Modeling and Analyzing Online Food Delivery Services Using Design Thinking: An Optimization Approach

The COVID-19 pandemic has significantly strained online food delivery services (OFDS) globally. This has challenged OFDS businesses to redesign and deploy technologies to meet customer demand. The purpose of this article is to identify the optimal factors contributing to customer experience with OFDS services during a black swan event such as the COVID-19 pandemic. We followed a four-step research design to identify the optimal factors for OFDS. First, we identified the major episodes in the OFDS process. Second, these episodes were evaluated by customers using the sequential incidence technique. Third, we used an orthogonal design to analyze the episodes at different levels based on customer preferences. Finally, we used the Taguchi approach to calculate the signal-to-noise ratios and identify the optimal factors and their preferred levels. We classify the optimal factors into customer-oriented and service-provider-oriented propositions. The option to select the delivery person and delivery conditions was found to be the most optimal customer-oriented attribute. We discuss the theoretical and managerial implications of the study and suggest major avenues for digital transformations in OFDS for better customer experience. IEEE

[Efficacy of tele-rehabilitation in patients with chronic obstructive pulmonary disease: a systematic review].

The COVID-19 pandemic has required the use of new technologies to carry out rehabilitation sessions for COP D remotely. The aim of this systematic review was to analyse the available evidence on the efficacy of telerehabilitation in COPD patients. PubMed, WOS, PEDro and Cochrane databases were consulted. The systematic review included nine clinical trials, 55.5% of which display good methodological quality. The most commonly used rehabilitation methods were applications or software for real-time video-calls, visualisation of exercises and recording progress. TR was as effective as outpatient pulmonary rehabilitation, with greater benefits in functional capacity, self-efficacy, mental health, exacerbations and emergency care visits, offering a cost-effective option with high patient satisfaction. The small number of studies and the variety of rehabilitation methods examined limit the value of the evidence obtained.

Interstitial changes after severe SARS-CoV-2 Infection

Introduction and aim: COVID19 pandemic caused by SARS-CoV-2 is associated with high morbidity and mortality rate worldwide,producing inflammation that can lead to persistent parenchymal lesions. The aim was to analyse the medium-long term evolution of patients with severe COVID19. Method(s): Follow-up of a cohort of 97 COVID19 patients admitted to intensive care unit from March 2020 to June 2021,requiring invasive/non-invasive mechanical ventilation (IMV/NIMV) and/or high-flow nasal cannula (HFNC). They were clinically evaluated in the Interstitial Diseases consult at 4-6 weeks after discharge with spirometry (SP),CO diffusion capacity (DLCO) and thoracic ultrasound (TU);those suggestive of mild interstitial changes (IC) were evaluated at 3 months and moderate-severe ones at 6 months with HRCT,SP and DLCO. Result(s): Mean age was 61+/-15 years (61% male) and hospital stay was 26+/-17 days.93% used HFNC,57% NIMV and 31% IMV. At 4-6 week after discharge assessment showed 45% dyspnea and 33% crackles. SP was normal in 63%,with mild DLCO disorders in 36% and 77% pathological TU. The most frequent abnormality on HRCT was ground glass. After clinical-functional and ultrasound-radiological evaluation at 4-6 weeks after COVID19,37% of cases were discharged,another 2% at 3 months,22% at 6 months and 7% at 12 months. The remaining 32% are still being followed up for persistent IC(6 receiving home oxygen therapy,6 treated with steroids and 4 with antifibrotic). Conclusion(s): Most patients with severe COVID19 infection have after discharge IC with mild clinical-functional impact at 4-6 weeks,although one third have persistent changes after 12 months. Medium to long-term follow-up of postCOVID19 patients is necessary to identify those with permanent abnormalities.

