Crisis Management and Public Policies. The Trend toward Regulatory Practices in Some Countries

The article aims to investigate whether governments tend to implement regulatory policies in response to the Covid-19 pandemic and to examine the type of citizen response to different types of policies. Given that active and collaborative citizen participation is an essential element of adequate crisis management, citizen resistance, active opposition, and demonstrations in public spaces are detrimental to the successful outcome of government policies in the face of a crisis. We employ the crisis management and institutional analyses theoretical perspectives, as well as the qualitative methods of study case and the comparative studies. We review the different types of policies implemented in different countries. Our analysis shows that there is indeed a tendency for implementing regulatory policies. It also identifies that the places where regulative policies are created and implemented without taking into account contextual aspects, it usually catalyzes citizen's discomfort. Therefore, we argue that the type of policy used is relevant to deciding what governments' responses should be and their effect on legitimacy during crises.

[Validation of a symptom scale for COVID-19 patients in ambulatory care]

Background: A symptom scale can be useful for the standardization of clinical evaluations and follow-up of COVID-19 patients in ambultaroy care. Scale development should be accompanied by an assessment of its reliablility and validity. Objective: To develop and measure the psychometric characteristics of a COVID-19 symptom scale to be answered by either healthcare personnel or adult patients in ambulatory care. Material and methods: The scale was developed by an expert panel using the Delphi method. We evaluated inter-rater reliability, where we defined a good correlation if Spearman's Rho was >= 0.8;test-retest, where we defined a good correlation if Spearman's Rho was >= 0.7;factor analysis using principal component methodology;and discriminant validity using Mann-Whitney's U test. A p < 0.05 was considered statistically significant. Results: We obtained an 8 symptom scale, each symptom is scored from 0-4, with a total minimum score of 0 and a maximum of 32 points. Inter-rater reliability was 0.995 (n = 31), test-retest showed correlation of 0.88 (n = 22), factor analysis detected 4 factors (n = 40) and discriminant capacity of healthy versus sick adults was significant (p < 0.0001, n = 60). Conclusions: We obtained a reliable and valid Spanish (from Mexico) symptom scale for COVID-19 ambulatory care, answerable by patients and health care staff. Copyright © 2023 Revista Medica del Instituto Mexicano del Seguro Social.

Economic development and democracy in Mexico in times of covid-19

In recent years COVID-19 has affected every country around the globe in a variety of different ways including economically, politically, and socially. Mexico has been no exception. This research analyzes the economic development and the democratic progress in Mexico in times of COVID-19 and the relationships between these variables. These relationships are estimated through a regression analysis for the period of 2019 to 2020. It has been found that the relationship of these variables is consistent and presented with a consensual view during the pandemic in Mexico. The data suggests that the higher the level of democracy, the higher the level of economic development.

Forecasting Based on Fuzzy Logic of the Level of Epidemiological Risk for the Mexican State of Tamaulipas

Nowadays, in Mexico there exists a traffic light monitoring system to regulate the use of public space according to the risk level of infection with SARS‒CoV‒2. The monitoring system is applied to each state in Mexico and consists of four levels of risk encoded with four colors: green, yellow, orange and red. In this chapter we propose a Fuzzy Time Series Model to forecast the next color to be assigned to the Mexican state of Tamaulipas based on historical data from the monitoring system. We conducted a computational experiment to measure the accuracy of the model. The model accuracy was measured by the well‒known Root Mean Square Error (RMSE) index. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Cold chain relevance in the food safety of perishable products

The food cold chain is an effective tool that allows food markets to maintain food quality and reduce losses. Poor logistics may result in foodborne disease outbreaks and greenhouse gas emissions caused by organic matter decay. The ongoing pandemic of COVID-19 makes it necessary to study the chances of SARS-CoV-2 transmissions in food products. This study reviews cold chain logistics as a handy tool for avoiding food safety risks, including COVID-19. The cold chain of perishables and its proper management make it possible to maintain quality and safety at any stage of the food supply chain. The technology covers each link of the food chain to prevent microbial spoilage caused by temperature fluctuations and the contamination with SARS-CoV-2 associated with perishable foods. Given the lack of knowledge in this field in Latin America, the region needs new research to determine the impact of the cold chain on perishable foodstuffs. The perishable cold chain is only as strong as its weakest link, and the national and international markets require new traceability protocols to minimize the effect of COVID-19. © 2023, Arriaga-Lorenzo et al

Gender and Precariousness of Employment and Care: Consequences of the Pandemic for Female Teachers of Early Childhood and Primary in Chile

