Ecuador and COVID-19: the "Guayaquil Effect" in contrast to Quito

The repercussions of COVID-19 are different throughout the world due to an assortment of aspects that distinguish some countries from others regarding the structure and response of health systems, the socioeconomic conditions of the population, the activation of emergency committees and contingency plans, and the coordination between central and sectional governments. Even among cities, regions and states of the same country, the pandemic presents a different face. In Ecuador, the effects in Guayaquil contributed to its being catalogued as the Wuhan of Latin America. This article sheds light on the social determinants that explain the consequences in Guayaquil, in contrast to what happened in the capital, Quito.

Diagnosis of surveillance, prevention, and control of COVID-19 in Peruvian mining work

Introduction: In Peru, mining companies had to register and implement the Plan for the surveillance, prevention, and control of COVID-19 at work (requested by the Ministry of Health), prior to restarting activities suspended due to the pandemic. Objective: To describe the situational status of the plans for the surveillance, prevention, and control of COVID-19 at work in the mining sector (1st and 2nd phases of economic reactivation, 2020). Methods: A cross-sectional study was carried out of the database from the SISCOVID-Empresas system. Frequencies and proportions of the characteristics of the plans were reported (region of origin, number of workers, number of health professionals, existence of an occupational health and safety committee or supervisor, status of registration and budget report) according to the number of company workers. Results: In total 2,236 plan records were reviewed. Of the total, 6.2% of the registered plans indicate that they do not have an occupational health and safety supervisor or committee, and 71.5% do not have a health professional. Furthermore, 81.2% of the companies with more than 500 workers had medicine and nursing professionals, and 89.2% of companies with 1 to 20 workers did not have health professionals. Conclusions: Three out of 4 companies in the mining sector fail to comply with the requirements of the plan for the surveillance, prevention, and control of COVID-19 at work. © 2023, Editorial Ciencias Medicas. All rights reserved.

"They Protect us as if they were our Mom" Masking Attitudes from Freelist Survey Data and Qualitative Interviews in San Diego School Communities.

BACKGROUND: Despite being disproportionately impacted by COVID-19 due to a lack of structural support, marginalized communities have been largely ignored in the politically polarized debate over school masking. In response to this, we sought to explore masking attitudes by centering the voices of parents and children at historically marginalized, predominantly Hispanic schools in southern California. METHODS: We conducted a mixed-methods study with parents and children attending 26 low-income predominantly Hispanic-serving elementary schools. A random sample of parents was asked to provide a freelist of words they associate with masking. A subset of parents with children aged 4-6 was recruited from these surveys to participate in parent-child interviews (PCI). We calculated Smith's salience index for all unique items, stratifying by language (English/Spanish). Item salience guided PCI thematic analysis for additional context and meaning. RESULTS: 648 participants provided 1118 unique freelist items in English and Spanish. 19 parent-child pairs were interviewed, 11 in Spanish and 8 in English. The most salient words were "safety"(0.37), "protection"(0.12), "prevention"(0.05), "health"(0.04), "good"(0.03), "can't breathe"(0.03), "necessary"(0.02), "care"(0.02), "precaution"(0.02), and "unnecessary"(0.02). Spanish speakers had a more favorable view of masking than English speakers, particularly regarding "protection" (0.20 vs 0.08) and "prevention" (0.10 vs 0.02). DISCUSSION: Masking is an affordable individual-level risk mitigation that protects the communities that have inequitably shouldered the burdens of the COVID-19 pandemic. We recommend that policymakers prioritize the views of those most impacted when deciding on risk mitigation policies like school masking.

