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In Cuba, the implementation of telework and distance work has expanded with the arrival of the Covid-19 pandemic. This happened in atypical confinement conditions in the family home, that leads to greater overload for women remote workers, due to the traditional gender roles. This paper discusses the results of the national study on distance work / telework seen from a gender perspective, that show the inequalities that these modalities have on men and women. The need of this approach is confirmed if a more equitable, inclusive and healthy work environment is to achieved for all.
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Different kind of smart healthcare ecosystems have been adopted in the last few years usually based on the continuous monitoring of people as well as other physical entities such as buildings or devices. The diverse nature and origins of the great amount of data that those novel smart healthcare ecosystems must process poses additional data management issues that restrict and difficult their design and construction. In order to improve data management in smart healthcare ecosystems, a data fabric architecture-like process for data lifecycle management has been obtained from the analysis of different architectural proposals intended for being used for different types of systems and contexts. This process integrates aspects of Digital Twins (DT) to tackle with the data contextualization problems that characterizes data fabric architectures. Based on the proposed approach, a prototype of a novel smart healthcare Internet of Things (IoT)-based ecosystem to prevent the spreading of the virus in a real Spanish nursing home has been developed. The evaluation of the prototype has been carried out following a specific novel IoT-based systems evaluation methodology combined with ISO software quality standards that determined that the system is reliable and efficient in performance. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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Background and AimsDifferent descriptions of long COVID have already been proposed, and the most common description includes symptoms lasting for over three months after the first symptom onset. One of the most frequent symptoms identified, besides fatigue and dyspnoea, is a new daily persistent headache.1MethodsWe describe a case of persistent headache associated with COVID-19, which had a poor response to pharmacological treatment. The patient scored a pain of 8 points in Visual Analog Scale (VAS). It was a widespread—affecting frontal, temporal, and occipital area—pulsating quality headache that worsened with mild physical activity.Since Botulinum toxin type A has been used to treat chronic migraine for over a decade, we decided to try this therapeutic option after proving that the response to local anesthetics was positive.ResultsShe responded satisfactorily to bilateral greater occipital nerve block and infiltration of the frontal and temporal muscles with local anesthetic and corticosteroids, with an improvement during approximately 48 hours.Two weeks later, we administered by ultrasound guidance 20 IU of botulinum toxin near the greater occipital nerve, and performed a mapping with botulinum toxin by administering it at different points: both trapezius, splenius, frontal muscles, bilateral orbicularis and bilateral temporal and parietal muscles. After seven days, the patient reported improvement of the symptoms (VAS 3) that were still present one month later.ConclusionsIn conclusion, we propose that botulinum toxin can be a therapeutic option for persistent headaches associated with COVID-19. However, future research studies are required to clarify this possibility.
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Purpose/Context. This text provides some contributions from bioethics to analyze together the effects of the COVID-19 pandemic in the primary health care setting in Argentina. Methodology/Approach. It is framed in the bioethical perspective of hu-man rights with focus on social inequalities, social determinations of heal-th and its historical/territorial processes of production and reproduction. Results/Findings. We consider the interweaving of emotions and fee-lings at play in health care at the first level of care, specific to the current pandemic, identifying appropriate, reasonable and containerized ways to facilitate accessibility to health care. Some lines to work in this direction are outlined. Discussion/Conclusions/Contributions. The topic is discussed on three axes: health system, actors involved in the course of the pandemic and pos-sible actions. It is postulated that, especially in the first half of the pandemic, the importance of primary health care as a strategy for its approach is blu-rred, which could have avoided "overflows" of the health system. We also discuss the possibilities of concrete actions at the primary health care level with emphasis on social inequalities, beyond the slogan for the policy.
