La comunicación de valores en la publicidad durante la primera oleada de covid-19 en España

También han formado parte activa del equipo de investigación que presenta este artículo: Norminanda Montoya, Luis E. Romero, Diana Miranda, Marillia Oliveira, Silvia A. Cris-tian Ladaga, Lissa Ferreira y Gerson MartinsEn este artículo se miden los valores comunicados en la oleada publicitaria que se distribuyó durante la primera etapa crítica de la pandemia de covid-19 en España. La investigación se apoya en la recopilación en línea de 45.000 respuestas a 1.880 test por parte de 470 receptores españoles e iberoamericanos. Cada uno de ellos evaluó 25 valores, tras exponerse a una muestra de cinco anuncios emitidos por televisión abierta durante el periodo estudiado. La metodología parte de cuatro objetivos de investigación y se apoya en un nuevo instrumento de medición científica: ProtocoloEva®. Las conclusiones revelan una estrategia comunicativa muy similar por parte de las cuatro fuentes estudiadas. Los valores cooperación, bienestar, esfuerzo, familia, salud, respeto y responsabilidad fueron transmitidos de manera intensa y son fuertemente homogéneos en todos los anuncios estudiados; en cambio, los valores derechos, justicia-equidad, dignidad y libertad fueron comunicados con una intensidad mucho más baja y de manera heterogénea. Se produce una transmisión más alta de valores entre las personas religiosas y entre las latinoamericanas, y una recepción de valores muy débil en las personas que han sufrido el covid-19 directamente o de manera cercana.En aquest article es mesuren valors comunicats en l'onada publicitària que es va distribuir durant la primera etapa crítica de la pandèmia de covid-19 a Espanya. La investigació es basa en la recopilació en línia de 45.000 respostes a 1.880 tests per part de 470 receptors espanyols i iberoamericans. Cadascun va avaluar 25 valors després de ser exposats en una mostra de cinc anuncis emesos per televisió oberta durant el període estudiat. La metodologia parteix de quatre objectius d'investigació i es basa en un nou instrument de mesura científica: ProtocoloEva®. Les conclusions revelen una estratègia comunicativa molt similar per part de les quatre fonts estudiades. Els valors cooperació, benestar, esforç, família, salut, respecte i responsabilitat es van transmetre de manera intensa i són fortament homogenis en tots els anuncis estudiats; en canvi, els valors drets, justícia-equitat, dignitat i llibertat van ser comunicats amb una intensitat molt més baixa i de manera heterogènia. Es produeix una transmissió més alta de valors entre les persones religioses i entre les llatinoamericanes, i una recepció de valors molt feble entre les persones que han patit la covid-19 de manera directa o propera.This article measures the values communicated in the wave of advertising launched during the first critical stage of the COVID-19 pandemic in Spain. The research is based on 45,000 on-line responses to 1,880 reception tests by 470 Spanish and Latin American recipients. Each of the receivers evaluated 25 values, after being exposed to a sample of five ads broadcast on TV during the period studied. The methodology is based on four research objectives and is supported by a new scientific measurement instrument: ProtocoloEva ®. Its conclusions reveal a very similar communication strategy in the four sources studied. The values cooperation, well-being, effort, family, health, respect and responsibility were strongly conveyed, and are strongly homogeneous in all the ads studied. In contrast, the values rights, justice-equity, dignity and freedom were perceived with a much lower intensity, and heterogeneously. There was a higher transmission of values among religious people and Latin American people, and a very weak reception of values in people who have suffered COVID-19 directly or closely

Medición de la influencia del sexismo en la transmisión de valores a través de la publicidad

Esta investigación, explora la relación del sexismo en el contenido de los spots publicitarios con la carga de valores humanos que transmiten a sus receptores. El estudio se apoya en la recopilación de 27.000 mediciones obtenidas en un test de percepción realizado con 270 receptores. Cada sujeto evaluó 25 valores, tras exponerse a una muestra de 4 spots publicitarios con distinto grado de contenido sexista, que fueron seleccionados mediante pretest. La metodología desarrolla un trabajo experimental exploratorio que compara las percepciones de los sujetos dividiéndolos en dos grupos, de modo que una mitad respondió a la prueba sin ninguna orientación específica, y para la otra, se introdujo en el test un efecto "priming" destinado a incrementar la atención sobre los contenidos de género. Las mediciones de las respuestas se apoyan en un nuevo instrumento de medición científica: ProtocoloEva. Las conclusiones revelan que primar la atención de los receptores hacia los contenidos de género aumenta la transmisión de valores humanos; y que a medida que baja el contenido sexista y crece el contenido igualitario de los spots, aumentan: a) el número de valores humanos comunicados a los receptores y b) la intensidad con la que es percibido cada valor.This research explores the relationship between sexism in the content of advertising spots and the human values that they transmit to their receivers. The study is based on the collection of 27,000 measurements obtained in a perception test with 270 receivers. Each participant assessed 25 values after watching a sample of 4 advertising spots with varying degrees of sexist content, which were selected by a pre-test. The methodology involves exploratory-experimental work comparing the perceptions of the subjects by dividing them into two groups, so one half took the test without any specific orientation, and with the other half the 'priming-effect' was introduced to the test to increase their attention to the gender content. The measurements of the responses were supported by a new scientific measurement tool: ProtocoloEva. The results reveal that focusing on receivers' attention on gender content increase the transmission of human values. If the sexist content decrease and the egalitarian content in the spots increase, it will increases a) the number of human values communicated to the receivers, and b) the intensity of the perception for each valu

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

Valores corporativos de los principales bancos españoles : localización y medición de su recepción

Tras una primera aproximación contextual y teórica desde las perspectivas: ética, psicosocial, sociotécnica y comunicológica sobre la investigación en valores, en esta investigación se mide la carga de valores transmitida por los cuatro principales bancos españoles: CaixaBank, Banco de Sabadell, Banco de Santander y BBVA, mediante un procedimiento on-line basado en test de recepción. El testeo se desarrolló a través de Internet, a partir de la exposición de 147 sujetos (87 españoles/as y 60 iberoamericanos/as) a los cuatro spots publicitarios que fueron divulgados simultáneamente por los canales institucionales en YouTube de cada banco y en los principales canales españoles de TV abierta durante el mes de abril de 2018 por esas entidades. El estudio localiza cuáles son los valores transmitidos por cada banco, los compara y mide sus respectivas potencias de transmisión. Con el apoyo de entrevistas en profundidad realizadas a los responsables de comunicación de los cuatro bancos, en este estudio se explora, también, la coherencia que logran los bancos entre los planteamientos básicos de su comunicación estratégica y los valores transmitidos por sus spots.This research measures the charge of values transmitted by the 4 main Spanish banks: CaixaBank, Banco de Sabadell, Banco de Santander and BBVA, through an on-line procedure based on reception tests. It starts from a deep contextual and theoretical approach to research in social values, from an ethical, psychosocial, sociotechnical and communicological perspective. The test consisted of an online questionnaire to 147 participants (87 Spanish and 60 Latin American), who watched 4 advertising spots shown on Youtube and broadcasted on open TV by the 4 main Spanish banks, all were aired during April 2018. The study locates the values transmitted by each bank spot, compares them and measures their respective transmission capability. With the support of in-depth interviews with the heads of communication of the 4 banks, our study also explores the coherence that banks achieve between their strategic communication and the values transmitted by their spot

A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study

© 2023Background: The benefit of pharmacogenetic testing before starting drug therapy has been well documented for several single gene–drug combinations. However, the clinical utility of a pre-emptive genotyping strategy using a pharmacogenetic panel has not been rigorously assessed. Methods: We conducted an open-label, multicentre, controlled, cluster-randomised, crossover implementation study of a 12-gene pharmacogenetic panel in 18 hospitals, nine community health centres, and 28 community pharmacies in seven European countries (Austria, Greece, Italy, the Netherlands, Slovenia, Spain, and the UK). Patients aged 18 years or older receiving a first prescription for a drug clinically recommended in the guidelines of the Dutch Pharmacogenetics Working Group (ie, the index drug) as part of routine care were eligible for inclusion. Exclusion criteria included previous genetic testing for a gene relevant to the index drug, a planned duration of treatment of less than 7 consecutive days, and severe renal or liver insufficiency. All patients gave written informed consent before taking part in the study. Participants were genotyped for 50 germline variants in 12 genes, and those with an actionable variant (ie, a drug–gene interaction test result for which the Dutch Pharmacogenetics Working Group [DPWG] recommended a change to standard-of-care drug treatment) were treated according to DPWG recommendations. Patients in the control group received standard treatment. To prepare clinicians for pre-emptive pharmacogenetic testing, local teams were educated during a site-initiation visit and online educational material was made available. The primary outcome was the occurrence of clinically relevant adverse drug reactions within the 12-week follow-up period. Analyses were irrespective of patient adherence to the DPWG guidelines. The primary analysis was done using a gatekeeping analysis, in which outcomes in people with an actionable drug–gene interaction in the study group versus the control group were compared, and only if the difference was statistically significant was an analysis done that included all of the patients in the study. Outcomes were compared between the study and control groups, both for patients with an actionable drug–gene interaction test result (ie, a result for which the DPWG recommended a change to standard-of-care drug treatment) and for all patients who received at least one dose of index drug. The safety analysis included all participants who received at least one dose of a study drug. This study is registered with ClinicalTrials.gov, NCT03093818 and is closed to new participants. Findings: Between March 7, 2017, and June 30, 2020, 41 696 patients were assessed for eligibility and 6944 (51·4 % female, 48·6% male; 97·7% self-reported European, Mediterranean, or Middle Eastern ethnicity) were enrolled and assigned to receive genotype-guided drug treatment (n=3342) or standard care (n=3602). 99 patients (52 [1·6%] of the study group and 47 [1·3%] of the control group) withdrew consent after group assignment. 652 participants (367 [11·0%] in the study group and 285 [7·9%] in the control group) were lost to follow-up. In patients with an actionable test result for the index drug (n=1558), a clinically relevant adverse drug reaction occurred in 152 (21·0%) of 725 patients in the study group and 231 (27·7%) of 833 patients in the control group (odds ratio [OR] 0·70 [95% CI 0·54–0·91]; p=0·0075), whereas for all patients, the incidence was 628 (21·5%) of 2923 patients in the study group and 934 (28·6%) of 3270 patients in the control group (OR 0·70 [95% CI 0·61–0·79]; p <0·0001). Interpretation: Genotype-guided treatment using a 12-gene pharmacogenetic panel significantly reduced the incidence of clinically relevant adverse drug reactions and was feasible across diverse European health-care system organisations and settings. Large-scale implementation could help to make drug therapy increasingly safe. Funding: European Union Horizon 2020

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially