Exercise effects on cardiovascular disease: from basic aspects to clinical evidence.

Cardiovascular (CV) disease (CVD) remains the leading cause of major morbidity and CVD- and all-cause mortality in most of the world. It is now clear that regular physical activity (PA) and exercise training (ET) induces a wide range of direct and indirect physiologic adaptations and pleiotropic benefits for human general and CV health. Generally, higher levels of PA, ET, and cardiorespiratory fitness (CRF) are correlated with reduced risk of CVD, including myocardial infarction, CVD-related death, and all-cause mortality. Although exact details regarding the ideal doses of ET, including resistance and, especially, aerobic ET, as well as the potential adverse effects of extreme levels of ET, continue to be investigated, there is no question that most of the world's population have insufficient levels of PA/ET, and many also have lower than ideal levels of CRF. Therefore, assessment and promotion of PA, ET, and efforts to improve levels of CRF should be integrated into all health professionals' practices worldwide. In this state-of-the-art review, we discuss the exercise effects on many areas related to CVD, from basic aspects to clinical practice.

Face mask use during the COVID-19 pandemic: how risk perception, experience with COVID-19, and attitude towards government interact with country-wide policy stringency.

BACKGROUND: During the 2020 COVID-19 pandemic, governments imposed numerous regulations to protect public health, particularly the (mandatory) use of face masks. However, the appropriateness and effectiveness of face mask regulations have been widely discussed, as is apparent from the divergent measures taken across and within countries over time, including mandating, recommending, and discouraging their use. In this study, we analyse how country-level policy stringency and individual-level predictors associate with face mask use during the early stages of the global COVID-19 pandemic. METHOD: First, we study how (self and other-related) risk perception, (direct and indirect) experience with COVID-19, attitude towards government and policy stringency shape face mask use. Second, we study whether there is an interaction between policy stringency and the individual-level variables. We conduct multilevel analyses exploiting variation in face mask regulations across countries and using data from approximately 7000 students collected in the beginning of the pandemic (weeks 17 through 19, 2020). RESULTS: We show that policy stringency is strongly positively associated with face mask use. We find a positive association between self-related risk perception and mask use, but no relationship of mask use with experience with COVID-19 and attitudes towards government. However, in the interaction analyses, we find that government trust and perceived clarity of communication moderate the link between stringency and mask use, with positive government perceptions relating to higher use in countries with regulations and to lower use in countries without regulations. CONCLUSIONS: We highlight that those countries that aim for widespread use of face masks should set strict measures, stress self-related risks of COVID-19, and use clear communication.

Coping and Anxiety During Lockdown in Spain: The Role of Perceived Impact and Information Sources.

Background/Purpose: In the context of COVID-19 lockdowns, extant research suggests that secondary coping (a strategy aimed at adjusting oneself self to the stressor) is more robustly associated with better mental health than primary coping (a strategy aimed at adjusting the stressor to oneself). We investigated whether these findings are generalizable to Spain-one of the most severely affected countries at that time. We also tested whether the link between secondary coping and mental health (as measured by anxiety) can be accounted for by how individuals perceive the COVID-19 impact (ie, perceived life changes and personal global impact) and how frequently they use traditional and social media to check COVID-19-related information. Methods: A diverse community sample (N = 408), collected during the first lockdown in Spain (early April 2020), completed a multi-measure online survey including the targeted variables. Results: Secondary coping outperformed primary coping in predicting reduced anxiety during the lockdown in Spain. Moreover, lower perceived life changes from COVID-19 and reduced personal global impact from COVID-19 both mediated the negative secondary coping-anxiety relationship. No indirect effects emerged for either conventional or social media exposure. Conclusion: These results (a) strengthen the cross-cultural validity of the link between secondary coping and anxiety and (b) advance our understanding of the psychological mechanisms underlying this association.

Elective Surgery during SARS-Cov-2/COVID-19 Pandemic: Safety Protocols with Literature Review.