Metaphorical Representation of Coronavirus in Spanish and Brazilian Cartoons

The worldwide outbreak of Covid-19 epidemic has been profusely covered by the mass media in 2020. This research focuses on the metaphorical content of cartoons from prominent Spanish and Brazilian newspapers published online in March and April 2020. In these satirical drawings the virus is portrayed through two main modes of representation: i) pictorial and ii) verbal. The conceptual metaphors conveyed in each cartoon were identified, analysed, and classified into four source domain scenarios: i) arts and literature, ii) conflicts, iii) sports, and iv) games, and other. Mainly, two theories coming from Cognitive Linguistics, Conceptual Metaphor Theory, and the Multimodal Metaphor Theory, have been used to approach this contrastive study in which the metaphorical representation of Covid-19 serves to offer a humorous and persuasive point of view about the impact of the pandemic in the Spanish and Brazilian society and the way the most important politicians of each country dealt with the sanitary crisis. © 2022, Asociacion Espanola de Linguistica Aplicada. All rights reserved.

FACTORS ASSOCIATED with the OCCURRENCE of MENTAL DISORDERS in PATIENTS with AUTOIMMUNE RHEUMATIC DISEASES during the COVID-19 PANDEMIC

Background: Mental disorders constitute a serious and underestimated problem in Latin America and they could have worse features in comparison with Europe or North America (1);that was the case even before the COVID-19 epidemic ensued in 2020. Objectives: The objective of this study was to determine the factors associated with the occurrence of mental health disorders (MHD) in patients with autoimmune rheumatic disease (ARD) from Perú, a high COVID-19 incidence country. Methods: Patients with ARD from a single center (Hospital Guillermo Almenara-EsSalud, Lima-Perú) were included during the frst and second waves of the COVID-19 pandemic (March to November 2020). Interviews, medical records reviews, and an electronic survey were performed. MHD explored were depression (assessed with the Patient Health Questionnaire 9: PHQ-9), anxiety (ascertained with the Generalized Anxiety Disorder-7: GAD-7) and post-traumatic stress disorder: PTSD (evaluated with the Event Scale-Revised: IES-R). Variables examined were sociodemographic (age, gender, educational level, marital status, living alone, job status, religiosity), previous diagnosis and treatment for mental disorders, living with a COVID-19 patient, COVID-19 diagnosis (current or past), fear of COVID-19 (assessed with the COVID-19 Scale: FCV-19S) and the ARD type. Multivariable logistic regression models using backward elimination procedure were performed to determine the variables associated with depression, anxiety, and PTSD. (See Table 1). Results: Nine hundred and thirteen ARD patients were evaluated. The most frequent diagnosis was rheumatoid arthritis in 446(48.8%) patients followed by systemic lupus erythematosus in 279 (30.6%). Depression, anxiety, and PTSD were observed in 128 (14.0%), 112 (12.30%) and 485 (53.1%) patients, respectively. In the multivariable analyses, previous treatment for mental disorders and fear of COVID-19 were associated with depression: OR=2.35 (95% CI 1.37-4.03;p=0.002) and OR=1.07 (95% CI 1.05-1.10;p<0.001) respectively;also with anxiety: OR= 2.42 (95% CI 1.37-4.26;p=0.002) and OR=1.09 (95% CI 1.06-1.12;p <0.01) and with PSTD: OR=2.42 (95% CI 1.39-4.21;p=0.002) and OR=1.41 (95% CI=1.11-1.17;p<0.001). A diagnosis of COVID-19 was associated with PTSD: OR=1.75 (95% CI 1.06-2.89, p=0.028), while being single was associated with a decreased probability of PTSD occurrence: OR=0.57 (95% CI=0.35-0.96;p=0.03). Finally, having a high educational level was associated with less anxiety: OR=0.43 (95% CI=0.82-0.21;p=0.009), for university/postgraduate studies and OR=0.52 (CI 95%=0.28-0.95;p=0.032) for secondary studies. Conclusion: Fear of COVID-19 and previous treatment for mental disorder were associated with all MHD explored on our ARD patients during the COVID-19 pandemic.

Air pollution and health prevention: A document of reflection.

