COVAD survey 2 long-term outcomes: unmet need and protocol

Vaccine hesitancy is considered a major barrier to achieving herd immunity against COVID-19. While multiple alternative and synergistic approaches including heterologous vaccination, booster doses, and antiviral drugs have been developed, equitable vaccine uptake remains the foremost strategy to manage pandemic. Although none of the currently approved vaccines are live-attenuated, several reports of disease flares, waning protection, and acute-onset syndromes have emerged as short-term adverse events after vaccination. Hence, scientific literature falls short when discussing potential long-term effects in vulnerable cohorts. The COVAD-2 survey follows on from the baseline COVAD-1 survey with the aim to collect patient-reported data on the long-term safety and tolerability of COVID-19 vaccines in immune modulation. The e-survey has been extensively pilot-tested and validated with translations into multiple languages. Anticipated results will help improve vaccination efforts and reduce the imminent risks of COVID-19 infection, especially in understudied vulnerable groups

International nosocomial infection control consortium (INICC) report, data summary of 36 countries, for 2004-2009

The results of a surveillance study conducted by the International Nosocomial Infection Control Consortium (INICC) from January 2004 through December 2009 in 422 intensive care units (ICUs) of 36 countries in Latin America, Asia, Africa, and Europe are reported. During the 6-year study period, using Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN; formerly the National Nosocomial Infection Surveillance system [NNIS]) definitions for device-associated health care-associated infections, we gathered prospective data from 313,008 patients hospitalized in the consortium's ICUs for an aggregate of 2,194,897 ICU bed-days. Despite the fact that the use of devices in the developing countries' ICUs was remarkably similar to that reported in US ICUs in the CDC's NHSN, rates of device-associated nosocomial infection were significantly higher in the ICUs of the INICC hospitals; the pooled rate of central line-associated bloodstream infection in the INICC ICUs of 6.8 per 1,000 central line-days was more than 3-fold higher than the 2.0 per 1,000 central line-days reported in comparable US ICUs. The overall rate of ventilator-associated pneumonia also was far higher (15.8 vs 3.3 per 1,000 ventilator-days), as was the rate of catheter-associated urinary tract infection (6.3 vs. 3.3 per 1,000 catheter-days). Notably, the frequencies of resistance of Pseudomonas aeruginosa isolates to imipenem (47.2% vs 23.0%), Klebsiella pneumoniae isolates to ceftazidime (76.3% vs 27.1%), Escherichia coli isolates to ceftazidime (66.7% vs 8.1%), Staphylococcus aureus isolates to methicillin (84.4% vs 56.8%), were also higher in the consortium's ICUs, and the crude unadjusted excess mortalities of device-related infections ranged from 7.3% (for catheter-associated urinary tract infection) to 15.2% (for ventilator-associated pneumonia). Copyright © 2012 by the Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Intensive parenting and the ethics of care: The discourses of low-income children and adults from Santiago, Chile

Las parentalidades desplegadas en los sectores más pobres han sido, históricamente, objeto de sospecha de parte del Estado y de la sociedad en general. Este artículo describe los resultados relativos al estrato socioeconómico bajo de una investigación orientada a comprender los discursos de niños y adultos acerca de la relación padres e hijos en Chile hoy. La investigación se basa en los Estudios Sociales de la Infancia, en los Estudios sobre Culturas Parentales, y el Análisis Crítico de Discursos, y fue desarrollada a través de entrevistas grupales abiertas y semiestructuradas. Los niños muestran a la parentalidad como una tarea sacrificial y solitaria, y dan cuenta de una búsqueda de formas de aliviar las vidas de sus padres; los padres, por su parte, enfatizan la temática de una presencia permanente, además de intentar contrarrestar los estereotipos que presentan a las parentalidades de sectores pobres como violentas o negligentes. En las conclusiones se destaca el carácter recíproco del cuidado entre padres e hijos, así como la intensificación de las demandas relacionadas con la parentalidades y la condición de ser hijos en contextos neoliberales, y se relacionan estos aspectos con las condiciones de existencia del estrato bajo.Parenting practiced by low-income families have historically been object of suspicion on behalf of State and of society in general. This article describes the results related to this social class of a research study which aimed to understand the discourses of children and adults about the parent-child relationship in Chile. The research is based on Childhood Studies, on Parenting Culture Studies, and Critical Discourse Analysis, developed through open and semi-structured group interviews. Children show parenting as a self-sacrificing and solitary task, and give account of the different ways they seek in order to ease their parent’s lives; parents, on the other hand, emphasize their constant presence as a relevant topic, besides trying to counteract the stereotypes that portray low strata parenting as violent or negligent. Conclusions highlight the reciprocal character of care between parents and children, as well as the intensification of the demands related to parenting and the status of children in neoliberal contexts, and relate these aspects to the conditions of existence of the low-income class

Trastornos metabólicos que complican el embarazo

El síndrome metabólico (SM) es un factor de riesgo para múltiples enfermedades cardiovasculares y metabólicas, e intervienen tantos factores genéticos, nutricionales y ambientales, influyendo sobre el tejido adiposo y sobre la inmunidad innata. Las embarazadas con SM tienen un mayor riesgo de morbimortalidad por enfermedades cardiovasculares y diabetes mellitus tipo 2. En el Ecuador en los últimos años. Los TM es una de las causas más frecuentes que obstaculizan el normal desenvolvimiento el embarazo La presente tesis se realizó en el Hospital Materno Infantil ―Matilde Hidalgo de Procel‖ durante el periodo de Mayo del 2015 a Febrero del 2016. El desarrollo del marco teórico se orientó en base a la investigación con conceptos claros y generales. La investigación fue de tipo prospectivo, descriptivo y analítico, el objetivo de este estudio es Determinar la influencia de la alimentación en los trastornos metabólicos que complican el embarazo en el hospital Matilde hidalgo de Procel en edades de 20 – 40 años,. En el presente estudio se pudo comprobar que el 35% de las gestantes tiene antecedentes familiares de diabetes, el 42% antecedentes familiares de hipertensión, un 15% con antecedentes familiares de obesidad, otras patologías en un 4% y finalmente el 12% no tiene antecedentes familiares que padezcan alguna enfermedad. En lo referente a la alimentación el 43% solo se alimenta 2 veces al día, alimentación rica en grasa el 36% y un 55% no conoce sobre la alimentación en el embarazo, antecedentes de diabetes un 14%, mientras que gestantes con problemas de hipertensión fueron un 38%, con cardiopatías el 7%, gestantes con otros tipos de antecedentes personales en un 8% y por último el 33% de las gestantes no refiriero