Perceptions of change in the environment caused by the COVID-19 pandemic: Implications for environmental policy.

COVID-19 lockdown measures have impacted the environment with both positive and negative effects. However, how human populations have perceived such changes in the natural environment and how they may have changed their daily habits have not been yet thoroughly evaluated. The objectives of this work were to investigate (1) the social perception of the environmental changes produced by the COVID-19 pandemic lockdown and the derived change in habits in relation to i) waste management, energy saving, and sustainable consumption, ii) mobility, iii) social inequalities, iv) generation of noise, v) utilization of natural spaces, and, vi) human population perception towards the future, and (2) the associations of these potential new habits with various socio-demographic variables. First, a SWOT analysis identified strengths (S), weaknesses (W), opportunities (O), and threats (T) generated by the pandemic lockdown measures. Second, a survey based on the aspects of the SWOT was administered among 2370 adults from 37 countries during the period from February to September 2021. We found that the short-term positive impacts on the natural environment were generally well recognized. In contrast, longer-term negative effects arise, but they were often not reported by the survey participants, such as greater production of plastic waste derived from health safety measures, and the increase in e-commerce use, which can displace small storefront businesses. We were able to capture a mismatch between perceptions and the reported data related to visits to natural areas, and generation of waste. We found that age and country of residence were major contributors in shaping the survey participants ´answers, which highlights the importance of government management strategies to address current and future environmental problems. Enhanced positive perceptions of the environment and ecosystems, combined with the understanding that livelihood sustainability, needs to be prioritized and would reinforce environmental protection policies to create greener cities. Moreover, new sustainable jobs in combination with more sustainable human habits represent an opportunity to reinforce environmental policy.

Response to the COVID-19 pandemic in the legally deprived population of liberty in Cali (Colombia) : Miyerlandi Torres Agredo

With the COVID-19 pandemic, the challenge of reducing the transmission of the disease has led to new challenges in decision-making. The vulnerability of persons deprived of liberty led to the design of contagion mitigation alternatives. Since February 2020, at the Villahermosa Penitentiary and Prison Center in Cali, the Secretaría de Salud Pública (SSP) began a series of actions that intensified on March 11, when the WHO declared COVID -19 as a pandemic. The SSP, in an articulated work;configured a series of strategies aimed at mitigating the impact and speed of contagion, infectious disease doctors and internists were also summoned who provided recommendations and contributed to decision-making. An intervention model was designed, which was guided by two main processes: promotion and prevention actions and service provision actions. The articulated work and the high commitment of the actors involved, the development of strategies for biosecurity, hygiene, isolation, rapid detection, and, above all, immediate control of symptoms and medical care on-site with adjustments that allowed managing patients inside the institution;It has meant that to date mortality is below 1% and that for the time being the situation is under control. Key messages • The humanization of health service provision is essential to achieve effective results. • The rapid and articulated responses made it possible to maintain a mortality of less than 1% in this population.

Training, trust, and technology: a mixed-methods study of Latin American extension workers' experiences during COVID-19. (Special covid issue.)

The COVID-19 pandemic has drastically affected people's lives around the world, including agricultural extension workers. To date, few studies have been conducted to understand the adaptation of extension services in Latin American countries during the pandemic. This mixed-methods study explored Latin-American extension professionals' preparation to implement knowledge-sharing activities and sought to understand extension professionals' responsiveness to COVID-19. The results revealed significant differences in extension responsiveness, between field extension workers and in-office extension workers. Delving into this difference revealed that field extension professionals perceived lower responsiveness because they were not able to continue their pre-pandemic, face-to-face activities in the field with farmers;on the other hand, office extension workers were able to complete and respond to their annual program objectives by increasing institutional partnerships by virtual means. Resilience was found in the two phases of this study. Extension professionals were viewed by farmers as a reliable resource for addressing COVID-19 challenges. Extension professionals began using new communications technologies to train farmers, even though they were not trained in these technologies themselves. It will be important to begin formally incorporating the use of new technology, and alternative communication strategies with communities during crises, as part of preparation for field technicians.

TIME IN RANGE AFTER 1 YEAR USING TELEHEALTH IN TYPE 1 DIABETES TREATED WITH HYBRID CLOSE LOOP THERAPY DURING THE COVID-19 PANDEMIC

Background and Aims: Literature supports efficacy and safety of Hybrid Close loop (HCL) system in type 1 diabetes (T1D) patients. Limited data are available showing the short and long-term outcomes of telehealth. Our study described efficacy and safety of HCL system at one year of follow-up through telehealth during COVID-19 pandemic. Methods: A prospective observational cohort study including T1D patients previously treated with multiple doses of insulin or sensor augmented pump therapy started on HCL system during COVID-19 pandemic. Virtual training and follow-up were done through telehealth. CGM data were analyzed to compare the time in range (TIR), time below range (TBR) and glycemic variability, GMI at base line, 3,6,9 and 12 months of virtual follow-up. Use of automatic mode (AM) was also evaluated. Results: 134 patients were included (54.9% female, baseline A1c 7.66% ± 1.15). 48.8% hypoglycemia was the main indication of HCL therapy. 32.6% had hypoglycemia unawareness and 40.5% had ≥1 severe hypoglycemia event in the last year. TIR at the end of the virtual training was 78 ± 0.14%. After 3,6,9 and 12 months of follow-up TIR was 78.5%, 77.6%, 76.8% and 77%, respectively. Coefficient of variation was 31.4 ± 6.05% at 12 months. TBR <70mg/dl and <54mg/dl was 2.39 ± 0.14% and 0.54 ± 0.07%, respectively. Use of AM was 80.7 ± 24.7% and percentage of use of sensor was 90.3 ± 7.3%. No severe adverse events were reported. Conclusions: HCL systems allows T1D patients to improve TIR, TBR and glycemic variability independently of previous treatment. Long term follow-up through virtual modality allows to maintain TIR with low TBR and adherence to AM of 80%.

