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During 2020, the governments determined the elimination of face-to-face activities in schools and universities to avoid crowds in the classrooms due to the Covid-19 pandemic. This article aims to understand the impacts of remote and hybrid teaching in Higher Education during the Covid 19 pandemic, which started at the end of 2019 all over the world and brought significant changes in various sectors, including education. We have three specific, very clear and defined objectives, namely: (i) verify the challenges faced by teachers and students in HEIs;(ii) highlight pedagogical practices during distance learning and hybrid teaching and (iii) highlight what actions were taken in Higher Education during and after the pandemic. The methodology adopted in this work is a systematic bibliographical research. The results of the investigation indicate that the changes in Higher Education are here to stay, the hybrid model that includes face-to-face and distance education is already a reality for Higher Education institutions and also its main challenge.
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Background: Vaccination plays an essential role in controlling SARS-CoV- 2 pandemics. Due to initial concerns about hypersensitivity reactions (HR) to these new vaccines, our department, in articulation with Primary Healthcare Services (PHS) has developed several strategies to support COVID-19 vaccination. This work aims to describe those strategies and report the results. Method(s): The strategies developed for COVID-19 vaccination, from March to December 2021, included: 1) telephone support for health professionals (TS for HP) from the Vaccination Centres (VC), 2) priority appointments (PA) of patients classified as a higher risk for HR, 3) hospital vaccination of high-risk patients as defined by the national health authority. A retrospective and descriptive analysis of the support activity developed and from the data of patients vaccinated at the hospital in the same period were performed. Result(s): During the considered period, our department screened 1618 patients: 420 (26%) through telephone support for HP (TS for HP) from VC and 1198 (74%) at priority appointments (PA). After TS for HP, community vaccination (CV) was recommended in 87% (n = 364) of cases and a PA was advised in 13% (n = 56). Of the patients evaluated in PA, 80% were recommended CV, with restriction of the vaccine to administer in 28% of them. We always found an option to vaccine all. At the hospital were vaccinated 178 patients, 83% (n = 147) women, median age (P25-75) 61 (46-76) years. Hospital vaccination criteria were: past history of multiple drug HR (n = 93;52%), HR to vaccines (n = 46;26%), HR to the 1st dose of anti-SARS- CoV- 2 vaccine (n = 30;17%), idiopathic anaphylaxis (n = 10;6%) and systemic mastocytosis (n = 2;1%). 15% of patients (n = 26) performed skin tests with vaccines, which were negative in 25 and inconclusive in 1 case. 145 (82%) were first shots, 32 (18%) second shots, and one booster shot. Only one patient had a mild immediate reaction (2nd booster vaccination), promptly treated with antihistamine and corticosteroid. Conclusion(s): The collaboration strategies adopted by our department allowed the vaccination of 1618 patients and avoided vaccination delays in most of the VC contacts. In our sample, hospital vaccination of patients at higher risk for HR was safe.