Ambient air quality, pollution and its implication on health is a topic of enormous importance that is normally dealt with by major specialists in their particular areas of interest. In general, it is not discussed from multidisciplinary approaches or with a language that can reach everyone. For this reason, the Health Sciences Foundation, from its prevention area, has formulated a series of questions to people with very varied competences in the area of ambient air quality in order to obtain a global panorama of the problem and its elements of measurement and control. The answers have been produced by specialists in each subject and have been subjected to a general discussion that has allowed conclusions to be reached on each point. The subject was divided into three main blocks: external ambient air, internal ambient air, mainly in the workplace, and hospital ambient air and the consequences of its poor control. Along with the definitions of each area and the indicators of good and bad quality, some necessary solutions have been pointed out. We have tried to know the current legislation on this problem and the competences of the different administrations on it. Despite its enormous importance, ambient air quality and health is not usually a topic of frequent presence in the general media and we have asked about the causes of this. Finally, the paper addresses a series of reflections from the perspective of ethics and very particularly in the light of the events that the present pandemic raises. This work aims to provide objective data and opinions that will enable non-specialists in the field to gain a better understanding of this worrying reality.

Mortality and Bleeding Complications of COVID-19 Critically Ill Patients with Venous Thrombo-Embolism

Introduction: Venous thrombo-embolism (VTE) disease in critically ill COVID-19 patients is a remarkable issue, especially its relationship with bleeding events and mortality. The objective of this study was to describe the outcomes of critically ill patients with COVID-19 hospitalised in the intensive care unit (ICU) in relationship with VTE during their stay. The secondary objective was to describe prognostic factors in relation with these outcomes. Methods: This was a prospective cohort study of critically ill COVID-19 patients in two Spanish university hospitals that underwent, at the beginning of the study, venous ultrasound of both lower limbs in April 2020. When there was clinical suspicion of new VTE during the 30 day follow up, additional ultrasound or thoracic computed tomography were performed. Global VTE frequency, major bleeding events, and survival were collected, and their predictors were studied. Results: In total, 230 patients were included. Mean age was 60.1 ± 9.9 years and 77% of them were men. After 30 days of follow up, there were 95 VTE events in 86 patients (37.4%). Of these, 60 patients (69.8%) presented with deep vein thrombosis (DVT), 17 patients with pulmonary embolism (PE;19.8%), and nine patients with DVT and PE (10.5%). VTE was related to a longer hospital stay: 50.3 days in VTE patients and 47.2 days in non-VTE patients (p =.014). D-dimer at admission was significantly related to VTE development (p =.007). Major bleeding complications were found in 13 patients (5.7%). None of the demographic variables, treatments, or classic risk factors were related to a higher risk of major bleeding. During the 30 day follow up, 42 patients (18.3%) died. Variables related to mortality were older age (67.4 vs. 58.4 years;p <.001), lower weight (77.9 vs. 87.5 kg;p <.001), lower body mass index (28.2 vs. 30,8 kg/m2;p =.006), hypertension (43.1% vs. 69% of patients;p =.002), lymphocyte count at admission < 0.45 ×109/L (p =.003) and D-dimer at admission > 1 500 ng/mL (p =.014). Patients with VTE at any moment during the follow up tended to die more frequently (50%) than non-VTE patients (34.6%), but this difference was not statistically significant (p =.062). Independent predictors of mortality in the regression model were older age (> 66 years), D-dimer at admission (> 1 500 ng/mL), and low lymphocyte count (< 0.45 ×109/L) with an area under the receiver operating curve of 0.81 (95% confidence interval 0.73 – 0.89). Patients presenting these three conditions presented a mortality of a 100% in the predictive model. Conclusion: VTE frequency in ICU COVID-19 patients is high and the risk of major bleeding is low. Comorbidities and laboratory parameters of admission in these patients can be a useful tool to predict mortality.

