Workplace Situation and Well-Being of Ecuadorian Self-Employed

Due to novel coronavirus 2019 (COVID-19), the labor market is going to undergo a profound restructuring. The creation of a new labor paradigm by all stakeholders is essential. This document contributes to the current political and social debates about self-employment, the need for economic growth, and how these labor measures, which are deeply institutionalized, need a change of attitude for an adequate job reconstruction in terms of welfare and sustainability. Currently, policy makers are proposing actions and policies because the new labor paradigm is being designed in the countries of Latin America. This research aims to analyze the JDCS model (Job Demand-Control-Support) and well-being in the self-employed in Ecuador. Unlike previous studies, this research takes a comprehensive approach by considering this theoretical model and the figure of the self-employed in terms of well-being. The logistic model, using cases of more than one thousand workers, generated estimated results that indicate the existence of a significant effect of physical and psychological demands at work on the balance between well-being and the management of angry clients; the speed of execution; and the complexity of the tasks. Regarding labor control, the ability to solve problems and make decisions for the company are detected as influencing factors; finally, social support is another factor influencing global well-being for the self-employed. These results show that with an effective management of the self-employed labor environment, it is possible to achieve an adequate level of workplace satisfaction

The reality of tourism in Manabí and the Circular economy (Ecuador) as a potential for tourism sustainability

Después del terremoto 2016 las provincias costeras de Manabí y Esmeraldas fueron azotadas por un fenómeno telúrico que afectó en gran proporción al sector turístico, lo que se ha ido acentuando hasta la actualidad por la presencia pandémica que ha puesto en serios riesgos la economía de este sector. El presente estudio analiza la operatividad de la Agenda de Reactivación (AR) propuesta por el Gobierno ecuatoriano a raíz del terremoto 2016, enfocando la economía circular como propuesta de sostenibilidad en los servicios complementarios del turismo, particularmente en hoteles y restaurantes. La metodología utilizada es el análisis comparativo de las metas propuestas en la AR y los logros alcanzados al 2019, además de la interpretación de la intervención de la economía circular como modelo de gestión en el marco de las investigaciones del Observatorio Ciudadano de Manabí y el uso de la economía circular como potencial de gestión para la reutilización de desechos sólidos en Portoviejo-Manabí. Como principales hallazgos se advierte que los alcances logrados en el sector turismo no se ajustan a lo planificado en la AR y que la ejecución de los proyectos no ha sido satisfactoria de acuerdo con las metas propuestas, además de la ausencia de articulación interinstitucional en la gestión de los mismos. Por otro lado, en la ciudad de Portoviejo se producen diariamente entre 50 y 100 kg de residuos sólidos en hoteles y restaurantes, de manera que la economía circular debería de considerarse como un mecanismo de sostenibilidad ambiental mediante la reutilización de los mismos, entre otras acciones.After the 2016 earthquake, the coastal provinces of Manabí and Esmeraldas were hit by a telluric phenomenon that greatly affected the tourism sector, currently accentuated by the pandemic presence that has put the economy of this sector at serious risk. This study analyzes the operation of the Reactivation Agenda (AR) proposed by the Ecuadorian Government as a result of the 2016 earthquake, focusing on the circular economy as a proposal for sustainability in complementary tourism services: hotels and restaurants. The methodology used is the comparative analysis of the goals proposed in the RA and the achievements obtained by 2019, in addition to interpreting the intervention of the circular economy as a management model within the framework of investigations of the Manabí Citizen Observatory and the use of the circular economy as a management potential for the reuse of solid waste in Portoviejo-Manabí. The main findings are that the achievements in the tourism sector do not conform to what was planned in the RA and that the execution of the projects has not been satisfactory to the proposed goals, in addition to the absence of inter-institutional coordination in the management thereof. On the other hand, in the city of Portoviejo (hotels and restaurants) between 50 and 100 kg of solid waste are produced daily, which could be considered within the circular economy, as a mechanism of environmental sustainability, the reuse of them

