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Objectives: Patients with systemic lupus erythematosus (SLE) present greater severity of SARS-CoV-2 infection compared to the general population, particularly those with glomerulonephritis and who are treated with glucocorticoids. Likewise, high disease activity and some immunosuppressants have been associated with worse outcomes. The aim of this study was to describe the characteristics of SARS-CoV-2 infection in patients with SLE in Argentina from the SAR-COVID registry and to establish factors associated with a worse outcome. Method(s): Observational study. Patients diagnosed with SLE with confirmed SARS-CoV-2 infection (RT-PCR and/or positive serology) from the SAR-COVID registry were included. Data were collected from August 2020 to March 2022. The outcome of the infection was measured using the World Health Organization-ordinal scale (WHO-OS). Severe COVID-19 was defined as an WHO-OS value >=5. Descriptive analysis, Student's t , Mann Whitney U, ANOVA, Chi2 and Fisher's tests. Multivariable logistic regression. Result(s): A total of 399 patients were included, 93%female, with a mean age of 40.9 years (SD 12.2), 39.6% had at least one comorbidity. At the time of infection, 54.9% were receiving glucocorticoids, 30.8% immunosuppressants, and 3.3% biological agents. SARS-CoV-2 infection was mild in most cases, while 4.6% had a severe course and/or died. The latter had comorbidities, used glucocorticoids, and had antiphospholipid syndrome (APS) more frequently and higher disease activity at the time of infection. In the multivariate analysis, high blood pressure (OR 5.1, 95% CI 1.8-15.0), the diagnosis of APS (4.7, 95% CI 1.2-15.8), and the use of glucocorticoids (10 mg/day or more: OR 5.5, 95% CI 1.6-20.5) were associated with severe hospitalization and/or death from COVID-19 (WHO-EO >= 5). Conclusion(s): In this cohort of SLE patients with confirmed SARS-CoV-2 infection, most had a symptomatic course, 22.1% were hospitalized, and 5% required mechanical ventilation. Mortality was close to 3%. The diagnosis of APS, having high blood pressure, and the use of glucocorticoids were significantly associated with severe COVID-19.
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INTRODUCTION: The multisystem COVID-19 can cause prolonged symptoms requiring rehabilitation. This study describes the creation of a remote COVID-19 rehabilitation assessment tool to allow timely triage, assessment and management. It hypotheses those with post-COVID-19 syndrome, potentially without laboratory confirmation and irrespective of initial disease severity, will have significant rehabilitation needs. METHODS: Cross-sectional study of consecutive patients referred by general practitioners (April-November 2020). Primary outcomes were presence/absence of anticipated sequelae. Binary logistic regression was used to test association between acute presentation and post-COVID-19 symptomatology. RESULTS: 155 patients (n=127 men, n=28 women, median age 39 years, median 13 weeks post-illness) were assessed using the tool. Acute symptoms were most commonly shortness of breath (SOB) (74.2%), fever (73.5%), fatigue (70.3%) and cough (64.5%); and post-acutely, SOB (76.7%), fatigue (70.3%), cough (57.4%) and anxiety/mood disturbance (39.4%). Individuals with a confirmed diagnosis of COVID-19 were 69% and 63% less likely to have anxiety/mood disturbance and pain, respectively, at 3 months. CONCLUSIONS: Rehabilitation assessment should be offered to all patients suffering post-COVID-19 symptoms, not only those with laboratory confirmation and considered independently from acute illness severity. This tool offers a structure for a remote assessment. Post-COVID-19 programmes should include SOB, fatigue and mood disturbance management.
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Prompt detection of viral respiratory pathogens is crucial in managing respiratory infection including severe acute respiratory infection (SARI). Metagenomics next-generation sequencing (mNGS) and bioinformatics analyses remain reliable strategies for diagnostic and surveillance purposes. This study evaluated the diagnostic utility of mNGS using multiple analysis tools compared with multiplex real-time PCR for the detection of viral respiratory pathogens in children under 5 years with SARI. Nasopharyngeal swabs collected in viral transport media from 84 children admitted with SARI as per the World Health Organization definition between December 2020 and August 2021 in the Free State Province, South Africa, were used in this study. The obtained specimens were subjected to mNGS using the Illumina MiSeq system, and bioinformatics analysis was performed using three web-based analysis tools; Genome Detective, One Codex and Twist Respiratory Viral Research Panel. With average reads of 211323, mNGS detected viral pathogens in 82 (97.6%) of the 84 patients. Viral aetiologies were established in nine previously undetected/missed cases with an additional bacterial aetiology (Neisseria meningitidis) detected in one patient. Furthermore, mNGS enabled the much needed viral genotypic and subtype differentiation and provided significant information on bacterial co-infection despite enrichment for RNA viruses. Sequences of nonhuman viruses, bacteriophages, and endogenous retrovirus K113 (constituting the respiratory virome) were also uncovered. Notably, mNGS had lower detectability rate for severe acute respiratory syndrome coronavirus 2 (missing 18/32 cases). This study suggests that mNGS, combined with multiple/improved bioinformatics tools, is practically feasible for increased viral and bacterial pathogen detection in SARI, especially in cases where no aetiological agent could be identified by available traditional methods.
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Bacterial Infections , COVID-19 , RNA Viruses , Viruses , Humans , Child , Child, Preschool , RNA, Viral/genetics , South Africa , Viruses/genetics , RNA Viruses/genetics , Bacteria/genetics , Metagenomics/methods , High-Throughput Nucleotide Sequencing/methods , Sensitivity and SpecificityABSTRACT
Introduction: Extracorporeal membrane oxygenation (ECMO) has been widely used in patients with ARDS due to COVID-19. In vivo hemolysis (ivH) is one of its complications, characterised by peaks of plasma free hemoglobin (fHb). However, an increase in carboxyhemoglobin (COHb) has also been observed due to Hb metabolism by heme-oxygenase that releases carbon monoxide. The aim of this study is to evaluate the incidence of ivH events and their relation to COHb in COVID-19 patients undergoing ECMO. Method(s): Single-centre observational retrospective study that included 33 COVID-19 patients with ARDS who received VV-ECMO treatment in the ICU from March 2020 to September 2021. Daily analytical monitoring was carried out including arterial blood gas test with cooximetry and biochemical parameters, incorporating the estimation of fHb using quantitative hemolysis index (HI). Significant ivH was considered with fHb > 50 mg/dL after discarding in vitro hemolysis. Daily maximum values of HI and COHb were recorded and paired in order to evaluate their correlation by generalised linear model. Result(s): The total prevalence of patients having ivH in our cohort was 27.3%. Mortality during ECMO treatment in our study was 57.6%, higher within the group of patients with ivH events (77.8% vs 50%). A total of 777 daily maximum values of fHb from all the patients were obtained. Values of COHb were significantly higher during ivH episodes. Furthermore, positive significant correlation was obtained between daily analytical values of fHb and COHb (B coefficient 42.156;p = 0.042), as shown in Fig. 1. The cut-off value of COHb to be discriminative for hemolysis (fHb > 50 mg/dL) was 3.85% COHb (90.5% sensitivity and 83.3% specificity). Conclusion(s): Point-of-care carboxyhemoglobin is a cheap and widely available parameter that could be useful when detecting in vivo hemolysis during ECMO treatment.