Variations in risks from smoking between high-income, middle-income, and low-income countries: an analysis of data from 179 000 participants from 63 countries

Background Separate studies suggest that the risks from smoking might vary between high-income (HICs), middle-income (MICs), and low-income (LICs) countries, but this has not yet been systematically examined within a single study using standardised approaches. We examined the variations in risks from smoking across different country income groups and some of their potential reasons. Methods We analysed data from 134 909 participants from 21 countries followed up for a median of 11.3 years in the Prospective Urban Rural Epidemiology (PURE) cohort study;9711 participants with myocardial infarction and 11 362 controls from 52 countries in the INTERHEART case-control study;and 11 580 participants with stroke and 11 331 controls from 32 countries in the INTERSTROKE case-control study. In PURE, all-cause mortality, major cardiovascular disease, cancers, respiratory diseases, and their composite were the primary outcomes for this analysis. Biochemical verification of urinary total nicotine equivalent was done in a substudy of 1000 participants in PURE. Findings In PURE, the adjusted hazard ratio (HR) for the composite outcome in current smokers (vs never smokers) was higher in HICs (HR 1.87, 95% CI 1.65-2.12) than in MICs (1.41, 1.34-1.49) and LICs (1.35, 1 .25-1.46;interaction p<0.0001). Similar patterns were observed for each component of the composite outcome in PURE, myocardial infarction in INTERHEART, and stroke in INTERSTROKE. The median levels of tar, nicotine, and carbon monoxide displayed on the cigarette packs from PURE HICs were higher than those on the packs from MICs. In PURE, the proportion of never smokers reporting high second-hand smoke exposure (>= 1 times/day) was 6.3% in HICs, 23.2% in MICs, and 14.0% in LICs. The adjusted geometric mean total nicotine equivalent was higher among current smokers in HICs (47.2 mu M) than in MICs (31. 1 mu M) and LICs (25.2 mu M;ANCOVA p<0.0001). By contrast, it was higher among never smokers in LICs (18.8 mu M) and MICs (11.3 mu M) than in HICs (5.0 mu M;ANCOVA p=0.0001). Interpretation The variations in risks from smoking between country income groups are probably related to the higher exposure of tobacco-derived toxicants among smokers in HICs and higher rates of high second-hand smoke exposure among never smokers in MICs and LICs. Copyright (C) 2022 The Author(s). Published by Elsevier Ltd.

COVID-19 is a new disease caused by the beta coronavirus SARS-CoV-2

The first registers of atypical pneumonia were reported in China by the end of December 2019. The disease was rapidly disseminated in the entire world. The spectrum of the clinical manifestations is large going from individuals without any symptoms to those who develop multisystem disease and death. It has been demonstrated that hypertension and diabetes are more frequent in people with COVID-19 and the presence of diabetes is associated with an increased risk of more severe disease and higher mortality. In the present article, we review the possible mechanism why the diabetes patients have an increased risk of mortality by COVID-19 and recommend preventive actions that must be implemented in the general population and particularly in individuals with diabetes. © 2020 Academia Nacional de Medicina. All rights reserved.

Performance of cardiovascular surgery services in Colombia during the COVID-19 pandemic

Introduction: The current pandemic represents a challenge at the hospital level, cardiovascular surgery services have modified their operation and are constantly evaluating cardiovascular risk vs. COVID-19 risk. Objective: To characterize the operation of 23 cardiovascular centers in Colombia, in order to obtain information that allows the optimization of services and to avoid preventable deaths from cardiovascular causes. Method: Cross sectional observational study with a primary source of information. A convenience sample of 23 cardiovascular centers in Colombia was used. Results: It was found that 39.1% of the centers suspended activity sometime between January to May 2020 and 34.8% had a decrease in service activity of 76-100%. In the months of April and May the reduction was around 50% compared to the first two months. Of the 2,258 interventions performed, only 0.17% were on positive COVID-19 patients. The study shows that 60.1% of the services have presented problems with the use of personal protection elements. 17.4% of the centers perform PCR to detect the virus in the preoperative routine, 44% perform it in respiratory symptomatic patients. Conclusions: During the pandemic, the need is to detect in early phases all the possible infected patients, that require surgical procedures, adapt the schedules and promote an adequate use of personal protective equipment. It is urgent to apply strategies aimed at patients in which surgical procedures cannot be postponed to avoid second and third victims of the pandemic. © 2020 Sociedad Colombiana de Cardiología y Cirugía Cardiovascular.