Purpose This paper aims to analyze the extent to which social capital (SC) spurs innovation in firms located within tourism clusters. Specifically, the study focuses on the mediating role of ambidextrous knowledge strategy (AKS) on the relationship between SC and innovation. Design/methodology/approach A structural model is used on a sample of 215 firms of the hospitality and tourism industry located in World Heritage Cities of Spain. Data analysis is carried out using partial least squares. Findings The combination of bonding and bridging capital yields higher innovation performance through AKS. Research limitations/implications This analysis does not take into account the full set of confounding factors that influence innovation. The factors captured by this study significantly explain heterogeneity in the intensity of innovation among the studied firms. Practical Implications The main recommendation is that firms located in cultural tourism clusters (CTCs) do not restrict the focus on either local or outside relations only but pursue a strategy based on the combination of internal and external relations. This will enable ambidextrous knowledge strategies and better innovation performance. Originality/value There are numerous studies on the relation between some dimensions of SC, some knowledge strategies and some types of innovation. The value added of the present study is the articulation of complementarities among these dimensions. In particular, this study integrates bonding and bridging dimensions of SC, exploration and exploitation of knowledge and incremental and radical innovation. In addition, the paper provides an empirical identification of World Heritage Cities of Spain as CTCs.

Background In addition to the lack of COVID-19 diagnostic tests for the whole Spanish population, the current strategy is to identify the disease early to limit contagion in the community. Aim To determine clinical factors of a poor prognosis in patients with COVID-19 infection. Design and setting Descriptive, observational, retrospective study in three primary healthcare centres with an assigned population of 100,000. Method Examination of the medical records of patients with COVID-19 infections confirmed by polymerase chain reaction. Logistic multivariate regression models adjusted for age and sex were constructed to analyse independent predictive factors associated with death, ICU admission and hospitalization. Results We included 322 patients (mean age 56.7 years, 50% female, 115 (35.7%) aged � 65 years): 123 (38.2) were health workers (doctors, nurses, auxiliaries

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Abstract. Migrants from developing countries are usually young and healthy but several studies report they may harbor asymptomatic infections for prolonged periods. Prevalence of infections were determined for asymptomatic immigrants from Latin America and sub-Saharan Africa who ettended to a European Tropical Medicine Referral Center from 2000 to 2009. A systematic screening protocol for selected infections was used. Data from 317 sub-Saharan Africans and 383 Latin Americans were analyzed. Patients were mostly young (mean age 29 years); there were significantly more males among sub-Saharan Africans (83% versus 31.6%) and pre-consultation period was longer for Latin Americans (5 versus 42 months). Diagnoses of human immunodeficiency virus (HIV), chronic hepatitis B and C virus infection, and latent tuberculosis were significantly more frequent in sub-Saharan Africans (2.3% versus 0.3%; 14% versus 1.6%; 1.3 versus 0%; 71% versus 32.1%). There were no significant differences in prevalence for syphilis and intestinal parasites. Malaria and schistosomiasis prevalence in sub-Saharan Africans was 4.6% and 5.9%, respectively, and prevalence of Chagas disease in Latin Americans was 48.5%. Identifying and treating asymptomatic imported infectious diseases may have an impact both for the individual concerned and for public health. Based on these results, a systematic screening protocol for asymptomatic immigrants is proposed.

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