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The objective of the study is to determine the stages of the evaluation of learning in online academic programs as a result of the digital transformation impelled by the Covid-19 pandemic in higher education. It is based on the digital transformation adopted in higher education since the Covid-19 pandemic, which accelerated the renewal of existing curricular programs and teaching-learning processes with a fragmented evaluation process. Through an explanatory research - purposeful and qualitative approach, the variables and metric indicators of pertinence, relevance and frequency of production of literature associated with the theme are studied to process the data. Likewise, a questionnaire was designed for the pilot study, selecting 25 teachers as sample units from two accredited private higher education institutions in Colombia located in Santiago de Cali and Barranquilla. The findings determined a 0.946 margin of reliability of the instrument for its application in the second phase and a matrix of indicators and the system of relations on the components and stages of the evaluation system were generated. The systematized practice of the stages is proposed as a conclusive basis for the definition of metrics that determine the incidence on the application of the evaluation of learning from academic programs mediated by digital technologies © 2023, Revista de Ciencias Sociales.All Rights Reserved.
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In Ecuador since 1902 the possibility of divorce is admit-ted. Statistics show that the trend of divorce is increasing, registering a divorce rate of 12.7 in 2021. The proposed objective of this research is to characterize the divorce processes executed in the first quarter of 2021 in the canton of Atacames in the province of Esmeraldas. With this, it is expected to identify the level of satisfaction of the participants in relation to this legal process, and thus determine whether there is adherence to current regula-tions and whether constitutional rights are complied with in the processing of divorce proceedings. It is concluded that the divorces show similarity with the data collected and published in the country in terms of age groups, pre-vious marital status, but differ in the grounds used, due to the impact of covid-19 on human and family relationships during isolation. There is satisfaction in the fulfillment of constitutional rights. In general, the respondents showed a higher degree of satisfaction with the legal services re-ceived through notaries than through the courts, with a satisfaction index of 0.50 and 0.369 respectively, stating that the notarial service has fulfilled their expectations.
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Background: SARS-CoV-2, the novel coronavirus identified for the first time in December 2019 in the city of Wuhan, China was identified for the first time in the Colombian territory on March 6, 2020. By November 2020, it had affected more than 47 million people and caused more than a million deaths worldwide. It has been observed that comorbidities such as diabetes can be associated with more severe forms of the disease and higher mortality rates. Hyperglycaemic crisis, referring to diabetic ketoacidosis and hyperosmolar nonketotic state can be precipitated by COVID-19. The following describes the cases of 15 patients who were admitted for COVID-19 and also had a hyperglycaemic crisis in a hospital in Medellín, Colombia. © 2021
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The present study seeks to determine the characteristics of the information about COVID-19 obtained through social networks in health sciences students in Lima. A sample of 384 health sciences students using social networks during the pandemic stage was taken and the survey technique was used to obtain relevant information. The results reveal that the most used social network for searching, and consulting information related to the pandemic were WhatsApp and Facebook. The presence fakenews about COVID-19 was observed 4 out of 5 times and more than half were about medicines for the treatment of the disease. Among the most important sources of information was the COVID Situational Room of the Peruvian government. Publications in research journals were found to be the main source of scientific information. It was perceived that the Peruvian Ministry of Health was the institution with the greatest presence in social networks and that the Peruvian Government and other public agencies were the main sources for sharing information on COVID-19 in social networks.
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Background: In Spain, the number of persons that are in a surgery waiting list as well as the available surgery resources, differ across autonomous communities. The pandemic generated by COVID-19 has increased these waiting lists. In this study two objectives were pursued: on the one hand, to determine which are the resources that are determining the number of persons that are in a surgery waiting list per 1,000 inhabitants;on the other hand, to estimate the impact that the current pandemic has on the latter.
