28 research outputs found

    A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

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    Meeting abstrac

    Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

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    Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

    Tópicos de marketing

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    Lograr un equilibrio entre acciones humanas, armonía con la naturaleza, y satisfacer las necesidades del mercado actual sin poner en riesgo aquellos recursos que pudieran precisar las futuras generaciones, es lo importante de impulsar la aplicación del marketing sostenible en las organizaciones. Esto se logra a través de la elaboración de un plan de marketing sostenible que permitirá promover un consumo responsable a través de información clara y oportuna sobre los beneficios personales y sociales que genera la adquisición de productos sostenibles; implantar el reciclado a través de la logística de reversa, procedimiento que origina poca o nula generación de desechos, proporcionar empleos seguros, apoyar al medio ambiente y con responsabilidad social, son algunos beneficios que aporta. El presente capítulo tiene como objetivo proporcionar los principales aspectos que abordan el marketing sostenible, mostrar la importancia de la realización de este marketing para las empresas, así como aportar los pasos para desarrollar un plan de marketing sostenible
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