CSR and SDGs Contribution to Hotels Resilience in COVID-19 days

The Virus SARS-Cov19 has put the hospitality sector under unprecedent distress. This essay tries to identify links between companies’ Corporate Social Responsibility approaches, SDGs performance, and their financial results for the period 2010–2019. The intention is to test the resilience of companies to the COVID-19 impact based on companies sustainable and responsible activity. The analysis starts with a multiple case study of four international, well-known hotel groups analyzing companies sustainable and responsible action from information disclosed in their corporate webpages and annual reports. Then we conduct statistical regressions analyses to observe potential correlations between the financial performance of each of the four companies with their activities and progress in the sustainable and responsible variables mentioned along the multiple case study. We find that environmental variables, particularly carbon emissions and water consumption are correlated with the Revenue, EBITDA and Net Results of the hotels. Besides, when companies provide training to their employees and the communities in which they operate, they can increase their performance in the long run. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Impact of lockdown on lifestyle: Healthcare professionals and overall population

Objective: to explore the effects of lockdown for the COVID-19 pandemic on the lifestyles of the overall population and healthcare professionals (HCPs). Method: a cross-sectional descriptive study. Non-probability snowball sampling was conducted through WhatsApp. After the pilot survey, an ad-hoc questionnaire was distributed on sociodemographic, clinical and lifestyle variables during lockdown. The parametric tests used for analysis were Student- Fisher's t and Pearson's Chi-squared test, and odds ratio with CI95%. Results: the study included 184 HCPs and 460 non-HCPs. The median age of the sample was 40.4 (SD: 12.8) years, they were mostly women (66.9%) with university education (65.8%). More HCPs had positive test results for COVID-19, OR= 17.1 (9.1- 32.1) or symptoms compatible with COVID-19, OR= 2.1 (1.4- 3.1). The psychological impact of lockdown was higher in HCPs, OR= 1.5 (1.0-2.1). There were no significant differences in the activities carried out during quarantine, except for telework (p< 0.001). The degree of concern self-reported by 68.0% of the non-HCP population was "Very concerned" and "Highly concerned", similarly to HCPs (65.8%) (p= 0.218). Healthy lifestyles were maintained during lockdown, except for physical exercise which was worse in both groups (66.3% of HCPs and 66.4% of non-HCPs). Smoking and/or alcohol intake increased between 20 and 30% in both groups. Conclusions: changes were perceived among HCPs and non- HCPs regarding occupation during lockdown, psychological impact or tendency to get infected. It is essential to introduce resources for mental healthcare, particularly for HCPs. © 2022 DAE Editorial, Grupo Paradigma. All rights reserved.

children, pandemic and school: Starting over is a political act

This article is an invitation to consider Paulo Freire's Pedagogy of the Question as a text that leads the reader to consider the possibilities offered by the post-Covid 19 resumption of daily school life with children as a political act. Based on a conversation that Freire had with Antônio Faundez in 1985, this text encourages researchers and educators to consider ways of returning to school life in ways that are welcoming, responsive and loving in the wake of the experience of "almost-exile" undergone during the covid-19 pandemic. It becomes necessary to think school life again from where the children truly are, restarting in full awareness of the adventures, the pains, the losses they have undergone, encouraging them to ask the questions that the pandemic experience has produced them, and to recognize the new forms of consciousness it has inaugurated. This paper explores the implications of the ideas found in the Freire-Faundez dialogue for this moment of reconstruction. © 2022 State Univ of Rio de Janeiro - Center of Childhood and Philosophy Studies. All rights reserved.

SARS-CoV-2-specific antibodies and neutralization capacity in breast milk following infection vs vaccination.

Anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies have been found in breast milk following both natural SARS-CoV-2 infection and coronavirus disease 2019 (COVID-19) vaccination. This was a prospective study to evaluate the temporal changes in amount and neutralization capacity of anti-SARS-CoV-2 antibodies in breast milk stimulated by natural infection and by vaccination. Serial breast milk samples were collected from postnatal women who were recruited through convenience sampling. We found a rapid increase in neutralizing SARS-CoV-2-specific antibodies in breast milk from both study groups. Amongst the infection group, the median immunoglobulin A (IgA) level was 16.99 (range, 0-86.56) ng/mL and median binding capacity was 33.65% (range, 0-67.65%), while in the vaccination group these were 30.80 (range, 0-77.40) ng/mL and 23.80% (range, 0-42.80%), respectively. In both groups, both binding capacity and IgA levels decreased progressively over time after peaking. Neutralizing activity had become undetectable by about 150 days after the first dose of the vaccine, but a vaccine booster dose restored secretion of neutralizing IgA, albeit with different levels of response in different individuals. This highlights the importance of the vaccine booster dose in sustaining neutralizing antibody levels in breast milk, which may potentially provide protection for very young children, who cannot receive the COVID-19 vaccine. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.

