Design of a Mobile Application for the Control of Pregnant Women

Due to the fact that the health information of pregnant women is extremely complex and delicate because of COVID-19. If adequate measures are not taken, it has to be mentioned that the exposure increases the chances of contagion, making the simple fact of having to receive one of the consultations for the control of gestation becomes very dangerous. The objective of the research is to design a mobile application for the control of pregnant women in times of pandemic in an effective and efficient way and thus decrease the contagion of COVID-19. The methodology used is the incremental model that allowed us to obtain the percentages of the application made. The result obtained is the design of the application for the control of pregnant women to show all the ailments and problems that can occur during pregnancy, from a headache to malfunction of the internal organs. Thanks to the application is already a great help for people's daily routines as these range from simple games to various applications to manage and control in making decisions from home. © 2023 Seventh Sense Research Group®

A Practical Approach of Actions for FAIRificationWorkflows

Since their proposal in 2016, the FAIR principles have been largely discussed by different communities and initiatives involved in the development of infrastructures to enhance support for data findability, accessibility, interoperability, and reuse. One of the challenges in implementing these principles lies in defining a well-delimited process with organized and detailed actions. This paper presents a workflow of actions that is being adopted in the VODAN BR pilot for generating FAIR (meta)data for COVID-19 research. It provides the understanding of each step of the process, establishing their contribution. In this work, we also evaluate potential tools to (semi)automatize (meta)data treatment whenever possible. Although defined for a particular use case, it is expected that this workflow can be applied for other epidemical research and in other domains, benefiting the entire scientific community.

The renin-angiotensin system in the eye

The renin–angiotensin system is major endocrine, paracrine, and autocrine system that has a notorious role in regulating hemodynamics and electrolyte balance, thus controlling blood pressure. Nonetheless, the functions of RAS are multiple and continue to expand, as its receptors, enzymes, and peptides have been identified in different organs/tissues, implying novel local effects of RAS and participation in the pathogenesis of different diseases in multiple organs, including the eyes. Vascularized, fibrous, and nervous structures of the eyes and their fluids express several RAS components including angiotensinogen, prorenin, renin, (P)RR, ACE, Ang II, AT1R, AT2R, ACE2, Ang 1-7, and Mas. Additionally, abundant RAS hormones are present in intraocular tissues implicating local production. Ocular RAS functions seem to be diverse;first, RAS is proposed to modulate aqueous humor biosynthesis and drainage, consequently regulating IOP. Exacerbation of ACE/ Ang II/ AT1R actions is observed in glaucoma, and blockage of this axis with ACEIs and ARBs is a feature that can be explored to reduce IOP and treat glaucoma. Second, impairment of RAS with exacerbation of ACE/ Ang II/ AT1R and depletion of ACE2/ Ang 1-7/ Mas culminate in an angiogenic, inflammatory, proliferative, and oxidative phenotype, which is tightly related to retinal vascular disorders such as diabetic retinopathy, age-related macular degeneration, and retinopathy of prematurity. Indeed, treatments blocking ACE/ Ang II/ AT1R or enhancing ACE2/ Ang 1-7/ Mas are reported to be beneficial to prevent or restrain the progression of these diseases. Finally, clinical manifestations of COVID-19 include ocular disorders such as conjunctivitis, dry eyes, eye pain, discharge, and blurred vision. ACE2 expression in ocular tissues may define ophthalmic susceptibility to SARS-CoV-2 infection. Moreover, SARS-CoV-2 entry mechanisms may cause depletion of ACE2 biological effects, which can contribute to RAS dysregulation and the ocular disorders observed in COVID-19. This chapter focuses on reviewing the components and functions of the ocular RAS, its implications for eye homeostasis, and the potential of RAS as a therapeutic target to treat ocular disorders, including glaucoma, diabetic retinopathy, age-related macular degeneration, and retinopathy of prematurity. © 2023 Elsevier Inc. All rights reserved.