In Chile there is a progressive precariousness of the teaching profession (Ruffinelli, 2016) aggravated by the current health crisis COVID 19. In this context, the implementation of distance education has had multiple consequences for teachers (Villalobos Muñoz, 2021) and, particularly for women, who must make their teaching function coexist with domestic and care work, complicating the already difficult reconciliation of work and family. On this basis, the aim of the article is to analyze, this article aims to analyze, from a gender perspective, the precarious situation experienced by early childhood and primary education teachers in Chile and, in addition, to know how this situation has worsened in the context of the pandemic. To achieve this objective, a qualitative study was carried out based on semi-structured interviews with nine early childhood and primary education teachers from the Province of Valparaíso. The main results indicate that the already precarious working condition has been aggravated by the lack of material, technical and procedural resources with which they face online teaching. On the other hand, the blurring of borders between the paid world of work and care, as part of the consequences of teleworking, has generated a physical and emotional overload for teachers. Finally, they realize that the management of educational authorities and schools during the pandemic is seen by those interviewed as inconsistent with reality, both by Chilean teachers and students. © 2022 FahrenHouse. All rights reserved.

Experience of using remdesivir in the treatment of patients with sars-CoV2 infection

Background and ImportanceRemdesivir was the first antiviral authorised by the European Medicines Agency for the treatment of CoVID-19 disease.Aim and ObjectivesThe aim is to describe the effectiveness and safety of remdesivir in patients with SARS-CoV-2 infection in real clinical practice.Material and MethodsObservational, descriptive, retrospective study in a level-II hospital.Hospitalised patients with SARS-CoV-2 infection and prescription of remdesivir from April21-March22 were included. Data were obtained from the Unidosis Farmatools® module and MambrinoXXI®.Variables: sex, age, recommendations of remdesivir datasheet (time from symptom onset to administration ≤7-days, dosing regimen, duration of treatment and glomerular filtration rate (GFR) (contraindicated if <30mL/min).Effectiveness assessment: hospital stay, Intensive Care Unit (ICU) admission, clinical recovery inpatients with 5-day treatment.Safety assessment: elevated transaminases (pre-and-post-remdesivir levels;contraindicated if ≥5 times upper limit of normal-LSN)Results59 patients were included, 64% male, median age 67(30-101) years.100% started within 7-days of symptomatology onset (median: 3-days) and complied with the recommended dosing regimen. In 93.2% the duration was 5-days, one patient remained on treatment for 7-days and 3 discontinued earlier due to clinical worsening. Mean GFR: 79ml/min and96.6% complied with the recommendation (GFR>30ml/min).The median hospital stay was 8-days (3-133). Twelve patients required admission to the ICU, two of whom died. Clinical recovery was achieved in 91.1% of patients who completed the 5-day regimen. During the hospital stay, 7 patients died with a median age of 85 years (59-95).Prior to administration, 22.2% patients showed transaminase levels above the LSN, including one patient with 5LSN. After administration, transaminases increased in 31.1%, including 5 patients with 5LSN, 2 of whom had initially normal values.Conclusion and RelevanceAll patients received remdesivir as early as recommended and according to the conclusions of the pivotal clinical trial, where this subgroup was postulated to have the greatest clinical benefit. Although one third of patients had elevated transaminasemia, none required treatment discontinuation. However, other parameters would need to be collected to assess safety more comprehensively. Despite the limitations of the study, in our experience, remdesivir appears to have a good effectiveness and safety profile and may be a therapeutic alternative in the treatment of COVID-19disease.References and/or AcknowledgementsConflict of InterestNo conflict of interest

New perspectives obtained during the COVID 19 pandemic: the importance of an adequate directed structured clinical interview prior to [18]FDG-PET/CT in cancer patients

