13 research outputs found
China's COVID‐19 pandemic response: A first anniversary assessment
No full textThe literature on crisis management reports that crises can be critical for organizations, including state and extra‐state actors; they either break down or reinvent themselves. Successful organizations, those that do not break down, use situations of crisis to restructure themselves and improve their performance. Applicable to all crises, this reasoning is also valid for the COVID‐19 pandemic and for government organizations in China. Drawing on documentary analysis, this article examines China's pandemic response from the social–political, technological and psychological perspectives using a holistic crisis management framework. It demonstrates that the Chinese state bureaucracy has assembled, expanded and strengthened its surveillance strategies to strive for comprehensive crisis response
Data for "Multi-scale lidar measurements suggest miombo woodlands contain substantially more carbon than thought"
No full text<p>This dataset contains data described in '<em>Multi-scale lidar measurements suggest miombo woodlands contain substantially more carbon than thought</em>' (<a href="doi.org/10.1038/s43247-024-01448-x">publication link</a>). These data are a subset of those collected across the 50,000 ha region of interest (designation: GIL) across and beyond Gilé National Park, Mozambique. In particular, these data concern a ~350 ha subsection (designation: GIL04). See the Materials and Methods section of the paper for a description of how these data were collected. Additionally, data used for creating the graphs and charts of the manuscript are included. This dataset comprises:</p>
<ul>
<li><strong>Conventional inventory measurements:</strong>
<ul>
<li>Digitised forest inventory of plot GIL04-01, including automatic correction of taxonomic information, and attribution of basic wood density (.csv)</li>
</ul>
</li>
<li><strong>Terrestrial laser scanning measurements and derived products:</strong>
<ul>
<li>0007MZ_GIL04-01_4587*_81616*.laz: 4 x 10 m tiled TLS point clouds</li>
<li>0007MZ_GIL04-01_t974.laz: point cloud of an individual tree segmented from the above tiles</li>
<li>0007MZ_GIL04-01_t974.mat: quantitative structural model constructed from the above individual tree point cloud</li>
<li>0007MZ_GIL04-01_L4_AGB_10m.tiff: gridded estimate (10 m resolution) of TLS-derived aboveground biomass across GIL04-01</li>
</ul>
</li>
<li><strong>Unoccupied aerial vehicle laser scanning measurements and derived products:</strong>
<ul>
<li>0007MZ_GIL04_4587*_81616*.laz: 4 x 50 m tiled UAV-LS point clouds overlapping the above TLS point clouds</li>
<li>0007MZ_GIL04_L3*.tiff: UAV-LS-derived metrics of forest structure across GIL04 (10 m resolution unless stated otherwise)</li>
<li>CHM: canopy height and digital elevation model (1 m resolution)</li>
<li>RH: 100 relative height metrics in 1% intervals</li>
<li>structure_metrics: 14 structural metrics (see paper for details)</li>
<li>voxelvolumes: 3D voxel occupancy rates in 1 m bands from 0 to 50 m above terrain</li>
<li>0007MZ_GIL04_L4_AGB.tiff: gridded estimate (10 m resolution) of predicted above-ground biomass across GIL04 (10 m resolution)</li>
</ul>
</li>
<li><strong>Aerial laser scanning measurements and derived products:</strong>
<ul>
<li>0007MZ_GIL_458700_8161600.laz: 1 x 100m tiled ALS point cloud coincident with above UAV-LS point clouds</li>
<li>0007MZ_GIL_L3*_clipped.tif: ALS-derived metrics of forest structure across GIL04, in the same format as above UAV-LS metrics</li>
<li>0007MZ_GIL_L4_AGB_clipped.tif: gridded estimate (10 m resolution) of predicted above-ground biomass across GIL04 (10 m resolution)</li>
</ul>
</li>
<li><strong>Data for manuscript graphs:</strong>
<ul>
<li>.csv files containing the data to reproduce Fig.3-5</li>
</ul>
</li>
</ul>
The contribution of educational class in improving accuracy of cardiovascular risk prediction across European regions:the MORGAM Project Cohort Component
No full textObjective To assess whether educational class, an index of socioeconomic position, improves the accuracy of the SCORE cardiovascular disease (CVD) risk prediction equation. Methods In a pooled analysis of 68 455 40-64-year-old men and women, free from coronary heart disease at baseline, from 47 prospective population-based cohorts from Nordic countries (Finland, Denmark, Sweden), the UK (Northern Ireland, Scotland), Central Europe (France, Germany, Italy) and Eastern Europe (Lithuania, Poland) and Russia, we assessed improvements in discrimination and in risk classification (net reclassification improvement (NRI)) when education was added to models including the SCORE risk equation. Results The lowest educational class was associated with higher CVD mortality in men (pooled age-adjusted HR=1.64, 95% CI 1.42 to 