Quantifying the patient´s perspective in neuromyelitis optica spectrum disorder: Psychometric properties of the SymptoMScreen questionnaire

Background: The assessment of self-reported outcomes in neuromyelitis optica spectrum disorder (NMOSD) is limited by the lack of validated disease-specific measures. The SymptoMScreen (SyMS) is a patient-reported questionnaire for measuring symptom severity in different domains affected by multiple sclerosis (MS), but has not been thoroughly evaluated in NMOSD. The aim of this study was to assess the psychometric properties of the SyMS in a sample of patients with NMOSD. Methods: A non-interventional, cross-sectional study in adult subjects with NMOSD (Wingerchuk 2015 criteria) was conducted at 13 neuroimmunology clinics applying the SyMS. A non-parametric item response theory procedure, Mokken analysis, was performed to assess the underlying dimensional structure and scalability of items and overall questionnaire. All analyses were performed with R (v4.0.3) using the mokken library. Results: A total of 70 patients were studied (mean age: 47.5 ± 15 years, 80% female, mean Expanded Disability Status Scale score: 3.0 [interquartile range 1.5, 4.5]). Symptom severity was low (median SyMS score: 19.0 [interquartile range 10.0, 32.0]). The SyMS showed a robust internal reliability (Cronbach's alpha: 0.90 [95% confidence interval 0.86, 0.93]) and behaved as a unidimensional scale with all items showing scalability coefficients > 0.30. The overall SyMS scalability was 0.45 conforming to a medium scale according to Mokken's criteria. Fatigue and body pain were the domains with the highest scalability coefficients. The SyMS was associated with disability (rho: 0.586), and physical and psychological quality of life (rho: 0.856 and 0.696, respectively). Conclusions: The SyMS shows appropriate psychometric characteristics and may constitute a valuable and easy-to-implement option to measure symptom severity in patients with NMOSD

Perception of Stigma in Patients with Neuromyelitis Optica Spectrum Disorder

Background: Perception of stigma was associated with low self-esteem, psychological problems, and decreased health-seeking behavior among patients with different neurological disorders. The purpose of this study was to assess stigmatization and its impact in patients with neuromyelitis optica spectrum disorder (NMOSD). Methods: A non-interventional study was conducted at thirteen neuroimmunology clinics in Spain. Patients with a diagnosis of NMOSD (2015 Wingerchuk criteria) were included. The 8-item Stigma Scale for Chronic Illness (SSCI-8), the Expanded Disability Status Scale (EDSS), the 29-item Multiple Sclerosis Impact Scale (MSIS-29), the Beck Depression Inventory-Fast Screen (BDI-FS), the MOS Pain Effects Scale (MOS-PES) and the Fatigue Impact Scale for Daily Use (D-FIS) were used to assess the perception of stigma, disability, quality of life, mood, pain, and fatigue, respectively. Associations between outcome measures were analyzed using Spearman's rank correlation. Results: Seventy-one patients were studied (mean age: 47.4 years ± 14.9, 81.7% female, mean time since disease onset: 9.9 years ± 8.1). The median EDSS score was 3.0 (interquartile range 1.5, 4.5). Stigma prevalence was 61.4% (n=43). Thirty-one patients (43.6%) had depression. The SSCI-8 score showed a significant correlation with both physical (rho=0.576, p<0.0001) and psychological (rho=0.608, p<0.0001) MSIS-29 scales scores, EDSS score (rho=0.349, p=0.0033), BDI-FS score (rho= 0.613, p<0.0001), MOS-PES score (rho= 0.457, p<0.0001), and D-FIS score (rho=0.556, p<0.0001). Conclusion: Stigma is a common phenomenon affecting over 6 out of 10 patients with NMOSD. Understanding stigma may be useful to develop educational strategies improving NMOSD knowledge

Cognitive Performance and Health-Related Quality of Life in Patients with Neuromyelitis Optica Spectrum Disorder