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Introduction: There are successful reports of the use of telemedicine in nephrology (TN), which would facilitate the access of patients with chronic kidney diseases (CKD) from the primary health centers (PHCs) to the nephrologist. Since 2019, TN has been implemented in Chile as a public health policy with national coverage. The process and outcome indicators associated with the Chilean National TN Program among PHCs and reference nephrologists are described. Methods: Descriptive study of asynchronous telemedicine care performed from urban and rural PHCs (574) (municipal health centers) to 17 nephrologists from Hospital Digital, between January 01, 2019 and June 30, 2021. The percentage of the rural population in Chile is 12.1%. Teleconsultations are sent by the PHCs doctor through a digital platform that contains clinical information, laboratory tests and treatments. The nephrologist in a deferred time, responds in the same way and decides between the options: 1) Counter-refer the patient to PHCs requesting more information or with treatment recommendations;2) Refer to a hospital for more complex studies or treatments. The following were analyzed: 1. Distribution by age, sex and comorbidities;2. Response times;3. Prevalence of CKD by stages;4. Destination post evaluation TN;5. Level of relevance of PHCs consultations. Results: In total, 12.705 asynchronous telemedicine visits were performed (2019: 50.8 %;2020: 31.9 %;2021:17.3%. During the Covid-19 pandemic, attention for TN was maintained although restricted by the health crisis in the public health network. The mean age was 65.9 (SD: 13.2) years;80% were older than 60 years;57%% women. CKD stages: S1 (8.5%%);S2 (16.2%);S3 (53.6%);S4 (17.9%) and S5 (3.7%). Comorbidities: diabetes 56%, hypertension 90.7%, dyslipidemia 65%, overweight 29.2% and obesity 38.7%. The average response time was 91 hrs. (range 1- 173). In total, 7.954 patients (62.6%) were referred to PHCs with recommendations, without requiring transfers to another center. In turn, 4.751 patients (37.4%) required face-to-face nephrological evaluation (58.1% high priority for CKD in stages 4-5). The relevance of the consultations according to the nephrologist's evaluation was considered high 23.1% and median 49.3%. Conclusions: The implementation of TN as a public policy has made it possible to facilitate expeditious access, evaluation and timely treatment of patients with CKD from urban and rural PHCs and prioritize face-to-face care by a nephrologist for those with greater risk or severity. Most of the patients evaluated (62.8%) were referred to PHCs, optimizing the limited space and high demand of face-to-face care per specialist. During the Covid-19 pandemic period, the use of TN was restricted but allowed continuity of control of patients with CKD and decongest PHCs and emergency care centers. Future studies should evaluate the impact of TN in the follow-up of patients screened with CKD, especially in stages 3-5, the decrease in travel-related CO2 emissions due to reduced displacement, the level of patient´s satisfaction/PHCs teams, and the evaluation effective cost of this care modality. No conflict of interest
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Objective: The objectives of this study were to measure the global impact of the pandemic on the volumes for intravenous thrombolysis (IVT), IVT transfers, and stroke hospitalizations over 4 months at the height of the pandemic (March 1 to June 30, 2020) compared with two control 4-month periods. Background: The COVID-19 pandemic led to widespread repercussions on the delivery of health care worldwide. Design/Methods: We conducted a cross-sectional, observational, retrospective study across 6 continents, 70 countries, and 457 stroke centers. Diagnoses were identified by ICD-10 codes and/or classifications in stroke center databases. Results: There were 91,373 stroke admissions in the 4 months immediately before compared to 80,894 admissions during the pandemic months, representing an 11.5% (95%CI,-11.7 to-11.3, p<0.0001) decline. There were 13,334 IVT therapies in the 4 months preceding compared to 11,570 procedures during the pandemic, representing a 13.2% (95%CI,-13.8 to-12.7, p<0.0001) drop. Interfacility IVT transfers decreased from 1,337 to 1,178, or an 11.9% decrease (95%CI,-13.7 to-10.3, p=0.001). There were greater declines in primary compared to comprehensive stroke centers (CSC) for stroke hospitalizations (-17.3% vs-10.3%, p<0.0001) and IVT (-15.5% vs-12.6%, p=0.0001). Recovery of stroke hospitalization volume (9.5%, 95%CI 9.2-9.8, p<0.0001) was noted over the two later (May, June) versus the two earlier (March, April) months of the pandemic, with greater recovery in hospitals with lower COVID-19 hospitalization volume, high volume stroke center, and CSC. There was a 1.48% stroke rate across 119,967 COVID-19 hospitalizations. SARS-CoV-2 infection was noted in 3.3% (1,722/52,026) of all stroke admissions. Conclusions: The COVID-19 pandemic was associated with a global decline in the volume of stroke hospitalizations, IVT, and interfacility IVT transfers. Primary stroke centers and centers with higher COVID19 inpatient volumes experienced steeper declines. Recovery of stroke hospitalization was noted in the later pandemic months, with greater recovery in hospitals with lower COVID-19 hospitalizations, high volume stroke centers, and CSCs.
