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Objective: Endotracheal intubation, as an emergent but also as an elective procedure, can be stressful and painful, causing hypoxemia, bradycardia, acidosis or increased intracranial pressure. We aimed to investigate the safety and efficacy of premedication prior to elective intubation in order to contribute to the development of a more standardized strategy. Method: A systematic review and meta-analysis was conducted. The PubMed database was searched using the PICO method and keywords according to MeSH terms were used. Only studies with control groups were included (ran­domized controlled trials, prospective observational and case-control studies). Results: Our search procedure yielded 722 potentially eligible studies. Finally, 26 studies were included for qualitative and quantitative analysis. Blood pressure during intubation was found lower for neonates that received premedication compared to controls (SMD = -1.27; 95% CI [-2.59; 0.05]; p < 0.01). Heart rate change was found higher in the control group (SMD = -0.26; 95% CI [-1.07; 0.55]; p = 0.54). Intervention groups were found to have higher odds for bradycardia (OR = 1.13; 95% CI [0.79; 1.62]; p = 0.51), and less odds for desaturation compared to control groups (OR = 0.69; 95% CI [0.33; 1.45]; p = 0.33). The odds for adverse events were found 3 times lower in the intervention group, in relation to controls (OR = 0.71; 95% CI [0.55; 0.73]; p = 0.012). Intubation time for the intervention groups was lower than controls (SMD = -0.59; 95% CI [-1.06; -0.11]; p < 0.02). Intubation attempts were found marginally increased in the intervention group (ROM = 1.10; 95% CI [0.79; 1.53]; p = 0.57). No difference was found regarding mortality rate between groups. Conclusion: Most Neonatal Intensive Care Units should consider premedication prior to intubation for vigorously and active term and preterm infants as a safe and efficient procedure that buffers serious physiological responses and assures better procedural conditions.

There are many dimensions to conflict in Africa. It depends on the nature of the underlying demography, heterogeneity, and historical context of the state’s social and political problems. The impact of the coronavirus has greatly affected the socioeconomic structure and governance system in Africa, leading to social conflicts. Moreover, the social conflict led to deaths, job losses, and human capital reductions, resulting in economic catastrophes in South Africa, Egypt, and Ethiopia, among others. In Nigeria, the government was unable to cushion the impact of Covid-19, frustrated by the issues of poverty and inequality, wherein the masses were pounded with hunger and insecurity; a corrupt policing system precipitated the social unrest in 2020. Nigeria’s social issues, coupled with the shock of Covid-19, cumulated into protest actions, looting, and police brutality. The government’s inadequate response to the political crisis and state of unrest greatly influenced the public’s belief and outlook on social concerns. The research postulates the following question: how did the social conflict in Africa and Nigeria become overheated during Covid-19? The paper adopts a qualitative method that explores existing literature and media sources on social conflicts and Covid-19 in Africa and Nigeria. The study anchors its theoretical framework on the fragile state theory. The paper concludes that Nigeria’s weakened socioeconomic structure met with the shock of the horror of Covid-19, which sparked social conflict in the country.

Background and Aims: Staphylococcus aureus is one of the most important pathogens of public health concern and a leading cause of nosocomial infections. In this study, we evaluated the effect of routinely used disinfectants in hospitals for surface decontamination on biofilm-forming S. aureus. Materials and Methods: forty-eight S. aureus isolates were phenotypically evaluated for biofilm formation using the Tissue Culture Plate (TCP) technique. Effect of disinfectants (Dettol®, Izal®, Jik® and Savlon®) on biofilm was tested and time-kill kinetics evaluated. PCR was used to confirm the identity of S. aureus using species-specific primers. Results: biofilm formation assay revealed that 15 (31.2%) of the isolates formed biofilm with 7 (14.5%) and 8 (16.6%) considered as strong and moderate biofilm formers, respectively. Biofilm formation was time-dependent (p