Putting Fairness into the Gig Economy: Delivery Cooperatives as Alternatives to Corporate Platforms

Since the COVID-19 pandemic began, platform capitalism has expanded greatly in the delivery sector. The consolidation of an oligopoly controlled by a few corporate platforms has led to precarious working conditions for "gig economy” workers. Increasing protests and strikes have led to the reform of labour directives and to the emergence of alternative ways of organising work through platform cooperatives. This article examines how these emergent platform cooperatives are mobilised and their challenges and implications. Barcelona, the cradle of many platform economy and delivery sector start-ups, is a critical case for examining the recent birth of alternative delivery cooperatives. This article is informed by the cases of three cooperatives, organised by those working as riders, providing delivery services in the city of Barcelona: Mensakas, Les Mercedes, and 2GoDelivery. The paper shows how the embeddedness of these nascent platform cooperatives in favourable governance arrangements, a supportive social and solidarity movement, the knowledge and experience of workers, and the territory where the cooperatives are embedded are essential for their creation. This multi-layered embeddedness is necessary, but not sufficient, to explain how platform cooperatives thrive. The study concludes that the agency of platform workers, who triggered this transformation, was essential for the emergence of alternative ways of organising work in the platform economy. © 2023 by the authors.

Isoniazid preventive therapy completion in children under 5 years old who are contacts of tuberculosis cases in Lima, Peru: study protocol for an open-label, cluster-randomized superiority trial.

BACKGROUND: Children < 5 years old in contact with TB cases are at high risk for developing severe and fatal forms of TB. Contact investigation, BCG vaccination, and isoniazid preventive therapy (IPT) are the most effective strategies to prevent TB among children. However, the implementation of IPT faces challenges at several stages of the cascade of care of TB infection among children, particularly those less than 5 years old. In Peru, a large proportion of children do not complete IPT, which highlights the need to design effective interventions that enhance preventive therapy adherence and completion. Although the body of evidence for such interventions has grown, interventions in medium TB incidence settings are lacking. This study aims to test the effectiveness, acceptability, and feasibility of an intervention package to increase information and motivation to complete IPT among children < 5 who have been prescribed IPT. METHODS: An open-label, cluster-randomized superiority trial will be conducted in two districts in South Lima, Peru. Thirty health facilities will be randomized as clusters, 10 to the intervention and 20 to control (standard of care). We aim to recruit 10 children from different households in each cluster. Participants will be caretakers of children aged < 5 years old who initiated IPT. The intervention consists of educational material, and short message services (SMS) reminders and motivators. The primary outcomes will be the proportion of children who picked up > 90% of the 24 weeks of IPT (22 pick-ups) and the proportion of children who picked up the 24 weeks of IPT. The standard of care is a weekly pick-up with monthly check-ups in a health facility. Feasibility and acceptability of the intervention will be assessed through an interview with the caretaker. DISCUSSION: Unfavorable outcomes of TB in young children, high effectiveness of IPT, and low rates of IPT completion highlight the need to enhance adherence and completion of IPT among children < 5 years old. Testing of a context-adapted intervention is needed to improve IPT completion rates and therefore TB prevention in young children. TRIAL REGISTRATION: ClinicalTrials.gov NCT03881228. Registered on March 19, 2019.

Transfusoes De Hemocomponentes Por Internacao Hospitalar Na Rede Publica Municipal De Belo Horizonte Entre 2008 E 2021: Uma Analise De Serie Temporal