ASSOCIATION BETWEEN OBSERVED MASKING AND SARS-CoV-2 PRESENCE IN SCHOOL WASTEWATER

Background: The SARS-CoV-2 virus is airborne and highly transmissible. Masking is an important strategy for source control and personal protection. The American Academy of Pediatrics recommends masking as part of a comprehensive strategy to reduce the spread of COVID-19 and respiratory diseases in school settings, however the effectiveness of school masking policies has been heavily debated. Previous studies of masking effectiveness have been limited by the use of self-reported masking behavior, policies as a proxy for masking behaviors, and/or case surveillance data that are biased by access to testing Methods: The Safer at School Early Alert (SASEA) project provided daily wastewater SARS-CoV-2 surveillance for elementary schools serving historically marginalized communities in San Diego County. We previously found that daily wastewater surveillance can identify 95% of PCR-detectable COVID-19 cases on campus. Between March 2 and May 27, 2022, we randomly selected 10 schools from the SASEA project for bi-weekly systematic observations of masking behaviors of students, staff, and parents. Each school was observed by 4 trained observers from the time school let out until all individuals had left. Observers counted the total number of adults and children and whether they were fully masked (nose and mouth covered), partially masked, or unmasked. We built a logistic regression model to measure the association between positive wastewater signals in the 5 days following an observation event (outcome) and the percentage of individuals who were observed fully masked vs partially or unmasked (primary predictor). Result(s): We conducted 60 observation events over 6 weeks, during which positive wastewater signals- suggesting the presence of at least one COVID-19 case on campus-occurred on 9 days. On average, 38.6% of individuals were observed fully masked. After adjusting for intra-site correlation, observation week, current case rate per 100,000 in the school ZIP code and vaccination rate in the school ZIP code, we found that the odds of a positive wastewater signal in the 5 days after observation decreased by 47% (aOR 0.53, 95% CI: 0.28 - 0.99) for each 10% increase in the proportion of fully masked individuals. Conclusion(s): Masking is an effective strategy to prevent the spread of COVID-19 in school settings. Even a relatively small increase in the proportion of individuals masking can potentially lead to a significant difference in epidemic spread.

The systemic competitiveness of latin american MSMEs under Covid-19

Competitiveness has become essential to business survival. Accordingly, the purpose of this chapter is to study the competitiveness of micro-, small-, and medium-sized enterprises (MSMEs) in Latin America under the systemic competitiveness model under COVID-19. Documentary research was conducted, based on reports from the Inter-American Development Bank, the Economic Commission for Latin America and the Caribbean, the World Bank, and the Organisation for Economic Co-operation and Development, among others. The main findings reveal an alarming deterioration at the macro, meso, and meta levels, which requires the design of public policies that consider the situation of MSMEs as essential for reducing poverty and unemployment affecting the region. Although MSMEs hold some advantages at the micro level, they need to receive direct support to enable them to stay afloat and make productive and technological investments. © 2022 Emerald Publishing Limited. All rights reserved.

Triple Positive Effect? Impact of Vaccination, Early Remdesivir Treatment and Omicron Expansion on the Evolution of Covid-19 Infection in Heart Transplant Recipients

To evaluate the evolution of COVID infection in heart transplant recipients (HT). Prospective, single-center observational study including all HT at risk for COVID infection between March 1st, 2020 and August 31th, 2022. We analyzed their baseline characteristics, COVID clinical presentations, and the variation in COVID prognosis over time. Of 309 HT, 121 had COVID infection. Baseline characteristics were similar among COVID and non-COVID HT. Most HT were on standard triple immunosuppression therapy in both groups. COVID HT with pneumonia were older (63±12 vs. 55±15 years, p <0.01), had more frequently chronic kidney (62.9% vs. 24.4%, p<0.01) and lung disease (22.9% vs. 7.0%, p=0.03), and were taking cyclosporine at a higher rate (65.7% vs. 32.6%, p<0.01). In addition, fewer of them were fully vaccinated (45.7% vs. 70.9%, p=0.05). COVID HT with pneumonia presented more frequently dyspnea (45.7% vs. 7.0%, p<0.01) and fever (77.1% vs. 29.1%, p<0.01), deeper lymphopenia (647 ± 420 vs. 972 ± 553 U/µl, p=0.02), and higher C-reactive protein (2.0±1.9 vs. 8.0±4.9 mg/dL, p<0.01). Most of them were admitted (94.3% vs. 16.3%, p<0.01), and required oxygen therapy (65.7%), noninvasive (34.3%) or invasive ventilation (20.0%). Their mortality was 33 times higher than that of patients without pneumonia (40% vs. 1.2%, p<0.01).There were 11 reinfections, 2 with pneumonia in nonvaccinated patients. One died, and the other 10 recovered. The image shows the impact of COVID infection over time in our HT population. Three factors have potentially contributed to improving the prognosis: high vaccination rate, early treatment with remdesivir, and omicron expansion as the main COVID variant. HT are at high risk for severe COVID infection. Older age and greater comorbidity increase the risk of pneumonia, with poor prognosis. Vaccination, remdesivir treatment and omicron spread seem to have improved the prognosis in recent times. [ FROM AUTHOR] Copyright of Journal of Heart & Lung Transplantation is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Studying teachers' work and lives: insights from research before and during the COVID-19 pandemic