Background: The frequency of cognitive impairment (CI) reported in neuromyelitis optica spectrum disorder (NMOSD) is highly variable, and its relationship with demographic and clinical characteristics is poorly understood. We aimed to describe the cognitive profile of NMOSD patients, and to analyse the cognitive differences according to their serostatus; furthermore, we aimed to assess the relationship between cognition, demographic and clinical characteristics, and other aspects linked to health-related quality of life (HRQoL). Methods: This cross-sectional study included 41 patients (median age, 44 years; 85% women) from 13 Spanish centres. Demographic and clinical characteristics were collected along with a cognitive z-score (Rao's Battery) and HRQoL patient-centred measures, and their relationship was explored using linear regression. We used the Akaike information criterion to model which characteristics were associated with cognition. Results: Fourteen patients (34%) had CI, and the most affected cognitive domain was visual memory. Cognition was similar in AQP4-IgG-positive and -negative patients. Gender, mood, fatigue, satisfaction with life, and perception of stigma were associated with cognitive performance (adjusted R-2 = 0.396, p < 0.001). Conclusions: The results highlight the presence of CI and its impact on HRQoL in NMOSD patients. Cognitive and psychological assessments may be crucial to achieve a holistic approach in patient care

Kappa free light chains index in multiple sclerosis very long-term prognosis

IntroductionThe role of the kappa-free light chain (kFLC) in the diagnosis of multiple sclerosis (MS) and, to a lesser extent, its role as a medium-term prognostic marker have been extensively studied. This study aimed to explore its potential as a long-term prognostic marker for MS.MethodsWe performed an exploratory retrospective observational study by selecting patients systemically followed up in our MS unit with available cerebrospinal fluid and serum samples at the time of initial evaluation. Two groups were defined: benign MS (bMS), defined as patients with Expanded Disability Status Scale (EDSS) ≤ 3 at 10 years of follow-up, and aggressive MS (aMS), defined as patients with EDSS ≥ 6 at 15 years of follow-up. Clinical variables were collected, and the immunoglobulin G (IgG) index, kFLC index, and oligoclonal bands (OCB) were determined for all patients and compared between the groups.ResultsTwenty bMS and 15 aMS patients were included in this study. Sixty percent (21/35) were female, and the mean age at the time of the first symptom was 31.5 ± 9.45 years, with no statistical differences between groups. Median follow-up time was 19.8 years (Interquartile range, IQR 15.9–24.6). The median EDSS scores at the last follow-up were 1.5 and 7.5 in the bMS and the aMS group, respectively. No statistically significant differences were found in the kFLC index between the two groups (136.6 vs. 140.27, p=0.59). The IgG index was positive in 62.9% of patients (55% bMS vs. 73.3% aMS, p&gt;0.05), and OCB was positive in 88.6% (90% bMS vs. 86.7% aMS, p&gt;0.05). A significant positive correlation was found between IgG and kFLC indices (rs = 0.85, p&lt;0.001).ConclusionGiven the absence of differences between the two groups with opposite disease courses, it is unlikely that the kFLC index is a reliable and powerful marker of long-term prognosis in MS

Programa de participación ciudadana para el relevamiento de impactos por eventos meteorológicos extremos en Córdoba, Argentina