Aim/Introduction: During the COVID 19 pandemic, mass vaccination campaign has played an important role, with a special importance in oncological and immunosuppressed patients, who form a large part of our [18F]FDG-PET/CT studies. Unexpected findings in the form of reactive lymphadenopathy were commonly detected in [18F]FDG-PET/CT studies. It is essential to recognize them and adapt their interpretation to the current epidemiological context. Material(s) and Method(s): Retrospective study of consecutive [18F] FDG-PET/CT studies performed at our center in 219 patients with oncological pathology from June 15 to September 20, 2021. A structured interview was conducted on all the patients who came to undergo [18F]FDG-PET/CT, in which they were asked about the type, date and arm of administration of the vaccine. The frequency of appearance of reactive lymphadenopathy, its relationship with the type of vaccine, sex, age and the importance of a detailed clinical interview prior to the isotope injection and/ or study interpretation were analyzed. Patients that presented ipsilateral axillary lymphadenopathies following vaccination and presented increased metabolic activity regardless of node size were considered positive, size and SUVmax were assessed. Result(s): From De 219 patients reviewed, 32% presented positive [18F]FDG-PET/CT axillary lymph nodes ipsilateral to the arm where the vaccine was inoculated. There was a relationship (p=0.01) between the mean size of the lymph nodes (11+/-9mm) and its mean metabolic activity (3.7+/-2.6 SUVmax). The appearance of lymphadenopathy was more frequent in women (40.5% vs 21% p<0.001), in younger patients (mean age 53+/-14 years vs 68.5+/-13 years p<0.001), in patients who had received the Moderna vaccine (58.5% p<0.001) and in which the time elapsed between vaccination and the performance of [18F]FDG-PET/CT was shorter. Conclusion(s): The appearance of post SARS-CoV2-vaccination reactive lymphadenopathies has been a frequent finding in [18F]FDG-PET/CT despite the main oncological indication of the study. Knowing the circumstances of these findings in oncological patients is important when interpreting them, so the use of a structured directed clinical interview has been very useful to help the physician understand and differentiate these findings.

Self-efficacy for physical exercise before and during the Covid-19 Pandemic

The appearance of the COVID-19 Pandemic has caused alteration in the daily routine, However, despite the circumstanc-es, self-efficacy plays a very important role for physical exercise. Objective: To determine the level of self-efficacy for physical exer-cise in men and women over 18 years of age, before and during the Covid-19 Pandemic, Method: A descriptive, cross quantitative study was carried out. The sample consisted of 1,612 adults from the city of Chihuahua (662 men and 950 women) older than 18 years. The Self-efficacy Questionnaire for the study (CAE-E) was used, validated in the Mexican version by Delgado et al. (2017). Results: It is verified with the Wilcoxon test that there is a significant difference before and during the Covid-19 Pandemic since it shows a significance of = 0.000 <? = 0.05, for which it is stated with 95% confidence that the averages of the medians are different. The most obvious changes are at the very low level of self-efficacy of 11.2%, which increased to 28.4% pooled, and at the moderate level that was before the pandemic of 35.9%, it fell to 21.9%. Conclusion: The results found in this work indicate that confinement in the city of Chihuahua, Mexico, affected self-efficacy in physical exercise, wich decreased in the population studied, people who had a moderate level before the Covid-19 pandemic suffered a decrease in their moderate to low self-efficacy and those who were before the Covid-19 pandemic at a low level of low to very low self-efficacy, this shows that the apparent level of self-efficacy to physical exercise before confinement was not entirely real and did not they made the necessary adjustments to maintain their level and remain physically active.

Professional practice in times of pandemic covid-19: case cecar university corporation of the caribbean

The professional practice is the means that allows students to apply the knowledge learned during their training process and strengthen the competencies of knowing, knowing how to do and being/coexisting. The article synthesizes the characteristics and processes developed from the professional practice course at the Corporación Universitaria del Caribe in pandemic. Meanwhile, the practice process was adapted to the contingency by adopting new modalities of practice at institutional level (telepractice, work at home, advisor/tutor practice, research, entrepreneurship and telepsychology) to guarantee the students the pedagogical space that allowed them to put into practice their knowledge and disciplinary competences. © GKA Ediciones, authors.

The Impact of the Pandemic on Young People with Intellectual Disabilities Participating in a University Training Course for Employment in Spain

Spanish universities still face many barriers to the training of people with disabilities, especially with intellectual disabilities (ID). In general, continuing higher education courses are the main training response for the latter. Knowing the impact that confinement by COVID-19 has had on the students of these courses is a relevant element. The present investigation focused on analyzing the case of the confinement experience of 12 young students with ID who attended the continuing training program called Unidiversidad at the University of Alcala (Spain). In particular, the implications on their emotional well-being, interpersonal relationships, and individual training were analyzed. Information was collected through a semi-structured interview with the students and a questionnaire with their relatives. The results reflect changes in emotional well-being linked to the increased concern of students for the health of their families. Interpersonal relationships were also affected, although participants tried to compensate for the lack of face-to-face interaction with instant messaging applications and video calls. The change in training to the online modality generated concern and uncertainty in students, although it also provided learning opportunities, which have been supported by peer tutoring and support from teachers.

