Educational inclusion in the perspective of university teachers from five Latin American universities: Notes on the validation of the questionnaire

University educational inclusion has been the subject of several studies at the international level and in the Latin American region in particular. The novelty of the present study lies in the fact that the diagnosis of the object of research has been carried out from a renewed theoretical basis, i.e., the incorporation of theoretical indicators not previously evaluated and which are considered by the authors as key aspects to measure educational inclusion from the viewpoint of university teachers. This made it necessary to design an instrument with technical capacity and scientific rigor, which was subjected to a validation process that provided new research horizons on the subject. A bibliometric review of Educational Inclusion and University Teaching variables was also carried out to know the current status of the scientific production published in high-impact journals indexed in the Scopus database, where the main characteristics within the volume of publications were described. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

A differential therapeutic consideration for use of corticosteroids according to established COVID-19 clinical phenotypes in critically ill patients.

OBJECTIVE: To determine if the use of corticosteroids was associated with Intensive Care Unit (ICU) mortality among whole population and pre-specified clinical phenotypes. DESIGN: A secondary analysis derived from multicenter, observational study. SETTING: Critical Care Units. PATIENTS: Adult critically ill patients with confirmed COVID-19 disease admitted to 63 ICUs in Spain. INTERVENTIONS: Corticosteroids vs. no corticosteroids. MAIN VARIABLES OF INTEREST: Three phenotypes were derived by non-supervised clustering analysis from whole population and classified as (A: severe, B: critical and C: life-threatening). We performed a multivariate analysis after propensity optimal full matching (PS) for whole population and weighted Cox regression (HR) and Fine-Gray analysis (sHR) to assess the impact of corticosteroids on ICU mortality according to the whole population and distinctive patient clinical phenotypes. RESULTS: A total of 2017 patients were analyzed, 1171 (58%) with corticosteroids. After PS, corticosteroids were shown not to be associated with ICU mortality (OR: 1.0; 95% CI: 0.98-1.15). Corticosteroids were administered in 298/537 (55.5%) patients of "A" phenotype and their use was not associated with ICU mortality (HR=0.85 [0.55-1.33]). A total of 338/623 (54.2%) patients in "B" phenotype received corticosteroids. No effect of corticosteroids on ICU mortality was observed when HR was performed (0.72 [0.49-1.05]). Finally, 535/857 (62.4%) patients in "C" phenotype received corticosteroids. In this phenotype HR (0.75 [0.58-0.98]) and sHR (0.79 [0.63-0.98]) suggest a protective effect of corticosteroids on ICU mortality. CONCLUSION: Our finding warns against the widespread use of corticosteroids in all critically ill patients with COVID-19 at moderate dose. Only patients with the highest inflammatory levels could benefit from steroid treatment.

A differential therapeutic consideration for use of corticosteroids according to established COVID-19 clinical phenotypes in critically ill patients Una consideración terapéutica diferencial para el uso de corticoesteroides en COVID-19 según los diferentes fenotipos clínicos establecidos en pacientes críticos

Objective To determine if the use of corticosteroids was associated with Intensive Care Unit (ICU) mortality among whole population and pre-specified clinical phenotypes. Design A secondary analysis derived from multicenter, observational study. Setting Critical Care Units. Patients Adult critically ill patients with confirmed COVID-19 disease admitted to 63 ICUs in Spain. Interventions Corticosteroids vs. no corticosteroids. Main variables of interest Three phenotypes were derived by non-supervised clustering analysis from whole population and classified as (A: severe, B: critical and C: life-threatening). We performed a multivariate analysis after propensity optimal full matching (PS) for whole population and weighted Cox regression (HR) and Fine-Gray analysis (sHR) to assess the impact of corticosteroids on ICU mortality according to the whole population and distinctive patient clinical phenotypes. Results A total of 2017 patients were analyzed, 1171 (58%) with corticosteroids. After PS, corticosteroids were shown not to be associated with ICU mortality (OR: 1.0;95% CI: 0.98–1.15). Corticosteroids were administered in 298/537 (55.5%) patients of “A” phenotype and their use was not associated with ICU mortality (HR = 0.85 [0.55–1.33]). A total of 338/623 (54.2%) patients in “B” phenotype received corticosteroids. No effect of corticosteroids on ICU mortality was observed when HR was performed (0.72 [0.49–1.05]). Finally, 535/857 (62.4%) patients in “C” phenotype received corticosteroids. In this phenotype HR (0.75 [0.58–0.98]) and sHR (0.79 [0.63–0.98]) suggest a protective effect of corticosteroids on ICU mortality. Conclusion Our finding warns against the widespread use of corticosteroids in all critically ill patients with COVID-19 at moderate dose. Only patients with the highest inflammatory levels could benefit from steroid treatment.

Optimal Strategies for Diabetic Foot Care in Times of Pandemic

Objectives: To determine optimal strategies for diabetic foot care in times of pandemic. Methods: Systematic review was conducted following PRISMA guidelines from May to December 2021, using Pubmed, Scopus, SCIelo, CINAHL and Lilacs databases, with the descriptors DeCs: Diabetic foot, (diabetic foot) AND: (disease prevention), (nursing care), (nursing care), (nursing care)) AND (disease prevention), (nursing care) AND (Strategies), (Coronavirus infections), (Coronavirus infections) Queries Covid-19 articles Category: General, ((diabetic foot) AND (nursing care)) AND (Coronavirus infections). Studies from 2018 to August 2021 were considered. Results: Out of 2464 articles, 28 were selected and evaluated using the Mixed Methods Appraisal Tool. 29% articles (8) were developed in countries belonging to Europe, followed by 25% (7) articles from countries in Asia and North America, 14% (4) from countries in South America and 4% (1) article from Oceania and Africa. The results obtained were differentiated between face-to-face and non-face-to-face strategies. Within the latter group, the lines of action defined in the Chilean National Telehealth Program were used to classify the results. Conclusions: The optimal strategies for diabetic foot care in times of pandemic were classified as face-to-face and non-face-to-face. As face-to-face strategy, foot care education and complications were identified. As non-face-to-face strategies, are those focused on the use of tele-education for patients and te-learning for professionals, in addition to support in the evaluation of lesions with telemedicine, tele-assistance, telemonitoring and telefolow-ups. The elements inherent to e-health should be considered, such as: infrastructure, collaboration with the private, associative and multisectoral sectors, evaluations of cost-effective models, adaptation of services to the needs of the population, particularly vulnerable groups.