Intraperitoneal drain placement and outcomes after elective colorectal surgery: international matched, prospective, cohort study

Despite current guidelines, intraperitoneal drain placement after elective colorectal surgery remains widespread. Drains were not associated with earlier detection of intraperitoneal collections, but were associated with prolonged hospital stay and increased risk of surgical-site infections.Background Many surgeons routinely place intraperitoneal drains after elective colorectal surgery. However, enhanced recovery after surgery guidelines recommend against their routine use owing to a lack of clear clinical benefit. This study aimed to describe international variation in intraperitoneal drain placement and the safety of this practice. Methods COMPASS (COMPlicAted intra-abdominal collectionS after colorectal Surgery) was a prospective, international, cohort study which enrolled consecutive adults undergoing elective colorectal surgery (February to March 2020). The primary outcome was the rate of intraperitoneal drain placement. Secondary outcomes included: rate and time to diagnosis of postoperative intraperitoneal collections; rate of surgical site infections (SSIs); time to discharge; and 30-day major postoperative complications (Clavien-Dindo grade at least III). After propensity score matching, multivariable logistic regression and Cox proportional hazards regression were used to estimate the independent association of the secondary outcomes with drain placement. Results Overall, 1805 patients from 22 countries were included (798 women, 44.2 per cent; median age 67.0 years). The drain insertion rate was 51.9 per cent (937 patients). After matching, drains were not associated with reduced rates (odds ratio (OR) 1.33, 95 per cent c.i. 0.79 to 2.23; P = 0.287) or earlier detection (hazard ratio (HR) 0.87, 0.33 to 2.31; P = 0.780) of collections. Although not associated with worse major postoperative complications (OR 1.09, 0.68 to 1.75; P = 0.709), drains were associated with delayed hospital discharge (HR 0.58, 0.52 to 0.66; P < 0.001) and an increased risk of SSIs (OR 2.47, 1.50 to 4.05; P < 0.001). Conclusion Intraperitoneal drain placement after elective colorectal surgery is not associated with earlier detection of postoperative collections, but prolongs hospital stay and increases SSI risk

Does corporate reputation matter? Role of social media in consumer intention to purchase innovative food product

The exponential growth of the corporate reputation in food industry has resulted in innovations in every link of its supply chain. There have been studies that have characterized innovation in various industries from the perspective of technology, but far fewer in the area of corporate reputation, consumer perception, and intention towards innovations in food products. This research analyses the innovations in the food industry from the perspective of the consumer and provides a conceptual framework of food innovation stages. The study also investigates the relationship between corporate reputation and intention towards food innovation along with the other components of TPB model with an extension of social media engagement. The results from India and US samples confirm that social media engagement have a significant role to play in creating intention to purchase innovative food products. The study compares the US and Indian samples and identifies differences in subjective norms and perceived behavioural control

Can patients with moderate to severe acute respiratory failure from COPD be treated safely with noninvasive mechanical ventilation on the ward?

Murat Yalcinsoy,1 Cuneyt Salturk,2 Selahattin Oztas,2 Sinem Gungor,2 Ipek Ozmen,2 Feyyaz Kabadayi,2 Aysem Askim Oztim,2 Emine Aksoy,2 Nalan Adıguzel,2 Ozlem Oruc,2 Zuhal Karakurt2 1Department of Pulmonary Medicine, Inonu University Medical Faculty, Turgut Ozal Medical Center, Malatya, 2Department of Pulmonary Medicine, Sureyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey Purpose: Noninvasive mechanical ventilation (NIMV) usage outside of intensive care unit is not recommended in patients with COPD for severe acute respiratory failure (ARF). We assessed the factors associated with failure of NIMV in patients with ARF and severe acidosis admitted to the emergency department and followed on respiratory ward.Patients and methods: This is a retrospective observational cohort study conducted in a tertiary teaching hospital specialized in chest diseases and thoracic surgery between June 1, 2013 and May 31, 2014. COPD patients who were admitted to our emergency department due to ARF were included. Patients were grouped according to the severity of acidosis into two groups: group 1 (pH=7.20–7.25) and group 2 (pH=7.26–7.30).Results: Group 1 included 59 patients (mean age: 70±10 years, 30.5% female) and group 2 included 171 patients (mean age: 67±11 years, 28.7% female). On multivariable analysis, partial arterial oxygen pressure to the inspired fractionated oxygen (PaO2/FiO2) ratio <200, delta pH value <0.30, and pH value <7.31 on control arterial blood gas after NIMV in the emergency room and peak C-reactive protein were found to be the risk factors for NIMV failure in COPD patients with ARF in the ward.Conclusion: NIMV is effective not only in mild respiratory failure but also with severe forms of COPD patients presenting with severe exacerbation. The determination of the failure criteria of NIMV and the expertise of the team is critical for treatment success. Keywords: noninvasive mechanical ventilation, COPD, acute respiratory failure, exacerbation, mortality&nbsp

Repensar los sistemas de servicios y las políticas públicas: un marco transformador de experiencias de servicios para refugiados

19 páginasThe global refugee crisis is a complex humanitarian problem. Service researchers can assist in solving this crisis because refugees are immersed in complex human service systems. Drawing on marketing, sociology, transformative service, and consumer research literature, this study develops a Transformative Refugee Service Experience Framework to enable researchers, service actors, and public policy makers to navigate the challenges faced throughout a refugee’s service journey. The primary dimensions of this framework encompass the spectrum from hostile to hospitable refugee service systems and the resulting suffering or wellbeing in refugees’ experiences. The authors conceptualize this at three refugee service journey phases (entry, transition, and exit) and at three refugee service system levels (macro, meso, and micro) of analysis. The framework is supported by brief examples from a range of service-related refugee contexts as well as a Web Appendix with additional cases. Moreover, the authors derive a comprehensive research agenda from the framework, with detailed research questions for public policy and (service) marketing researchers. Managerial directions are provided to increase awareness of refugee service problems; stimulate productive interactions; and improve collaboration among public and nonprofit organizations, private service providers, and refugees. Finally, this work provides a vision for creating hospitable refugee service systems.La crisis mundial de refugiados es un problema humanitario complejo. Los investigadores del servicio pueden ayudar a resolver esta crisis porque los refugiados están inmersos en sistemas complejos de servicios humanos. Basándose en el marketing, la sociología, el servicio transformador y el consumidor literatura de investigación, este estudio desarrolla un marco de experiencia de servicio transformativo para refugiados para permitir a los investigadores, el servicio actores y formuladores de políticas públicas para navegar los desafíos que se enfrentan a lo largo del viaje de servicio de un refugiado. Las dimensiones primarias de este marco abarcan el espectro de sistemas de servicios para refugiados hostiles a hospitalarios y el sufrimiento o bienestar resultante en las experiencias de los refugiados. Los autores conceptualizan esto en tres fases del viaje del servicio de refugiados (entrada, transición y salida) y en tres niveles de análisis del sistema de servicios para refugiados (macro, meso y micro). El marco está respaldado por breves ejemplos. de una variedad de contextos de refugiados relacionados con el servicio, así como un apéndice web con casos adicionales. Además, los autores derivan una agenda de investigación integral del marco, con preguntas de investigación detalladas para políticas públicas y marketing (de servicios) investigadores Se proporcionan instrucciones gerenciales para aumentar la conciencia de los problemas de servicio a los refugiados; estimular la productividad interacciones; y mejorar la colaboración entre organizaciones públicas y sin fines de lucro, proveedores de servicios privados y refugiados. Finalmente, este trabajo proporciona una visión para crear sistemas hospitalarios de servicios para refugiados