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Introduction: The COVID-19 pandemic and preventive measures led to changes in the quality and quantity of sleep, impacting mental health. Objectives: To understand how the pandemic and confinement interfered with the routines and/or sleeping habits of children and adolescents and influenced mental health. Methodology: A literature review on MEDLINE was conducted, with the research question: What are the changes in the routines or sleep habits of children and adolescents during the pandemic? Results and discussion: From the 370 articles analysed, 35 were selected. Due to confinement and online learning, the number of hours of sleep increased. However, the quality of sleep decreased due to decreased physical activity, an unbalanced diet, and increased time in front of screens. Consequently, there was a negative influence on mental health. Conclusion: The increase in sleep disorders and their influence on mental health was observed, with the need to develop awareness and literacy strategies addressing this area.
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Much has happened in the world and in my own professional life in the past year. The US has been rocked by a wave of anti-Asian sentiment due in part to the framing of the COVID-19 pandemic as a "China virus” by Right wing, anti-immigrant and racist quarters. And within my own professional life, I have added a new portfolio, namely, that of first Vice-President of the American Association for Applied Linguistics (AAAL). I wear this new hat along with my other professional hat, that of being the co-editor of TESOL Quarterly. © The Editor(s) (if applicable) and The Author(s), under exclusive licence to Springer Nature Switzerland AG 2022.
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Introduction: The debate about optimal management of patients with COVID-19 ARDS remains, including medical treatment, ventilatory strategies, awake proning and others. COVIP is a multicentric observational study with over 3000 patients under NIV. A substudy by Polok and al. evaluated patients (PTS) >= 70 years old. At our intermediate care unit (IU) we used a strategy of high dose corticosteroid started when the work of breathing (WOB) increased, prolonged awake prone positioning (> 12 h) and high CPAP ventilatory strategy. We describe our cohort of >= 70 years old NIV PTS and compare it to COVIP substudy results. Method(s): Descriptive retrospective study. Data were collected from electronic medical records of 95 COVID-19 PTS aged 70 years old or above under NIV at the IU between September/20 and March/21. Categorical data are presented as frequency (percentage) and were compared using chi2-test. Continuous variables were compared using Mann-Whitney U test. Cohort results were compared with those from Polok et al. COVIP substudy (COVIPss). Result(s): 95 of PTS were submitted to NIV. Median age was 76 years and 49.5% were male, versus 75.7 and 71.4% in COVIPss. Median admission SOFA score was 4 and CFS was 3 with 14% considered frail (CFS > 5). In COVIPss median SOFA was 5 and 17% of PTS were frail. The preferred mode was CPAP with median maximum pressure of 13. Mean PaO2/fiO2 ratio after start of NIV was 125, 30% < 100. NIV failure occurred in 46.3% versus 74,7% in COVIPss. Our intra-unit mortality was 31.6%. 14 PTS (14.7%) were submitted to invasive mechanical ventilation and 57% of those died. In COVIPss mortality at 30d was 52.9% in NIV and 47.7 in IMV groups. Conclusion(s): We argue that NIV is a valid option for COVID ARDS management if supported by a multifaceted strategy such as ours, using prone and CPAP for WOB control. We agree with COVIPss authors as NIV trial should be short and intubation promptly if WOB not controlled. Comparison with COVIP substudy NIV failure and mortality results, support our belief.