Drawing on the notion of professionalism and the role of emotions, this chapter examines teachers' work and lives based on data from two major research projects. Data were collected before and after the COVID-19 pandemic through two online surveys. Findings point to collaboration as one of the key dimensions of teachers' work. While individual and collegial professionalism were identified, managerial and functional issues have also played a role in how teachers deal with tensions and contradictions in their daily professional lives. Positive and negative emotions stand out in teachers' accounts as well as the relational dimension of teaching and the use of ICT. © 2023 Elsevier Ltd. All rights reserved.

Online teaching and learning practices in teacher education: past, present and future

The outbreak of the COVID-19 pandemic has marked a before and after for online teacher education that needs to be examined. This article provides a review of the literature on online teaching and learning practices in teacher education. Drawing on previous research that analyzes online educational practices before (past) and after (present) the irruption of the pandemic, it aims to understand the nature and the kinds of practices and factors affecting impact in the online environment. The article discusses the implications of the findings for the development of online teaching and learning practices in the post-pandemic time (future). © 2023 Elsevier Ltd. All rights reserved.

Bachelor of Science in Nursing faculty perceptions of distance education during the COVID-19 pandemic [Version 1, Peer Review - In Progress]

Introduction: the COVID-19 pandemic generated a disruption in the modality of face-to-face education, forcing an abrupt migration to virtuality with little or no prior preparation, which makes it necessary to analyze the perception and satisfaction of teachers with the development of activities in this format. Objective: to analyze the perception and satisfaction with education in virtual modality during the COVID-19 pandemic of the teachers of the Nursing Degree of the University Institute of the Argentine Federal Police of the Autonomous City of Buenos Aires, Argentina. Methods: a descriptive, cross-sectional, and quantitative study was designed. The sample consisted of 23 teachers who responded to an instrument consisting of 21 questions with closed response options. Results: the mean age was 52 years (SD: 10), 87 % were women and 79,9 % have children, 56,5 % are teachers of third-year subjects of the curriculum and 56,5 % have a degree level of training. 65,2 % mentioned that in virtuality their main difficulty was the resistance of students to turn on their cameras and 43,5 % perceive the qualifications obtained in virtuality as equivalent to face-to-face. Those who possessed a postgraduate degree (p=0,005) and those who wished to continue virtual activities after isolation (p=0,041) were found to have higher levels of satisfaction. Conclusions: an average level of satisfaction was found with a score of 6.8 out of 10 and the perception of the virtual modality for the development of classes during the pandemic was positive. © 2023, Publicacion de la Asociacion Salud, Ciencia y Tecnologia. All rights reserved.

