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Walking provides numerous benefits to older persons, but its practice is hindered by social factors and the built environment. This article aims to understand the factors that encourage or discourage older people's walking behaviors, as well as the policies influencing those factors in Chile. It does so by reporting the analysis of twenty-five semi-structured interviews with Chilean policymakers and local leaders. The experts consistently represented walking as a beneficial activity for older persons that, nonetheless, occurs in adverse built environments. They asserted that the absence of older people in the public discussion and a top-down policy-making structure hamper its promotion.
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Environment Design , Pedestrians , Humans , Aged , Aged, 80 and over , Chile , Walking , Built EnvironmentABSTRACT
Background The US Department of Agriculture granted waivers to allow flexibility in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) operations during the coronavirus disease 2019 (COVID-19) pandemic;however, research examining the associations between waiver introduction and changes in perceptions, practices, and challenges of WIC participants' and agency directors' experiences is limited. Objective The objective of this study was to assess California WIC participants' and agency directors' perceptions and practices of remote WIC services during the COVID-19 pandemic. A secondary aim was to understand other COVID-19 challenges related to maintaining access to healthy foods by WIC participants. Design A qualitative study that included semistructured interviews was conducted between June 2020 and March 2021. Participants and setting One hundred eighty-two WIC participants with a child aged 0 to 5 years from three regions of California (Southern, Central, and Northern) and 22 local WIC agency directors across the state were interviewed. Main outcome measures WIC participants' and agency directors' perceptions, practices, and other challenges during COVID-19. Statistical analyses performed Interviews were recorded, transcribed, and analyzed using a grounded theory approach. Results Participants shared that they valued the information received from WIC and were very satisfied with remote WIC services. Participants reported that enrolling in WIC remotely was easier than coming in person. All waivers and changes to WIC operations, namely the physical presence, remote benefit issuance, and separation of duties waivers, and remote work and remote delivery of nutrition education, were largely viewed by WIC agency directors as options that should be continued post-pandemic. Further, a majority (63%) of households reported experiencing food insecurity, and half of respondents received food from a food bank or pantry during the pandemic. Conclusions Findings suggest WIC will attract and retain the most families by offering a hybrid model of services, incorporating both onsite services and remote options to work more efficiently and effectively.
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In the last decade, medical students stood out as active agents in their training, which implies their involvement in the design, implementation, evaluation, and curricular co-governance. This article describes a model of active undergraduate student participation from 2014 to 2021 and compares the face-to-face and synchronous online modalities, later brought forward by the SARS-COV-2 pandemic. Annually, a call was made to UC School of Medicine undergraduate students to establish the topics and areas to be addressed during self-managed seminars. Then, medical students located in Chile were invited to attend the activity. Psychiatry was established as a priority topic in six out of eight years. Five seminars were conducted, the last two in synchronous online mode. The number of people enrolled in the online modality increased by 251% compared to the face-to-face modality (face-to-face mean = 133 +/- 33 SD;online mean = 336 +/- 24SD), with no significant differences in rates of attendance between modalities (Odds ratio (OR) = 1,12;95% CI= 0,82 - 1,55;p = 0,45). The online modality was associated with a higher proportion of enrollees belonging to an institution outside the Metropolitan Region (OR 12,63;95% CI = 8,64 - 18,46;p < 0,01). The self-managed psychiatry seminars correspond to a model of active undergraduate student participation, with the synchronous online modality representing an opportunity to massify it throughout the national territory.
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The current Pandemic has exposed the crisis in the health system and the urgency that, once the trance is over, structural problems be addressed to increase the quality and opportunity of access to the health system. This article seeks to analyze whether, during the pandemic, the principles of universality, solidarity and integrality, established in the General System of Social Security in Health and that respond to the content of the Political Constitution of 1991, were ignored. For the above, the proposed objectives correspond to the review of the current state of health care and the elements available to the State in the face of the health crisis, to understand the dangers that a global crisis such as Covid-19 can represent for compliance with the principles of the Social Security System in Health in Colombia, as well as the implications in the paradigm shift from a health model as a public policy to a fundamental right, to finally analyze the right to health of the elderly in the face of the pandemic. The social security health system in Colombia was not designed to deal with crises like the current one, and fortunately there have not been the mortality rates that were expected. However, it is necessary to rethink the rights around the health care of the vulnerable population in catastrophic situations, since the government risk of violating the enjoyment of life in decent conditions is latent, given the potential prioritization of intermediate care. and intensive in health centers in the face of the crisis generated by the Coronavirus pandemic. © 2022, Corporacion Universitaria Republicana. All rights reserved.
