications during the COVID-19 period, in the work context in a primary care health department of the Spanish national health system. DESIGN: This is a qualitative phenomenological study. SITE: Carried out in the Department of Health 21 (Alicante, Spain) between the months of September 2021 and November 2021. PARTICIPANTS: Fifteen nurses chosen by intentional sampling. METHODS: A semi-structured interview lasting between 30 and 60min was used, recorded and transcribed verbatim by the research team. A main category called "know" is established, which encompasses all the reflections about the nurse's performance during the medication administration process. RESULTS: The participants expressed concern about the performance of medication administration procedures, which made it possible to perceive safety as the greatest concern in the study unit. From this main category, the following subcategories are developed: work overload, insufficient training, distractions and communication and information failures. CONCLUSION: Knowing the perception of nurses about the factors that influence the safe administration of medications could facilitate the use of instruments to standardize and reduce variability in the safe administration of medications. As well as improving conditions in work environments at the community level, and not favoring social, personal and professional stigmatization due to care error.