"I've discovered the COVID-19 vaccine". Approach of a bipolar disorder clinical case in the Mental Health Day Hospital of Salamanca during the pandemic

Introduction: A 21-year-old woman diagnosed with bipolar disorder was hospitalized in the Mental Health Day Hospital of Salamanca during the Covid pandemic. The patient engaged with 4 different jobs and a master's degree, beginning with verbose speech, dysphoria, global insomnia, grandiose delusions, extremely high energy and thinking she has the vaccine. She works the following objectives: illness insight, risk factors, psychopathological stabilization, social skills, slowing down of activities and taking responsibilities. Objective(s): The objective is do a follow-up of the patient during her hospitalization in the Mental Health Day Hospital and to carry out a structured search in PubMed and Up-to-Date about psychotherapy and bipolar disorder. Method(s): 3-month follow-up of a 21-year-old woman diagnosed with bipolar disorder during her hospitalization in the Mental Health Day Hospital in Salamanca and a structured search in PubMed and Up-to-Date in April 2021 in English, French and Spanish, including the last 10 years with the keywords "psychotherapy", "psychotherapies" and "bipolar disorder ".77 studies were analyzed: 12 included, 65 excluded. Result(s): Several randomized trials highlight the efficacy of group psychoeducation and cognitive-behavioural therapy in relapse prevention, improving illness insight, medical adherence and less hospitalizations. Therapeutic alliance plays a significant role in the process. Our patient improved her knowledge of her illness and treatment, her social skills and reconnected with her relatives and slowed down her activity. She then was referred to her community mental heath center psychiatrist. Conclusion(s): The insight in bipolar disorder plays an important role in medical adherence and prevention of relapses. Therapeutic alliance improves their insight, their functionality in their daily life and enables close monitoring. Medical treatment should be accompanied by psychotherapy for a complete approach of the treatment.

Mexico: Remittances, Organized Crime and US Drug Overdose Crisis in Borderlands (2015-2021)

The present article aims at shedding some light to the question whether Mexicos boom in remittances between 2015 and 2021 was the result of low rates of unemployment in the USA or of higher revenues of drug trafficking made by Mexican Criminal Groups. We found that Mexican migration to the USA took off up 2019 and accelerated with Covid-19 pandemic. Since higher rates of unemployment matched with larger number of remittances and a spike in drug overdose deaths in the USA, a hypothesis aroused stating that Mexican remittances could be related to drug trafficking revenues. An Exploratory Data Analysis (EDA) found a normal negative correlation (not causation) between US-unemployment rate and remittances from 2015 to 2019 but an abnormal negative correlation from 2020 to 2021. We conclude that the record level in Mexican remittances between 2020 and 2021 could be the result of an increase in Mexican migration but also from a windfall in drug trafficking earnings mirrored in a spike of drug overdose deaths in the USA. © 2023, Norteamerica. All Rights Reserved.

Participatory prioritization of preventive strategies against COVID-19 for work environments

As part of an initiative to support Chilean companies, has been conducted a panoramic literature review and a priorization of preventive measures against COVID. 204 preventive measures were identified in the literature, the 20 measures most applicable to the Chilean reality were categorized by cost and effectivity by two groups of experts. Among the most effective and less costly measures, experts selected immediate notification of symptoms and self-care at home and the workplace and risk communication based on education. The priorization strategy used to arrange preventive measures according to cost and effectiveness is a participative tool in the decision-making process in the workplace. © 2022 Universidad Nacional Experimental Rafael Maria Baralt. All Rights Reserved.

Two-class structure of forbes global 2000 firms sales per employee similar to countries income distributions including some COVID-19 pandemic effects

Sales per capita (per number of employees) of the two thousand Forbes Magazine top publicly-traded companies (G-2000) for years 2015, 2020 and 2021 are statistically analyzed. Employing an econophysical model, the sales distributions per capita for the three years exhibit a two-class structure: a Pareto power law in the higher part and exponential in the lower part resembling a Boltzmann-Gibbs distribution. This distribution is consistent with income distributions around the world as if a fraction of a firms’ wealth goes to its employees in the form of wages and salaries. We highlight some changes in sales between 2020 and 2021 on selected industries that had the biggest negative and positive impacts partially due to the COVID-19 pandemic. © 2022. Revista Mexicana de Fisica. All Rights Reserved.