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Introduction: In the SARS COV2 pneumonia acute-phase reactants, such as ferritin levels (FL), are elevated due to cytokine storm and hemophagocytic lymphohistocytosis. No direct relation between radiographic pulmonary involvement and blood levels of ferritin has been proved. In this study we try to identify this relation. Material(s) and Method(s): We carried on a descriptive retrospective matched cohort study of patients diagnosed with COVID-19 from 07/01/20 to 12/31/20 who were reviewed in PostCOVID consult. For quantifying the severity of pneumonia, a score was calculated by adapting and simplifying the Radiographic Evaluation of Pulmonary Edema (RALE) scale proposed by Warren et al (2018). We chose more severe X-rays at diagnosis and the FL at that time and at 6 weeks. Statistical studies were performed with SPSS (v25). Result(s): The analysed sample was 130 patients (70 men) with average age 62yrs. The 96% required hospitalization. FL at diagnosis were high, in men 1.080mug/l (IQR=1.036) and in women 629mug/l (IQR=816), p=0.003. No significant differences were found when analysing by age groups (<54, 55-75 and >75yrs). When we compared FL and severity of Xr affectation with SCORE RALE (SR) at diagnosis, we obtained p=0.007 for mild-severe comparison. No other comparisons with statistical significance were obtained. The median of FL at review normalized regardless of the initial SR (global decrease 66%), with no differences observed between groups. Conclusion(s): - The patients in our study had high FL at diagnosis, being higher in men, and were normalized at control. - Patients with severe radiographic affectation had higher median of ferritin at diagnosis compared to the ones with mild affectation.
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Introduction: The COVID-19 pandemic has transformed medical practice and severely disrupted the training of medical residents worldwide. The Spanish Society of Neurology conducted a study to assess its impact on the training of neurology residents in Spain. Method(s): We performed a descriptive, cross-sectional study through a survey distributed by e-mail to all neurology residents belonging to the Society. The survey included questions on demographic variables, care activity, and personal and educational impact of the pandemic, as well as respondents' expectations for the future of their work in the post-pandemic era. Result(s): Of 422 surveys sent, we received a total of 152 responses (36%);79 respondents (52%) were women and 73 (48%) were men. By year of residency, 51 respondents (33.6%) were in the fourth year, 45 (29.6%) in the third year, 28 (18.4%) in the second year, and 28 (18.4%) in the first year. A total of 139 respondents (90.8%) reported changes in hospital activity, and 126 (82.8%) considered the situation to have had a negative impact on their training, with 99 (64.7%) having lost non-recoverable rotations. Sixty-six percent of respondents (n=101) expressed a desire to extend their residency period. Conclusion(s): The pandemic has had an extremely severe impact on all areas of the health system, with trainee physicians being one of the most affected groups. Among neurology residents, the crisis has caused significant shortcomings in their training and clinical activities, through the suspension of specific rotations. A high percentage of respondents wished to extend the residency period.Copyright © 2021 Sociedad Espanola de Neurologia
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The article exposes the mothers' perception regarding the work overload with and without pay that they experienced during the pandemic caused by Covid-19. The methodology used was a qualitative investigation based on 8 mothers from La Araucanía, Chile. The research approach is descriptive, in which the personal and work experiences lived by the mothers are densely detailed, from their own voices, interpretations, and meanings attributed in the context of the pandemic. It is based on the interpretive paradigm to prioritize subjective awareness from the beliefs, values, and reflections of the women participating in this study. The data collection instrument is a semi-directed interview that consulted on the following topics: 1) workload experienced by women daily;2) changes in your organization and free time during the pandemic;3) affectation of emotions during the confinement. The data analysis technique used was thematic analysis to develop an inductive theory based on the testimonies of the women who participated in the study. Concepts, ideas, and meanings that result from the detailed analysis of the data are identified to specify and conceptualize the meanings and themes that the text contains about the work overload that women face in pandemic. The main results show a situation where the work overload of mothers has caused a negative impact on their mental health. In addition, there are patriarchal roots found in the conception of gender roles, increasing the stigma towards women as being in charge of raising and caring for their children and doing the housework. The main conclusions show that there is a high work overload on mothers, due to the high demand for work that increased as a result of the pandemic. It is also evidenced that despite living in a modern society, the perpetuation of gender roles still persists, meaning that women are the main ones in charge of taking care of the home and children, which has brought them negative physical and mental consequences © 2023, Revista Colombiana de Sociologia.All Rights Reserved.
