Digital equity and inclusion in technology-based mental health services

Digital mental health is rapidly growing and has the potential to address issues of mental health equity and disparities among underserved populations. Digital mental health (DMH) can increase the accessibility, efficacy and efficiency of delivering mental health services to vulnerable populations and those who need it most. At the same time, as technology keeps booming, those who are most disenfranchised are at the greatest risk of not benefitting from technological advances, which could result in DMH interventions not reaching vulnerable populations and further increasing health disparities. This chapter explores the importance of digital equity and inclusion in technology-based mental health services. We begin with an overview of the digitalisation of mental health services via the internet, mobile phones and digital ‘apps' and discuss how the COVID-19 pandemic outbreak has further demonstrated the need for the digital mental health and policy changes required for the greater adoption of DMH by health care professionals. The authors further discuss the various ways in which DMH, including telehealth and remote monitoring, might be helpful for improving the delivery of and access to mental health care services. Despite the benefits of DMH (e.g. efficacious treatment, cost-effectiveness, accessibility), the widespread adoption of DMH interventions is not without concerns. In this chapter, the authors discuss the need for privacy in DMH and how privacy concerns may further exacerbate health disparities, which may be a leading factor in clinicians' and users' decisions not to engage with these services/interventions. In addition, we discuss how the technology divide (e.g. lack of adequate technological services and lack of digital literacy) further fuels equity concerns in the field of DMH. Finally, the authors discuss how digital inclusion and equity may be promoted via the integration of user-centred design into app development and research processes, as well as the role of digital health navigators in helping to bridge the technology divide and promoting high-quality care within DMH services. © 2023 selection and editorial matter, Antonio López Peláez, Sang-Mok Suh and Sergei Zelenev;individual chapters, the contributors.

Acute phase characteristics and long-term complications of pulmonary embolism in COVID-19 compared to non-COVID-19 cohort: a large single-centre study.

BACKGROUND: To compare the severity of pulmonary embolism (PE) and the long-term complications between patients with and without COVID-19, and to investigate whether the tools for risk stratification of death are valid in this population. METHODS: We retrospectively included hospitalized patients with PE from 1 January 2016 to 31 December 2022. Comparisons for acute episode characteristics, risk stratification of the PE, outcomes, and long-term complications were made between COVID and non-COVID patients. RESULTS: We analyzed 116 (27.5%) COVID patients and 305 (72.4%) non-COVID patients. In patients with COVID-19, the traditional risk factors for PE were absent, and the incidence of deep vein thrombosis was lower. COVID patients showed significantly higher lymphocyte count, lactate dehydrogenase, lactic acid, and D-dimer levels. COVID patients had PE of smaller size (12.3% vs. 25.5% main pulmonary artery, 29.8% vs. 37.1% lobar, 44.7% vs. 29.5% segmental and 13.2% vs. 7.9% subsegmental, respectively; p < 0.001), less right ventricular dysfunction (7.7% vs. 17.7%; p = 0.007) and higher sPESI score (1.66 vs. 1.11; p < 0.001). The need for mechanical ventilation was significantly higher in COVID patients (8.6% vs. 1.3%; p < 0.001); However, the in-hospital death was less (5.2% vs. 10.8%; p = 0.074). The incidence of long-term complications was lower in COVID cohort (p < 0.001). PE severity assessed by high sPESI and intermediate and high-risk categories were independently associated with in-hospital mortality in COVID patients. CONCLUSION: The risk of in-hospital mortality and the incidence of long-term complications were lower in COVID-19. The usual tools for risk stratification of PE are valid in COVID patients.

Knowledge about COVID-19 infection and associated factors in a Cuban population sample

