Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay.
Purpose -The aim of this paper is to explore the components of entrepreneurship education programs (EEPs) and their interrelationships to develop a conceptual framework through which entrepreneurship education may be contextually evaluated and developed. Design/methodology/approach -The paper presents an extensive literature review of the entrepreneurship education literature which is used to inform a comprehensive framework for entrepreneurial education; based upon contextualisation, outcomes, objectives, audience, assessment, content and pedagogy. Findings -The paper develops a comprehensive and parsimonious framework for understanding and evaluating entrepreneurship education programs based on and adapted from the extended conceptualisations and contextualisation of previous research on entrepreneurship education programs. Research limitations/implications -This paper presents preliminary conceptualisation and as such requires subsequent testing in various entrepreneurship contexts. Practical implications -The framework elaborated upon can provide a comprehensive view of entrepreneurship education programs by examining and describing the relationships between the components. In so doing, the paper illuminates for educators and researchers a comprehensive view of an entrepreneurship education program which can be used by contextualising the components of outcomes, objectives, assessment and pedagogy. Originality/value -The value of this work lies in its responsiveness to the calls in the academic literature for more appropriate evaluations of entrepreneurship programs and greater contextualisation of the programs to facilitate research into the effectiveness of such programs. The paper proposes that EEPs have to be developed, not only with objectives in mind, but in the context within which they operate.
Among HIV-seropositive patients with pulmonary tuberculosis, extending treatment from 6 to 12 months reduces the rate of relapse but does not improve survival. The six-month program of partly intermittent antituberculous treatment may be an acceptable alternative when resources are limited.
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