BACKGROUND: Health care systems worldwide have been affected by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emergence since December 2019. The coronavirus disease 2019 (COVID-19) pandemic caused a steep decrease in elective surgery scheduling, to the extent of complete cancellation without future planning of safe development. PURPOSE: We performed a review of the literature and diagnosis data analysis with the aim to reduce the risk of operating a patient infected with SARS-CoV-2/COVID-19 during the incubation period. METHODS: We searched for specific words and phrases about SARS-CoV-2 and COVID-19 in the PubMed database (US National Library of Medicine) from December 2019 to April 2020. A detailed analysis of the clinical picture and existing diagnostic tests for COVID-19 was performed to achieve the desired objectives. RESULTS: A total of 1273 out of 5930 articles about COVID-19/SARS-CoV-2 did meet the criteria for the searched terms. We reviewed 105 articles, and 60 were selected for analysis. Specific recommendations were described based on our revision. CONCLUSIONS: With the combination of immunoglobulin M and immunoglobulin G antibody tests + real-time polymerase chain reaction for SARS-CoV-2 implemented in different time periods by taking into account the natural history of the disease, it is possible to decrease the risk of operating a patient during the incubation period higher than 93%. Adding other security measures can further increase this percentage. As long as there is no immunity to COVID-19, these measures will help us to perform safer elective surgeries.

In Situ Pulmonary Thrombolysis and Perfusion Lung Angiography in Severe COVID-19 Respiratory Failure.

A proof-of-concept study using thrombolysis with catheter-directed tissue plasminogen activator (tPA) and pulmonary angiography imaging was performed to visualize perfusion deficits and reperfusion/therapeutic effects of tPA. DESIGN: A prospective, open-label, compassionate study. Descriptive statistics were presented for categorical variables and as means with sds for continuous variables. The Wilcoxon test was used to determine the differences between the two-related samples and a t test for continuous variables. Statistical significance was set at p value of less than 0.05. Agreement between observations was evaluated using the Kappa Cohen index and overall agreement using the Fleiss Kappa coefficient. SETTING: A single COVID-19 ICU of Mexico´s General Hospital Dr Eduardo Liceaga. SUBJECTS: Fifteen patients with severe Delta variant severe acute respiratory syndrome coronavirus 2 infection, 18-75 years old, requiring mechanical ventilation with a persistent Fio2 requirement of 70% or higher and Pao2/Fio2 ratio (or imputed ratio) less than 150 for more than 4 hours. The coagulation inclusion criteria were International Society on Thrombosis and Haemostasis score greater than 5, and presence of a d-dimer greater than 1,200, with viscoelastic testing using rotational thromboelastometry (Instrumentation Laboratories, Mexico City, Mexico) showing both hypercoagulability (EXTEM amplitude at 5 min > 65 FIBTEM > 30) and hypofibrinolysis (EXTEM maximum lysis < 8%). INTERVENTIONS: Catheter-directed tPA angiography and iFlow system analysis to assess pre-tPA baseline pulmonary perfusion and changes in response to thrombolysis. RESULTS: Nine patients had microvascular filling defects demonstrated by angiography, and good agreement was found with iFlow analysis (ƙ = 0.714). Statistically significant differences were identified in the area under the curve (AUC) region of interest/AUC reference tissue with and without filling defects in phase 2 DM -0.09206 (sd ± 0.16684) (p = 0.003). The Pao2/Fio2 values measured immediately and 48 hours after the procedure were significantly higher (p = 0.001 and p = 0.005, respectively). Statistically significant differences were found in d-dimer values (p = 0.007), Fio2 (p = 0.002), and oxygen saturation in arterial blood/Fio2 (p = 0.045), as well as in the number of patients who required prone positioning before, immediately after the procedure, and at 48 hours after the procedure (p = 0.002). CONCLUSIONS: Thrombolysis with catheter-directed tPA resulted in imaging evidence via pulmonary angiography and iFlow technology of improved lung perfusion in COVID-19 patients with severe respiratory failure.

Hygiene and social distancing as distinct public health related behaviours among university students during the COVID-19 pandemic

Prevailing research on individuals' compliance with public health related behaviours during the COVID-19 pandemic tends to study composite measures of multiple types of behaviours, without distinguishing between different types of behaviours. However, measures taken by governments involve adjustments concerning a range of different daily behaviours. In this study, we seek to explain students' public health related compliance behaviours during the COVID-19 pandemic by examining the underlying components of such behaviours. Subsequently, we investigate how these components relate to individual attitudes towards public health measures, descriptive norms among friends and family, and key demographics. We surveyed 7,403 university students in ten countries regarding these behaviours. Principal Components Analysis reveals that compliance related to hygiene (hand washing, coughing behaviours) is uniformly distinct from compliance related to social distancing behaviours. Regression analyses predicting Social Distancing and Hygiene lead to differences in explained variance and type of predictors. Our study shows that treating public health compliance as a sole construct obfuscates the dimensionality of compliance behaviours, which risks poorer prediction of individuals' compliance behaviours and problems in generating valid public health recommendations. Affecting these distinct behaviours may require different types of interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Humor Styles, Perceived Threat, Funniness of COVID-19 Memes, and Affective Mood in the Early Stages of COVID-19 Lockdown.