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Introduction: The SARS-CoV-2 (COVID-19) pandemic continues in the United States, and patients actively receiving chemotherapy are known to be at enhanced risk for developing symptomatic disease. Our study evaluated the prevalence of COVID-19 among patients and providers of our community-facing county health system during the B1.1.529 ("Omicron") COVID-19 variant wave. Method(s): We retrospectively analyzed patients that received care and clinical providers whom worked at the Jackson Memorial Hospital Hematology/Oncology clinic in Miami, Florida from December 1st, 2021 through April 30th, 2022. After categorizing basic demographic factors for individuals whom tested positive for COVID-19 during the study timeframe, we analyzed additional risk factors leading to COVID-19 positivity including, but not limited to, vaccination status, previous COVID-19 positivity, and active receipt of chemotherapeutics. We then analyzed outcomes related to COVID-19, including treatment with advanced COVID-19 therapies such as oral or intravenous antivirals, monoclonal antibodies, convalescent plasma, steroids, or interleukin-6 inhibitors;interactions with inpatient services including emergency department (ED)/urgent care visits, inpatient and/or ICU admissions, and deaths from COVID-19. We finally assessed quality outcomes such as delay in cancer-directed therapy. This study was approved by the University of Miami IRB and Jackson Health System Clinical Trials Office. Result(s): 498 patients and 18 providers were retrospectively analyzed during the study timeframe. 49 patients tested positive for COVID-19 (9.84%), while 6 providers tested positive (33.3%) (p = 0.015). Patients whom tested positive were 51.0% female (n = 25), 26.5% Black (n = 13), 73.5% Hispanic/Latinx (n = 36), and 2.05% Asian (n = 1). Only 6.12% patients had tested positive for COVID-19 previously (n = 3), and 42.9% were considered unvaccinated (n = 21) while 14.3% were boosted (n = 7). 73.5% (n = 36) presented with symptomatic disease, 46.9% (n = 23) sought care at an ED/urgent care, 32.6% (n = 13) were admitted to the hospital, 6.12% were admitted to the ICU (n = 3), and 16.3% (n = 8) received advanced therapeutics. There were 2 (8.0%) COVID-19-related deaths (and another outside our study timeframe) among 23 non-COVID-19 related deaths in the patient population (p = 0.75). More than half of the patients whom tested positive experienced a cancer treatment delay (n = 27/49;55.1%). Conclusion(s): The prevalence of COVID-19 positivity in our patient cohort during the initial Omicron wave mirrored local, state, and national trends, however a statistically significant greater proportion of our providers tested positive. COVID-19 positivity conferred appreciable disparities in the presentation of disease as well as receipt of cancer treatment. COVID-19 positivity was more likely to result in symptomatic disease and ED/urgent care visit in cancer patients without previous COVID infection and unvaccinated status. COVID-19 accounted for 8.0% of our clinic's total mortality.
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Firstly, the motive behind this research is to know about the factors that lead to Job Satisfaction;secondly, the most authoritative factor of Job Satisfaction;thirdly, to find out which generation is the most satisfied with their current job across different generations of people. The study provides a descriptive and comparative analysis of working professionals during pandemic from all domains, industries, gender, age, and sectors across India selected based on random sampling using quantitative research methods. It aims to analyze the results on SPSS based on a survey in a close-ended and Likert-scale based questionnaire. Baby boomers are the most satisfied with their job. Generation X is satisfied but lesser than Baby Boomers. Generation Y and Generation Z are not satisfied. Still, Millennials are more satisfied than Generation Z. Their dominant factor for job satisfaction is Job Security, Work Culture, Equality, and Career Growth Opportunities. Not much research has been done on Gen Z by researchers, as they are young and will be entering the market. This study focuses on Gen Z. The findings will help analyze people of different ages to their work and participation levels. The HR could formulate their policies and practices according to the findings generated, which will help reshape their reward structure, decide how they can manage talent, control bad attrition, and a basis for further research, if anyone wants to study particularly about one factor.
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This article presents findings of a qualitative study reporting older adults’ experiences of solitary home confinement during Portugal’s first COVID-19 lockdown in 2020. Home confinement was marked by negative experiences, with the exception of one participant who had a particularly favorable combination of resources and circumstances. Negative experiences involved losses in several areas, such as being deprived of out-of-home activities, independence and face-to-face social interactions. Losing out-of-home activities and independence promoted a sense of imprisonment, while losing face-to-face social interactions triggered a feeling of physical loneliness. Considering the potential negative implications of these losses, it is crucial to create innovative solutions that can mitigate them in future lockdowns. © 2022 Centro de Estudos Sociais da Universidade de Coimbra. All rights reserved.