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Introduction: Evaluation of prognostic factors in patients with ventilator- associated pneumonia (VAP) due to P. aeruginosa. The effectiveness of novel antipseudomonal antibiotics was reviewed. Method(s): Retrospective, single-center cohort analysis between April 2018 and June 2022. Data were obtained from the ENVIN-HELICS and electronic medical records. Demographic variables, underlying diseases and diagnosis to admission were registered. We considered each treatment appropriate according to Tamma PD et al. [1] criteria. We registered ventilator-associated tracheobronchitis (VAT) and pneumonia (VAP) episodes together with the recurrency of the infection. Result(s): From 61 patients included, 77% were admitted for ARDS due to COVID-19. The mean APACHE-II was 14.3 +/- 6.6. 7 patients required ECMO and 4 required RRT. The median length of stay in the ICU was 52 (ICR 36-84) days. 91 respiratory infections were recorded: 60 VAP and 31 VAT. On the first episode, carbapenem-resistance to meropenem was 40%;rising up to 58% on the second one. 6 patients developed a third episode (VAT) with a 100% of carbapenem- resistance. 13 (14%) respiratory infections showed resistance to the novel beta-lactamase inhibitor cephalosporins (8 to ceftalozanetazobactam and 5 to ceftazidime-avibactam). No resistance to cefiderocol was detected. During ICU stay, 21 patients (34%) developed secondary bacteremia from other foci and 7 (11%) invasive mycoses. Overall mortality was 49.2%. On the univariate analysis we found statistical significant relationships between mortality and COVID-19 admission, SOFA >= 7 points on the first VAP or the development of secondary bacteremia (Table 1). Conclusion(s): COVID-19 admission, SOFA >= 7 points on the first VAP or other secondary bacteremia were associated with mortality. The 14.3% of respiratory infections were resistant to the new beta-lactamase inhibitor cephalosporins. No resistance to cefiderocol was detected.
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Purpose of Study: Health policy regarding possible mother-to-child transmission of SARS-CoV-2 via breastfeeding was highly debated during the first months of the COVID-19 pandemic. However, subsequent research revealed that mother-to-infant transmission of SARS-COV-2 through breastmilk is highly unlikely, and the World Health Organization continues to recommend breastfeeding for all mothers, including those with confirmed COVID-19. Another mode of viral transmission and diagnostic testing that garnered scientific interest is the fecal route.The purpose of this study was to determine the detection rate of SARS-CoV-2 RNA in fecal samples collected from breastfeeding mothers with and without confirmed COVID-19. Methods Used: From April 2020 to March 2021, fecal samples were collected repeatedly over an 8-wk period from 28 nursing mothers with confirmed COVID-19 (162 total fecal samples) and from 24 healthy nursing mothers with no known exposure to COVID-19 (93 total fecal samples). For mothers enrolled within 7 d of a positive COVID-19 test, up to 7 repeated samples were collected: 3 in the first wk and 1 each at wk 2, 3, 4, and 8. For self-reported healthy mothers, up to 4 samples were collected: d 1, d 7, wk 3, and wk 8. RNA was isolated, and the presence of SARS-CoV-2 RNA was determined using RT-qPCR following a modified version of the CDC's SARS-CoV-2 assay. Summary of Results: Among COVID-19-positive mothers, 7/28 (25%) had SARS-CoV-2 in at least one fecal sample. Among these mothers, mean duration of presence of SARS-CoV-2 in feces was 1.6 +/- 1.4 wk. One mother had SARS-CoV-2 in feces in five samples (d 1, d 3, d 7, wk 2, wk 4), while two mothers only had SARS-CoV-2 in a single fecal sample. Among healthy breastfeeding mothers without known COVID-19 exposures, 1/24 (4.2%) had SARS-CoV-2 in a single sample (d 7). Conclusion(s): We detected SARS-CoV-2 in feces of 25% of breastfeeding mothers with COVID-19 and 4.2% of breastfeeding mothers who self-reported no known COVID-19 sickness or exposures. Our data reveal that only 5/28 (17.9%) of d 1 fecal samples collected from mothers with COVID-19 had detectable SARS-CoV-2. (Table Presented).
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BACKGROUND // During the ageing process the loss of family and social relationships is frequent which conditions loneliness, similarly the current COVID-19 pandemic has generated more social limitations in this age group and has increased the risk factors to trigger feelings of loneliness. This paper aimed to examine how loneliness among older people had been studied in Europe over the last ten years. Specific objectives were: i) to describe the methodological aspects;ii) to identify the scales or questions for the assessment of loneliness;iii) what were the main variables or dimensions that were related to loneliness in old age. METHODS // A total of 1,591 articles were found in WoS and Scopus digital platforms. After initial assessment of titles and s, full text reading and review of the established criteria, 42 scientific articles were finally included in the systematic review. RESULTS // The countries that had carried out the most studies were the Netherlands and Spain. Most of the research was quanti-tative and uses the De Jong Gierveld Loneliness Scale (DJGLS) and the University of California at Los Angeles (UCLA) Loneliness Scale. The most analysed variables were: marital status, household structure, social support networks, social participation, depression, health problems, co-morbidity and physical functioning. CONCLUSIONS // The scientific interest in studying loneliness, with a focus on social support networks, in older people in Europe and strategically addressing loneliness as a public health problem is confirmed.