Introducción: El presente trabajo examina, de manera crítica y rigurosa, el rol actual de las redes sociales como productoras y amplificadoras de bulos en cuestiones de derechos, seguridad y salud pública. A lo largo del mismo se han abordado las agresiones sexuales, por una parte, y por otra, las consecuencias sociales y culturales derivadas de la nueva oleada de infecciones provocadas por la viruela del mono. Como hipótesis de partida, las redes sociales han sido consideradas como elementos cada vez más usados para el asentamiento y la expansión de bulos que, cada vez más, tienen a transmitir discursos de odio. Metodología: Para constatarla, el artículo utiliza una metodología cualitativa consistente en analizar, comparar y constrastar la veracidad de los mensajes publicados con las temáticas indicadas. Resultados: Como resultado, se la comprobado que las redes sociales se han convertido en plataformas para la propagación de todo tipo de falacias capaces de estigmatizar a ciertos colectivos en dos campos muy sensibles de la sociedad: la seguridad y la salud pública. Discusión: Esto ha sido posible mediante la banalización de problemas complejos, criminalizaciones a determinados grupos sociales y apelaciones constantes a lo puramente visceral y emocional, despertando emociones que pueden granjear beneficios a nivel político. Conclusiones: Por tanto, se concluye que la situación actual de crisis en sus distintas dimensiones (económica, social, sanitaria, ecológica, mediática, política) genera una tendencia hacia la consolidación y expansión tanto de conductas como mensajes criminalizadores.

Referência do artigo comentado: PAIVA, Rita. Impulso criador e drama vital em Bergson. Trans/Form/Ação: Revista de Filosofia da Unesp, v. 46, n. 2, p. 253 – 274, 2023.

O objetivo deste artigo é indagar de que maneira a filosofia pode ser compreendida como um ato de resistência. Deleuze introduz essa tese, ao aproximar a filosofia da arte, porquanto ambas são atos de criação. Nesse sentido, o método filosófico de Bergson – a intuição – já indica um tipo de atividade filosófica que se caracteriza, antes de tudo, pela criação de conceitos. Ora, como é que um conceito filosófico pode constituir um ato de resistência? Para responder a essa questão, retomamos uma análise sobre a relação entre o método de intuição e a criação artística, seguida da interpretação deleuziana acerca do que significa ter uma ideia. Contudo, a passagem da ideia ao ato de resistência exige uma transposição do plano teórico para o plano concreto. Com esse intuito, focalizamos um exemplo sugerido pela filosofia de Bergson: a ideia de um possível retorno à vida simples. Isso nos permitirá avaliar até que ponto uma ideia filosófica pode ser confrontada com a realidade no mundo atual e, nesse sentido, entendida como um ato de resistência.

In this piece we offer a reflexive account of our recent experiences of teaching with drama in two different online settings. Eva will recount her practice teaching trainee teachers in Switzerland and Nicky will recall her practice working with postgraduate applied theatre students in a drama school in the UK. Over and over again, we have encountered the mind-set that teaching drama online is “not possible”, or at the very least, that it is but a pale reflection of face-to-face teaching. Although we were out of our comfort zone at first, we now feel that teaching with drama online has its place in our fast-paced and increasingly technological world. Teaching and learning in digital contexts will likely remain a reality from now on, thus it is the purpose of this article to make the case for the creative potential of and indeed urgent need for online teaching that includes drama.

Introduction: The management of a patient with severe hemophilia A with inhibitors is a challenge for any healthcare professional. The present analysis shows the clinical and economic impact of the therapeutic approach in the most critical patient of the Cuban Hemophilia Cohort. Objective: To evaluate the economic and clinical impact of the implementation of Emicizumab therapy in the first Cuban patient. Case presentation: Adult patient who started to use recombinant activated factor VII episodically during adolescence when he was diagnosed with the presence of high-responding antibodies against factor VIII. During the years that he used this medication, he had recorded between 95 and 105 bleeds annually. In 2018, he presented with severe hemoperitoneum and was admitted to the intensive care unit with high doses of recombinant factor VII activated, multiple transfusions of packed red blood cells, and other care typical of a critically ill patient; his evolution was satisfactory. He started emicizumab prophylaxis 7 months after this event and is currently on Week 133 of treatment. He has not presented with further bleeding, nor has he reported adverse reactions to this treatment. The biannual cost savings for on-demand treatment and prophylaxis have been US $792,509.24. Conclusions: Emicizumab prophylaxis improved the patient’s quality of life and that of his family. From the perspective of the Cuban health system, the use of emicizumab in this clinical case was satisfactory and its experience will be analyzed in new patients.

