QUALIDADE DOS ESTABELECIMENTOS DE A&B NO CENTRO HISTÓRICO DE SALVADOR: UMA ANÁLISE A PARTIR DA PERCEPÇÃO DE SEUS PREPOSTOS E CLIENTES

The Historic Center is one of the most visited areas of Salvador and concentrates a large offer of Food and Beverage establishments (A&B) that, due to their location, serve a significant portion of the tourists who arrive in the City. Understanding that the quality of services provided by these establishments affects the assessment that tourists make about a given destination, this article seeks to investigate the level of quality of services provided by the Food and Beverage establishments in the Historic Center of Salvador (CHS). Among the research procedures used, in addition to the literature review by founding authors of the topic addressed and guides and publications specific to the area, a survey was conducted, with the application of questionnaires to the representatives of the establishments and their clients besides a direct observation. Regarding the results, it was concluded that the perception of the two audiences surveyed differs significantly in all aspects, with human and sensory factors being the ones with the lowest degree of compliance, deserving greater attention on the part of management.El Centro Histórico es una de las áreas más visitadas en Salvador y concentra una gran oferta de establecimientos de Alimentos y Bebidas (A&B) que, debido a su ubicación, sirven a una porción significativa de los turistas que llegan a la ciudad. Entendiendo que la calidad de los servicios prestados por estos establecimientos afecta la evaluación que los turistas hacen sobre un destino determinado, este artículo busca investigar el nivel de calidad de los servicios prestados por los establecimientos de Alimentos y Bebidas en el Centro Histórico de Salvador (CHS). Entre los procedimientos de investigación utilizados, además de la revisión de la literatura realizada por los autores fundadores del tema abordado y las guías y publicaciones específicas del área, se realizó una encuesta, con la aplicación de cuestionarios a los representantes de los establecimientos y sus clientes habituales y observación directa. Con respecto a los resultados, se concluyó que la percepción de las dos audiencias encuestadas difiere significativamente en todos los aspectos, siendo los factores humanos y sensoriales los que tienen el menor grado de cumplimiento, mereciendo una mayor atención por parte de la gerencia.O Centro Histórico é uma das áreas mais visitadas de Salvador e concentra uma grande oferta de estabelecimentos de Alimentos e Bebidas (A&B) que, por sua localização, atendem a uma parcela significativa dos turistas que chegam a Cidade. Por entender que a qualidade dos serviços prestados por esses estabelecimentos afeta a avaliação que os turistas realizam sobre um determinado destino, este artigo busca investigar o nível de qualidade dos serviços prestados pelos estabelecimentos de Alimentos e Bebidas do Centro de Histórico de Salvador (CHS). Dentre os procedimentos de pesquisa utilizados, além da revisão de literatura de autores fundantes da temática abordada e de guias e publicações específicas da área, recorreu-se à pesquisa de levantamento, com aplicação de questionários junto aos prepostos dos estabelecimentos e seus frequentadores e à observação direta. Referente aos resultados concluiu-se que a percepção dos dois públicos pesquisados diverge significativamente em todos os aspectos, tendo sido os fatores Humanos e Sensoriais os que apresentaram menor grau de conformidade, merecendo maior atenção por parte da gestão.DOI: 10.21714/2178-8030gep.v.21.665

Predictors for prolonged hospital stay solely to complete intravenous antifungal treatment in patients with candidemia: Results from the ECMM candida III multinational European observational cohort study

Background To date, azoles represent the only viable option for oral treatment of invasive Candida infections, while rates of azole resistance among non-albicans Candida spp. continue to increase. The objective of this sub-analysis of the European multicenter observational cohort study Candida III was to describe demographical and clinical characteristics of the cohort requiring prolonged hospitalization solely to complete intravenous (iv) antifungal treatment (AF Tx). Methods Each participating hospital (number of eligible hospitals per country determined by population size) included the first ~ 10 blood culture proven adult candidemia cases occurring consecutively after July 1st, 2018, and treating physicians answered the question on whether hospital stay was prolonged only for completion of intravenous antifungal therapy. Descriptive analyses as well as binary logistic regression was used to assess for predictors of prolonged hospitalization solely to complete iv AF Tx. Findings Hospital stay was prolonged solely for the completion of iv AF Tx in 16% (100/621) of candidemia cases by a median of 16 days (IQR 8 – 28). In the multivariable model, initial echinocandin treatment was a positive predictor for prolonged hospitalization to complete iv AF Tx (aOR 2.87, 95% CI 1.55 – 5.32, p < 0.001), while (i) neutropenia, (ii) intensive care unit admission, (iii) catheter related candidemia, (iv) total parenteral nutrition, and (v) C. parapsilosis as causative pathogen were found to be negative predictors (aOR 0.22 – 0.45; p < 0.03). Interpretation Hospital stays were prolonged due to need of iv AF Tx in 16% of patients with candidemia. Those patients were more likely to receive echinocandins as initial treatment and were less severely ill and less likely infected with C. parapsilosis

Guideline adherence and survival of patients with candidaemia in Europe : results from the ECMM Candida III multinational European observational cohort study

International audienceBackground: The European Confederation of Medical Mycology (ECMM) collected data on epidemiology, risk factors, treatment, and outcomes of patients with culture-proven candidaemia across Europe to assess how adherence to guideline recommendations is associated with outcomes.Methods: In this observational cohort study, 64 participating hospitals located in 20 European countries, with the number of eligible hospitals per country determined by population size, included the first ten consecutive adults with culture-proven candidaemia after July 1, 2018, and entered data into the ECMM Candida Registry (FungiScope CandiReg). We assessed ECMM Quality of Clinical Candidaemia Management (EQUAL Candida) scores reflecting adherence to recommendations of the European Society of Clinical Microbiology and Infectious Diseases and the Infectious Diseases Society of America guidelines.Findings: 632 patients with candidaemia were included from 64 institutions. Overall 90-day mortality was 43% (265/617), and increasing age, intensive care unit admission, point increases in the Charlson comorbidity index score, and Candida tropicalis as causative pathogen were independent baseline predictors of mortality in Cox regression analysis. EQUAL Candida score remained an independent predictor of mortality in the multivariable Cox regression analyses after adjusting for the baseline predictors, even after restricting the analysis to patients who survived for more than 7 days after diagnosis (adjusted hazard ratio 1·08 [95% CI 1·04-1·11; p<0·0001] in patients with a central venous catheter and 1·09 [1·05-1·13; p<0·0001] in those without one, per one score point decrease). Median duration of hospital stay was 15 days (IQR 4-30) after diagnosis of candidaemia and was extended specifically for completion of parenteral therapy in 100 (16%) of 621 patients. Initial echinocandin treatment was associated with lower overall mortality and longer duration of hospital stay among survivors than treatment with other antifungals.Interpretation: Although overall mortality in patients with candidaemia was high, our study indicates that adherence to clinical guideline recommendations, reflected by higher EQUAL Candida scores, might increase survival. New antifungals, with similar activity as current echinocandins but with longer half-lives or oral bioavailability, are needed to reduce duration of hospital stay