Introduction: COVID-19 is considered a biological risk due to its high contagiousness. In the measure in that people possess knowledge on the illness they will be able to be more protected. Objective: To characterize the level of knowledge about general aspects of COVID-19 infection and to identify some factors associated in a Cuban population. Methods: Cross-sectional and analytic study performed with people belonging to “Edor de los Reyes Martínez Áreas” polyclinic, Jiguaní municipality, Granma province. The sample was constituted by 326 people. A validated scale was used and it was considered as appropriate knowledge the punctuation located in the higher global tertil. Frequencies and percentages are described, and generalized linear models were used to establish statistical associations. Results: In the 326 participants, mean age was 52.47 years and 63.50% were female. The better responded question was the related with the behavior in case of symptoms of a cold and suspicions for SARS-CoV-2 infection (98% success). In the multivariate analysis, had an appropriate level of knowledge those of smaller age (cPR: 0.995;CI 95%: 0.994-0.995;p< 0.001), the university graduates (cPR: 1.230;CI 95%: 1.141-1.327;p<0.001), the state workers (cPR: 1.100;CI 95%: 1.054-1.148;p< 0.001), as well as, those that had been informed by television (cPR: 1.331;CI 95%: 1.233-1.436;p< 0.001). Conclusions: The majority of the people had an adequate level of knowledge and it is associated to had less age, university studies, being state worker and have been informed through television. © 2021, Editorial Ciencias Medicas. All rights reserved.

Acute Kidney Injury and Urinary and Histopathological Disorders in Kidney Transplant Patients with SARS-CoV-2 Infection.

BACKGROUND: Acute kidney injury (AKI) is a manifestation of SARS-CoV-2 infection. The evidence in kidney transplant (KT) is limited, as there are scarce data about the histologic features in graft biopsies of these patients. MATERIAL AND METHODS: A retrospective cohort study of KTs with SARS-CoV-2 infection from August 28, 2020, to April 23, 2021. We collected the incidence of AKI and the presence of urinary and histopathological disorders. Both groups were compared (AKI vs no AKI). Immunohistochemical and reverse transcription-polymerase chain reaction studies were performed on the anatomopathological samples. RESULTS: In our study, 72 KTs had SARS-CoV-2 infection and, among them, 27 patients (35.1%) developed AKI related to increased severity and a worse evolution of the infection, defined by a greater presence of pneumonia (P < .001), hospitalization (P < .001), admission to the intensive care unit (P < .001), the need for ventilation support (P < .001), and continuous renal replacement therapy (P < .001). In the multivariable analysis, pneumonia behaved as an independent predictor for AKI development (P = .046). No differences were observed between proteinuria a month before and after infection (P = .224). In addition, 5 patients showed microhematuria and 2 patients presented transient glycosuria without hyperglycemia. Of the 5 kidney biopsies performed, 1 biopsy (20%) showed positive reverse transcription polymerase chain reaction for SARS-CoV-2. CONCLUSIONS: AKI is a frequent and potentially serious complication in KT patients. Occasionally it could be accompanied by abnormalities in the urinary sediment. Of 5 biopsied patients, 1 patient had positive reverse transcription polymerase chain reaction in renal tissue, which suggests the systemic spread of the virus and the tropism for the renal graft.

Usefulness of Active Screening in the Confrontation of COVID-19 for Epidemiological Control and Cultural Formation

Introduction: Active screening in Cuba demonstrated wide usefulness and effectiveness in the confrontation of the COVID-19 pandemic. The participation of students and professors from medical universities contributed to greater efficiency. Objective: To describe the usefulness of active research in the confrontation of the COVID-19 pandemic, as an epidemiological strategy and a scientific-cultural experience. Methods: An observational, descriptive and cross-sectional study was carried out. The universe was made up of 140 students of medical science. The sample was composed of twelve students from a screening brigade, two family medicine specialists and two nursing graduates from the family medical offices selected by nonprobabilistic sampling by feasibility, organized in pairs. The actions were structured in four stages: recognition, characterization, rectification-confrontation and consolidation. The data were obtained from the surveys carried out and from the daily data collection model. Results: The procedure used, with dates of history, arts and sciences, as well as field trip to historical sites, was novel for the students and staff of the family medical offices. 83% considered the work carried out as very useful and 75% valued it as mostly different. 100% of the population was studied by screening every week. Conclusions: Active screening is an effective diagnostic action that can be used for contributing to cultural training and strengthening ideological-political work with students. © 2021, Editorial Ciencias Medicas. All rights reserved.

