Mortality in a swiftly repurposed hospital in northeast Brazil during the first and second COVID-19 waves: A retrospective cohort study.

Background: The first months of the coronavirus disease 2019 (COVID-19) pandemic demanded rapid re-organization of available local resources. This study evaluated the performance of a private hospital in the Brazilian state of Ceará that was swiftly repurposed into a public tertiary COVID-19 centre during the first wave of the COVID-19 pandemic, and how it improved in the second wave. Methods: This retrospective cohort study included 2492 patients with COVID-19 at Hospital Estadual Leonardo da Vinci (HELV) during the first and second waves. Demographic, clinical and laboratory data were collected using a dedicated web platform (ResCOVID). A Poisson regression model was used to estimate factors associated with in-hospital mortality. Results: Differences in demographics and clinical features were found between the two waves. There was reduced in-hospital mortality during the second wave (36.2%) in comparison with the first wave (48.8%). Invasive mechanical ventilation showed the strongest association with increased risk of death in both waves {first wave: relative risk (RR) 4.28 [95% confidence interval (CI) 2.86-6.41], P<0.001; second wave: RR 12.94 (95% CI 3.4-49.12), P<0.001}. Conclusions: HELV was a pillar in the strategic public health plan to respond to COVID-19 in Ceará, helping to assist a group of moderate-to-severe cases and reduce the pressure on emergency and primary care facilities. Although mortality in intubated individuals remained high, there was an overall decrease in the in-hospital mortality rate in the second wave.

Mortality in a swiftly repurposed hospital in northeast Brazil during first and second COVID-19 waves: a retrospective cohort study

Background The first months of COVID-19 pandemic demanded rapid reorganization of available local resources. We evaluated the performance obtained by swiftly repurposing a private hospital in the Brazilian state of Ceará into a public tertiary COVID-19 center under the 1st wave and how it evolved to improved levels in the 2nd wave. Methods Retrospective cohort of 2492 COVID-19 patients at Hospital Estadual Leonardo da Vinci (HELV) during the 1st and 2nd waves. Demographic, clinical and laboratorial data were collected using a dedicated web platform (ResCOVID). A Poisson regression model was used to estimate factors associated with in-hospital mortality. Results We found differences in demographics and clinical features between the two waves. There was a reduced in-hospital mortality during the 2nd wave (36.2%) in comparison with the 1st wave (48.8%). Invasive mechanical ventilation showed the strongest association with increased risk of death in both waves (1st wave: RR 4.28 [2.86-6.41], p<0.001;2nd wave: RR 12.94 [3.4-49.12], p<0.001). Conclusions HELV was a pillar in the strategic public health plan to respond to COVID-19 in Ceará, helping to assist a group of moderate to severe patients and to decompress the demand from emergency and primary care. Although mortality in intubated individuals remained high, we found an overall decreased in-hospital mortality in the 2nd wave.

Systemic Corticosteroids in Patients with Bronchial Asthma: A Real-Life Study.

OBJECTIVES: The objective of the present study was to determine the use of systemic corti-costeroids (SCs) in patients with bronchial asthma using big data analysis. METHODS: We performed an observational, retrospective, noninterventional study based on secondary data captured from free text in the electronic health records. This study was per-formed based on data from the regional health service of Castille-La Mancha (SESCAM), Spain. We performed the analysis using big data and artificial intelligence via Savana® Manager version 3.0. RESULTS: During the study period, 103 667 patients were diagnosed with and treated for asthma at different care levels. The search was restricted to patients aged 10 to 90 years (mean age, 43.5 [95%CI, 43.4-43.7] years). Of these, 59.8% were women. SCs were taken for treatment of asthma by 58 745 patients at some point during the study period. These patients were older, with a higher prevalence of hypertension, dyslipidemia, diabetes, ob-esity, depression, and hiatus hernia. SCs are used frequently in the general population with asthma (31.4% in 2015 and 39.6% in 2019). SCs were prescribed mainly in primary care (59%), allergy (13%) and pulmonology (20%). The frequency of prescription of SCs had a direct impact on the main associated adverse effects. CONCLUSION: In clinical practice, SCs are frequently prescribed to patients with asthma, especially in primary care. Use of SCs is associated with a greater number of adverse events. It is necessary to implement measures to reduce prescription of SCs to patients with asthma, especially in primary care.

Towards more sustainable tourism under a carbon footprint approach: the Camino Lebaniego case study. (Special Issue: Sustainable development of integrated energy, water and environment systems.)