Córdoba, Argentina es una región del planeta, especificada por tormentas severas con gran desarrollo vertical, vientos intensos, descargas eléctricas, granizo de gran tamaño y abundante, y lluvias torrenciales, ocasionando en algunos casos, inundaciones rápidas y repentinas. La caracterización de los impactos por granizo resulta dificultosa sin datos en terreno. El enfoque de la participación ciudadana en el relevamiento de información espacial de eventos extremos, mediante aplicaciones móviles y redes sociales, ha mostrado ser de utilidad para su caracterización y monitoreo. En este sentido, desde 2018, se ha desarrollado el programa COSECHEROS, inicialmente de granizos Córdoba que hoy es de Eventos Meteorológicos Extremos, que tiene la finalidad de relevar estos fenómenos extremos en un trabajo colaborativo entre los ciudadanos voluntarios y los investigadores. Para la implementación del programa en zonas rurales, el programa se articula con iniciativas en territorio, destinadas a integrar esfuerzos entre organismos de ciencia y técnica, técnicos agropecuarios, productores y tomadores de decisiones locales, en Mesas Agro-climáticas y Ambientales (MACA). En este marco, se realizaron diferentes actividades de formación tales como talleres y conferencias, con participación interinstitucional, multi e interdisciplinar (biólogo, arquitecto, médico, nutricionistas, estudiantes, asociación de productoras/es y gobiernos locales). En el presente trabajo se describirán las actividades realizadas con el fin de divulgar el programa y los resultados de su implementación en la MACA de Río Segundo y Pilar, en el caso de dos eventos meteorológicos extremos de granizo; uno de ellos, en el que el relevamiento de campo se realizó en forma absolutamente manual y tradicional y sólo se registraron los datos meteorológicos y de sensores remotos desde el programa y su aplicación y un segundo evento ( un año después- abril de 2022) en el que los datos fueron registrados en la APP y cotejados con el trabajo de campo.EEA ManfrediFil: Arena, Lucía. Observatorio Hidrometeorológico de Córdoba; ArgentinaFil: Pons, Diego Hernan. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Manfredi; ArgentinaFil: Pons, Diego Hernan. Universidad Nacional de Córdoba. Instituto de Altos Estudios Espaciales “Mario Gulich”; ArgentinaFil: Pons, Diego Hernan. Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET). Instituto de Altos Estudios Espaciales “Mario Gulich”; ArgentinaFil: Giobellina, Beatriz Liliana. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Manfredi. Observatorio de Agricultura Urbana y Periurbana y Agroecología (O-AUPA); ArgentinaFil: Osiecki Tomás. Observatorio Hidrometeorológico de Córdoba; ArgentinaFil: Silva, Alejandro Ismael. Observatorio Hidrometeorológico de Córdoba; ArgentinaFil: Lighezzolo, Andres. Universidad Nacional de Córdoba. Unidad de desarrollos y Soluciones Ambientales - Comisión Nacional de Actividades Espaciales. Observatorio Hidrometeorológico de la Provincia de Córdoba. Laboratorio de Hidraúlica; ArgentinaFil: Narmona, Luis Rogelio. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Manfredi. Observatorio de Agricultura Urbana y Periurbana y Agroecología (O-AUPA); ArgentinaFil: Narmona, Luis Rogelio. Consejo Nacional de Investigaciones Científicas y Técnicas. Observatorio de Agricultura Urbana y Periurbana y Agroecología (O-AUPA); ArgentinaFil: Arrascaeta, Ana Mercedes. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Manfredi; ArgentinaFil: Garello, Adriana Del Lourdes. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Manfredi. Agencia de Extensión Rural Oncativo; ArgentinaFil: Eandi, Mariana. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Grupo de Epidemiología Ambiental del Cáncer en Córdoba; ArgentinaFil: Dezzotti, Luciana. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Grupo de Epidemiología Ambiental del Cáncer en Córdoba; ArgentinaFil: Butinof, Mariana. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Grupo de Epidemiología Ambiental del Cáncer en Córdoba; ArgentinaFil: Bustos, Daniela. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Grupo de Epidemiología Ambiental del Cáncer en Córdoba; ArgentinaFil: Romero Asis, Melisa. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Grupo de Epidemiología Ambiental del Cáncer en Córdoba; ArgentinaFil: Aparicio, Lourdes. Universidad Nacional de Córdoba. Facultad de Ciencias Médicas. Grupo de Epidemiología Ambiental del Cáncer en Córdoba; ArgentinaFil: Viale, María Virginia. Instituto Nacional de Tecnología Agropecuaria (INTA). Instituto de Fisiología y Recursos Genéticos Vegetales; ArgentinaFil: Quinteros, Mario Gustavo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Manfredi. Agencia de Extensión Rural Córdoba; ArgentinaFil: Occhionero, Federico. Universidad Nacional de Córdoba. Facultad de Matemática, Astronomía, Física y Computación; ArgentinaFil: Cortés, Luciano. Gobierno de Córdoba. Ministerio de Agricultura y Ganadería; ArgentinaFil: Bisio, Cali. Gobierno de Córdoba. Ministerio de Agricultura y Ganadería; Argentin