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The work routine of education workers has been modified by the COVID-19 pandemic. Technological transformations in the delivery of educational services have been an extra stress factor. The adaptation to all this and the well-being of the workers depend to a great extent on the governance and management developed by the schools. The main objective of this work is to study the governance of three schools in Chile, analyzing the perception of healthy organizational practices (POS) of workers and the impact they have on engagement and burnout. For this purpose, an analysis and comparison of the perception of healthy organizational practices (HOP) of the employees of the selected schools is carried out. This is a research with a correlational-explanatory methodological approach. To obtain the information, a questionnaire was applied to 231 workers. Through the application of ANOVA we found significant differences between the three schools for healthy organizational practices, engagement and emotional exhaustion;the workers of the school that have higher perceptions of healthy organizational practices, also have higher scores in engagement and lower scores in emotional exhaustion, which is corroborated when performing the correlations between the variables. These results place the school with higher scores as a possible healthy organization. © 2021 by the authors.
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Purpose: The authors examined the impact of the Market Facilitation Program (MFP) and Coronavirus Food Assistance Program (CFAP) payments to United States agricultural producers on non-real estate agricultural loans. Design/methodology/approach: The authors used quarterly, state-level commercial bank data from 2016–2020 to estimate dynamic panel models. Findings: The authors found MFP and CFAP payments not associated with the percentage of non-real estate agricultural loans with payments over 90 days late. However, these payments associated with the percentage of non-real estate agricultural loans with payments between 30 and 89 days late. The available data utilized cannot consider when producers received the actual payment and what they specifically did with those funds. Originality/value: The contribution of this study is for US policymakers and agricultural lenders. The findings could be helpful in designing and implementing future ad hoc payment programs and provide an understanding of potential shortcomings of the current safety net for agricultural producers in the Farm Bill. Additionally, findings can assist agricultural lenders in predicting the impact of ad hoc payments on their distressed loan portfolios. © 2022, Charles Martinez, Christopher N. Boyer, Tun-Hsiang Yu, S. Aaron Smith and Adam Rabinowitz.
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Introduction. In the 21st century, the struggle to achieve truly inclusive education continues. The explosion of the pandemic has only served to highlight the great inequalities that exist in the different education systems. Method. In this starting scenario, a qualitative study has been conducted with the aim of reviewing the guidelines and reports offered in the literature to support educational centres on their path towards inclusion in times of pandemic. The article provides content analysis of a total of 17 documents that constitute the first sources of knowledge on this topic (published in Spanish and English, and contextualised in the educational stages from Early Childhood Education to Higher Education). This has made possible the identification of the main challenges facing the inclusive education model, the key priorities/areas for inclusion and the proposed guidelines to address this current period of crisis from an inclusive educational and social response. Results. The results point to overcoming the digital divide, the continuity of learning, the application of new methodologies, the improvement of teacher training in inclusive education and socioemotional support, among others, as the major bulwarks on which to fortify the post-COVID school. Discussion. The conclusions note the opportunity provided by the pandemic to make another (fairer and more inclusive) education possible. © 2023, Universidad Compultense Madrid. All rights reserved.
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Introduction. In the 21st century, the struggle to achieve truly inclusive education continues. The explosion of the pandemic has only served to highlight the great inequalities that exist in the different education systems. Method. In this starting scenario, a qualitative study has been conducted with the aim of reviewing the guidelines and reports offered in the literature to support educational centres on their path towards inclusion in times of pandemic. The article provides content analysis of a total of 17 documents that constitute the first sources of knowledge on this topic (published in Spanish and English, and contextualised in the educational stages from Early Childhood Education to Higher Education). This has made possible the identification of the main challenges facing the inclusive education model, the key priorities/areas for inclusion and the proposed guidelines to address this current period of crisis from an inclusive educational and social response. Results. The results point to overcoming the digital divide, the continuity of learning, the application of new methodologies, the improvement of teacher training in inclusive education and socioemotional support, among others, as the major bulwarks on which to fortify the post-COVID school. Discussion. The conclusions note the opportunity provided by the pandemic to make another (fairer and more inclusive) education possible. © 2023, Universidad Compultense Madrid. All rights reserved.
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Subleasing is the housing solution that accommodates the most vulnerable and residentially excluded urban groups, including a large part of the Latin American immigrants residing in the city of Barcelona and its metropolitan area. By conducting 16 interviews with members of this group living in sublet rooms, this article analyzes the impact on them of the compulsory confinement decreed in the wake of the COVID-19 pandemic. The results indicate that subleasing can mask situations of homelessness and substandard housing that does not guarantee security or stability for this group when facing confinement. On the contrary, the residential deficiencies became more tangible during this period, penalizing especially those nuclear families living in a room, women and those in an irregular administrative situation.