From an economic point of view, the tourism sector is one of the most important in the world with religious tourism, such as pilgrimages, being a growth area. Tourism activities also make a significant contribution to CO2 emissions (roughly 8% of the world's carbon emissions). In this framework, the main objective of this research is to develop an integrated sustainable model by assessing the impact of pilgrimages to the Camino Lebaniego (Lebaniego Way) in the Cantabrian region, which is one of the most popular routes in northern Spain. To do this, it is necessary to quantify the environmental impacts of this activity since this is a key element in establishing appropriate and effective environmental management programmes. This study uses the Life Cycle Assessment (LCA) method, focused on the Carbon Footprint (CF) impact category, to assess the greenhouse gas (GHG) emissions of this activity considering 'a pilgrim who completes the route in three days' as the selected functional unit (FU). In addition, the sub-sectors of accommodation, food and beverages, and waste management are taken into account. Following this route generated a total of 13.69 kg CO2 eq./FU, of which accommodation and the services offered there contributed almost 71.47%, food was 17.08%, and waste management 11.45%. The evening meal and propane consumption were the hotspots in the hostel, accounting for almost 74% of the total impact, so alternatives were proposed to reduce the impacts associated with these. In terms of transport, it was found that for the same destination, it was better to use a car rather than a plane, because the associated CO2 emissions were lower. Finally, these aspects are discussed and improvement measures for reducing GHG emissions are proposed, involving the introduction of good practices and environmental commitments from the pilgrims themselves, as well as enterprises and local communities. Ecolabels and environmental certifications should become a key tool for sending this signal to the market as should the use of public transport to the destination, among other actions. Ultimately, religious and nature tourism seems to be on the upturn, and it is likely that pilgrimage routes could be the next post-COVID travel trend.

Argentine Universities: Problems, COVID-19, ICT & Efforts

In this paper the general objective was determine the situation of Argentine universities: Problems, COVID-19, ICT & efforts. Methodology, in this research, 36 documents have been selected, carried out in the period 2016 - 2021;including: scientific articles, review articles and information from websites of recognized organizations. The keywords used in the searches were: Argentine universities, COVID-19 and ICT. Results, Argentine universities have many difficulties, like other Latin American universities. The pandemic has reduced access to economic resources. However, Argentine universities are making many efforts to fulfill their social role. Conclusions, the oldest university in Argentina is the National University of Cordoba, founded in 1613. Higher education in Argentina is primarily public, where direct entry is offered to students. The professional careers preferred by Argentine students are engineering, law and administration. There are also very internationally recognized private universities. Many universities are struggling to quickly set up their virtual platforms, before classes start. The difficult economic situation that the country is going through for several years, the health emergency and social isolation due to the pandemic, have paralyzed public and private university activity. It is important and urgent that Argentine universities strengthen the adoption of ICT and also promote innovation.

Gender-based-violence and pandemic

The article presents experiences from three extension projects carried out in Brazilian universities, and discusses the “reinvention” of university performance during the COVID-19 pandemic in extension activities related to violence against women. The right of access to justice for women was considerably affected by the difficulty of accessing information and communication technologies. Despite the limitations of remote working conditions and adaptation to the dynamics of virtual service, the projects have established themselves as important interlocutors, providing women, with respect for autonomy and decision-making capacity, a welcoming environment based on the feminist logic of intervention. © 2022. Revista Estudos Feministas. All Rights Reserved.

University Education in Times of Pandemic in Latin America

COVID-19 brought the temporary suspension of face-to-face education, leading to the urgent transformation and adaptation of teaching-learning processes in the university context. The objective of this research is to analyze the impact of COVID-19 on university education in Latin America. The methodology applied was documentary research, using the method of content analysis through a systemic review. Academic articles were searched between the years 2020 and 2022 from the Scopus and Web of Science databases and that contain the concepts: COVID-19, university education, Latin America. It was found that, in Latin American studies, categories were found regarding university teaching in times of pandemic, advantages, disadvantages, difficulties and limitations and challenges. It was concluded that teachers have responded positively to the abrupt changes produced by the pandemic, ensuring essential university educational processes;being necessary their training and updating in the use of technology applied to teaching.

