a cross-sectional study

Publisher Copyright: Copyright © 2023 Gonzalez Delgado, Cortes Gil, Rodriguez Araujo, Mira Solves, Rodriguez Gallo, Salcedo Monsalve, Arrieta Arteta, Villalba Toquica and Morales Ruiz.Objectives: Analyze the presence of acute stress response after adverse events in human talent in Colombian health institutions from 2017 to 2021. Methods: Cross-sectional study of prevalence, carried out on 838 members of the human talent in health (professionals, technicians, technologists, and auxiliaries) of Colombian health institutions in the study period with the application of the EASE instrument. Univariate analysis using descriptive statistical techniques, chi-square and Student’s t-test, and bivariate analysis with a Poisson regression model using the institucional SPSS v. 26. Results: The prevalence of adverse events in the last 5 years was 33.8%, presenting levels of acute stress qualifying as Medium-high emotional overload at 21.91%, while extreme acute stress was at 3.53%. The prevalence of risk for presenting acute stress after being involved in an adverse event was PR: 1.30 (CI: 1.24–1.36). Conclusion: Acute stress in human talent after adverse events is limiting health and care capacity and must be efficiently addressed by health institutions. Psychosocial risk is linked within the framework of the patient safety program and the institutional occupational health and safety management systems.publishersversionpublishe

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Transversalización de la Salud ambiental hospitalaria en el currículo de programas de Ciencias de la Salud a través de las TICS en el año 2018

La salud ambiental es un área priorizada de la salud pública debido a los impactos que tiene el ambiente en la carga de enfermedad y mortalidad en la población mundial. Por tanto, todas las profesiones y en especial las del sector salud requieren de su inclusión en el currículo formativo. En consecuencia, la presente experiencia busco transversalizar la salud ambiental hospitalaria en los programas de Ciencias de la Salud dentro del componente de proyección social a través del uso de las TICS en el año 2018. La estrategia partió de la realización de grupos focales con los miembros del Consejo Académico de la Facultad, donde se establecieron los componentes abordados en el currículo, estos fueron: contexto normativo y abordaje de los aspectos ambientales en una institución de salud desde la Red Global de Hospitales Verdes y Saludables; gestión estratégica ambiental y producción limpia; infraestructuras sostenibles, estilos de vida sustentable y finalmente responsabilidad social corporativa; posteriormente se diseñó el curso virtual en Moodle en el que participaron 85 estudiantes de 2 programas. La estrategia permitió el abordaje de los objetivos de desarrollo sostenible, la formación de líderes en temas de la realidad social y ambiental, convirtiéndose en una impronta y un diferenciador de los futuros profesionales de la salud

Transversalización de la Salud ambiental hospitalaria en el currículo de programas de Ciencias de la Salud a través de las TICS en el año 2018

La salud ambiental es un área priorizada de la salud pública debido a los impactos que tiene el ambiente en la carga de enfermedad y mortalidad en la población mundial. Por tanto, todas las profesiones y en especial las del sector salud requieren de su inclusión en el currículo formativo. En consecuencia, la presente experiencia busco transversalizar la salud ambiental hospitalaria en los programas de Ciencias de la Salud dentro del componente de proyección social a través del uso de las TICS en el año 2018. La estrategia partió de la realización de grupos focales con los miembros del Consejo Académico de la Facultad, donde se establecieron los componentes abordados en el currículo, estos fueron: contexto normativo y abordaje de los aspectos ambientales en una institución de salud desde la Red Global de Hospitales Verdes y Saludables; gestión estratégica ambiental y producción limpia; infraestructuras sostenibles, estilos de vida sustentable y finalmente responsabilidad social corporativa; posteriormente se diseñó el curso virtual en Moodle en el que participaron 85 estudiantes de 2 programas. La estrategia permitió el abordaje de los objetivos de desarrollo sostenible, la formación de líderes en temas de la realidad social y ambiental, convirtiéndose en una impronta y un diferenciador de los futuros profesionales de la salud

Definitions of the categories of Unsafe act and Physical risk.

<p>*For the logistic regression, “unsafe act” was considered as a dichotomous variable (Yes versus No), since the kind of unsafe act depends mainly on the specific occupation, and is highly variable in our sample.</p><p>Definitions of the categories of Unsafe act and Physical risk.</p

Rate of work-related illnesses and injuries per 100 employees, in the IMSS, 2006 to 2012.

<p>Rate of work-related illnesses and injuries per 100 employees, in the IMSS, 2006 to 2012.</p

Characteristics related to sociodemographics and the company, according to the type of consequence—non-fatal occupational injury (with temporary disability and without sequels, or without disability) and fatal occupational injury (death)—among workers affiliated with the IMSS in Mexico in 2012.

<p>+: Proportion(%) or median (Interquartile Range);</p><p>++: p-values adjusted by Bonferroni associated with chi-squared; Cramér's phi or Mann-Whitney U tests;</p><p>*p<0.001.</p><p>Characteristics related to sociodemographics and the company, according to the type of consequence—non-fatal occupational injury (with temporary disability and without sequels, or without disability) and fatal occupational injury (death)—among workers affiliated with the IMSS in Mexico in 2012.</p

Relation between the logit of fatality versus continuous age.

<p>Relation between the logit of fatality versus continuous age.</p

Logistic regression model for fatal occupational injuries (deaths) versus non-fatal occupational injuries (with temporary disability and without sequels, or without disability) among workers in the IMSS in 2012.

<p>OR = Odds ratio;</p><p>CI 95% = 95% Confidence Interval.</p><p>*p<0.01;</p><p>**p<0.05;</p><p>n.s: not significant.</p><p>Logistic regression model for fatal occupational injuries (deaths) versus non-fatal occupational injuries (with temporary disability and without sequels, or without disability) among workers in the IMSS in 2012.</p