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Background. Antibiotic stewardship (AS) is at the core of patient safety and prevention of antimicrobial resistance. Healthcare providers prescribe antibiotics for COVID-19 despite low rates of bacterial co-infection. Our regional hospital had antibiotic utilization (AU) rates higher than other health systems even prior to the emergence of SARS-Cov2. We analyzed the effect AS on AU during the pandemic. Methods. Total and specific AU rates were benchmarked using BD MedMined's medication analytics system from 2nd quarter 2019 to 1st quarter 2021. The AS team released yearly antibiogram and individual prescriber's AU rates and performed weekly, and as needed, review of antibiotic ordering and feedback. To assist in appropriate prescribing decisions, remote educational sessions or mini-lectures and local antibiotic guidelines were developed during the pandemic period. AU rates were monitored quarterly to determine the effects of the AS interventions to prescribing practices. Results. Total and specific AU rates were higher (up to 34% and 80%, respectively) in our index hospital compared to other non-teaching hospitals nationally prior to the pandemic. Total antibiotic utilization increased by only 5.5% in the 2nd quarter 2020, peak of AU during the pandemic. Total, vancomycin, piperacillin-tazobactam and quinolone utilization rates decreased by 19%, 41%, 38%, and 52%, respectively, at 1st quarter 2021 compared to 4th quarter 2019. Steeper decreases were noted with implementation of educational activities. Ceftriaxone use remained high and was 50% greater than comparator hospitals at 1st quarter 2021. Conclusion. Although problematic during the COVID-19 pandemic, AS can have significant impact on provider prescribing practices and decrease total and specific antibiotic utilization rates. The use of ceftriaxone, an antibiotic commonly used for empiric bacterial coverage for community acquired pneumonia, presents as a continuing challenge.
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The main objectives of this research study are: a) to evaluate the levels of academic engagement (AE), in Spanish) in higher education students, b) to validate UWES-S for Spanish (Mexico) with higher education students, and c) to identify associations between AE dimensions and the socio-demographic characteristics of online students. The sample for the study is composed of 223 Mexican students from Potosi enrolled in social administration degrees. The results show that there are two types of students: encouraged and discouraged. Differences in AE levels are influenced by educational institution. There is evidence of increased AE as there is progress in academic trajectory. In addition, there is a correlation between pride in belonging to a degree and happiness inherent to the activities of the degree program. It is concluded that the results obtained serve to support decisions aimed at managing university and pedagogical education processes mediated by information and communication technologies (ICTs). © 2021,Formacion Universitaria.All Rights Reserved
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In times of pandemic, the meeting spaces formed by university groups have been replaced by virtual communication meetings. This has benefited young people by generating options to continue with their preparation in associative training groups that they find in the university, which have been creatively supported by means of technologies. Google Classroom has been part of those solutions that students and tutors have found to meet, train, and share content on topics specific to their associations or extracurricular groups, as well as an exchange of interactions that minimize the impact of social isolation. The advent of education carried out with technological means in emergency situations has opened virtual meeting spaces that manage to create meeting spaces that go beyond the frontier of face-to-face meetings. This paper presents the strategy of using Google Classroom technology for groups of Salesian University Associations that promote the continuity of their activities supported by blended learning technology to meet the objectives within an academic period during a second wave of the COVID-19 pandemic. The results presented open one more path, like those found in previous works, from a practical action for university extracurricular work groups. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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BACKGROUND: Surgical wait list time is a major problem in many health-care systems and its influence on survival is unclear. The aim of this study is to assess the impact of wait list time on long-term disease-free survival in patients scheduled for colorectal cancer resection. MATERIALS AND METHODS: A prospective study was carried out in patients with colorectal cancer scheduled for surgery at a tertiary care center. Wait list time was defined as the time from completion of diagnostic workup to definitive surgery and divided into 2-week intervals from 0 to 6 weeks. The outcome variables were 2-year and 5-year disease-free survival. RESULTS: A total of 602 patients, 364 (60.5%) male, median age 73 years (range = 71) were defined. The median wait list time was 28 days (range = 99). Two and 5-year disease-free survival rates were 521 (86.5%) and 500 (83.1%) respectively. There were no differences in 2-year or 5-year disease-free survival for the whole cohort or by tumor stage between wait list time intervals except for AJCC stage II tumors which showed a higher 5-year disease-free survival for the 2-4 and 4-6-week wait list time interval (p = 0.021). CONCLUSIONS: Time from diagnosis to definitive surgery up to 6 weeks is not associated with a decrease in 2-year or 5-year disease-free survival (DFS) in AJCC stage I through III colorectal cancer patients. These are important findings in the light of the COVID-19 pandemic and offer a window of opportunity for preoperative optimization and prehabilitation.