Structural racism and health in the age of COVID-19: A selective review with policy implications

Structural racism encompasses the effects of racial bias across all systems of society. A growing body of data indicates that structural racism contributes to racial inequities in health across the lifespan. Investigators have documented associations of different dimensions of structural racism, including cultural and institutional discrimination, to health. To clarify and integrate the scope of these data, we examine a broad array of manifestations of both cultural and institutional racism and review their associations to specific health effects outcomes. We examine effects on COVID-19 prevalence and mortality, but also investigate data on birth outcomes and premature mortality to gain insight into health effects at each end of the lifespan. Given the pervasive and well-documented history of racism facing Black Americans, we focus this review on the effects of structural racism on the health of Black populations in the United States. To examine the association of cultural discrimination to health, we review studies of prejudicial communications assessed with measures of area-level prejudice, leader communications of prejudice, and reactions to race-related cultural events. To examine the association of institutional discrimination to health, we examine laws and institutional policies that discriminated against Black Americans and shaped social and physical environments characterized by residential racial segregation and disadvantage, occupational segregation, and restricted voting rights, among other manifestations of inequity. As we document, research has demonstrated associations of cultural racism to birth outcomes and mortality, data are lacking on direct relations to COVID-19 mortality. Institutional discrimination has been consistently linked to the increased prevalence of and mortality from COVID-19, and some aspects are associated with birth outcomes and mortality. Understanding the interrelations among cultural and institutional aspects of discrimination and their historical roots have important implications for the development of policies and interventions to reduce structural racism and mitigate its effects on health. © 2023 The Society for the Psychological Study of Social Issues.

The Peruvian university professor and the virtuality in the health emergency

During the current global health crisis, governments have dictated emergency measures;as a result, Peruvian universities interrupted academic work and began remote teaching. The changes from an in-person to non-face-to-face teaching process and adaptation of teachers to virtual teaching are analyzed. It is a mixed investigation, performing regressions and characterizing each component. Connectivity gaps, knowledge in digital tools, pedagogical and technological approach are identified that affect efficiency and teaching productivity of the non-face-to-face teaching process. The university community needs to develop and reinforce new techno-pedagogical capacities towards hybrid education in a new normal scenario. © GKA Ediciones, authors. Creative Commons Reconocimiento-NoComercial-SinObraDerivada.

Clinical Features in Children and Adolescents Aged < 18 Years with Severe Covid in a Mexican Pediatric Critical Care Unit

BACKGROUND AND AIM: Overall mortality in children with severe COVID is less tan 1%. In Mexico, there are no reports regarding the epidemiology or clinical characteristics of severe covid. AIM: To describe clinical characteristics in children with severe outcomes and testing positive for SARS-CoV-2 in a pediatric critical care unit. METHOD(S): This retrospective cohort study enrolled participants between April 2020 and April 2021 in a pediatric terciary unit. Participants were youths aged younger than 18 years who were tested positive for SARS-CoV-2 infection and required hospitalization for severe COVID19. Main Outcomes and Measures: Severe outcomes, defined as intensive interventions during hospitalization (eg, inotropic support, positive pressure ventilation) or death. RESULT(S): Sixteen patients met the criteria for severe COVID according to the WHO definition4, 10 patients were men (62.5%) and 6 women (37.5%), with median age of 7.16 (0.2- 15, SD 4.95), 2 children have under 1 year (12.5%), 4 children aged 1-4 (25%), 7 children aged 5-11 (43.7%) and 3 aged 12-17 (18.7). (Table 1). A higher percentage of patients hospitalized for COVID-19 in our unit had an underlying condition (75%) compared with those without an underlying condition (25%) CONCLUSION(S): In our study, we found a high mortality in patients with severe COVID compared to that reported worldwide. In most of the countries across the world the mortality is less than 2%, but we found a 56% mortality. (Figure Presented).

Systematic Review on Photogrammetry, Streaming, Virtual and Augmented Reality for Virtual Tourism

Photogrammetry, streaming, virtual reality, and augmented reality are technologies that are having a great impact in fields such as education, medicine, video games, and lately in tourism, especially in recent years due to the COVID19 pandemic;however, the area of tourism had limitations in terms of face-to-face tourism, but thanks to the use of the aforementioned technologies, it has been possible to virtualize the interactions of the users. In this work, we have carried out a review of applications of photogrammetry, streaming, virtual and augmented reality focused on the area of tourism. Which were found through a systematic review of the literature focused on the use of these technologies as tools for the generation of immersive environments for tourist sites. The objective of this work is to serve as a basis for future research focused on virtualizing tourist sites;That is why we focused on the following topics (1) the application of these technologies to tourism in related works, (2) the advantages and disadvantages in the use of these technologies, (3) the problems that these technologies present and how they would be solved and (4) future work. After conducting the research review, we have been able to confirm that photogrammetry, streaming, virtual reality, and augmented reality can be used effectively to generate an inmersive interaction between the tourist and the tourist site in a virtual way, but it is still necessary to take considerations about its use. © 2022, Springer Nature Switzerland AG.

