Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Analyze the impact of the application of the Organization and Function Manual as part of the talent management of the sports betting company Gangabet in the year 2023

La Gestión del personal y la manera en que esta se encuentra estructurada representa la base y punto de partida de las oportunidades que permitan gatillar acciones hacia la búsqueda de la productividad y maximización del valor agregado de la compañía. No obstante, dichas gestiones base son un factor común de lo que las organizaciones actuales y en particular las de índole nacional no consideran una prioridad y menos una necesidad a entablar dentro de la toma de decisiones cotidianas. En el Perú, son pocas las Mypes que destinan recursos y esfuerzo por robustecer y transversalizar las actividades y tareas diarias del colaborador en aras de fomentar un ambiente co-creativo de generación de valor. El presente trabajo de investigación tiene como objetivo plasmar la realidad de negocio de la empresa Gangabet, una organización dedicada al rubro de las apuestas deportivas, con respecto a la gestión de su personal y al impacto de sus funciones se refiere. Para ello, se ha considerado recabar información en base a las percepciones y experiencias de los especialistas del área de soporte y atención al cliente permitiendo la identificación de los puntos críticos del desempeño de los colaboradores con la etapa de inducción y herramientas que Gangabet brindó en el inicio de su etapa incorporativa a la organización. La solución planteada consiste en la creación e implementación de un Manual de Organización y Funciones (MOF) que clarifique y plasme tanto la orientación como la definición de las labores diarias de cada colaborador y no desemboquen en redundancias ni en esfuerzos innecesarios maximizando la productividad y satisfacción del cliente.Personnel Management and the way it is structured represents the basis and starting point of opportunities that allow triggering actions towards the search for productivity and maximization of the company's added value. However, these basic procedures are a common factor of what current organizations, and particularly those of a national nature, do not consider a priority and even less a necessity to engage in daily decision-making. In Peru, there are few Mypes that allocate resources and effort to strengthen and mainstream the daily activities and tasks of the collaborator in order to foster a co-creative environment of value generation. The objective of this research work is to capture the business reality of the company Gangabet, an organization dedicated to the field of sports betting, with respect to the management of its personnel and the impact of its functions. To this end, it has been considered to collect information based on the perceptions and experiences of the specialists in the support and customer service area, allowing the identification of the critical points of the employees' performance with the induction stage and tools that Gangabet provided in the beginning of their incorporation stage into the organization. The proposed solution consists of the creation and implementation of an Organization and Functions Manual (MOF) that clarifies and reflects both the orientation and the definition of the daily tasks of each collaborator and does not lead to redundancies or unnecessary efforts, maximizing productivity and satisfaction the client's.Trabajo de Suficiencia Profesiona

Youwin

Youwin es un proyecto que busca ayudar a los microempresarios en aspectos de marketing digital. Para ello, se le ofrece un servicio integrado que abarca la creación de un logo o portada, en caso no lo tuviera, así como la planificación y ejecución de un sorteo en redes sociales. Adicional a ello, durante el proceso se dan recomendaciones que puedan ayudar a sostener esta estrategia de promoción, así como algunos detalles tributarios a tomar en cuenta que permitan crecer el negocio del microempresario. Difundirse en redes sociales en esta época de confinamiento social es clave para los pequeños negocios, pues ya no podrán ofrecer sus servicios presencialmente como lo solían hacer ni con la frecuencia de antes cuando la cuarentena termine. Con recientes estudios estadísticos y entrevistas propias realizadas se determinó que alrededor del 50% de microempresas no tienen redes o son incipientes en estas. En este contexto nace Youwin, que busca a largo plazo posicionarse como un aliado del microempresario y ser reconocidos como una ventana para ofrecer sus servicios o productos.Youwin is a project that seeks to help microentrepreneurs in aspects of digital marketing. For this, an integrated service is offered that covers the creation of a logo or cover, in case it does not have it, as well as the planning and execution of a draw on social networks. In addition to this, during the process recommendations are given that may help sustain this promotion strategy, as well as some tax details to take into account that allow the microentrepreneur´s business to grow. Spreading on social networks in this time of social confinement is key for small businesses, since they will no longer be able to offer their services in person as they used to do or as often as before when the quarantine ends. With recent statistical studies and own interviews, it was determined that around 50% of microenterprises do not have networks or are incipient in these. In this context, Youwin was born, which seeks in the long term to position itself as an ally of the microentrepreneur and to be recognized as a window to offer its services or BLABproducts.Trabajo de investigació