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In early 2020, the COVID-19 pandemic forced the higher education institutions to adapt to a new form of teaching and learning, from presential to full remote, blended and hybrid environment. This challenge had a particular impact in the life sciences field where the courses have a high content of laboratorial classes. The main issue was how to transition from hands-on practical classes to remote instruction, assuring that our students continued engaged and acquiring the necessary skills, in a short amount of time. To address this, we took advantage of already available digital tools that facilitated the interface with the students such as Moodle, Skype, Teams and ZOOM and explored online resources such as virtual labs, simulations and video demonstrations. Additionally, several classes and laboratorial experiments were recorded by the teachers in the school labs and the research labs where we develop our research activity. The creation of teachers' work groups to share experiences and tools was key in the success of this process. To ensure the students evaluation we used preferentially Moodle platform which allowed the used of digital tools to control and prevent fraud by copying, plagiarism or false identity. Despite all efforts from teachers and students, crucial elements of the high education experience, particularly for undergraduates, were disrupted. Namely the student-teacher and student-student contact and interaction and the integration in the academic setting, resulting in stress and feeling of isolation and overwhelm. Even with the difficulties faced by all the academic community, we observed no major changes regarding the academic success reflected in the final grades, comparing with previous years. In our understanding the core skills proposed for these courses were acquired successfully and the digital tools used with exception for the student's evaluation, are now considered an added value and bring flexibility to the teaching-learning process.
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Objectives: Due to COVID-19 pandemic, social distancing policies were enacted worldwide, including by the Portuguese official authorities. However, the impact of these measures on maxillofacial trauma and fracture surgical repair remains poorly understood. The aim of this study was to evaluate and compare the incidence and aetiology of facial fractures submitted to surgical repair during 1-year of COVID-19 pandemic versus the previous 4 years, in a level III Trauma Centre located in Lisbon, Portugal. Materials and methods: All emergency episodes registered in our hospital between March 2016 and February 2021 that resulted in patient admittance for surgical treatment of facial fracture were included. Comparative analysis was performed for variables such as fracture type and aetiology. Results: Analysis showed that surgeries performed during the 1st year of COVID-19 were reduced by 37.5 %. Considering only the 75-day lockdown period at the beginning of the pandemic, reduction was even more pronounced and reached-66.7 %. Significant differences in the aetiology were also found, with physical assault and sport accidents relative frequency decreasing. Moreover, despite being systematically the second most common cause of fracture, during lockdown, fall ranked first, over physical assault. The relative frequency of nasal fractures, the most common facial fracture treated in our hospital, decreased during both the 1st year of COVID-19 and the lockdown period, while mandible fractures ranked first during lockdown. Conclusions: Our study shows that COVID-19 pandemic and enacted policies have significantly changed the epidemiology of maxillofacial trauma. © 2022 Elsevier Espana S.L.. All rights reserved.
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BACKGROUND: The existing digital healthcare solutions demand a service development approach that assesses needs, experience, and outcomes, to develop high-value digital healthcare services. The objective of this study was to develop a digital transformation of the patients' follow-up service after cardiac surgery, based on a remote patient monitoring service that would respond to the real context challenges. METHODS: The study followed the Design Science Research methodology framework and incorporated concepts from the Lean startup method to start designing a minimal viable product (MVP) from the available resources. The service was implemented in a pilot study with 29 patients in 4 iterative develop-test-learn cycles, with the engagement of developers, researchers, clinical teams, and patients. RESULTS: Patients reported outcomes daily for 30 days after surgery through Internet-of-Things (IoT) devices and a mobile app. The service's evaluation considered experience, feasibility, and effectiveness. It generated high satisfaction and high adherence among users, fewer readmissions, with an average of 7 ± 4.5 clinical actions per patient, primarily due to abnormal systolic blood pressure or wound-related issues. CONCLUSIONS: We propose a 6-step methodology to design and validate a high-value digital health care service based on collaborative learning, real-time development, iterative testing, and value assessment.
