'A picture is worth a thousand words’— A photovoice study exploring health professionals’ experiences during the COVID- 19 pandemic

Aim: To elicit the experiences and perspectives of health professionals working on the frontline in the COVID-19 pandemic. Background: Although some qualitative studies have been carried out in health professionals during COVID-19 pandemic, to our knowledge, no study has used the Photovoice method. Design: A qualitative descriptive study using Photovoice was carried out between March and June 2020. Methods: A total of 20 health professionals were recruited from public and private healthcare services. The participants were invited to share photographs about their experiences while working during COVID-19 pandemic. Following the Photovoice method, audio-recorded interviews were conducted. The data were analysed using the ‘SHOWED’ mnemonic, with five questions answered about each photograph. The EQUATOR checklist has been used. Results/Findings: Three themes emerged: (1) Personal attitudes of health professionals; (2) Support from the community; and (3) Management of institutional resources. Despite the fact that health professionals in this study were exposed to major risks while caring for patients with COVID-19’ they felt a strong sense of responsibility towards the community. In order to handle these stressful situations, they used coping mechanisms, good humour and leisure, but also received support from the population, who saw them as highly skilled health professionals. Conclusion: These findings highlight the essential role of health professionals in the COVID-19 pandemic and the tireless work they are carrying out to provided highly skilled care. Relevance to clinical practice: These findings could contribute to raise awareness on the needs of health professionals during the pandemic, allowing managers to plan strategies to ensure the safety, and well-being of these professionals, as well as adopting similar strategies in their practice to create a space for critical reflection through participatory approaches.Andalusian Research Ethics Committee (0873-N-16

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised

Perfil de morbilidad del adulto en situación de calle del Hogar de Cristo

Tesis (Licenciado en Enfermería)La Morbilidad actual en Chile, se obtiene principalmente de los egresos hospitalarios, esta información nos permite clasificar las patologías más predominantes en nuestra población. El objetivo de nuestro estudio se enfoca en conocer la morbilidad y características de hospitalización de los adultos en situación de calle pertenecientes a la "Sala de Enfermos en Tránsito" del Hogar de Cristo. Método: Se utilizó una muestra de 366 fichas correspondientes a pacientes atendidos durante un periodo de 12 meses que abarcaron desde octubre del 2004 hasta septiembre del año 2005. Resultados: La clasificación por sistemas señala que las enfermedades pertenecientes al sistema respiratorio y de Piel son las más frecuentes con un 18%. Dentro de los grupos de edad destaca como el que más frecuenta la Sala de Enfermos en Tránsito el rango comprendido entre 30-49 años con un 52%. Entre las enfermedades Crónicas destaca como primera mayoría la situación de alcoholismo con un 67%. De acuerdo a las características de hospitalización la forma de ingreso mas empleada corresponde al programa de acogida con un 51%, mientras que al referirnos a la forma de egreso el primer lugar concierne al alta médica con un 48%. Comentarios: esta investigación, nos permite conocer el perfil de morbilidad de la población que proviene de la calle, aportando antecedentes desconocidos para el profesional que trabaja en otros establecimientos de salud

Estudio de caso sobre la significación que asignan docentes pertenecientes al segundo ciclo del programa "Habilidades para la Vida" de una escuela municipal sobre las estrategias para la mejora de la convivencia escolar y clima de aula

Tesis (Trabajo Social)La presente investigación pretende dar a conocer la significación que asignan los Docentes a la estrategias para la mejora de la Convivencia Escolar y Clima de Aula, en una Escuela Municipal con altos índices de vulnerabilidad, participante del Programa Habilidades Para La Vida en la Comuna de Quilpué. Uno de los principales propósitos del Programa es la mejora de la convivencia escolar y el clima de aula, los que en diversos contextos de aplicación y según los resultados del Sistema de Medición de la Calidad de la Enseñanza (SIMCE), han demostrado una incidencia positiva en la mejora del rendimiento académico. Como se mencionó anteriormente, éste estudio releva las formas de significación de los Docentes, en cuanto a la definición de las estrategias que el Programa "Habilidades Para La Vida" entrega, la evaluación que éstos realizan y la incidencia que éste tiene en los Estudiantes

A Coffee Berry Borer (Coleoptera: Curculionidae: Scolytinae) Bibliography

Native to Africa, the coffee berry borer, Hypothenemus hampei (Ferrari) (Coleoptera: Curculionidae: Scolytinae), has gradually invaded most coffee-growing areas worldwide. Adult females colonize the coffee berry and oviposit within galleries in the coffee seeds. Larvae and adults consume the seeds, resulting in drastic reductions in yields and quality, negatively affecting the income of approximately 20 million coffee-growing families (~100 million people) in ~80 countries, with losses surpassing more than $500 million annually (Vega et al. 2015). It has become evident that the coffee berry borer scientific community could greatly benefit from having access to a bibliography of the literature related to the insect. Such an information source would allow scientists to find out what research areas have been explored throughout the many coffee berry borer-infested countries after more than 100 years of research on the topic. It could also help to direct lead future research efforts into novel areas, and away from topics and ideas that have been thoroughly investigated in the past

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

Background: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit