32 research outputs found
Plano de Negócio: Empresa de Animação Turística Stella Tour
A ideia primordial deste projeto conjuga o Turismo e o Lazer. O projeto consiste na
elaboração da proposta de criação de uma empresa de serviços focados na exploração de
tours exclusivos e diferenciadores com o objetivo de oferecer experiências distintas e
diferenciadoras. Este projeto pretende avaliar a viabilidade de mercado, bem como, a
viabilidade económica e financeira da criação de uma empresa de animação turística,
recorrendo à elaboração de um plano de negócio.
Para que a economia nacional possa aproveitar cada unidade de valor acrescentado
que o turismo gera e pode gerar, importa reconhecer a imperiosa necessidade de, por um
lado, acelerar alterações ao próprio setor, que lhe permita continuar a competir
internacionalmente ao mais alto nível, e, por outro lado, de intensificar a interconexão e
interseção com os demais setores de atividade económica em todo o território. Numa
perspetiva global, existe uma constante mudança nos mercados o que se apresenta como
motivo de preocupação por parte das empresas. Estar preparado, antecipar as mudanças
e definir os caminhos a seguir, tendo em conta os possíveis cenários, é uma das maiores
valias que uma empresa pode obter nos dias de hoje.
Após a realização da análise económica e financeira do projeto, chegou-se a conclusão de
que o projeto é economicamente viável e que existe um grande interesse tanto do setor
privado como no público de investimentos desta natureza, considerando-se pertinente a
implementação do Projeto.The main idea of this project combines Tourism and Leisure. The project consists in the
elaboration of the proposal to create a services company focused on the exploration of
exclusive and differentiating tours with the objective of offering distinct and
differentiating experiences. This project aims to evaluate the market viability, as well as
the economic and financial viability of creating a tourist entertainment company, using
the preparation of a business plan.
In order for the national economy to be able to take advantage of every unit of added
value that tourism generates and can generate, it is important to recognize the imperative
need, on the one hand, to accelerate changes to the sector itself, allowing it to continue
to compete internationally at the highest level, and, on the other hand, to intensify the
interconnection and intersection with other sectors of economic activity throughout the
territory. From a global perspective, there is a constant change in the markets, which
presents itself as a reason for concern on the part of companies. Being prepared,
anticipating changes and defining the paths to follow, taking into account possible
scenarios, is one of the greatest values a company can obtain these days.
After carrying out the economic and financial analysis of the project, it was concluded
that the project is economically viable and that there is great interest from both the
private and public sectors in investments of this nature, considering that the
implementation of the Project is relevant
First-time success with needle procedures was higher with a warm lidocaine and tetracaine patch than an eutectic mixture of lidocaine and prilocaine cream
AIM: More than 50% of children report apian during venepuncture or intravenous cannulation and using local anaesthetics before needle procedures can lead to different success rates. This study examined how many needle procedures were successful at the first attempt when children received either a warm lidocaine and tetracaine patch or an eutectic mixture of lidocaine and prilocaine (EMLA) cream.
METHODS: We conducted this multicentre randomised controlled trial at three tertiary-level children's hospitals in Italy in 2015. Children aged three to 10 years were enrolled in an emergency department, paediatric day hospital and paediatric ward and randomly allocated to receive a warm lidocaine and tetracaine patch or EMLA cream. The primary outcome was the success rate at the first attempt.
RESULTS: The analysis included 172 children who received a warm lidocaine and tetracaine patch and 167 who received an EMLA cream. The needle procedure was successful at the first attempt in 158 children (92.4%) who received the warm patch and in 142 children (85.0%) who received the cream (p = 0.03). The pain scores were similar in both groups.
CONCLUSION: This study showed that the first-time needle procedure success was 7.4% higher in children receiving a warm lidocaine and tetracaine patch than EMLA cream
Study protocol for a randomised controlled trial to determine the effectiveness of a mHealth application as a family supportive tool in paediatric otolaryngology perioperative process (TONAPP)
Background: Otorhinolaryngology (ORL) surgery is common in children, but hospitalisation, surgery, and home care after discharge are stressful experiences for young patients and their family caregivers. Findings from literature highlight a lack of time in hospitals to support ORL surgery children and their caregivers through the perioperative process, along with the risks of caregivers' autonomous web or social media resources investigation. Therefore, this study aims to evaluate the effectiveness of a mobile health application with content to support ORL patients and their caregivers in the perioperative period to reduce caregiver anxiety and child distress compared to standard care. Methods: An open-label, two-arm randomised control trial design is being adopted. The intervention consists of a mobile health application with content to support ORL patients and their caregivers during the perioperative period. One hundred eighty participants will be enrolled and randomly assigned to the experimental group using the mHealth application or the control group. The control group receives standard information and education about the ORL perioperative period from healthcare providers orally or through brochures. The primary outcome is the difference between the intervention and control groups in preoperative caregiver state anxiety. Secondary outcome measures include children's distress before surgery and family preparation for hospitalisation. Discussion: The results of this study will be critical to the implementation of a new and safe model for the management of care and education in paediatrics. This model can achieve positive organisational and health outcomes by supporting continuity of care and empowering citizens to have informed participation and satisfaction in paediatric health promotion and management. Trial registration: Trial identifier: NCT05460689 registry name: ClinicalTrials.gov. Date of registration: July 15, 2022. Last update posted: February 23, 2023
Nosocomial COVID-19 Incidence and Secondary Attack Rates among Patients of Tertiary Care Center, Zurich, Switzerland
Of 1,118 patients with COVID-19 at a university hospital in Switzerland during October 2020-June 2021, we found 83 (7.4%) had probable or definite healthcare-associated COVID-19. After in-hospital exposure, we estimated secondary attack rate at 23.3%. Transmission was associated with longer contact times and with lower cycle threshold values among index patients.
Keywords: COVID-19; SARS-COV-2; Switzerland; coronavirus disease; cross-infection; infection control; infectious disease transmission; nosocomial infections; risk factors; severe acute respiratory syndrome coronavirus 2; viruses; zoonoses
Genome-wide identification and phenotypic characterization of seizure-associated copy number variations in 741,075 individuals
Copy number variants (CNV) are established risk factors for neurodevelopmental disorders with seizures or epilepsy. With the hypothesis that seizure disorders share genetic risk factors, we pooled CNV data from 10,590 individuals with seizure disorders, 16,109 individuals with clinically validated epilepsy, and 492,324 population controls and identified 25 genome-wide significant loci, 22 of which are novel for seizure disorders, such as deletions at 1p36.33, 1q44, 2p21-p16.3, 3q29, 8p23.3-p23.2, 9p24.3, 10q26.3, 15q11.2, 15q12-q13.1, 16p12.2, 17q21.31, duplications at 2q13, 9q34.3, 16p13.3, 17q12, 19p13.3, 20q13.33, and reciprocal CNVs at 16p11.2, and 22q11.21. Using genetic data from additional 248,751 individuals with 23 neuropsychiatric phenotypes, we explored the pleiotropy of these 25 loci. Finally, in a subset of individuals with epilepsy and detailed clinical data available, we performed phenome-wide association analyses between individual CNVs and clinical annotations categorized through the Human Phenotype Ontology (HPO). For six CNVs, we identified 19 significant associations with specific HPO terms and generated, for all CNVs, phenotype signatures across 17 clinical categories relevant for epileptologists. This is the most comprehensive investigation of CNVs in epilepsy and related seizure disorders, with potential implications for clinical practice
Dolore da venipuntura: come trattarlo?
Venipuncture, although it is relatively simple and fast, is one of the painful procedures which is most frequently performed on paediatric patients. The pain in this context is present in 50% of children, and has been rated as moderate to severe in 36% of children aged 3 to 6 years and 13% of those aged 7 to 17 years. The response to pain is influenced and shaped by past painful experiences. Infants who have not been adequately treated in regard to procedural analgesia undergo a real conditioning. Considering that pain has two basic components, nociception and suffering, the best approach will be multidisciplinary, based on pharmacological and non-pharmacological strategies
Does respiratory co-infection facilitate dispersal of SARS-CoV-2? investigation of a super-spreading event in an open-space office
BACKGROUND
Super-spreaders are individuals infecting disproportionately large numbers of contacts. They probably play a crucial role in the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We describe a super-spreading event within a team working in an open-space office and investigate factors potentially having facilitated SARS-CoV-2 transmission.
METHODS
In this retrospective cohort study, semi-structured telephone interviews with all team members were carried out to identify symptoms, contacts, and adherence to basic hygiene measures. During site visits, we gathered information about workplace and seating arrangements. The secondary attack rate in office and households was calculated. Potential respiratory viral co-infections were assessed by multiplex PCR. SARS-CoV-2 whole-genome sequencing was performed using a tiled-amplicon sequencing approach.
RESULTS
Of 13 team members, 11 fell ill with Coronavirus disease 2019 (COVID-19). Due to the sequence of events and full genome sequence data, one person was considered the index case for this outbreak, directly infecting 67 to 83% of the teammates. All team members reported repetitive close contacts among themselves during joint computer work, team meetings and a "Happy Birthday" serenade. Two individuals shared nuts and dates. The arrangement of the office and meeting rooms precluded sufficient adherence to physical distancing. The index case and a further individual were diagnosed with an adenovirus serotype 4 co-infection.
CONCLUSION
We identified several environmental and behavioral factors that probably have facilitated the transmission of SARS-CoV-2. The relevance of the adenovirus co-infection remains unclear and merits further investigation
Does the Application of Heat Gel Pack After Eutectic Mixture of Local Anesthetic Cream Improve Venipuncture or Intravenous Cannulation Success Rate in Children? A Randomized Control Trial
OBJECTIVE: Needle-related procedures are the most common sources of pain for children in the hospital setting. The most used topical anesthetic, eutectic mixture of local anesthetic (EMLA) cream, may cause transient vasoconstriction. It has been postulated that this vasoconstriction may decrease vein visualization. The application of heat gel pack after removal of EMLA cream in the site of venipuncture counteracts the vasoconstriction, improving vein visualization. We assessed using a prospective randomized controlled trial whether the application of heat gel pack increases the needle procedure success rate. The primary study outcome was procedural success rate at the first attempt. METHODS: The study enrolled 400 children, 200 of whom applied heat gel pack after removing EMLA (treatment group) and 200 did not (control group). Procedural success rate at the first attempt, vein perception before procedure, procedural pain, and adverse events were recorded in both groups. RESULTS: Eighty-eight percent of the procedures were successful at the first attempt in the treatment group and 89% in the control group (P = 0.876). Vein perception was not significantly different in the 2 groups (P = 0.081). Pain score after the procedure was similar in the 2 groups. CONCLUSIONS: This study shows that the application of heat gel pack after removal of EMLA cream does not improve venipuncture or intravenous cannulation success rate
Il dolore acuto del bambino: Dalla misurazione al trattamento, farmacologico e non.
Background - Pain is a relevant symptom reported by children who require Emergency Unit evaluation, but it is still underestimated and undertreated. Purpose - This review offers simple information about pharmacological and non-pharmacological approaches in the management of pain in emergency settings and in subcentres. Data sources - Found on PubMed articles, using different key-words: pain, procedural pain, children, emergency unit, epidemiology, measurement, management, and treatment. Results - Pain has to be measured before treatment. It can be controlled with non-pharmacological and pharmacological approaches, which have specific guidelines.
Conclusions - Instruments for any kind of pain are available; an insufficient management is attributable to poor knowledge rather than to lack of means
Normal saline flushes performed once daily maintain peripheral intravenous catheter patency: a randomised controlled trial
8noOBJECTIVE:
Recent evidence supports the use of normal saline flushes in place of heparin to maintain the patency of peripheral intravenous locks (IVLs); however, there are no data regarding the recommended flush frequency.
STUDY DESIGN:
This was an open, non-inferiority, randomised controlled trial. Children with IVLs, aged 1-17 years, were randomly assigned to receive saline flushing every 12 h (group A) or every 24 h (group B). The main outcome was the maintenance of catheter patency.
RESULTS:
Four hundred patients were randomised; 198 subjects were analysed in the 12 h group and 199 in the 24 h group (three patients were lost at follow-up). Occlusion occurred in 15 children (7.6%) in group A versus 9 (4.5%) in group B (p=0.21). The difference in catheter patency was +3.1% in favour of the 24 h group (95% CI -1.6% to 7.7%), showing the non-inferiority of the 24 h procedure (the non-inferiority margin was set at -4%). Catheter-related complications were not different between the two groups (12.1% in group A vs 9.5% in group B; p=0.42).
CONCLUSIONS:
A flushing procedure with one flush per day allows maintenance of catheter patency without an increase in catheter-related complications. We propose a simplification of the flushing procedure with only one flush per day, thereby reducing costs (materials use and nursing time), labour and unnecessary manipulation of the catheters which can cause distress in younger children and their parents.reservedmixedSchreiber, Silvana; Zanchi, Chiara; Ronfani, Luca; Delise, Anna; Corbelli, Annalisa; Bortoluzzi, Roberta; Taddio, Andrea; Barbi, EgidioSchreiber, Silvana; Zanchi, Chiara; Ronfani, Luca; Delise, Anna; Corbelli, Annalisa; Bortoluzzi, Roberta; Taddio, Andrea; Barbi, Egidi