The value of human resources: experience of critical care nurses during the COVID-19 epidemic El valor del recurso humano: experiencia de profesionales enfermeros de cuidados críticos durante la pandemia por COVID-19

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units. Objective To learn about the experience of nurses in caring for people with coronavirus in critical care units. Method A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis. Results This article shows the findings around the theme “the value of human resources” which is nuanced through sub-themes “it's not the beds, it's the expert staff”, “shouldering the patient's burden”, and suffering because “they have not cared well”. Discussion Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge. Conclusions Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.

The value of human resources: Experience of critical care nurses during the COVID-19 epidemic.

The COVID-19 pandemic has caused an unprecedented health crisis. Pressure on the National Health System has created unique demand particularly in certain services and care units like the critical care units. OBJECTIVE: To learn about the experience of nurses in caring for people with coronavirus in critical care units. METHOD: A qualitative phenomenological study that constitutes the second phase of a mixed methodology project. We conducted interviews with 17 nurses caring for patients affected by COVID-19 in critical care units. The interviews were audio-recorded, transcribed, and analysed using thematic discourse analysis. RESULTS: This article shows the findings around the theme "the value of human resources" which is nuanced through sub-themes "it's not the beds, it's the expert staff", "shouldering the patient's burden", and suffering because "they have not cared well". DISCUSSION: Expert nurses have emerged as leading professionals in the care of the critical patient during the COVID-19 pandemic. This leadership is executed from a profile framed in an inclusive philosophy where wisdom, agility and intuition are the key elements underpinning problem identification and solving in a creative way, while adapting to the needs of the patient and healthcare team as they emerge. CONCLUSIONS: Expert nurses have played an advanced role in the management of care and human resources by exercising effective leadership in the clinical setting. Care has been hampered due to the crisis, which causes nurses moral distress because they have been unable to meet standards of quality and excellence in care.

Coronavirus disease 2019 vaccination and infertility treatment outcomes.

OBJECTIVE: To assess the influence of coronavirus disease 2019 (COVID-19) messenger ribonucleic acid vaccine on ovarian response and in vitro fertilization (IVF) treatment outcomes. DESIGN: A retrospective cohort study. SETTING: A tertiary university-affiliated medical center and a private medical center. PATIENT(S): The study included a total of 400 patients, 200 vaccinated women and 200 age-matched unvaccinated women, who underwent IVF in January-April 2021. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): The mean number of oocytes retrieved and clinical pregnancy rates in vaccinated vs. unvaccinated patients. RESULT(S): A total of 200 patients underwent oocyte retrieval 14-68 days after receiving COVID-19 vaccination. No difference was found in the mean number of oocytes retrieved per cycle (10.63 vs. 10.72) between vaccinated and unvaccinated patients. Among 128 vaccinated and 133 unvaccinated patients who underwent fresh embryos transfers, no difference was demonstrated in the clinical pregnancy rates (32.8% vs. 33.1%), with 42 and 44 clinical pregnancies, respectively. The fertilization rates and mean number of cryopreserved embryos were similar between the 2 groups in freeze-all cycles (55.43% vs. 54.29% and 3.59 vs. 3.28, respectively). Among vaccinated and unvaccinated patients who underwent fresh embryo transfers, no difference was noted in the fertilization rate (64.81% vs. 61.98%) and transferred embryos' quality. Regression models applied demonstrated no effect of the vaccine on oocyte yields and pregnancy rates. CONCLUSION(S): The COVID-19 messenger ribonucleic acid vaccine did not affect the ovarian response or pregnancy rates in IVF treatment. Women should be vaccinated for COVID-19 before attempting to conceive via IVF treatments, given the higher risk of severe illness in pregnant women.