The Socioconstructivist Approach for the Teaching Process in the Training Conditions of COVID-19

Introduction: The current condition marked by the Covid 19 require graduating professionals who resolve with integrity, Independence and in a creative way, the problems that arise in the exercise of their work activity. Objective: To show, organically and in the context of the pandemic, the arguments regarding the importance of the socioconstructivist didactic approach focused on the development of logical-intellectual and professional skills. Development: A qualitative study was carried out on the socioconstructivist approach and the teaching process in the training conditions of COVID-19. A bibliographic review was carried out based on theoretical inquiries such as logical-historical analysis and documental analysis, with vast information that served as a source of knowledge about the professional training process demanded nowadays. A challenge is imposed on the training process and its main actors (professors and students), because the assimilation of contents by anybody who learns must be based on the development of the logical-professional skills included in the professional profile. This requires a teaching leadership for encouraging the development of theoretical-systemic, critical and creative thinking, closely related to values and to work ethics. Conclusions: The socioconstructivist didactic approach focused on the development of logical-intellectual and professional skills imposes a challenge to the training process and its main actors (teachers and students), due to the assimilation of contents by learners based on the development of logical-intellectual and professional skills, included in the professional profile. © 2021, Editorial Ciencias Medicas. All rights reserved.

An interactive 3D interface for a virtual Chilean artisan fairs

Craft fairs are spaces where artisans can exhibit their artistic pieces and interact with the public, however this activity is always affected by external factors, such as weather, stoppages, health situation (due to covid-19), among others. This proposal is an innovative contribution to this problem that makes technology available to support this sector. Through a Web platform that incorporates a 3D interface, the craftsman will reach his audience without having to leave his home, since it simulates the environment of a craft fair where you can browse and see the crafts in its 360°, admiring each detail as if the user were in person. The technological infrastructure includes a catalog of all the pieces offered by the artisans and contact details. A filter facilitates the search for parts according to established criteria. The proposal has validations and various functional tests that show the technical feasibility and usability tests that demonstrate its usefulness and ease of use. © 2021 IEEE.

Strategic dental marketing within the framework of COVID-19 in Ambato, Ecuador

In a pandemic context fraught with socioeconomic crisis, the field of dentistry has also had challenges in providing its services, since caring for patients implies high risks of infection in dental settings;However, commitments to society have led them to reconfigure their actions, in accordance with the needs of the market. In this framework, the present research aimed to determine the marketing strategies implemented by specialized dental centers in the canton of Ambato (Ecuador), to face the economic crisis generated by COVID-19. For this, strategic marketing was investigated by consulting the positions of Lambin (2009), Kotler and Armstrong (2007) and Munuera and Rodriguez (2012), among others. Methodologically, a type of applieddescriptive research was used, with a field-transectional design. The population was made up of all the specialized dental centers active and with physical infrastructure in the canton of Ambato, the informant agents being the dentists who provide their services in the aforementioned centers. The technique for data collection was the survey, using a structured questionnaire with a Likert scale, its content validated by five (5) marketing experts and reliability was measured using Cronbach's Alpha coefficient, which yielded 0.99. The results show a positive trend in the implementation of marketing strategies oriented towards diversification, growth and competitiveness. It is concluded that specialized dental centers develop marketing strategies to face the turbulent environment and to be able to function in competitive terms, according to the dental needs of the local society.

Contagion modeling and simulation in transport and air travel networks during the COVID-19 pandemic: a survey

The COVID-19 pandemic has generated a huge volume of research from various disciplines, such as health sciences, social sciences, mathematical modeling, social network analysis, complex systems, decision-making processes, computer simulation, economics, among many others. One of the key problems has been to understand the diffusion processes of the virus, which quickly spread worldwide through transport networks, mainly air flights. Almost two years after start the pandemic, it is necessary to collect and synthesize the existing work on this matter. This work focuses on studies related to the COVID-19 contagion simulation through transport networks. In particular, we are specially interested in the different datasets and epidemiological models used. The search methodology consists of four exhaustive searches in Google Scholar carried out between January 2020 and January 2021. Of the 1786 findings, we chose 54 articles related to Covid-19 contagion modeling and simulation through transport networks. The results show 30 different data sources for the collection of air flights and 11 additional sources for maritime and land transport. These datasets are usually complemented with other data sources, local and international, with demographic information, economic data, and statistics of traceability of the pandemic. The findings also found 15 spread models of contagion, with the SEIR model being the most widely used, followed by mathematical-based risk models. This diversity of results validates the need for these types of compilation efforts since researchers do not have a single centralized repository to collect air flight data. Author