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Introduction: The aim of our study is to evaluate the relationship between dexmedetomidine (DEX) use as a sedative agent in mechanical ventilated ICU patients and 28-day mortality. DEX, a selective alfa-2 adrenergic receptor agonist, widely used for its sedative and analgesic properties, has been linked to increasing parasympathetic tone, reducing the inflammatory response and oxidative stress [1]. Since severe COVID-19 is associated with an hyperinflammatory state, it is hypothesized that DEX might improve outcomes in these patients. Method(s): This is a retrospective observational study of mechanically ventilated patients admitted with COVID-19 pneumonia in the ICU of a tertiary center in Portugal, between March 2020 and December 2021. Logistic regression analysis was performed to evaluate the association of DEX use and 28-day mortality from time of intubation. Result(s): A total of 277 patients were analyzed, 151 in the DEX group and 126 in the no DEX group. Patients in the DEX group were younger (53.3 vs. 63.3 years, p < 0.001), had less comorbidities (2.8 vs. 3.5, p = 0.01), lower SOFA at admission (6.2 vs. 7.1, p = 0.01) but had a prolonged ICU stay (21.4 vs. 15.9, p < 0.001). Male gender (65.6 vs. 69.0, p = 0.54), incidence of obesity (56.3 vs. 46.8, p = 0.12), coronary artery disease (4.0 vs. 7.9, p = 0.16) and atrial fibrillation (4.0 vs. 7.1, p = 0.25) were similar between groups. PaO2/ FiO2 ratio at admission (111.1 vs. 108.1, p = 0.61), days spent in RASS < 3 (13.7 vs. 12.4, p = 0.31) and opioid use (14.8 vs. 13.1, p = 0.16) were also similar. From time of intubation, 28-day mortality in the cohort receiving DEX was 14.7% compared to 59.5% in the no DEX group (OR 0.12;95% CI 0.07-0.21;p = 0.01). Conclusion(s): Use of DEX was associated with lower 28-day mortality in COVID-19 critically ill patients requiring invasive mechanical ventilation in our study analysis. Considering the limitations of a retrospective observational study, RCTs are needed to confirm the results.
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Introduction: The aim of this study is to identify the factors associated with an increased risk of developing nosocomial infections (NI) in COVID-19 patients admitted with pulmonary involvement in the ICU. NI in COVID-19 ICU population are an important cause of morbidity and mortality worldwide and its prompt identification might lead to its prevention and better outcomes. Method(s): This is a retrospective observational study of patients admitted with COVID-19 pneumonia in the ICU of a tertiary center in Portugal, between March 2020 and December 2021. We considered NI as any infection acquired > 48 h post ICU admission. Clinical, analytical and baseline patient data were evaluated. Logistic regression analysis was performed to correlate patient related variables with the development of NI. Result(s): A total of 338 patients were enrolled, from which 167 (47.9%) presented with NI. Baseline characteristics are described in Table 1. In the logistic regression analysis, older age (OR 1.13;95% CI 1.03-1.25;p = 0.013), coronary artery disease (CAD) (OR 28.7;95% CI 1.92-429;p = 0.02), obesity (OR 3.14;95% CI 0.86-11.42;p = 0.008), chronic liver disease (CLD) (OR 104.33;95% CI 1,.04-1008.49;p = 0.04), use of dexamethasone (OR 21.89;95% CI 3.04-157.85;p = 0.002) and days in RASS < 3 (OR 1.4;95% CI 1.05-1.86;p = 0.02) were associated with an increased risk of developing NI in the ICU. Surprisingly, SOFA at admission, days of invasive mechanical ventilation, days of sedation and PaO2/ FiO2 ratio at admission, although statistically significantly different between groups, did not correlate with the risk of infection. Conclusion(s): We identified prolonged deep sedation, corticosteroid use, and patient characteristics (CAD, obesity, CLD, older age) as independent risk factors for NI development in COVID-19 critically ill patients. It is also noteworthy to point out for the presence of confounding variables, including the excessive workload in the ICU during this period, leading to an increase in NI numbers.
