ABSTRACT
Consumer demands and current legislation require intensive greenhouse horticulture to be sustainable. This poses the challenge of how to teach the concept of sustainable horticulture to all professionals involved in farming. The province of Almeria, in the south-east of Spain, is one of the major horticulture greenhouse areas in Europe, and an expert panel of relevant stakeholders was invited to look into the best pedagogical practices and methods to transfer technology and knowledge, with the goal of improving the sustainability of greenhouse horticulture. A combination of an online questionnaire, a Delphi method, and desk research was, therefore, used as the strategy to collect the data and implement the research design during 2021. On-farm/business demonstrations, virtual education, and classroom education were common pedagogical methods used. On-farm/business demonstrations, participatory education, and co-learning were identified as the best pedagogical methods to use in sustainable agriculture/horticulture training. The expert panel also concluded that participatory education and co-learning should be further explored whereas virtual and classroom education should play a less dominant role in the training activities. This knowledge can help training organizations and designers to avoid common mistakes, tailor their training activities, and be mindful of common barriers and (mis)conceptions. © 2023 by the authors.
ABSTRACT
Background: Mechanical complications (MC) give a poor prognosis for ST elevation myocardial infarction (STEMI). Its prevalence had decreased in the era of primary angioplasty, at the expense of free wall rupture (FWR). Purpose: To analyse the prevalence of post-STEMI MC for two periods, before and after the COVID-19 pandemic. Methods: Unicentric prospective registration of patients with STEMI admitted between January-2018 and December-2021. They are classified into two groups according to the onset of the pandemic by COVID-19: Pre-COVID: January-2018 to December-2019, and Post-COVID: January-2020 to December-2021. The prevalence of post-STEMI MC is analysed, including ventricular septal rupture (VSR), papillary muscle rupture (PMR) and FWR, and 30-day mortality. Results: 1507 consecutive patients with STEMI (Pre-COVID n=775, Post-COVID n=732) are included. Age 62.9 years vs 63.3 years (p=0.5097). Men 78.1% Vs 79.5% (p=0.493). No differences in cardiovascular risk factors, previous heart infarction or anterior wall STEMI. Primary angioplasty was similar in both groups (92%). The Post-COVID group has a higher prevalence of Killip>I (21.7% vs 17.2% p=0.025) and LVEF ≤40% (27.2% vs 20% p=0.001), and longer symptom onset to balloon dilatation interval (316 min vs 257 min p=0.0004). MC are most developed in Post-COVID (2.6% vs 1.2% p=0.039), at the expense of FWR (1.91% vs 0.3% p=0.001). No significant changes in VSR and PMR prevalence or 30-day mortality. Multivariate analysis identifies the independent predictors of FWR: Age (OR 1.05, p=0.024), Primary angioplasty (OR 0.09, p<0.001), and Post-COVID (OR 6.8, p=0.013). Conclusions: The COVID-19 pandemic is independently associated with a higher prevalence of FWR, probably due to delayed reperfusion. Funding Acknowledgement: Type of funding sources: None.
ABSTRACT
Objectives: To describe risk perception and its relationship with sources of information consulted, actions, and the impact of the pandemic on the physical and mental health as well as social aspects of a group of patients from the rheumatology consultation. Methods: A survey was conducted from August 10 to November 29, 2020 in rheumatic diseases (RD) patients who returned to an outpatient clinic in Mexico following the Stay at home program implemented from March 23 to July 31. An online questionnaire was administered on mobile devices. Measurements: Assessment of the patient's health status by rheumatologist (visual analog scale ranging 0-10) and some sections of the UNIV-COVID-19 questionnaire. A descriptive analysis was performed. Measures of central tendency and dispersion for continuous variables and frequency measures for categorical variables. Normality was checked with the Shapiro-Wilk test. Inferential statistical tests were performed to determine differences between the COVID-19 + vs -groups with Chi-square and Student's t test for nominal and continuous sociodemographic variables, respectively. Logistic regressions were performed. Results: A total of 471 patients with RD were included, 84.5% women, aged 46.9 (SD 14.5) years old;rheumatoid arthritis (RA) was the most prevalent diagnosis 42.4%. 4.8%had SARS-CoV-2 infection, 21.74% required hospitalization. Treatment modification was reported in 36.1% (66.6% discontinued);health condition worsened in 39.1% of the patients. 52.1% of the patients who made modifications in their treatment had COVID-19 and 39.1% of those who had COVID-19 reported that their health condition worsened. The perception of risk was 85.9% (very serious/serious). The preventive action carried out was home isolation 44.3%. Television was consulted 88.7%and alert 74.5%the most prevalent feeling, while 7% said they felt discriminated. The logistic regression analysis revealed that having SpA, taking leflunomide, feeling discriminated, and greater perception of risk were associated with having COVID-19. The bimodal results for each variable are presented to indicate the change on action taken per group. Conclusion: The risk perception in RD patients was very high. 5% had COVID-19. The impact on disease activity, physical/mental health was greater in patients with COVID-19. Discrimination of RD and COVID-19 patients is an important phenomenon.