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Background: COVID-19 pandemic has forced important changes in health care worldwide. Stroke care networks have been affected, especially acute admissions and ancillary tests availability. We assessed the impact of the pandemic and the lockdowns imposed in stroke admissions in Latin America. Methods: A multinational study (7 countries, 18 centers) of patients admitted since the pandemic outbreak (January - June 2020). These cases were compared with the same period in 2019. We also assessed patterns during the strictest lockdown period (March-June 2020). Number of cases, stroke etiology and severity, acute care and functional outcomes were compared per periods, months, centers and countries. Results: There were 1863 stroke cases in 2019 and 1781 cases in 2020 (p=0.02). We found a significant increase in strokes of undetermined etiology due to incomplete studies in 2020 [16.8% vs 27.6%, p<0.001]). Most countries reported decreases in all-type stroke admissions, except México and Brasil (16% and 36% increases in admissions, respectively). There were no significant differences among months. All-type mortality increased (6.2% vs. 12.6%, p<0.001), and poor functional outcome (mRs 3-6) increased from 32.2% to 38.8% (p=0.007) in 2020. During the period of strict lockdown (March-June 2020), ischemic stroke admissions during the first 24 hours of onset (68.3% vs. 64.4%, p=0.1) and in-hospital stroke code activation (35.1% vs. 27.6%, p=0.005) diminished compared to 2019 period. No differences in total reperfusion treatment rates were observed, with similar door-to-needle and door-to-groin times in both periods. Conclusions: All-type stroke admissions diminished only slightly during the first months of the COVID-19 pandemic. However, in this region, we found substantial deficiencies in stroke work-up, poor short-term outcome and increased mortality.
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Background: Ischemic stroke has been reported to occur in approximately 5% of COVID-19 patients, although some reports are contradictory. Proposed mechanisms of this association are hypercoagulable state, vasculitis and cardiomyopathy, together with traditional vascular risk factors. We analyzed the frequency and clinical characteristics of COVID-19 positive stroke cases during the first months of the pandemic in Latin America. Methods: A multinational study (7 countries, 18 centers) of patients admitted during the pandemic outbreak (March - June 2020). We assessed acute stroke cases associated to COVID-19 infection. Clinical characteristics, stroke etiology and severity, acute care and functional outcomes, were compared between non-COVID-19 and COVID-19 cases. Results: There were a total of 1037 stroke cases;sixty-two of them (6.0%) were diagnosed with COVID-19 infection. This group consisted of 38 men [61.3%], with a median age of 68 years [IQR 59-79 years]. From these cases, 80.6% were ischemic stroke, 16.1% hemorrhagic stroke, and 1.6% transient ischemic attack and cerebral venous thrombosis respectively. The most common etiology reported for ischemic cases was atherosclerotic large vessel occlusion (30.6% vs. 12.7% in non- COVID cases, p<0.001), and undetermined etiology for hemorrhagic stroke (55.6%). Median NIHSS for COVID-stroke patients was higher (7 IQR 2-16 vs. 5 IQR 2-11, p=0.05). Five (8.1%) patients received acute reperfusion therapy, with no differences in door-to-CT, door-to-needle and door-togroin times, compared to non-COVID cases. Most characteristics did not differ from those of COVID-19 negative patients. Mortality was higher in COVID-stroke cases (20.9% vs. 9.6%,p<0.001). Conclusions: COVID-19 infection frequency in stroke patients in Latin America is similar to thatreported in several series worldwide, with a higher frequency of atherosclerotic ischemic strokes andmortality compared to non COVID-19 strokes.