Arab Universities: Problems, COVID-19 and Efforts

It is necessary to know the state of the Arab universities. In this paper the general objective was to determine the situation of Arab universities: Problems, COVID-19 & efforts. Methodology, in this research, 36 documents have been selected, carried out in the period 2016 -2021;including: scientific articles, review articles and information from websites of recognized organizations. The keywords used in the searches were: Arab universities and COVID-19. Results. Arab universities have faced many problems during the pandemic, but they have struggled to overcome them and offer a virtual education to their students. Conclusions. Covid-19 forced the closure of Arab universities, affecting the education of students, who have problems accessing to the internet. Arab universities that used traditional education are gradually migrating to virtual education. King Abdulaziz University of Saudi Arabia ranks first in the Arab Universities Ranking 2021.

REFLECTIONS ON THE IMPACT OF THE COVID-19 PANDEMIC ON EDUCATION

In this article we seek to compile some academic publications made in the years 2020 and 2021 that brought the problem of remote teaching that suddenly replaced the face-to-face teaching in the mentioned years. To do so, we did a bibliographical search with the help of Google Scholar and selected the three articles in foreign language most referenced by this search engine. One of these articles was written by a Brazilian researcher, another brought an account of the reality of teaching in Zambia, while the third talked about mathematics education in Germany. We have also selected articles in Portuguese, which brought some ideas that goes from political issues to issues related to the classroom and the role of mathematics in the context of the pandemic. Additionally, we searched for books published in 2020 and 2021 that brought reports and ideas from several authors that we have shorted up here. Finally, we highlighted our experiences, trying to link them with the authors referenced earlier. © 2022 CONICET - Emiliano Aldegani. All rights reserved.

Analysis of the degree of motivation in Physical Education in relation to the theory of self-determination in post COVID-19 period

Due to all the changes in the educational paradigm and the restrictions in social relationships due to this new post-COVID-19 reality, this study is aimed at determining the motivation levels towards Physical Education of following the self-determination theory of Ryan & Deci (2012). Also, the influence of the non-curricular physical activity on the three psychological necessities gathered in the self-determination theory (i.e., autonomy, competence, and relatedness) will be analyzed. 300 students from three Valencian schools voluntarily participated in the study. Students from 12 to 17 years old were included (mean: 13.93, standard deviation: 1.32). 72.7% of the students practice non-curricular physical activities and 27.3 don't practice. Statistically significant differences were encountered in the three psychological dimensions assessed (i.e., autonomy, competence, and relatedness) between the students who practice non-curricular physical activity and those who not. Also, a significant correlation was observed between the three tested dimensions. It is also worth mentioning that relatedness is the dimension obtaining higher motivation values (4.07 out of 5 maximum points on a Likert scale). The results of the present study suggest that students who present higher motivation in one area, also present higher motivation in the other two areas. This research highlights the importance of non-curricular physical activity as a crucial factor influencing the motivation of high-school students in Physical Education.

Knowledge mediated by digital technologies internalization: An analysis of synchronous communication and learning in the covid-19 pandemic

Due to the social isolation caused by the rapid expansion of COVID-19, several higher education institutions have replaced classroom classes with classes with synchronous communication. This investigation aims to identify the level of satisfaction related to the absorption of pedagogical content in online classes applied through synchronous communication. For that, we opted for the quantitative approach, using the data collection technique through the application of an online questionnaire. The investigation was carried out after the practice of the first two months, with students enrolled in face-to-face higher education, in the countries of Brazil and Portugal, who had their teaching changed to classes with synchronous communication, taught by videoconference, through digital platforms. The results showed that both in Brazil and in Portugal, there was greater student satisfaction regarding the absorption of teaching content in this period. © Atas da Conferencia da Associacao Portuguesa de Sistemas de Informacao 2020.

An automated room disinfection system using ozone is highly active against surrogates for SARS-CoV-2.