Bestiario marino, de Abraham Truxillo

The environment has gained significant relevance on a global scale, owing to research by scientists and environmental movements that have been able to place global environmental problems such as earth warming and pollution. Social and environmental aspects are related to organizations and are being transcendental for various international institutions and organizations. The accounting has been present in humanity for several years now, as a result of the need that man has had to control and quantify the information generated from the economic activities that he has developed in the course of history. Today, accounting is required to report how organizations harm nature and its environment, because traditional accounting does not clearly reflect social and environmental costs The accounting area must make efforts so that the environmental accounting is developed and provides useful, clear and relevant information for the interested parties. In this research, a documentary review of the proposals on environmental accounts and the current state of environmental accounting was made. This research is descriptive with a qualitative approach and the design applied is non-experimental. Its objective is to analyse the elements of environmental accounts and show the efforts of the accounting area in terms of environmental impact. As a result, environmental accounts are conceptualized differently by each author depending on the reference on which they are based. It is concluded that there are great advances in environmental accounting and in the conceptualization of environmental accounts, however, further development is required for its uniformity and application. It is required that at the level of undergraduate studies are taught more subjects of corporate social responsibility for the graduates to develop an early awareness of the social and environmental aspects related to the organizations with the objective of establishing better accounting practices in order to reduce the impact of the current environmental damage and that could have been part of the regular accounting procedures that are carried out within organizations.

Background and Aims: Diarrheal diseases caused by bacterial pathogens are widespread and they result in morbidity and mortality of a lot of people yearly. The aim of this study was to assess the role of the environment, health workers and food handlers as reservoirs of Vibrio cholerae, and other diarrhea causing bacteria. Methods: Healthcare workers were proportionally selected and multistage sampling technique was adopted in selecting food handlers for the study. A total of 374 participants consisting of health workers and food handlers were recruited. Socio-demographic and clinical information were collected using questionnaires, while stool and environmental samples were also collected. Results: More female 55.9 % than male 44.1 % participated in the study and the mean age of participants was 38.7 ± 10.9. A significant number of participants identified poor hygiene practices as the major cause of diarrhea. V. cholerae O1 serotype was not detected in any of the environmental samples nor stool samples of both food handlers and health workers. However, V. cholerae (Non O1/Non O139) was isolated from the stool samples of food handlers and health workers in Kano State implying that they could be serving a source of the continuous dissemination of the pathogen. Other bacterial pathogens that are aetiology of diarrhea including Salmonella spp. Escherichia coli, Klebsiella oxytoca, and Enterobacter spp. were also isolated. Conclusion: It is therefore imperative that food handlers and health workers undergo periodic health checks to ensure they are free of pathogens they could easily transmit through food or to patients.