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Introduction: Our goal is to describe outcomes of critically ill COVID-19 patients submitted to renal replacement therapy (RRT), in particular the association of RRT with mortality. Multi-system organ failure or direct kidney injury caused by SARS-CoV-2 is associated with the development of acute kidney injury (AKI) which subsequently increases the need for RRT and may affect the outcomes. Method(s): This is a retrospective observational study of 338 critically ill patients admitted with COVID-19 pneumonia in the ICU of a tertiary center in Portugal, between March 2020 and December 2021. Clinical, analytical and baseline patient characteristics were evaluated. Logistic regression analysis was performed to correlate patient data with the need for RRT and ICU mortality. Result(s): From a total of 338 patients, 5% required RRT (n = 16), 25% of which received intermittent hemodialysis (n = 4) and 87,5% continuous veno-venous hemofiltration (n = 14). Baseline characteristics are described in Table 1. In our sample, 61 patients (18%) presented with acute AKI, from whom 14 (23%) were submitted to RRT. From all the patients receiving RRT, 10 (62.5%) did not have pre-existing chronic kidney disease. In the logistic regression analysis, AKI (OR 45.4;95% CI 7.7-269.5;p < 0.001), higher SOFA (OR 1.24;95% CI 103-1.51;p = 0,03), creatinine (OR 2.01;95% CI 1.4-3.0;p < 0.001) and C-reactive protein (OR 1.09;95% CI 1.02-1.16;p = 0,01) on admission were associated with the need for RRT. Additionally, ICU mortality associated with RRT was 75% compared to 28.3% in the group not submitted to RRT (OR 7.6;2.4-24.2;p = 0.001). Conclusion(s): The need for RRT in critically ill COVID-19 patients is associated with an increased mortality rate in our study. We were also able to identify AKI, higher SOFA, creatinine and C-reactive protein at admission as risk factors for RRT. However, due to the retrospective nature of our analysis and our small sample size, more studies on this topic are needed to confirm these results.
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Architecture education is mainly monoscalar, in the sense that it tends to focus on one level of scale. Habitation, instead, is multiscalar. The asynchrony between design and habitation produces a tension between the built environment and its users. The paper connects the effects of this tension with the issues generated by pandemic health emergencies, analysing how limited sociality imposed by prevention measures affects habitation. Copyright © FrancoAngeli.
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Introduction: Ageism and loneliness are two relevant public health phenomena because of their negative impact on the senior's mental health. With the increase in average life expectancy, these tend to co-occur, which may increase the psychological distress (PD) of seniors. Resilience has been shown to be an important protective factor of seniors mental health, although its potential buffering role of public health risk factors with cumulative impact on mental health, such as loneliness and ageism, needs to be more studied. Aim: To assess the potential mediator role of resilience between the effects of ageism and loneliness on PD in seniors. Methods: A sample of 349 Portuguese seniors aged 60 years and over was collected through an online survey and during the COVID-19 pandemic period. Seniors completed the Kessler Psychological Distress Scale (K6), the Short-Form of UCLA Loneliness Scale (USL-6), the Ambivalent Ageism Scale (AAS) and the Connor-Davidson Resilience Scale (CD-RISC-10). A mediation analysis model was developed with resilience as a mediating variable. Results: There were moderate to high levels of PD and moderate levels of ageism, loneliness and resilience. Resilience fully mediated the effect of ageism on PD and partially mediated the effect of loneliness on PD. Conclusions: Resilience was an important protective factor of mental health against the effects of ageism, and partially protected mental health from the effects of loneliness among seniors. It is suggested that resilience be considered as a factor to be integrated in future intervention programs for mental health. The practical applicability of this study is discussed. © 2022 The Authors
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The aim of this study was to ascertain the level of occupational stress before and during the COVID-19 pandemic, how it changed, and its association with health outcomes of hospital workers in the Recôncavo of Bahia, Brazil. A longitudinal study was conducted with 218 hospital workers over 18 years old. A semi-structured questionnaire was used for collecting sociodemographic, occupational, lifestyle, anthropometric, and health data. The main exposures were occupational stress, assessed through Job Content Questionnaire and classified according to the Demand-Control Model and reported shift work. Health outcomes considered were nutritional status assessed by Body Mass Index (BMI), Waist Circumference (WC), and Body Fat Percentage (BF%); health self-perception; and cardiovascular risk factors. We used McNemar chi-squared or Wilcoxon tests to compare levels of exposure and outcome variables before and during the pandemic, and odds ratios to evaluate associations between changes in occupational stress and shiftwork with health outcomes. During the pandemic, participants reported increased occupational stress and shift work, lower self-perceived health, and had higher BMI and cardiovascular risk factors, compared with before the pandemic. No association was observed between change in occupational stress and health outcomes. However, increased amount of shift work was related to increased BMI in the overall sample (OR 3.79, CI95% 1.40-10.30), and in health workers (OR 11.56; CI95% 2.57-52.00). These findings support calls to strengthen labour policies to ensure adequate working conditions for hospital workers in context of the COVID-19 pandemic.