BACKGROUND: The presence of coronaviruses on surfaces in the patient environment is a potential source of indirect transmission. Manual cleaning and disinfection measures do not always achieve sufficient removal of surface contamination. This increases the importance of automated solutions in the context of final disinfection of rooms in the hospital setting. Ozone is a highly effective disinfectant which, combined with high humidity, is an effective agent against respiratory viruses. Current devices allow continuous nebulization for high room humidity as well as ozone production without any consumables. AIM: In the following study, the effectiveness of a fully automatic room decontamination system based on ozone was tested against bacteriophage Φ6 (phi 6) and bovine coronavirus L9, as surrogate viruses for the pandemic coronavirus SARS-CoV-2. METHODS: For this purpose, various surfaces (ceramic tile, stainless steel surface and furniture board) were soiled with the surrogate viruses and placed at two different levels in a gas-tight test room. After using the automatic decontamination device according to the manufacturer's instructions, the surrogate viruses were recovered from the surfaces and examined by quantitative cultures. Then, reduction factors were calculated. FINDINGS: The ozone-based room decontamination device achieved virucidal efficacy (reduction factor >4 log10) against both surrogate organisms regardless of the different surfaces and positions confirming a high activity under the used conditions. CONCLUSION: Ozone is highly active against SARS-CoV-2 surrogate organisms. Further investigations are necessary for a safe application and efficacy in practice as well as integration into routine processes.

Guidelines for management of patients with neuromuscular disorders during covid-19 pandemic

The coronavirus-19 disease (COVID-19) pandemic has resulted in reorganization of healthcare settings with potential impact in the delivery of clinical care to patients with neuromuscular disorders. These patients may harbour an increased risk of severe complications related to COVID-19. Several risk factors are identified such as respiratory weakness, cardiac involvement, immunosuppression and presence of comorbidities, among others. Therapeutic decisions must be considered in the best interest of the patients, and the society, with no denial of the best treatment possible. Clinical recommendations, based on expertise opinion, are presented for clinical care of patients with neuromuscular disorders.

Mental health interventions for health professionals in the context of the coronavirus pandemic

Objective: to reflect on mental health care interventions/actions aimed at health professionals who provide assistance to patients suspected or diagnosed with COVID-19. Content: The COVID-19 pandemic challenges health professionals to lead with their own and patients’ mental health. It is essential to know and to reflect about countries’ initiatives to deal with health professional’s mental health maintenance in times of pandemic, and to help to re-think strategies planning, execution and evaluation to be used in Brazil. Final considerations: it was possible to list actions in mental health that have shown to be assertive in the care of health workers who are in the front line of caring, especially those based on clarifying the disease, appropriate use of individual protective equipment, in addition to mapping those emotionally weakened professionals and or with mental suffering prior to the pandemic, in addition to the emotional support offered through digital platforms. © 2020, Centro de Estudos da Faculdade de Enfermagem da UERJ. All rights reserved.

MALARIA AND COVID-19 IN NATIVE COMMUNITIES OF AMAZONAS, PERU

Introduction: In recent years, the number of malaria cases in native communities from Condorcanqui, Amazonas has considerably increased. Plasmodium vivax malaria is endemic in the region and the reintroduction of Plasmodium falciparum was reported in 2019. Objective: Here, we compiled and analyzed malaria and COVID-19 data reported by the Dirección Regional de Salud (DIRESA) during the 2020. Methods: Additionally, we performed an odds ratio analysis to evaluate significant associations between COVID-19 symptoms and previous malaria infections. In 2020, 1547 malaria (97% were P. vivax) and 5968 COVID-19 cases were reported. Furthermore, 96 patients got COVID-19 after getting a malaria infection. Results: From these, 87 were symptomatic (90.6%), and mostly adults, ages 30 to 59 (62.3%). Also, we found that malaria previous infections represent a risk for the presence of symptoms such as fever, cough, throat pain, and respiratory difficulty. Nevertheless, there was no significant association between these patients and hospitalization or death. Conclusions: Our analysis suggests that previous malaria infections might affect COVID-19 symptomatology, which highlights the importance of a continuing control and surveillance malaria program to avoid potential syndemics with COVID-19.

Risk factors associated with mortality in patients hospitalized for coronavirus disease 2019 in Rio de Janeiro, Brazil

INTRODUCTION: Understanding the mortality-associated risk factors of coronavirus disease 2019 will impact clinical decisions. METHODS: This retrospective longitudinal study included patients hospitalized for coronavirus disease in Rio de Janeiro, Brazil. The Kaplan-Meier method and multivariate Cox regression analysis were used. RESULTS: Sequential Organ Failure Assessment score of >=2 (hazard ratio 4.614;95% confidence interval =2.210-9.634;p<0.001) and neutrophil/lymphocyte ratio of >5 (hazard ratio=2.616;95% confidence interval=1.303-5.252;p=0.007) were independently associated with mortality. CONCLUSIONS: Sequential Organ Failure Assessment score and neutrophil/lymphocyte ratio on admission can identify coronavirus disease patients at increased risk of death and guide subsequent clinical decisions.