Resumo: Estudo retrospectivo longitudinal ecologico com dados referentes ao uso de hemocomponentes entre janeiro de 2008 e dezembro de 2021 na rede hospitalar do municipio de Belo Horizonte, Minas Gerais. Objetivos: Descrever as series mensais do numero de transfusoes de hemocomponentes e a taxa de transfusao por internacao em internacoes gerais na rede publica hospitalar sob a perspectiva da analise de series temporais. Metodos: A partir de dados do Sistema de Informacao Hospitalar do SUS (SIH-SUS), foram criadas seis series temporais de periodicidade mensal do numero de transfusoes de hemocomponentes e da taxa de transfusao por internacao. A estacionariedade, a tendencia e a sazonalidade das series foram verificadas pelo teste de raiz unitaria, pelo teste de Mann-Kendall e pelo teste de Fisher, respectivamente, utilizando-se os niveis de significancia de 10% para o primeiro teste e de 5% para os dois ultimos. Resultados: A taxa media mensal de uso de hemocomponentes por internacao hospitalar observada foi de 45,5%, 26,9% e 26,3% no Hospital Risoleta Tolentino Neves (HRN), Hospital Dr. Celio de Castro (HCC) e Hospital Odilon Behrens (HOB), respectivamente. A maior reducao do numero de transfusoes de hemocomponentes foi observada no HCC e a maior reducao da taxa de uso de hemocomponentes foi observada no HRN. O concentrado de hemacias foi o hemocomponente mais utilizado no HRN, HOB e HCC (54,6%, 58,3% e 65,4%, respectivamente). Todas as series apresentaram-se nao estacionarias, com tendencia de queda e presenca do componente sazonal com periodicidade de 12 meses. Todas as series apresentaram reducao da tendencia de queda durante o periodo critico da pandemia da COVID-19. Discussao: Os resultados encontrados neste estudo confirmam a hipotese inicial deste estudo de que o principal hemocomponente transfundido nos servicos de saude hospitalares publicos do municipio de Belo Horizonte sao os concentrados de hemacias. As taxas de transfusoes de hemocomponentes observadas nos tres hospitais sao semelhantes as taxas observadas em estudos nacionais e internacionais. A tendencia de queda na taxa de transfusoes de hemocomponentes por internacao hospitalar vai de encontro ao observado na literatura, que aponta para o aumento das taxas de transfusoes de hemocomponentes e dos resultados de um estudo semelhante realizado com uma rede de hospitais privados do mesmo municipio, no qual foi identificada a tendencia de alta em todos os hospitais analisados no estudo. A inexistencia dos dados sociodemograficos e informacoes sobre o local de utilizacao dos hemocomponentes podem ser considerados limitacoes do estudo. Conclusao: O estudo permitiu compreender o comportamento das series temporais relacionadas ao uso de hemocomponentes na rede publica hospitalar do municipio de Belo Horizonte. Acoes que envolvem a reducao da demanda por hemocomponentes, como, por exemplo, a implementacao de programas de Patient Blood Management, podem ser realizadas nos tres hospitais, com primazia para o HRN e para os concentrados de hemacias nos tres hospitais. Copyright © 2022

Interventive psychodiagnosis of children through online orientation of parents in a University Clinical Practice in Brazil: an alternative for underserved populations during the COVID-19 pandemic

Introduction: A private university in Santos offers a free psychological service for assessing and intervening in chilhood psychological problems through a internship program which had to be delivered online due to the COVID-19 pandemic. The interns were only allowed to attend their parents online, instead of their children. Objective(s): Evaluating this new online service is the aim of this work. Method(s): 24 parents of 34 children aged 4-10 years were attended by pairs or trios of 52 interns. The were modules made up of assessment, intervention and feedback, using different instruments such as interviews, screening questionnaires and the observation of 5-minute free play in domestic environment and of a family collage through a video recorded by parents. Feedback and intervention happened in various moments. The interns created a storybook using metaphoric narrative as a feedback tool in which a synthesis of the psychodiagnostic process and orientation was presented to the children. Result(s): There was progress and decrease or elimination of symptons in 19 of the 34 children. Among the children who did not improve, one of them did not present any difficulties;7 of them had many absences and the other 7 were referred to further assessment for reasons related to the complexity of their difficulties or a probable unsuitability of the online orientation. Conclusion(s): The orientation was helpful for 55,89% of the children, showing to be a valid alternative for families who do not have financial resources for attending private clinics or fail to access public health services or even during social distance measures.