1.90) and women (HR=1.31, 1.02 to 1.68). In men, the HRs ranged from 1.3 (Central Europe) to 2.1 (Eastern Europe and Russia). After adjustment for the SCORE risk, the association remained statistically significant overall, in the UK and Eastern Europe and Russia. Education significantly improved discrimination in all European regions and classification in Nordic countries (clinical NRI=5.3%) and in Eastern Europe and Russia (NRI=24.7%). In women, after SCORE risk adjustment, the association was not statistically significant, but the reduced number of deaths plays a major role, and the addition of education led to improvements in discrimination and classification in the Nordic countries only. Conclusions We recommend the inclusion of education in SCORE CVD risk equation in men, particularly in Nordic and East European countries, to improve social equity in primary prevention. Weaker evidence for women warrants the need for further investigations
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
No full textBackground: 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 < 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)
Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): A multicentre, prospective observational study
No full textBackground: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj −0·3%, 95% CI −2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; −0·4%, −3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation: We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications. Funding: European Society of Anaesthesiology
Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study
No full textBackground Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications.Methods We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged >= 18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARR(adj)). This study is registered with ClinicalTrials. gov, number NCT01865513.Findings Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7.6%] of 21 694); ORadj 1.86, 95% CI 1.53-2.26; ARR(adj) -4.4%, 95% CI -5.5 to -3.2). Only 2.3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1.31, 95% CI 1.15-1.49; ARR(adj) -2.6%, 95% CI -3.9 to -1.4) and the administration of reversal agents (1.23, 1.07-1.41; -1.9%, -3.2 to -0.7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1.03, 95% CI 0.85-1 center dot 25; ARR(adj) -0.3%, 95% CI -2.4 to 1.5) nor extubation at a train-of-four ratio of 0.9 or more (1.03, 0.82-1.31; -0.4%, -3.5 to 2.2) was associated with better pulmonary outcomes.Interpretation We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications
Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR) : a multicentre, prospective observational study
No full textBackground: Results from retrospective studies suggest that use of neuromuscular blocking agents during general anaesthesia might be linked to postoperative pulmonary complications. We therefore aimed to assess whether the use of neuromuscular blocking agents is associated with postoperative pulmonary complications. Methods: We did a multicentre, prospective observational cohort study. Patients were recruited from 211 hospitals in 28 European countries. We included patients (aged ≥18 years) who received general anaesthesia for any in-hospital procedure except cardiac surgery. Patient characteristics, surgical and anaesthetic details, and chart review at discharge were prospectively collected over 2 weeks. Additionally, each patient underwent postoperative physical examination within 3 days of surgery to check for adverse pulmonary events. The study outcome was the incidence of postoperative pulmonary complications from the end of surgery up to postoperative day 28. Logistic regression analyses were adjusted for surgical factors and patients' preoperative physical status, providing adjusted odds ratios (ORadj) and adjusted absolute risk reduction (ARRadj). This study is registered with ClinicalTrials.gov, number NCT01865513. Findings: Between June 16, 2014, and April 29, 2015, data from 22 803 patients were collected. The use of neuromuscular blocking agents was associated with an increased incidence of postoperative pulmonary complications in patients who had undergone general anaesthesia (1658 [7·6%] of 21 694); ORadj 1·86, 95% CI 1·53–2·26; ARRadj −4·4%, 95% CI −5·5 to −3·2). Only 2·3% of high-risk surgical patients and those with adverse respiratory profiles were anaesthetised without neuromuscular blocking agents. The use of neuromuscular monitoring (ORadj 1·31, 95% CI 1·15–1·49; ARRadj −2·6%, 95% CI −3·9 to −1·4) and the administration of reversal agents (1·23, 1·07–1·41; −1·9%, −3·2 to −0·7) were not associated with a decreased risk of postoperative pulmonary complications. Neither the choice of sugammadex instead of neostigmine for reversal (ORadj 1·03, 95% CI 0·85–1·25; ARRadj −0·3%, 95% CI −2·4 to 1·5) nor extubation at a train-of-four ratio of 0·9 or more (1·03, 0·82–1·31; −0·4%, −3·5 to 2·2) was associated with better pulmonary outcomes. Interpretation: We showed that the use of neuromuscular blocking drugs in general anaesthesia is associated with an increased risk of postoperative pulmonary complications. Anaesthetists must balance the potential benefits of neuromuscular blockade against the increased risk of postoperative pulmonary complications. Funding: European Society of Anaesthesiology
Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries
No full textBackground: 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 < 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)
Relación entre el mobbing y la presencia de sintomatología en crisis hipertensa en empleados de Villavicencio
No full textEn la presente investigación se evidencia la existencia de una relación estrecha, entre la salud y enfermedad que se sustenta desde el modelo biopsicosocial de Engel (1977), el cual posibilita que surja un enfoque específico a temas relacionados con enfermedad física, salud mental y estabilidad psicológica que le ha permitido a la psicología integrarse dentro de estos escenarios propios de las ciencias de la salud; el mobbing y los problemas cardiovasculares son dos factores que influyen de manera certera y significativa en el desempeño laboral, en la cual se muestran los diferentes síntomas que cada persona hipertensa presentan.
El objetivo general de esta investigación es determinar si existe una correlación positiva entre el mobbing y la presentación de sintomatología en la crisis hipertensa en los empleados de la ciudad de Villavicencio; Por tanto, para dar respuesta a dicho estudio, se llevó a cabo a través un método de corte cuantitativo, con diseño no experimental de tipo correlacional, y técnica de muestreo probabilístico de tipo aleatorio simple; aplicándose el cuestionario LIPT-60 y el cuestionario de datos sociodemográficos, a 300 personas diagnosticadas con hipertensión, 215 haciendo parte del programa atención a crónicos de Medimás, y 85 siendo empleados de la Alcaldía de Villavicencio.
Obteniéndose como resultado que no existe presencia de mobbing en los participantes, pero si hay presencia de estrategias de acoso laboral ( ,79 DT ,89). Y que a pesar de la ausencia de mobbing los participantes perciben que su organización es generadora de estrés laboral y se considera un ambiente hostil ( 1,6 DT 1,4).This research shows the existence of the relationship between health and illness that is supported by Engel's biopsychosocial model (1977), which allows a specific approach to issues related to physical illness, mental health and psychological stability that has allowed psychology to integrate into these stage of health sciences; Mobbing and cardiovascular problems are two factors that have a certain and significant influence on work performance, which shows the different symptoms that each hypertensive person presents.
The general objective of this investigation is to determine if there is a relationship between mobbing and the presece of hypertension symptoms in the employees of the Villavicencio city; Therefore, in order to respond to this study, a quantitative method was carried out, with a non-experimental design of a correlational type, and a simple random type probabilistic sampling technique; applying the LIPT-60 questionnaire and the sociodemographic data questionnaire, to 300 people diagnosed with hypertension, 215 being part of Medimas chronic care program, and 85 being employed by the Mayor of Villavicencio.
Obtaining as a result that there is no presence of mobbing in the participants, but there is presence of workplace harassment strategies (, 79 DT, 89). And that despite the absence of mobbing, participants perceive that their organization is generator work stress and is considered a hostile environment (1.6 DT 1.4).Psicólogohttp://www.ustavillavicencio.edu.co/home/index.php/unidades/extension-y-proyeccion/investigacionPregrad
Diseño de un programa de promoción y prevención del síndrome de burnout para docentes e instituciones educativas privadas situados al norte de la ciudad de Bogotá
No full textCurso de especial interésEste trabajo tiene como objetivo diseñar un programa promoción y prevención con el fin de disminuir el Síndrome de Burnout en docentes de instituciones educativas privadas del norte de Bogotá; donde se logre una sensibilización de conductas por medio del desarrollo y fortalecimiento en manejo del estrés. A partir de tres fases como la evaluación, intervención y seguimiento. Ya que la docencia es la profesión más expuesta a estos riesgos psicosociales.PregradoPsicólogoResumen
1. Justificación
2. Síndrome de Burnout
3. Objetivos
4. Método
5. Estudio del Mercado
6. Resultados
Discusión
Referencias
Apéndice