Myoclonus after Vaccination for SARS COVID19

Objective: To report two patients with movement disorders after vaccination for SARS COVID 19 with non-replicating viral vector vaccine. Background: As a result of the SARS COVID 19 pandemic, different types of vaccines have been developed to reduce the worldwide spread of the virus. Non-replicating viral vector vaccines (recombinant viruses) offer a rapid immune response, may require booster doses to acquire long-lasting immunity and may exhibit reactogenicity. Methods: We studied the clinical features and complementary examinations of two patients, who presented myoclonus after vaccination for SARS COVID19. Results: Case 1: Male, 75 year old with Parkinson's disease since 2003 treated with levodopa and amantadine. Hoehn&Yahr: II. He lived alone and was actively working as a psychologist. After the first dose of SARS COVID vaccine he felt severe asthenia. On the fourth day postvaccination, he presented upper and lower limbs myoclonus that made him unable to walk, and myoclonus in phonatory muscles. He was treated with levetiracetam up to a dose of 1500 mg/day with clear improvement of symptoms.Brain MRI showed no pathological findings. Caso 2: Female 80 year old with hemifacial spasm due to herpes zoster. One day after the second dose of SARS COVID vaccine she developed rhythmic involuntary movement in her left hand (3 Hz). Two months later, the involuntary movement spontaneously improved, remaining a mild myoclonic jerk. Brain MRI and Fluorodopa PET were normal. Conclusion: Both patients presented myoclonus one to four days after vaccination. In patient two, the initial interpretation of the involuntary movement as a tremor, led us to indicate a Fluorodopa PET to rule out dopamine deficient related movement disorder.Sputnik and Covishield share the same platform;they use non-replicating viral vectors also called recombinant virus vaccines.Based on the similar mechanism of action, we hypothesize that an immune-mediated mechanism, related to the faster occurrence of myoclonus in patient two (who had already been exposed to the vaccine) as compared to the delayed symptoms in patient one (who received his first dose), may underly the occurrence of symptoms.A detailed description and report on these findings can alert to the health organizations to contribute to a better understanding of the adverse effects profile associated with these different types of immunizations and to the level of evidence.

RESPIRATORY DISTRESS IN A NEONATE - WHEN BOARDS MEET REAL LIFE

Case Report A male infant is born at 37w to a 34-year-old G3P2 mother by vaginal delivery after an uncomplicated pregnancy. Prenatal screens are negative. The patient had a birth weight of 2,620 g, with Apgar scores of 9 and 9. On day 2 after birth, had increased work of breathing which prompted transfer to a level II NICU for further management. On arrival to the unit, the infant is tachypneic with mild chest wall retractions and thick nasal secretions. A CBC and blood culture were collected and empiric antibiotic therapy was started. Respiratory viral panel and COVID test are negative. A chest radiograph shows a middle lobe opacity concerning for pneumonia (figure 1). His clinical status failed to improve and on day 4 after birth, supplemental oxygen was provided. The primary team consulted ENT and Pulmonology services. Flexible laryngoscopy showed a normal anatomy. Pulmonology recommended transferring to our NICU for a chest CT with bronchoscopy. Our differential diagnosis for this neonate with respiratory distress that fails to improve over time or with antibiotics was broad, but further testing revealed this infant's condition. A CBC, CRP and a blood gas were collected on admission and were normal. ID service was consulted. A Chest CT showed bilateral atelectasis. Bronchoscopy showed a normal anatomy. Bronchoalveolar lavage was sent. Umbilicus swab was positive for MRSA, nasal wash/sputum culture/bronchoalveolar fluid also grew moderate S. aureus. Nasal ciliary biopsy sent for electron microscopy. Positive umbilicus and nasal swab, and subsequently BAL for MRSA led to a diagnosis of MRSA neonatal rhinitis. Therapy with IV vancomycin was initiated and later changed to oral clindamycin to complete a total of 14 days of therapy. The neonate was weaned off oxygen support on day 11. His clinical symptoms improved. He was discharged on oral clindamycin with follow up appointments with pulmonology and ID clinics. His ciliary biopsy showed absence of outer and inner dynein arms, compatible with the diagnosis of primary ciliary dyskinesia (PCD) (figure 2). Genetic testing for PCD showed mutations in the DNAAF1 and CCDC40 genes. This neonate was diagnosed with primary ciliary dyskinesia (PCD) but his presentation at birth was nonspecific and the differential diagnosis was broad. There is no gold standard diagnostic test for PCD and high clinical suspicion is important. Since it is most likely an AR inheritance, screening of family members is essential. Initial management of neonates may include measures that manage the respiratory distress, airway clearance to prevent respiratory infections and treat bacterial infections. Chest physiotherapy may help if recurrent atelectasis. Flexible bronchoscopy and bronchoalveolar lavage may help both to diagnose and treat the underlying infection. Antibiotic therapy based on organism growth for exacerbations may prevent development of bronchiectasis. (Figure Presented).