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The COVID-19 pandemic forced much of schooling online and limited students' access to informal learning opportunities such as afterschool programs. The purpose of this study was to investigate how fourth-and fifth-grade students engaged in an online engineering program and what factors influenced their engagement. We drew on a four-dimensional model of student engagement to describe how students engaged in the afterschool engineering program and to identify the factors that enhanced or inhibited engagement. Using a case study design, we drew on interviews with six program mentors and ten students and observation data from weekly Zoom sessions throughout the 2020–2021 school year. We found examples of all four dimensions of engagement, but also of disengagement. The program influenced student engagement in multiple ways, including through the program mentors' social, pedagogical, and managerial roles, students' interest in and enjoyment of engineering, the drawbacks and benefits of the online learning environment and Zoom's affordances, and the nature of the program's activities. We connect these factors to the different dimensions of engagement. We conclude with a discussion of how our findings add to research on engineering education in informal online settings and offer implications for practitioners. © 2022, Purdue University Press. All rights reserved.
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The COVID-19 pandemic has generated a major global health crisis. It has also been reported that its impact has been greater in the specific case of tourism, compared to the economy as a whole. Cancun, the highly positioned Mexican sun and beach destination, has an economy concentrated on tourism, which magnified the impacts of the contingency measures applied, particularly on the vulnerability of workers in the sector. The objective of this work is to identify the impacts on the social vulnerability of tourism workers in Cancun, derived from contingency measures during the shock of the pandemic in 2020. The research consisted of a quantitative study through a survey not probabilistic and convenience focused on working conditions, habitability and emotionality of workers in tourist services. The results allowed us to recognize the high, medium and low levels of impact on the social vulnerability of workers, with the average vulnerability being the highest proportion in the case of Cancun.
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Interactions between the human angiotensin-converting enzyme 2 (ACE2) and the RBD region of the SARS-CoV-2 Spike protein are critical for virus entry into the host cell. The objective of this work was to identify some of the most relevant SARS-CoV-2 Spike variants that emerged during the pandemic and evaluate their binding affinity with human variants of ACE2 since some ACE2 variants can enhance or reduce the affinity of the interaction between the ACE2 and S proteins. However, no information has been sought to extrapolate to different variants of SARS-CoV-2. Therefore, to understand the impact on the affinity of the interaction between ACE2 protein variants and SARS-CoV-2 protein S variants, molecular docking was used in this study to predict the effects of five mutations of ACE2 when they interact with Alpha, Beta, Delta, Omicron variants and a hypothetical variant, which present mutations in the RBD region of the SARS-CoV-2 Spike protein. Our results suggest that these variants could alter the interaction of the Spike and the human ACE2 protein, losing or creating new inter-protein contacts, enhancing viral fitness by improving binding affinity, and leading to an increase in infectivity, virulence, and transmission. This investigation highlighted that the S19P mutation of ACE2 decreases the binding affinity between the ACE2 and Spike proteins in the presence of the Beta variant and the wild-type variant of SARS-CoV-2 isolated in Wuhan-2019. The R115Q mutation of ACE2 lowers the binding affinity of these two proteins in the presence of the Beta and Delta variants. Similarly, the K26R mutation lowers the affinity of the interaction between the ACE2 and Spike proteins in the presence of the Alpha variant. This decrease in binding affinity is probably due to the lack of interaction between some of the key residues of the interaction complex between the ACE2 protein and the RBD region of the SARS-CoV-2 Spike protein. Therefore, ACE2 mutations appear in the presence of these variants, they could suggest an intrinsic resistance to COVID-19 disease. On the other hand, our results suggested that the K26R, M332L, and K341R mutations of ACE2 expressively showed the affinity between the ACE2 and Spike proteins in the Alpha, Beta, and Delta variants. Consequently, these ACE2 mutations in the presence of the Alpha, Beta, and delta variants of SARS-CoV-2 could be more infectious and virulent in human cells compared to the SARS-CoV-2 isolated in Wuhan-2019 and it could have a negative prognosis of the disease. Finally, the Omicron variant in interaction with ACE2 WT, S19P, R115Q, M332L, and K341R mutations of ACE2 showed a significant decrease in binding affinity. This could be consistent that the Omicron variant causes less severe symptoms than previous variants. On the other hand, our results suggested Omicron in the complex with K26R, the binding affinity is increased between ACE2/RBD, which could indicate a negative prognosis of the disease in people with these allelic conditions.