Mental Health in the Consorci Sanitari del Maresme workers during the COVID-19 pandemic: A descriptive cross sectional study

Introduction: The global health emergency caused by the COVID- 19 pandemic has put healthcare professionals in an unprecedented challenge, considering them extremely at risk population. Objective(s): To estimate the prevalence of clinically significant mental disorders and to assess associated factors among Consorci Sanitari del Maresme workers during the COVID-19 pandemic. Method(s): We made a descriptive cross-sectional study. All workers were invited to participate in an online survey during May 2021. Individual characteristics and frequency of direct exposure to COVID during professional activity were assessed. We used three Spanish versions of psychometric scales: the Patient Health Questionnaire to evaluate depressive symptomatology, the Generalized Anxiety Disorder scale, which detects anxiety, and the 4-item version of the PTSD checklist for DSM-5 for PTSD screening purposes. Chi-square tests and logistic regression were used to analyze the data. Result(s): A total of 355 workers participated. Overall, 31% met the criteria forMajor Depressive Disorder (PHQ-9> 9), 36% for Generalized Anxiety Disorder (GAD-7> 9) and 22% for Post-traumatic Stress Disorder (PCL-5> 7). It has been found that young adult, women, those with prior mental disorders or those with greater exposure to COVID-19 are risk factors for any current mental disorder. Conclusion(s): There are large mental healthcare needs among healthcare professionals. There is a clear need to closely monitor the extent to which these needs are adequately met. In the design of measures and interventions to reduce this impact, an individualized approach should be considered while taking into account sociodemographic variables, psychiatric history and the frequency of direct exposure to COVID-19.

A Platform to Generate FAIR Data for COVID-19 Clinical Research in Brazil

The COVID-19 pandemic and the global actions to address it have highlighted the importance of clinical care data for more detailed studies of the virus and its effects. Extracting and processing such data, in terms of confidentiality issues, is a challenge. In addition, the mechanisms necessary for their publication are aimed at reuse in research to better understand the effects of this pandemic or other viral outbreaks. This paper describes a modular, scalable, distributed, and flexible platform, based on a generic architecture, to promote the publication of FAIR clinical research data. This platform collects heterogeneous data from Electronic Health Records, transforms these data into interconnected and interoperable (meta)data that are processable by software agents, and publishes them through technological solutions such as repositories and FAIR Data Point. Copyright © 2022 by SCITEPRESS - Science and Technology Publications, Lda. All rights reserved.

Privacy-preservation and the Use of Data for Research: A COVID-19 Use Case in Randomly Generated Healthcare Records

The provision of clinical data for research purposes has become central to monitoring and understanding the COVID-19 outbreak. In such a pandemic scenario, obtaining new research results is an imperative and urgent requirement. However, nowadays, personal data are protected by different legal regulations, to which all these data must comply, especially those related to the health of individuals. Then, a tough challenge arises in the academic sphere: how to provide a large amount of detailed clinical data for research and, simultaneously, guarantee the privacy of the individuals involved? Thus, this article discusses how the biomedical community may face this challenge and it presents the main ongoing initiatives and available emergent technologies that are useful to meet such urgent demand. Moreover, it also shows, through a use case, how it is possible to deal with this challenge, presenting the applicability of privacy-preserving techniques over a randomly generated typical dataset of COVID-19 health records. Copyright © 2022 by SCITEPRESS – Science and Technology Publications, Lda. All rights reserved.

Mechanical power as a predictor of mortality in critical ill patients with acute respiratory distress syndrome by COVID-19 in the intensive care unit

Background: Invasive mechanical ventilation as a therapeutic strategy is not without complications. It is imperative to have protective ventilation parameters in those patients who are subjected to it. We aim to demonstrate whether mechanical power as a ventilatory parameter has prognostic validity for mortality in critically ill patients with prolonged invasive mechanical ventilation. Material and Methods: An analytical cross-sectional study was carried out of critically ill patients on prolonged invasive mechanical ventilation due to Acute Respiratory Distress Syndrome due to COVID-19 who were admitted to the Intensive Care Unit of the Hospital Regional de Trujillo during the March 2020 to March 2021 period.