Association between study year and depressive and anxious symptoms during the first months of confinement due to COVID-19 pandemic in a sample of medical students from a private university in Lima, Peru

Objective: To determine the relationship between year levels of medical studies and depressive and anxious symptoms during the first months of the COVID-19 pandemic in a sample of medical students in Lima, controlling specifically the variables sex and presence of underlying medical conditions. Material(s) and Method(s): An online survey collected information from 250 medical students, covering general data, previous medical history and symptoms of depression (PHQ-9) and anxiety (GAD-7). Data were managed using multivariate analysis of covariance. Result(s): Differences were found between years of study and the combined values of PHQ-9 and GAD-7 (Wilks' LAMBDA = 0.86;p = 1.68 x 10-4;eta2p = 0.08). Underlying medical conditions also showed significant differences for the combined values of PHQ-9 and GAD-7 (Wilks' LAMBDA = 0.94, p = 4.43 x 10-4, eta2p = 0.06). The univariate test for year of study showed differences for PHQ-9 (F6.241 = 4.12, p = 0.001, eta2p = 0.09) and GAD-7 (F6.241 = 2.81, p = 0.01, eta2p = 0.07). The post hoc analysis showed statistically significant differences in the first years of study. Conclusion(s): These results suggest that medical students of the first years show higher levels of depression and anxiety symptoms than participants from more advanced years of the medical career. Likewise, the occurrence of previous medical conditions also explained high levels of depression and anxiety. Copyright 2022 With Intelligence Ltd.

Psychopathological symptomatology as a mediator between negative emotions and life satisfaction in Peruvian population in the context of COVID-19

Introduction: The objective was to establish an explana-tory model of life satisfaction as a function of negative emotions mediated by the psychopathological severity index, as well as to describe and compare psychopathological symp-tomatology as a function of sociodemographic variables. Methodology: The research design was non-experimental, cross-sectional, descriptive and structural equation modeling. The sample consisted of 1965 Peruvians of both sexes aged 17 to 71 years. The instruments used were the Depression, Anxiety and Stress Abbreviated Scale (DASS 21), Symptom Assessment-45 Questionnaire (SA-45) and Satisfaction with Life Scale (SWLS). Result(s): The structural regression model shows that negative emotions have a positive effect (R2 = 64%) on the global severity index (GSI) of psychopathological symptomatology and in turn the latter has a negative impact (R2 = 23%) on the life satisfaction of Peruvians. Among the psychopathological symptoms, psychoticism (19.64%), followed by phobic anxiety (19.44%) and depression (19.03%) stand out. In the macroregions, the GSI varied between 12.54% and 19.32%, with the lowest GSI in the northeast-ern macroregion and the highest in the north. Conclusion(s): Significant differences in psychopathological symptomatol-ogy were found according to macroregions, sex, age, having children, having a family member infected or deceased by COVID-19. Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.

Effects of a Prevention Program on Technological Addictions and Cognitive-Affective Dispositions in University Students

Objective: The effects of an online prevention program on technological addictions and cognitive -affective dispositions in university students during the COVID-19 pandemic were evaluated. Methods: Forty-two students participated in the sample, of which 21 formed the experimental group (EG) and the other 21 students the control group (CG). Academic efficacy and academic engagement scales were used, as well as cell phone, internet and video game addiction tests. Results: The application of the program significantly reduced the internet addiction, cell phone and video games and at the same time significantly increased the positive assessment of academic engagement and academic efficacy;comparisons between the study groups (GE versus GC) according to the effect sizes (.30 d . 50) evidenced important practical differences in the internet addiction, cell phone and video games, for the three variables the GE showed lower averages than the GC;on the other hand the comparisons between GE and GC resulted with effect size differences between medium (d >.50) and large (d >.80) in academic efficacy and academic engagement respectively, in these two variables the GE showed higher averages. Conclusion: the prevention program has reduced technological addictions, as well as increased cognitive-affective dispositions in students.