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Objectives: This study aims to explore the relationships between resilience, fear of COVID-19, anxiety and use of preventive behaviors related to COVID-19 among nursing students. Methods: A cross-sectional study was conducted with 220 first-year nursing students during 2020. Results: A significant relationship emerged between resilience (p <.05), fear of COVID-19 (p =.01), anxiety (p <.01) and use of preventive behaviors. Overall, the independent predictors were fear of COVID-19 (p =.003) and male sex (p =.016). Conclusions: It is essential to develop resilience among students further to increase their preventive behaviors against COVID-19.
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The proliferation of the SARS-CoV-2 global pandemic has brought to attention the need for epidemiological tools that can detect diseases in specific geographical areas through non-contact means. Such methods may protect those potentially infected by facilitating early quarantine policies to prevent the spread of the disease. Sampling of municipal wastewater has been studied as a plausible solution to detect pathogen spread, even from asymptomatic patients. However, many challenges exist in wastewater-based epidemiology such as identifying a representative sample for a population, determining the appropriate sample size, and establishing the right time and place for samples. In this work, a new approach to address these questions is assessed using stochastic modeling to represent wastewater sampling given a particular community of interest. Using estimates for various process parameters, inferences on the population infected are generated with Monte Carlo simulation output. A case study at the University of Oklahoma is examined to calibrate and evaluate the model output. Finally, extensions are provided for more efficient wastewater sampling campaigns in the future. This research provides greater insight into the effects of viral load, the percentage of the population infected, and sampling time on mean SARS-CoV-2 concentration through simulation. In doing so, an earlier warning of infection for a given population may be obtained and aid in reducing the spread of viruses. © 2023, The Author(s).
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Several measures have been implemented to reduce the spread of the COVID-19, with mask-wearing among the most widely used measures. Yet, the barriers to mask-wearing are unclear. This study examined whether different types of anxiety symptom clusters (i.e., symptoms of claustrophobia, physical anxiety sensitivity, and social anxiety sensitivity) are associated with mask-wearing tendencies during the COVID-19 pandemic and investigated how anxiety symptom clusters relate to mask-wearing discomfort and self-isolation distress. A total of 556 Canadian adults were recruited online between January and February of 2021. The study was administered online via Qualtrics. Participants completed questionnaires measuring symptoms of claustrophobia, anxiety sensitivity, and isolation distress, along with a measure of mask-wearing behaviours. Linear regression analyses revealed that elevated anxiety symptoms across all symptom clusters predicted more physical and emotional discomfort related to mask-wearing, as well as reduced likelihood of leaving the home due to mask-related discomfort. Leaving home less often due to mask-related discomfort was significantly associated with more self-isolation distress and poorer coping overall. Differential patterns of mask-wearing behaviours across anxiety symptom clusters were not detected. These findings suggest that anxiety symptoms (i.e., including claustrophobia, physical anxiety sensitivity, and social anxiety sensitivity) are positively associated with mask-related distress. This, in turn, may lead people to avoid leaving their home and consequently experience increased self-isolation distress. Furthermore, these findings suggest that people with heightened anxiety symptoms tend to experience more discomfort with mask-wearing, which may perpetuate a cycle of avoidance and poorer coping overall. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (French) Plusieurs mesures ont ete mises en oeuvre pour reduire la propagation de la COVID-19, le port du masque etant l'une des mesures les plus utilisees. Pourtant, les obstacles au port du masque ne sont pas clairs. Cette etude a examine si differents types de groupes de symptomes d'anxiete (c'est-a-dire les symptomes de claustrophobie, de sensibilite a l'anxiete physique et de sensibilite a l'anxiete sociale) etaient associes aux tendances de port du masque pendant la pandemie de COVID-19 et a etudie comment les groupes de symptomes d'anxiete sont lies a l'inconfort du port de masque et a la detresse liee a l'isolement. Un total de 556 adultes canadiens ont ete recrutes en ligne entre janvier et fevrier 2021. L'etude a ete administree en ligne via Qualtrics. Les participants ont rempli des questionnaires mesurant les symptomes de claustrophobie, la sensibilite a l'anxiete et la detresse liee a l'isolement, ainsi qu'une mesure des comportements lies au port du masque. Les analyses de regression lineaire ont revele que des symptomes d'anxiete eleves dans tous les groupes de symptomes predisaient un plus grand inconfort physique et emotionnel lie au port du masque, ainsi qu'une probabilite reduite de quitter le domicile en raison de l'inconfort lie au port du masque. Le fait de quitter le domicile moins souvent en raison d'un inconfort lie au port du masque etait significativement associe a une plus grande detresse liee a l'isolement et a une moins bonne adaptation globale. Il n'a pas ete possible de detecter des comportements differents en matiere de port de masque selon les groupes de symptomes d'anxiete. Ces resultats indiquent que les symptomes d'anxiete (y compris la claustrophobie, la sensibilite a l'anxiete physique et la sensibilite a l'anxiete sociale) sont positivement associes a la detresse liee au port du masque. Cela peut conduire les personnes a eviter de quitter leur domicile et, par consequent, a eprouver une detresse accrue liee a l'isolement. De plus, ces resultats suggerent que les personnes presentant des symptomes d'anxiete eleves ont tendance a eprouver plus d'inconfort lie au port du masque, ce qui peut perpetuer un cycle d'evitement et une moins bonne adaptation globale. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement The findings suggest that anxiety symptoms may interfere with engagement in this important public health measure, informing policy-makers of at-risk groups in the population. Moreover, those who experience higher mask-related anxiety are more likely to stay at home, leading to increased self-isolation and isolation-related distress. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Air pollution severely compromises children's health and development, causing physical and mental implications. We have explored the use of site-specific green infrastructure (green barriers) in a school playground in Sheffield, UK, as an air-pollution-mitigation measure to improve children's environment. The study assessed air quality pre-post intervention and compared it with two control sites. Nitrogen dioxide (NO2) and particulate matter <2.5 µm in size (PM2.5) concentration change was assessed via three methods: (1) continuous monitoring with fixed devices (de-seasonalised);(2) monthly monitoring with diffusion tubes (spatial analysis);(3) intermittent monitoring with a mobile device at children's height (spatial analysis). De-seasonalised results indicate a reduction of 13% for NO2 and of 2% for PM2.5 in the school playground after two years of plant establishment. Further reductions in NO2 levels (25%) were observed during an exceptionally low mobility period (first COVID-19 lockdown);this is contrary to PM2.5 levels, which increased. Additionally, particles captured by a green barrier plant, Hedera helix ‘Woerner', were observed and analysed using SEM/EDX techniques. Particle elemental analysis suggested natural and potential anthropogenic origins, potentially signalling vehicle traffic. Overall, green barriers are a valid complementary tool to improve school air quality, with quantifiable and significant air pollution changes even in our space-constrained site. © 2023 by the authors. Licensee MDPI, Basel, Switzerland.