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Cardiac Surgical Procedures , Delivery of Health Care , Follow-Up Studies , Humans , Learning , Pilot ProjectsABSTRACT
Background: Patients with coronavirus disease 2019 (COVID-19) and cancer have worse clinical outcomes compared to those without cancer. Primary studies have examined this population, but most had small sample sizes and conflicting results. Prior meta-analyses exclude most US and European data or only examine mortality. The present meta-analysis evaluates the prevalence of several clinical outcomes in cancer patients with COVID-19, including new emerging data from Europe and the US. Methods: A systematic search of PubMED, medRxiv, JMIR and Embase by two independent investigators included peer-reviewed papers and preprints up to July 8, 2020. The primary outcome was mortality. Other outcomes were ICU and non-ICU admission, mild, moderate and severe complications, ARDS, invasive ventilation, stable, and clinically improved rates. Study quality was assessed through the Newcastle-Ottawa scale. Random effects model was used to derive prevalence rates, their 95% confidence intervals (CI) and 95% prediction intervals (PI). Results: Thirty-four studies (N = 4,371) were included in the analysis. The mortality prevalence rate was 25.2% (95% CI: 21.1-29.7;95% PI: 9.8-51.1;I2= 85.4), with 11.9% ICU admissions (95% CI: 9.2-15.4;95% PI: 4.3- 28.9;I2= 77.8) and 25.2% clinically stable (95% CI: 21.1-29.7;95% PI: 9.8-51.1;I2= 85.4). Furthermore, 42.5% developed severe complications (95% CI: 30.4-55.7;95% PI: 8.2- 85.9;I2= 94.3), with 22.7% developing ARDS (95% CI: 15.4-32.2;95% PI: 5.8-58.6;I2= 82.4), and 11.3% needing invasive ventilation (95% CI: 6.7-18.4;95% PI: 2.3-41.1;I2= 79.8). Post-follow up, 49% clinically improved (95% CI: 35.6-62.6;95% PI: 9.8-89.4;I2= 92.5). All outcomes had large I2 , suggesting high levels of heterogeneity among studies, and wide PIs indicating high variability within outcomes. Despite this variability, the mortality rate in cancer patients with COVID-19, even at the lower end of the PI (9.8%), is higher than the 2% mortality rate of the non-cancer with COVID-19 population, but not as high as what other meta-analyses conclude, which is around 25%. Conclusions: Patients with cancer who develop COVID-19 have a higher probability of mortality compared to the general population with COVID-19, but possibly not as high as previous studies have shown. A large proportion of them developed severe complications, but a larger proportion recovered. Prevalence of mortality and other outcomes published in prior meta-analyses did not report prediction intervals, which compromises the clinical utilization of such results.
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Background: Acute respiratory distress syndrome (ARDS) is a severe critical condition with a high mortality that is currently in focus given that it is associated with mortality caused by coronavirus disease 2019 (COVID-19). Neutrophils play a key role in the lung injury characteristic of non-COVID-19 ARDS and there is also accumulating evidence of neutrophil mediated lung injury in patients who succumb to infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Methods: We undertook a functional proteomic and metabolomic survey of circulating neutrophil populations, comparing patients with COVID-19 ARDS and non-COVID-19 ARDS to understand the molecular basis of neutrophil dysregulation.
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In December 2019, it was reported in the Chinese city of Wuhan an epidemic outbreak of viral pneumonia associated with a new coronavirus, later called coronavirus (CoV) type 2 related with the severe acute respiratory syndrome (SARS) (SARS-CoV-2), the causal agent of the COVID-19 disease (coronavirus disease 2019). Despite being considered viruses with tropism for the respiratory tract, the ability to invade the nervous system and potentially cause neurological disease or it decom-pensation is currently recognized to them. Regarding to epilepsy or acute symptomatic seizures, the literature is scarce with only few reported clinical cases, but which still allow some theoretical pathophysiological extrapolations. In the current pandemic context, it becomes essential to redefine the approaches of patients with suspected epilepsy and epileptic seizures, especially regarding to their diagnosis and treatment. This article aims to review the knowledge and current approaches published in the context of SARS-CoV-2 infection.