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Background: In Spain, the number of persons that are in a surgery waiting list as well as the available surgery resources, differ across autonomous communities. The pandemic generated by COVID-19 has increased these waiting lists. In this study two objectives were pursued: on the one hand, to determine which are the resources that are determining the number of persons that are in a surgery waiting list per 1,000 inhabitants;on the other hand, to estimate the impact that the current pandemic has on the latter. Methods: To estimate which are the resources that are having a greater impact on the waiting lists and to forecast the effect that the COVID-19 has on them, we use dynamic panel data models. The data on the surgery resources and on the waiting lists by autonomous communities is obtained from the Surveys on Health, Hospital Statistics and reports on waiting lists of the Ministry of Health, Consumption and Social Well Being and the Counsels. The sample period is 2012-2017 (last published year for surgery resources). In addition, a literature review is conducted and it shows the important and complexity of waiting list like a gestion tool of health system (Science, SciELO and Dialnet web data bases). Results: COVID-19 will increase the waiting lists by approximately 7.6% to 19.14%, depending on the autonomous community. Not all the available surgery resources have the same relevance nor an equal effect on the reduction of the waiting lists. The most significant resources are the beds and operating rooms per 1,000 inhabitants. The hospital expenditure is not so relevant. Conclusions: The panel data models estimate the relation between the surgery resources and the waiting list. The latter is deemed complex and different across autonomous communities. In addition, these models allow to predict the expected increase in the waiting lists and are, thus, a useful instrument for their management.
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OBJECTIVE: In Spain, the number of persons that are in a surgery waiting list as well as the available surgery resources, differ across autonomous communities. The pandemic generated by COVID-19 has increased these waiting lists. In this study two objectives were pursued: on the one hand, to determine which are the resources that are determining the number of persons that are in a surgery waiting list per 1,000 inhabitants;on the other hand, to estimate the impact that the current pandemic has on the latter. METHODS: To estimate which are the resources that are having a greater impact on the waiting lists and to forecast the effect that the COVID-19 has on them, we use dynamic panel data models. The data on the surgery resources and on the waiting lists by autonomous communities is obtained from the Surveys on Health, Hospital Statistics and reports on waiting lists of the Ministry of Health, Consumption and Social Well Being and the Counsels. The sample period is 2012-2017 (last published year for surgery resources). In addition, a literature review is conducted and it shows the important and complexity of waiting list like a gestion tool of health system (Science, SciELO and Dialnet web data bases). RESULTS: COVID-19 will increase the waiting lists by approximately 7.6% to 19.14%, depending on the autonomous community. Not all the available surgery resources have the same relevance nor an equal effect on the reduction of the waiting lists. The most significant resources are the beds and operating rooms per 1,000 inhabitants. The hospital expenditure is not so relevant. CONCLUSIONS: The panel data models estimate the relation between the surgery resources and the waiting list. The latter is deemed complex and different across autonomous communities. In addition, these models allow to predict the expected increase in the waiting lists and are, thus, a useful instrument for their management.
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The rapid spread of COVID-19 has affected economies and global health. Latin America and especially Ecuador have also felt the negative influence of the pandemic caused by the virus. The economic effects of microenterprises that contribute significantly to the country’s economic growth have been destabilized, in some cases going bankrupt. The objective of this research is to carry out a study of the microenterprise scenario based on their Weaknesses, Threats, Strengths and Opportunities in order to make consistent decisions. Once the analysis has been carried out, a strategy is defined that enhances the identified strengths to overcome the weaknesses and control the threats that allows obtaining the maximum benefit from the opportunities. © 2020, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.
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OBJECTIVE: To describe the associated factors with the degree of severity in pregnant Mexican women reported with SARS-CoV-2 virus infection. MATERIAL AND METHODS: Descriptive, transversal and comparative study of free dates reported by Mexico’s Health Secretary of COVID-19 patients until April 26th, 2020. Pregnant women positive to SARS-CoV-2 infection were included. Control group were women in reproductive age. Exclusion criteria were women with puerperal status reported as unknown or does not apply. Infection was analyzed by severity in both groups, then comorbidities associated to degree of severity were determined with descriptive statistic. RESULTS: 84 pregnant women were positive to SARS-CoV-2 vs 2,836 non-pregnant infected women in reproductive age. 33% of pregnant women required hospitalization vs 17% of control group. 2.4% vs 0.08% required intubation, 3.6% vs 1.3% were admitted to critical care unit and lethality was 7.14% vs 0.7% in pregnant vs control group respectively. Main comorbidities associated with severity in pregnant women were diabetes (50%) and tobacco use (33%). CONCLUSION: Pregnant women have greater probability to develop a severe form of SAR-CoV-2 infection compared to women in reproductive age. The main associated factors to severe forms were diabetes and tobacco use. © 2020 Asociacion Mexicana de Ginecologia y Obstetricia. All rights reserved.