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The experimental component is an essential method in Engineering education. Sometimes the availability of laboratories and components is compromised, and the COVID-19 pandemic worsened the situation. Resorting to an accurate simulation seems to help this process by allowing students to develop the work, program, test, and validate it. Moreover, it lowers the development time and cost of the prototyping stages of a robotics project. As a multidisciplinary area, robotics requires simulation environments with essential characteristics, such as dynamics, connection to hardware (embedded systems), and other applications. Thus, this paper presents the Simulation environment of SimTwo, emphasizing previous publications with models of sensors, actuators, and simulation scenes. The simulator can be used for free, and the source code is available to the community. Proposed scenes and examples can inspire the development of other simulation scenes to be used in electrical and mechanical Engineering projects. © 2022 IEEE.
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The public-health-driven COVID-19 lockdowns unpredictably forced organization development (OD) consultants to work from home in no time. Because original interventions, driven by behavioral and social-science knowledge, were predominantly designed for face-to-face encounters, adaptation to virtual OD services was inevitable. This article analyzes that process. This study aimed to investigate how OD consultants adjusted their labor activity from a predominantly face-to-face to a solely technology mediated setting. We adopted a bottom-up research approach to inductive concept development, following Gioia and colleagues' (2013) methodology to study the adaptation process of 10 external and internal OD consultants. The findings indicate a parallel to Lewin's (1951) famous three-phase model of change. We suggest that our emergent framework can be well applied by other occupational fields (e.g., education sector, therapy, consultancies) in a transition process to a virtual setting. To facilitate the transition in other occupational fields we present a guiding framework.
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Laboratory experiments are important pedagogical tools in engineering courses. Restrictions related to the COVID-19 pandemic made it very difficult or impossible for laboratory classes to take place, resulting on a fast transition to simulation as an approach to guarantee the effectiveness of teaching. Simulation environments are powerful tools that can be adopted for remote classes and self-study. With these tools, students can perform experiments and, in some cases, make use of the laboratory facilities from outside of the University. This paper proposes and describes two free tools developed during the COVID-19 pandemic lock-down that allowed students to work from home, namely a set of simulation experiments and a Hardware-in-the-loop simulator, accessible 24/7. Two approaches in Python and C languages are presented, both in the context of Robotics courses for Engineering students. Successful results and student feedback indicate the effectiveness of the proposed approaches in institutions in Portugal and in the Netherlands. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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The Covid-19 pandemic has affected all aspects of our lives. Women in the perinatal period have unique needs, demanding health and safety guidelines regarding the risks associated to social isolation. The objective was to know the women's experience during pregnancy or puerperium in the pandemic while being cared at a hospital. Qualitative study referenced on concepts of integrality of care and daily life. Eighteen pregnant and postpartum participated. Three themes emerged: Repercussions on pregnancy and puerperium, repercussions on practical life, and coping strategies created by women. The reports reveal different repercussions of the pandemic in the lives of women and their families, also the strategies and precautions used to mitigate its adverse effects. We suggest directing preventive measures and public health policies to prioritize pregnant and postpartum women, recognizing and embracing subjective issues involved at this moment in women's lives. Copyright © 2022, Fundacao UNI Botucatu/UNESP. All rights reserved.
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The activities that comprise a requirements engineering process involve elicitation, modeling, validation, and verification of requirements, and these activities tend to be more communication and interaction-intensive than others during the software development process. This paper presents an experience report on requirements validation and verification techniques applied to a mobile application project developed for the Brazilian prison system's former inmates, aiming to support them in their resocialization process. Besides, it presents the decisions we made in agreement with the project stakeholders to guarantee the end-users data privacy. Our results show that even with the Covid-19 pandemic and social isolation restrictions, it was possible to apply the requirements validation techniques. Furthermore, the mobile application's acceptance tests with both stakeholders and the end-users demonstrate that the developers duly followed the privacy guidelines. Finally, all privacy requirements comply with the stakeholders and the application's end-users needs and are under the Brazilian General Data Protection Law (LGPD). Copyright © 2022 by SCITEPRESS - Science and Technology Publications, Lda. All rights reserved.