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Background: Pancreatic Ductal Adenocarcinoma (PDAC) has historically been an important diagnostic and therapeutic challenge. The multidisciplinary approach and new diagnostic techniques' implementation have modified this process. Method(s): We conducted a retrospective analysis based on clinical data of patients with PDAC between the years 2010 to 2021, analyzing the diagnosis and initial treatment evolution. Result(s): 673 patients between 2010-2021 with a suspected diagnosis of pancreatic adenocarcinoma were reviewed. Most of them were metastatic (n=362;53.8%), followed by locally advanced unresectable (n=166;24.7%) and resectable or borderline resectable (n=145;21.5%). Regarding the pathological diagnosis, it was not possible in 62 patients (9.2%), varying over time from 21.2%in 2010-2012 to 1% in 2019-2021 (p<0,0001). Moreover, the number of biopsies has decreased with a mean number of biopsies to obtain a pathological diagnosis of 1.55 (2010-2012) vs 1.31 (2019-2021). During this last period, most of the diagnoses were made by cytological analysis (61.4%;n=121). Specifically in the 2019-2021 patients subgroup, we found that 18 NGS (9,1%) were performed in this period (solid tumor), with 4 patients having actionable mutations (22.2%;3 KRAS G12C). Germline (g) mutational panels were carried out in 89 patients, finding only 9 positive cases (10.1%), being 3 of them gBRCA1/2 mutated (3,4%). In our study, a decrease in palliative management was evidenced over time. In 2010-2012, 28,8% of patients received exclusively palliative care against 9,6% in 2019-21 (p, 0.0001). An increase in PDAC diagnosis was observed since 2010, 44 patients/year in 2010-12 vs. 66 patients/year in 2019-21 (including COVID-19 pandemic period). All previous results are summarized. Conclusion(s): The diagnosis of PDAC has changed throughout the last decade, increasing the percentage of patients with a pathological diagnosis without increasing the number of invasive procedures. The number of patients suitable for anti-cancer therapy has also increased among time. In our cohort, the implementation of molecular testing would change the therapeutic approach in more than 20% of patients.
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AbstractPrior to the COVID-19 pandemic, the United States housed 2.3 million inmates in 7,147 incarceration structures that, because of age, overcrowding, and poor ventilation, exacerbated the spread of airborne infections. The flow of individuals into and out of correctional facilities compounded the challenges in keeping them COVID-free. This article focuses on the work of the health and administrative leadership, in partnership with judicial and police personnel, to prevent COVID-19 inside the Albemarle-Charlottesville Regional Jail and to mitigate its spread when the jail population and/or its staff became infected. From the onset, implementing science-based policies and upholding the human right to health and healthcare for all were priorities.
Subject(s)
COVID-19 , Prisoners , Humans , United States/epidemiology , Pandemics/prevention & control , Jails , Delivery of Health CareABSTRACT
The Health Sciences Foundation has assembled a multidisciplinary group around a series of questions about the impact of the COVID-19 pandemic on the mental health of the general population and specific groups within that population, particularly healthcare workers. In the general population, the most prevalent mental disorders have been anxiety, sleep disorders and affective disorders, primarily depression. There has been a considerable increase in suicidal behavior, especially in young women and men over 70 years of age. There has been an increase in alcohol abuse and nicotine, cannabis and cocaine use. In contrast, the use of synthetic stimulants during periods of confinement has decreased. With regard to non-substance addictions, gambling was very limited, pornography consumption increased significantly and there was an increase in compulsive shopping and the use of video games. Particularly vulnerable groups include adolescents and patients with autism spectrum disorders. Healthcare workers suffered an increase in depression, anxiety and post-traumatic stress, especially those who were exposed during the early stages of the pandemic. Female sex, being a nurse, proximity to patients with COVID-19, working in a rural environment and having previous psychiatric or organic illnesses were some of the most frequently repeated factors in various studies in this population group. The media have shown a good degree of knowledge about these problems and have dealt with them frequently and from the point of view of ethics, crisis situations, such as the one experienced, have triggered not only physical but also moral claudications.