Neuropsychiatric symptomatology in post-COVID syndrome. Intervention proposal and referral from primary care

SARS-CoV-2 infection is a multiorgan disease with a wide spectrum of clinical mani-festations, including neurological and psychiatric, which are expressed in all stages of the disease and often has long-term symptoms, called post-COVID syndrome. Among the neuropsychiatric symptoms derived from this syndrome, in this article we focus on headache, cognitive impairment, taste and smell alterations, depression, anxiety and sleep disorders. Intervention algorithms for these symptoms in primary care establishing criteria for referral to specialized care are proposed. (C) 2021 Sociedad Espanola de Medicos de Atencion Primaria (SEMERGEN). Published by Elsevier Espana, S.L.U. All rights reserved.

Observational study of the first month of the influenza vaccination campaign in patients followed up for asthma in 2019 and 2020. Does one month make a difference?

Introduction: the main objective of the study was to analyse the influenza vaccination coverage in years 2019 and 2020 and assess the impact of the COVID-19 pandemic on it. To do so, we compared the patients vaccinated in 2 primary care centres (PCCs) of similar characteristics but that differed in that one of them actively recruited patients for vaccination by sending a reminder to their home address. Material and methods: we conducted an observational study in a sample of 934 patients vaccinated in the first month of the influenza vaccination campaign in years 2019 and 2020. We did a descriptive analysis of the sample. Subsequently, we compared the percentage of vaccinated patients at the end of the first month of the campaign in 2019 and 2020 and in the 2 PCCs using the χ2 test. Results: the overall percentage of patients vaccinated after the first month of the campaign was 33.9% in 2020 and 19.9% in 2019 (p <0.001), with significant differences between PCCs as well. A greater percentage of patients received the vaccine in PCC 1, which had an active patient recruitment strategy (p <0.001). Conclusions: the vaccination coverage was higher in 2020 compared to 2019, which could be explained by the anxiety elicited in the population by coexistence of influenza virus and SARS-CoV-2. Active recruitment strategies help increase vaccination coverage in patients with asthma. © 2022, Spanish Association of Primary Care Pediatrics. All rights reserved.

Mental impact of Covid-19 among Spanish healthcare workers. A large longitudinal survey.

AIMS: Longitudinal data on the mental health impact of the coronavirus disease 2019 (Covid-19) pandemic in healthcare workers is limited. We estimated prevalence, incidence and persistence of probable mental disorders in a cohort of Spanish healthcare workers (Covid-19 waves 1 and 2) -and identified associated risk factors. METHODS: 8996 healthcare workers evaluated on 5 May-7 September 2020 (baseline) were invited to a second web-based survey (October-December 2020). Major depressive disorder (PHQ-8 ≥ 10), generalised anxiety disorder (GAD-7 ≥ 10), panic attacks, post-traumatic stress disorder (PCL-5 ≥ 7), and alcohol use disorder (CAGE-AID ≥ 2) were assessed. Distal (pre-pandemic) and proximal (pandemic) risk factors were included. We estimated the incidence of probable mental disorders (among those without disorders at baseline) and persistence (among those with disorders at baseline). Logistic regression of individual-level [odds ratios (OR)] and population-level (population attributable risk proportions) associations were estimated, adjusting by all distal risk factors, health care centre and time of baseline interview. RESULTS: 4809 healthcare workers participated at four months follow-up (cooperation rate = 65.7%; mean = 120 days s.d. = 22 days from baseline assessment). Follow-up prevalence of any disorder was 41.5%, (v. 45.4% at baseline, p < 0.001); incidence, 19.7% (s.e. = 1.6) and persistence, 67.7% (s.e. = 2.3). Proximal factors showing significant bivariate-adjusted associations with incidence included: work-related factors [prioritising Covid-19 patients (OR = 1.62)], stress factors [personal health-related stress (OR = 1.61)], interpersonal stress (OR = 1.53) and financial factors [significant income loss (OR = 1.37)]. Risk factors associated with persistence were largely similar. CONCLUSIONS: Our study indicates that the prevalence of probable mental disorders among Spanish healthcare workers during the second wave of the Covid-19 pandemic was similarly high to that after the first wave. This was in good part due to the persistence of mental disorders detected at the baseline, but with a relevant incidence of about 1 in 5 of HCWs without mental disorders during the first wave of the Covid-19 pandemic. Health-related factors, work-related factors and interpersonal stress are important risks of persistence of mental disorders and of incidence of mental disorders. Adequately addressing these factors might have prevented a considerable amount of mental health impact of the pandemic among this vulnerable population. Addressing health-related stress, work-related factors and interpersonal stress might reduce the prevalence of these disorders substantially. Study registration number: NCT04556565.