Subject(s)
Angiotensin-Converting Enzyme 2 , COVID-19 , Humans , Angiotensin-Converting Enzyme 2/genetics , COVID-19/genetics , Molecular Docking Simulation , Mutation , Peptidyl-Dipeptidase A/chemistry , Protein Binding , SARS-CoV-2/genetics , Spike Glycoprotein, Coronavirus/genetics , Spike Glycoprotein, Coronavirus/metabolism , Viral Envelope Proteins/chemistry , Viral Envelope Proteins/genetics , Viral Envelope Proteins/metabolism , Virulence/geneticsABSTRACT
Purpose: The OPTN implemented emergency policy on 5/27/21 requiring lower respiratory testing (LRT) by nucleic acid test (NAT) for SARS-CoV-2 (COVID-19) for all potential deceased lung donors. Our objective was to assess the policy's impact on organ utilization and patient safety. Method(s): OPTN data were analyzed for LRT information reported in discrete data fields or attachments in DonorNet for deceased lung donors recovered 5/27/21- 10/31/21. We used natural language processing to identify donor attachments with terminology related to COVID-19 (e.g., "COVID", "SARS-COV-2") and LRT (e.g., "BAL", "tracheal aspirate") in the attachment filename or description. Result(s): In the first 5 months since implementation, lungs were transplanted from 1037 donors (963 (92.9%) non-DCD, 74 (7.1%) DCD) (Figure). Lung utilization decreased slightly from pre- to post-policy for both non-DCD and DCD donors (overall: 17.7% vs 16.2%;non-DCD: 22.9% vs 21.7%;DCD: 5.1% vs 3.8%). 99.8% (N=1035/1037) of transplanted lung donors had LRT;the majority (99.2%) had LRT results reported in DonorNet on/before day of lung transplant. There have been no reported potential donor-derived SARS-CoV-2 transmissions to lung recipients since implementation. 58 donors had a positive LRT (LRT+), including 27 (46.6%) with a negative upper respiratory test. Lungs were not transplanted from 57/58 LRT+ donors;1 LRT+ donor was believed to be a false positive based on confirmatory test results and had lungs transplanted. Non-lung organs were recovered and transplanted from LRT+ donors without evidence of disease transmission (Table). While the kidney discard rate was higher for LRT+ donors relative to donors without LRT+ (30.2% vs 24.8%), liver discards were lower (5.6% vs 9.9%), and heart utilization was similar (27.6% vs 28.0%). Conclusion(s): Early results suggest that the LRT policy has minimized the risk of donor-derived COVID-19 transmission to lung recipients with minimal impact on lung utilization and allowing transplantation of non-lung organs from LRT+ donors. (Figure Presented).
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Engagement and burnout have been defined as extremes of a continuum to represent the health and well-being of people at work, whether as a work result or other life circumstances. On the other hand, it must be recognized that the pandemic times have considerably affected all areas of human life, and the organizational one has not escaped this. In this context, this research aims to review scientific articles that deal with Engagement and Burnout to know the contributions made by researchers in this relevant organizational field, focusing the analysis on the times we live in as a result of the Covid-19 pandemic. To achieve the objectives, a database of 315 articles published in Web of Science (WOS) indexed journals during the period 2020-2022 was analyzed. Following the guidelines of Toulmin's argumentative model (Rodriguez-Bello, 2004), the following causal assertion was defined: "The engagement and burnout of workers during the COVID-19 pandemic is influenced by the governance of organizations". The reviewed articles were established as evidence and the database as collateral. The main results show that social and organizational governance influences the health and well-being of workers, which impacts their performance and thus the outcomes of their respective organizations.
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Objective: to identify the knowledge, prevention behaviors and perceived risk of covid-19 in medical students. Methods: descriptive, cross-sectional study. Students from a medical school participated from September to December 2020. The inclusion criteria were: to be enrolled in the first to tenth semester of the Medical Surgeon Bachelor's Degree, no matter age or gender, who agreed to participate in the research giving informed consent by answering an online survey consisting of 26 questions including fifteen items on knowledge of covid-19, nine on prevention behaviors, and two on covid-19 risk perception. Descriptive analysis was performed. Results:912 surveys were included, 62.2% were female (n=567), 82% said they had received information related to covid-19 from reliable information sources (n=748), 96.5% talked to their family and friends about prevention measures (n=880), 63.8% were unaware of N95 mask use during intubation, suctioning, bronchoscopy and cardiopulmonary resuscitation procedures (n=582) and 43.3% indicated that they were afraid of becoming infected (n=395).Conclusion: most of the participants reported having received adequate information to learn about aspects related to covid-19, but were unaware of essential aspects such as the use of N95 masks. It is necessary to educate and inform the medical school student population in order to decrease the perceptionof risk and increase prevention behaviors.