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COVID-19 , Male , Adolescent , Humans , Female , Aged , Aged, 80 and over , Mental Health , Pandemics , SARS-CoV-2 , Population Groups , Health PersonnelABSTRACT
Since SARS-CoV-2 spread worldwide in early 2020, many countries established lockdowns for protection. With a main transmission by aerosols, ventilation was promoted. This article analyses natural ventilation of Spanish housing during the spring 2020. An online questionnaire was launched, obtaining for this study 1502 responses. The comparative window opening before and during confinement, and households, dwellings and home activity variables, were analysed. The binary logistic regression model before pandemic indicated that ventilating properly related to: a worse perceived IAQ (OR = 1.56);thermal adaptation measures, especially those that prefer to open/close windows (OR = 1.45);not having heating system (OR = 1.15);and using power to heat water (OR = 1.60). For the confinement period, the model highlighted: being an employee (OR = 1.88);using heavy clothing in the home (OR = 2.36);and again, open/close windows for adaptation (OR = 2.24). According to specific tasks in quarantine, frequent ventilation was boosted by: an increasing use of oven (OR = 14.81);and alteration of work-habits (OR = 2.70), sport-habits (OR = 1.79), and outdoor-activities (OR = 1.60). Thus, an adequate natural ventilation pattern during the quarantine was linked to low environmental comfort in general, by virtue of indoor air quality. This is corroborated by less acoustic-thermal insulation, worse indicators of heating use, and the adaptive response to opening/closing windows when external temperature changed. © 2022 The Authors
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COVID-19 pandemic led Spanish population to a mandatory lockdown between March and May 2020. This meant closing schools and moving the rest of the 2019-2020 academic year to an online format. This work analyzes how the educational process developed during lockdown and estimates the impact that the interaction between online education and parents' teleworking situation had on students' critical thinking skills. To do this, we collected data at the beginning and at the end of the 2019-2020 academic year on critical thinking from students at the third year of secondary education from 15 educational institutions in the Region of Madrid. Firstly, we concluded that public schools faced more difficulties than private government-dependent schools for continuing with the teaching-learning process. In order to follow online classes, 70% of the students in private government-dependent schools had a desktop or laptop compared to 40% of the students in public schools. Moreover, meanwhile 73% of the students in private publicly funded schools devoted more than 4 hours to classes and online tasks, this figure slightly exceeded 50% for students in public schools. Secondly, in general, the different work situations of parents did not have significant effects on students' critical thinking. However, we did find that, for students with academic results below the average at the beginning of the school year, the fact that the mother teleworked during school closing had a positive and significant impact on their academic results. This suggests that teleworking allowed mothers to provide greater support and supervision to their children. © 2023, Univ Nacional de Educacion a Distancia (UNED). All rights reserved.
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OBJECTIVE: During the ageing process the loss of family and social relationships is frequent which conditions loneliness, similarly the current COVID-19 pandemic has generated more social limitations in this age group and has increased the risk factors to trigger feelings of loneliness. This paper aimed to examine how loneliness among older people had been studied in Europe over the last ten years. Specific objectives were: i) to describe the methodological aspects;ii) to identify the scales or questions for the assessment of loneliness;iii) what were the main variables or dimensions that were related to loneliness in old age. METHODS: A total of 1,591 articles were found in WoS and Scopus digital platforms. After initial assessment of titles and s, full text reading and review of the established criteria, 42 scientific articles were finally included in the systematic review. RESULTS: The countries that had carried out the most studies were the Netherlands and Spain. Most of the research was quantitative and uses the De Jong Gierveld Loneliness Scale (DJGLS) and the University of California at Los Angeles (UCLA) Loneliness Scale. The most analysed variables were: marital status, household structure, social support networks, social participation, depression, health problems, co-morbidity and physical functioning. CONCLUSIONS: The scientific interest in studying loneliness, with a focus on social support networks, in older people in Europe and strategically addressing loneliness as a public health problem is confirmed. OBJETIVO: Durante el proceso de envejecimiento es frecuente la pérdida de relaciones familiares y sociales, lo cual condiciona la soledad. Además, la actual pandemia de la COVID-19 ha generado más limitaciones en las relaciones sociales de este grupo de edad y ha aumentado los factores de riesgo para desencadenar sentimientos de soledad. Este trabajo tuvo el objetivo de examinar cómo se había estudiado la soledad en las personas mayores en Europa en los últimos diez años. Se propusieron como objetivos específicos: i) describir los aspectos metodológicos;ii) identificar las escalas o preguntas para la valoración de la soledad;iii) cuáles eran las principales variables o dimensiones que se relacionaban con la soledad en la vejez, priorizando el rol de las redes de apoyo social. METODOS: Se encontraron 1.591 artículos en total en las plataformas digitales WoS y Scopus. Tras la valoración inicial de los títulos y resúmenes, lectura de texto completo y revisión de los criterios establecidos, al final se incluyeron en la revisión sistemática 42 artículos científicos. RESULTADOS: Los países que más estudios habían realizado eran Países Bajos y España, en su mayoría las investigaciones eran cuantitativas y utilizaban las escalas De Jong Gierveld Loneliness Scale (DJGLS) y University of California at Los Angeles (UCLA) Loneliness Scale. Las variables más analizadas fueron: estado civil, estructura del hogar, redes de apoyo social, participación social, depresión, problemas de salud, comorbilidad y funcionalidad física. CONCLUSIONES: Se confirma el interés científico por estudiar la soledad, con un énfasis central en las redes de apoyo social, en las personas mayores en Europa y abordar estratégicamente la soledad como un problema de Salud Pública.