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Introduction Coronaviruses traditionally are considered to cause pulmonary diseases, often accompanied by gastrointestinal symptoms. Since the COVID-19 pandemic start in early 2020, there have been reports of a high prevalence of neuropsychiatric symptoms. Recent data show significant rates of neuropsychiatric diagnosis over the subsequent 6 months post-infection. Some of the data suggest the COVID-19 as a cause of new-onset psychotic symptoms in patients with no psychiatric history. Delusions, hallucinations, disorganized thoughts, and confusion were the most frequently reported psychotic features which low doses of antipsychotics seem to be helpful. Objectives Brief literature review about the relationship between COVID-19 and new-onset psychotic symptomatology. Methods Non-systematic review through PubMed research using the terms “COVID-19”, “SARS-CoV-2”, “pandemics”, “psychotic symptoms” and “psychosis”. Results The severity of the infection, especially in those with the need for hospitalization/intensive care, seems to have a clear effect on the gravity of subsequent neuropsychiatric symptoms, namely psychosis. Viral invasion of the central neural system, hypercoagulable states, and neuroinflammation are potential associated mechanisms. It’s important to consider the effect of therapies that may have the potential to cause psychosis (eg steroids). According to recent literature, around 0.9-4% of people exposed to the COVID-19 virus develop psychotic episodes, which is much higher than the incidence in the general population. Conclusions Post-COVID-19 related psychosis has been reported in different nations. The pathophysiology is yet not clear, although the hyperinflammatory response has been suggested as the main mechanism for the neuropsychiatric manifestations. Given the high number of case reports with similar presentations, it’s important to proceed with more investigations. Disclosure No significant relationships.
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Introduction Since the COVID-19 pandemic start in early 2020, there have been reports of a high prevalence of neuropsychiatric symptoms. Cognitive impairment is being increasingly recognized as an acute and possibly long-term sequel of the disease. According to recent data, limited evidence point to SARS-CoV-2 having a preferential neurotropism for the frontal lobes, as suggested by behavioral and dysexecutive symptoms, frontotemporal hypoperfusion on MRI, EEG slowing in frontal regions, and frontal hypometabolism on 18F-FDG-PET. Nevertheless, there isn’t a specific biomarker. Objectives Brief literature review about the relationship between COVID-19, cognitive impairement onset and risk for dementia. Methods Non-systematic review through PubMed research using the terms “COVID-19”, “SARS-CoV-2”, “pandemics”, “cognitive impairement”, “dementia” and “risk factor”. Results Direct neuronal infection via angiotensin-converting enzyme 2 receptor (ACE2R), hyperinflammation, brain ischemia related to respiratory failure or thromboembolic strokes, and severe psychological stress are the mechanisms more associated with a deleterious effect on cognition. The relation between SARS-CoV-2 infection and neurodegenerative diseases is still unclear. However, the high expression of the ACE2R in the brain, may explain the acute brain damage and could also be the basis for later neurodegenerative changes. The potentially long-term nature of the deficits makes it important to do an early identification, management, rehabilitation and follow-up of the patients exhibiting cognitive symptoms. Conclusions Given the reports of brain damage by SARS-CoV-2, there are concerns that this damage may substantially increase the incidence of neurodegenerative diseases and promote dementia. Further long-term studies may be required to identify the relationships between SARS-CoV-2 infection and risk for dementia. Disclosure No significant relationships.