The interests of India and the United States (US) converge on multiple aspects in the Indo-Pacific. These interests range from economics to geopolitics to regional stability. India’s Look East Policy, rechristened as Act East Policy, in addition to economic, cultural and commercial goals, includes strategic interests to expand India’s influence in East Asia and to the larger Indo-Pacific. The US, challenged by the rise of China, has initiated a quadrilateral grouping of democracies (QUAD) and the Free and Open Indo-Pacific (FOIP) strategy with the objective of reasserting American primacy in the Indo-Pacific. The US-India Joint Strategic Vision for the Asia-Pacific and Indian Ocean Region signed in 2015 and the Indo-Pacific Strategy Report 2019 emphasize the indispensability of the partnership between the US and India in the Indo-Pacific. The policies of the US and India towards the Indo-Pacific converge on ensuring peace, stability, maritime security, freedom of navigation, the fight against terrorism, peaceful settlement of disputes and ensuring connectivity of land, sea, and air transportation. Though not stated bluntly, containing the growing Chinese influence by mobilizing countries in the region figures prominently in the strategic schemes of both India and the US. As the most important strategic region in world politics, India, the US and China have vital economic and security interests at stake. By relying on a realist approach, the paper probes the main drivers and constraints of the Indo-US strategic partnership in the Indo-Pacific. The paper outlines and analyses the context of the Indo-US collaboration in the Indo-Pacific, their shared views and concerns, its anti-China mode and the constraints of the partnership. This study adopts qualitative methods and uses interpretative and analytical tools to explain the case.

Johann Georg Hamann was the first critic of the Enlightenment and his first victim. His thought, enormously complex and articulated through some ideas well ahead of his time, was quickly covered with “irrationalism” by the hermeneutical incapacity of the enlightened circles of the moment, which subsequently resulted in a notorious disregard for his work by the History of Philosophy. The present article intends to show that the categories used at the time to define the thought of Hamann are inadequate. More specifically, it will attempt to show how the revision of the Enlightenment carried out by Hamann reflects an attitude of “radical enlightenment” and not of “irrationalism”.

El objetivo de este trabajo consistió en explorar el valor simbólico que posee un queso tradicional mexicano, el Queso Crema de Chiapas. Para ello, se recorrió un largo camino de caracterización técnica de los rasgos fisicoquímicos, microbiológicos y sensoriales del producto, así como también de sus canales de comercialización y su red de valor. Una vez que se conocieron y se identificaron los aspectos tecnológicos mensurables, que imparten las características especiales al Queso Crema de Chiapas. La presente investigación mostró la existencia de aspectos subjetivos que aportan un valor y significado a este queso genuino; aspectos determinados por la sociedad, y en especial por los productores. El simbolismo es un rasgo asignado por las personas; se trata de un concepto subjetivo que está determinado por la necesidade, y fundamentado por la historia, la cultura, la idiosincrasia y su forma de vida. Estos valores favorecen la presencia del queso en el mercado, lo que contribuye a su preservación como patrimonio alimentario. Esta investigación se realizó con un enfoque antropológico, cualitativo-cuantitativo y observacional en campo, que se complementó con investigaciones anteriores, demostrando el valor de este alimento identitario de Chiapas. Sus resultados pueden ser empleados como instrumento para promover acciones de valorización adecuadas y contribuir al desarrollo socioeconómico y cultural de su región de origen.

El objetivo del presente trabajo es analizar la dificultad y los límites para comprender el significado ético de las decisiones profesionales. Éstas denotan tensiones dialécticas entre lo que el individuo considera su responsabilidad directa y las condiciones en las cuales se ve obligado a actuar y no puede controlar. En otras palabras, se cree actuar con buenas intenciones y razones legítimas y termina determinado por una cadena de acciones que lo llevan a un colapso del significado moral, tanto de sí mismo y del valor del acto en sí, lo cual se convierte en un argumento para justificar la violencia de sus actos. Proponemos que la ética puede comprender estas tensiones si se toman en cuenta las problemáticas existenciales internas de la persona que decide, como son la angustia y la desesperación en conjunto con las aportaciones de las teorías del comportamiento y la comunicación organizacional. Para ello se analiza el caso de las decisiones del fraude financiero llevado a cabo por Bernard Madoff.