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We do not know the precise figure for solid organ tumors diagnosed each year in Spain and it is therefore difficult to calculate whether there has been a decrease in cancer diagnoses as a consequence of the pandemic. Some indirect data suggest that the pandemic has worsened the stage at which some non-hematological neoplasms are diagnosed. Despite the lack of robust evidence, oncology patients seem more likely to have a poor outcome when they contract COVID-19. The antibody response to infection in cancer patients will be fundamentally conditioned by the type of neoplasia present, the treatment received and the time of its administration. In patients with hematological malignancies, the incidence of infection is probably similar or lower than in the general population, due to the better protective measures adopted by the patients and their environment. The severity and mortality of COVID-19 in patients with hematologic malignancies is clearly higher than the general population. Since the immune response to vaccination in hematologic patients is generally worse than in comparable populations, alternative methods of prevention must be established in these patients, as well as actions for earlier diagnosis and treatment. Campaigns for the early diagnosis of malignant neoplasms must be urgently resumed, post-COVID manifestations should be monitored, collaboration with patient associations is indisputable and it is urgent to draw the right conclusions to improve our preparedness to fight against possible future catastrophes.
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Aim/Introduction: Although pulmonary findings of COVID-19 on PET/CT have been previously described, a comprehensive metabolic characterization of diagnostic lung parenchyma changes of COVID-19 pneumonia is still lacking. Our purpose is to evaluate the metabolic uptake of different tomographic signs observed in patients with incidental structural findings suggesting COVID-19 pneumonia through 18F-FDG PET/CT. Material(s) and Method(s): We retrospectively analyzed 596 PET/CT studies performed from February 21, 2020 to April 17, 2020. After excluding 37 scans (PET with non-18F-FDG tracers and brain studies), we analyzed the metabolic activity of several individual structural changes integrated and beyond CO-RADS score through SUVmax of multimodal studies with18F-FDG. Result(s): 43 patients with 18F-FDG PET/CT findings suggestive of COVID-19 pneumonia were included (mean age: 68+/-12.3 years, 22 male). SUVmax values were higher in patients with CO-RADS categories 5-6 than in those with lower, nonspecific CO-RADS categories (6.1+/-3.0 vs. 3.6+/-2.1, p=0.004). Groundglass opacities, bilaterality, consolidations, patchy distribution and crazy paving pattern were associated with higher SUVmax values in patients with CO-RADS 5-6 scores (p-values of 0.01, 0.02, 0,01, 0.002 and 0.01, respectively). SUVmax was significantly associated with a positive structural diagnosis of COVID-19 pneumonia (odds ratio=0.63, 95% confidence interval=0.41-0.90;p=0.02). The ROC curve of the regression model aimed to confirm or discard the structural diagnosis of COVID-19 pneumonia showed an AUC of 0.77 (standard error=0.072, p=0.003). Conclusion(s): Multimodal18F-FDG PET/CT is a useful tool during the incidental detection of COVID-19 pneumonia in patients referred for standard oncological and nononcological indications (43/559;7.7%). CT findings characteristic of COVID-19 pneumonia, specifically CO-RADS 5-6, were associated with higher SUVmax.