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Purpose/Objectives: Acute and chronic respiratory diseases constitute a substantial socioeconomic burden on a global scale, as made abundantly clear in the last two years with the rampant coronavirus disease 2019 (COVID-19) pandemic. Alas, the development of new therapies for pathological respiratory conditions has been hindered by the inadequacy of current preclinical models, which often fail to provide reliable predictions on drug safety and efficacy in humans. In particular, considerable anatomical and physiological differences between the respiratory systems of commonly used animal models and humans are one of the main issues leading to high drug attrition and clinical failure rates. Accordingly, the generation of physiologically relevant preclinical lung models for early drug development and pharmaceutical research is urgently needed. In this work, poly(ϵ-caprolactone) (PCL) and gelatin were used as raw materials to produce electrospun scaffolds for in vitro lung tissue engineering, in order to generate human biomimetic platforms for preclinical drug safety and efficacy testing. Methodology: PCL and gelatin were mixed at varying volume ratios: 1:0 (PP), 6:1 (PPG61), 4:1 (PPG41), and 2:1 (PPG21), so as to determine the optimal gelatin concentration for cell adhesion and growth. Poly(vinylpyrrolidone) (PVP) was added to every polymer mixture to facilitate the electrospinning process, and electrospun fibrous matrices were fabricated using a needleless electrospinning technique. Scaffold morphology, chemical composition, and wettability were characterized with scanning electron microscopy (SEM), Fourier transform infrared (FTIR) spectroscopy, and water contact angle analysis, respectively. Biocompatibility testing was performed using human bronchial (16HBE) and alveolar (A549) epithelial cell lines, consisting of cell metabolic activity, proliferation, and adhesion evaluation over two weeks of in vitro culture. Results: All polymer blends resulted in the formation of electrospun scaffolds with a nanofibrous structure. The addition of gelatin in PPG61 scaffolds improved fiber morphology compared to PP formulations, but increasing proportions of this polymer in PPG41 and PPG21 mats caused a larger number of defects, such as beading and branching. FTIR analysis confirmed the presence of PCL and PVP in PP scaffolds, as well as the addition of gelatin in all PPG blends. Moreover, as expected, all scaffolds were hydrophilic, with water contact angles below 90°, being suitable for protein adsorption and cell adhesion. Regarding 16HBE and A549 cell viability, surprisingly, no major differences were found between the different formulations over the two-week culture period, showing that all polymer blends were equally capable of promoting cell adhesion and growth. While PP scaffolds significantly outperformed PPG electrospun mats in early timepoints, no such differences were identified at the end of the experimental period. Conclusion/Significance: These results suggested that PCL, PVP, and/or gelatin blend electrospun scaffolds are conducive to lung epithelial cell adhesion and proliferation. Nevertheless, further studies investigating epithelial cell differentiation and function should be conducted to fully assess the suitability of these biomaterials as platforms for in vitro lung tissue engineering.
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Academic success is a priority, and according to the literature review, it is associated with the application of problem-based learning methodologies or the continuous assessment model. The case study performed was based on the course unit Corporate Simulation (CS), part of the Accounting and Finance course academic curriculum. After describing the functioning process, objectives, and assessment model of CS, it was shown that from 2014/15 to 2019/20, the level of approval of CS was 94.8%. Also, from the results of the survey conducted with the students who completed CS, from 2007/08 to 2018/19, on a scale of 1 to 5, in options 4 and 5 (good and very good), the objectives weigh on average, 85.3%, and that, in the academic year 2019/20, the specific characteristics of functioning, as a consequence of COVID 19, did not cause changes in the trends of assessment and approval in CS. © 2022, IGI Global.
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Education is one of the most important pillars of our society, thus there is a constant need of adapting to new contexts. The COVID-19 pandemic impacted schools and demanded change in technological literacy. This case study, conducted in a European public school, aims at understanding the context and developing an intervention under the assessment of the pandemic’s impact on such organizations. Hence, a literature review was performed, comprising a framing of the current conditions and relevant constructs to cope with change. Examples of the last are reflexivity, psychological safety and adaptivity. This review led to the diagnosis and the intervention proposal development following Porras’ [23] and Kurt Lewin’s (1947) change models. The diagnosis encompassed the conduction of interviews and focus groups. Hence, several intervention proposals framed by the job demands and resources model by Bakker et al. (Annu Rev Organ Psych Organ Behav 1:389–411, 2014) were developed. All the proposals are presented in this chapter, as well as their desired effects. From the data gathering process and its following analysis, the needs of the school arose, and topics such as exhaustion, the perception of low digital skills, the inability of establishing barriers, lack of digital resources and technologies’ integration, as well as a weak internal communication were mentioned. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.