El turismo cultural se ha convertido en una de las modalidades de mayor crecimiento, suponiendo una oportunidad de desarrollo para muchos espacios fuera de los tradicionales destinos de “sol y playa”. Sin embargo, aún es escaso el número de trabajos sobre las tipologías y valoraciones de los turistas que visitan destinos culturales. Desde esta perspectiva, este artículo propone un acercamiento a las diferentes valoraciones que distintos grupos de turistas, identificados por su motivación, realizaron sobre la ciudad de Cuenca, en Ecuador. A partir del análisis e interpretación de los resultados de una encuesta a los turistas que visitan esta ciudad, este trabajo indaga sobre estas cuestiones. The cultural tourist: typologies and analysis of the valuations of the destination from the case study of Cuenca-Ecuador Abstract: Cultural tourism has become one of the fastest growing modalities, assuming a development opportunity for many spaces outside of traditional “sun and beach” destinations. However, there is a limited the number of works about the typologies and valuations of these cultural tourists. In this sense, this article proposes an approach to the types and different ratings that different groups of tourists made on the city of Cuenca, in Ecuador. Based on the analysis and interpretation of the results of a survey of tourists visiting this city, this paper explores these issues. Keywords: Cultural tourism, typology of tourists, destination rating, Cuenca, Ecuador.

This paper looks at the gendered underpinnings of religion using a feminist lens. It names the violence embedded in the gendered notions of religious ideology and praxis and shows how religion can be “injurious” to women’s growth because of the following factors: the hierarchical dualism that alienates them from the Spirit and identifies them with the body while marginalizing them through their positioning on the lower rungs of the hierarchical ladder; the exclusive male imagery of God and its mediation by an all male priestly class and the scriptural injunctions which are inscribed by patriarchal thought and deployed to keep women in defined roles and spaces. Catholic teachings and practices are taken as a case of analysis to unearth the political dynamics by which religion reinforces ‘gendering –women’s exclusion from theological knowledge making spaces and the gendered religious indoctrination which become hegemonic codes that shape women’s consciousness and keep them without grievance in their subjugated status. It shows further how female body and sexuality are major sites of religious gender politics through the strict controls on women’s dress-codes and the sexual servicing expected of them in marriage. Finally, the paper advocates critical thought as a tool for exploding the hardened rock of gendered religious foundations and shows how overcoming the contradictory consciousness and waking up to a critical consciousness becomes imperative for women to be freed of the gender dictates of religion. Key words: gender, religion, theological knowledge-making, sexuality, critical consciusness

En este artículo se desarrolla el papel que cumple la diferencia en la construcción del concepto de Ereignis. Pese a la insistencia de Heidegger en el predominio que la identidad tiene sobre la diferencia, el artículo tratará de detectar el rumor insistente que la diferencia produce en su obra y cuáles son sus puntos de cristalización en el Ereignis, analizando cómo el propio Heidegger se ve, a veces, viviendo en sí mismo el desgarro que la propia diferencia lleva consigo.

Este ensayo está dedicado a analizar la producción fantástica y de terror de Raimunda Torres y Quiroga, escritora argentina que, utilizando diversos seudónimos, publicó sus textos en periódicos y revistas literarias del siglo XIX, compilándolos posteriormente en formato de libro. Sus textos fantásticos se caracterizan por su defensa de la mujer frente a la violencia masculina, presentando con frecuencia venganzas de ultratumba. Hasta el presente ensayo, era una autora desconocida por la crítica literaria.

The text is inspired by some of Freud’s observations, regarding, among other things, the pleasure the child takes from playing with words as preliminary degree of wit. As zealous follower, Brill extends and intensifies the importance of Freud’s thought trying to establish a link, or at least a point of contact between the poetry in a generic sense and the various forms of oral gratification. This gives rise to unusual associations that are for the contemporary reader slightly comical: if poetry can be seen as an expression of the mysteries of oral Erotica, the relationship between poet and gourmet can only be the closest. To define and limit the scopes of fulfillment that is realized in oral poetry, Brill passes rapidly through the various forms this satisfaction takes in neurotics, in psychotics, in the child, in the primitive. The conclusions, unfortunately, are very general: many poets do not go beyond the oral stage and give clear signs of a fixation of libidinal development at this level.