A Practical Approach of Actions for FAIRification Workflows

Since their proposal in 2016, the FAIR principles have been largely discussed by different communities and initiatives involved in the development of infrastructures to enhance support for data findability, accessibility, interoperability, and reuse. One of the challenges in implementing these principles lies in defining a well-delimited process with organized and detailed actions. This paper presents a workflow of actions that is being adopted in the VODAN BR pilot for generating FAIR (meta)data for COVID-19 research. It provides the understanding of each step of the process, establishing their contribution. In this work, we also evaluate potential tools to (semi)automatize (meta)data treatment whenever possible. Although defined for a particular use case, it is expected that this workflow can be applied for other epidemical research and in other domains, benefiting the entire scientific community. © 2022, Springer Nature Switzerland AG.

NARRATIVAS DOCENTES E CRIAÇÃO CURRICULAR, DESAFIOS DE TEMPOS PANDÊMICOS

This text aims to present the research we have been developing in the pandemic period with teachers about their curricular productions. In this sense, we provoke to think about the regulation devices that permeate the teaching and the curricula that are crossed by what happens in this school that today, due to the pandemic of COVID-19, draws or redesigns itself by necessity to exist and resist. We point out that the daily curricular creation happens in many other ways than those intended by the current curriculum and training policies by the hands of thousands of teachers who insist on producing knowledge with their students, despite the precariousness to which their work is sometimes subjected. Taken by the desire to understand this school without solid bases and all the production that takes place in it even without its physical structure, we chose to work with narrative research, understanding that it helps us to know what has been produced, besides allowing us to dialogue with these practices from our own experiences, also narrated. © 2021 Curriculo sem Fronteiras. All rights reserved.

The COVID-19 Crisis and Complexity in the United States

The main objective of this research is to present a transdisciplinary research process which identifies the complexity of the issues surrounding COVID-19 using collective intelligence through transdisciplinary collaborative effort. Interpretive Structural Modeling (ISM), a methodology for dealing with complex system design and development has been the key component of this research. Building collective intelligence to understand how factors affecting COVID-19 transmission and fatality and their relationships were investigated. Two different approaches were used to describe the complexity of the COVID-19 issue. (a) the Situation Complexity and (b) Cyclomatic complexity. The results showed that the complexity of the COVID-19 is difficult to understand and handle. © 2021 by the authors.

[Neuropsychiatric symptomatology in post-COVID syndrome. Intervention proposal and referral from primary care]. / Sintomatología neuropsiquiátrica en el síndrome post-COVID. Propuesta de manejo y derivación desde atención primaria.

SARS-CoV-2 infection is a multiorgan disease with a wide spectrum of clinical manifestations, including neurological and psychiatric, which are expressed in all stages of the disease and often has long-term symptoms, called post-COVID syndrome. Among the neuropsychiatric symptoms derived from this syndrome, in this article we focus on headache, cognitive impairment, taste and smell alterations, depression, anxiety and sleep disorders. Intervention algorithms for these symptoms in primary care establishing criteria for referral to specialized care are proposed.