ANTISYNTHETASE SYNDROME PRESENTING AS INTERSTITIAL LUNG DISEASE: A CASE OF ANCHORING BIAS DURING THE COVID-19 PANDEMIC

SESSION TITLE: Dyspne Mysteries SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/18/2022 01:35 pm - 02:35 pm INTRODUCTION: Anti-synthetase (AS) syndrome is characterized by interstitial lung disease (ILD), arthritis, myositis, fever, or Raynaud's phenomenon in the presence of an AS autoantibody (1). At least 70% of patients with AS syndrome develop ILD (2), and it represents the major cause of mortality in these patients with a 10 year survival rate of 73%. In a small cohort study, the anti-PL-12 antibody subtype was found to be strongly associated with ILD (3). CASE PRESENTATION: A 35 year old female with a history of tobacco use disorder presented to the hospital with three months of recurrent subjective fevers, non-productive cough, and dyspnea on exertion. She denied arthralgias, muscle weakness and hemoptysis. She initially presented to her primary care physician with these symptoms and was prescribed amoxicillin for streptococcal pharyngitis. The patient continued to be symptomatic and was treated empirically for COVID-19 pneumonia twice despite two negative COVID-19 tests and without any significant clinical improvement in her respiratory status. On admission, she was febrile, tachycardic, and had a new oxygen requirement with bilateral coarse breath sounds on exam. She had no leukocytosis and her COVID-19 test was negative. CT angiography of the chest showed extensive mixed reticular and airspace opacities with peribronchial predilection and peripheral sparing (figure 1). A bronchial alveolar lavage was notable only for neutrophilia (19%) and eosinophilia (4%). Rheumatological workup revealed elevated rheumatoid factor, positive antinuclear antibody (1:40), weakly positive anti–Sjögren's-syndrome-related antigen A antibody (50 AU/ml), undetectable anti-Jo-1 antibody and positive anti-PL-12 antibody. Pulmonary function testing revealed a TLC of 40% and DLCO of 28%, consistent with a restrictive pattern. Considering the patient's organizing pneumonia, positive antibodies, and findings of "mechanic's hands,” the patient was diagnosed with anti-synthetase syndrome with ILD. She was started on oral prednisone and mycophenolate mofetil. On follow-up, she was noted to have symptomatic improvement and stable hypoxia without clinical signs of disease progression. DISCUSSION: During the coronavirus pandemic, the resemblance of COVID-19 pneumonia to other diseases, in the absence of conscious suspicion for other etiologies, can lead to anchoring and availability bias thereby delaying diagnosis and appropriate treatment. Additionally, anti-synthetase syndrome should be considered in the differential diagnosis of ILD even in the absence of arthritis and myositis, as respiratory symptoms are often the first presenting signs. CONCLUSIONS: Increased responsibility is required of diagnosticians to exercise due diligence and active recognition of COVID availability and anchor bias to avoid missing crucial diagnoses. Reference #1: Cojocaru, Manole, Inimioara Mihaela Cojocaru, and Bogdan Chicos. "New insights into antisynthetase syndrome.” Maedica 11.2 (2016): 130. Reference #2: Marco, Joanna L., and Bridget F. Collins. "Clinical manifestations and treatment of antisynthetase syndrome.” Best Practice & Research Clinical Rheumatology 34.4 (2020): 101503. Reference #3: Kalluri, Meena, et al. "Clinical profile of anti-PL-12 autoantibody: cohort study and review of the literature.” Chest 135.6 (2009): 1550-1556. DISCLOSURES: No relevant relationships by Mario Flores No relevant relationships by David Jackson No relevant relationships by Lisa Saa No relevant relationships by Abu Baker Sheikh