Land- and water-based exercise intervention in women with fibromyalgia: the al-andalus physical activity randomised controlled trial

Background The al-Andalus physical activity intervention study is a randomised control trial to investigate the effectiveness of a land- and water-based exercise intervention for reducing the overall impact of fibromyalgia (primary outcome), and for improving tenderness and pain-related measures, body composition, functional capacity, physical activity and sedentary behaviour, fatigue, sleep quality, health-related quality of life, and cognitive function (secondary outcomes) in women with fibromyalgia. Methods/Design One hundred eighty women with fibromyalgia (age range: 35-65 years) will be recruited from local associations of fibromyalgia patients in Andalucía (Southern Spain). Patients will be randomly assigned to a usual care (control) group (n = 60), a water-based exercise intervention group (n = 60) or a land-based exercise intervention group (n = 60). Participants in the usual care group will receive general physical activity guidelines and participants allocated in the intervention groups will attend three non-consecutive training sessions (60 min each) per week during 24 weeks. Both exercise interventions will consist of aerobic, muscular strength and flexibility exercises. We will also study the effect of a detraining period (i.e., 12 weeks with no exercise intervention) on the studied variables. Discussion Our study attempts to reduce the impact of fibromyalgia and improve patients' health status by implementing two types of exercise interventions. Results from this study will help to assess the efficacy of exercise interventions for the treatment of fibromyalgia. If the interventions would be effective, this study will provide low-cost and feasible alternatives for health professionals in the management of fibromyalgia. Results from the al-Andalus physical activity intervention will help to better understand the potential of regular physical activity for improving the well-being of women with fibromyalgia.This study was supported by the Consejeria de Turismo, Comercio y Deporte (CTCD-201000019242-TRA), the Spanish Ministry of Science and Innovation (I + D + I DEP2010-15639, grants: BES-2009-013442, BES-2011-047133, RYC-2010-05957, RYC-2011-09011), the Swedish Heart-Lung Foundation (20090635), the Spanish Ministry of Education (AP-2009-3173), Granada Research of Excelence Initiative on Biohealth (GREIB), Campus BioTic, University of Granada, Spain and European University of Madrid. Escuela de Estudios Universitarios Real Madrid. 2010/04RM

Predictive Power of the "Trigger Tool" for the detection of adverse events in general surgery: a multicenter observational validation study

Background In spite of the global implementation of standardized surgical safety checklists and evidence-based practices, general surgery remains associated with a high residual risk of preventable perioperative complications and adverse events. This study was designed to validate the hypothesis that a new “Trigger Tool” represents a sensitive predictor of adverse events in general surgery. Methods An observational multicenter validation study was performed among 31 hospitals in Spain. The previously described “Trigger Tool” based on 40 specific triggers was applied to validate the predictive power of predicting adverse events in the perioperative care of surgical patients. A prediction model was used by means of a binary logistic regression analysis. Results The prevalence of adverse events among a total of 1,132 surgical cases included in this study was 31.53%. The “Trigger Tool” had a sensitivity and specificity of 86.27% and 79.55% respectively for predicting these adverse events. A total of 12 selected triggers of overall 40 triggers were identified for optimizing the predictive power of the “Trigger Tool”. Conclusions The “Trigger Tool” has a high predictive capacity for predicting adverse events in surgical procedures. We recommend a revision of the original 40 triggers to 12 selected triggers to optimize the predictive power of this tool, which will have to be validated in future studies