Existing psychological research has long considered humor as a useful strategy for individuals in coping with adverse circumstances and life stressors. However, empirical studies are called for to better understand the role of humor in facing the COVID-19 pandemic. In a community sample of 527 Spanish adults, we investigated the associations between humor styles, perceived threat from COVID-19, funniness of COVID-19 memes, and individuals' affective mood. Data were collected during the third week of lockdown in Spain (from 26 to 31 March 2020). Our results suggest that intrapsychic humor styles were associated with better coping with the COVID-19 pandemic. Structural equation modelling showed that self-enhancing and aggressive humor styles were related to perceiving COVID-19 as less psychologically threatening, which, in turn, was associated with a greater perceived funniness of COVID-19 memes, thus predicting higher levels of happiness. Interestingly, the opposite pattern of connections was found for self-defeating humor. These findings suggest that humor styles aimed at boosting one's own self, irrespective of their potentially lighter or darker nature, may contribute to alleviating adverse psychological consequences arising from the COVID-19 pandemic.

Fear in the Stock Market: How COVID-19 Affects Preference for High- and Low-Priced Stocks

Does fear create a bias in favor of high-priced stocks? An analysis of the S&P 500 stock prices during the COVID-19 market crash showed that high-priced stocks outperformed low-priced ones (study 1). Experimental data further confirmed that fear induced by thoughts about the pandemic increased individuals’ preference for high-priced stocks when they were forced to choose one stock from a set of alternatives (study 2). Although fear generally decreased the preference for stocks when the market trended downward, this decrease was less for high-priced stocks than for low-priced ones (study 3). Reasons for and implications of this bias are discussed.

The fear of COVID-19 scale: Its structure and measurement invariance across 48 countries.

Coronavirus disease (COVID-19) has been a source of fear around the world. We asked whether the measurement of this fear is trustworthy and comparable across countries. In particular, we explored the measurement invariance and cross-cultural replicability of the widely used Fear of COVID-19 scale (FCV-19S), testing community samples from 48 countries (N = 14,558). The findings indicate that the FCV-19S has a somewhat problematic structure, yet the one-factor solution is replicable across cultural contexts and could be used in studies that compare people who vary on gender and educational level. The validity of the scale is supported by a consistent pattern of positive correlations with perceived stress and general anxiety. However, given the unclear structure of the FCV-19S, we recommend using latent factor scores, instead of raw scores, especially in cross-cultural comparisons. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

End of Life Intervention Program During COVID-19 in Vall d'Hebron University Hospital.

Introduction: The coronavirus disease 19 (COVID-19) and its consequences have placed our societies and healthcare systems under pressure. Also, a major impact on the individual and societal experience of death, dying, and bereavement has been observed. Factors such as social distancing, unexpected death or not being able to say goodbye, which might predict Prolonged Grief Disorder (PGD), are taking place. Moreover, hospitals have become a habitual place for End of Life (EOL) situations but not in the usual conditions because, for example, mitigation measures prevent families from being together with hospitalized relatives. Therefore, we implemented an EOL program with a multidisciplinary team involving health social workers (HSW) and clinical psychologists (CP) in coordination with the medical teams and nursing staff. Objectives: We aim to describe an EOL intervention program implemented during COVID-19 in the Vall d'Hebron University Hospital (HUVH). We present its structure, circuit, and functions. Descriptive analyses of the sample and the interventions that required psychological and social attention are reported. Material and methods: The total sample consists of 359 relatives of 219 EOL patients. Inclusion criteria were families cared for during the COVID-19 pandemic with family patients admitted to the HUVH in an EOL situation regardless of whether or not the patient was diagnosed with COVID-19. Results: Our program is based on family EOL care perceptions and the COVID-19 context features that hinder EOL situations. The program attended 219 families, of which 55.3% were COVID-19 patients and 44.7% had other pathologies. The EOL intervention program was activated in most of the EOL situations, specifically, in 85% of cases, and 78% of relatives were able to come and say goodbye to their loved ones. An emotional impact on the EOL team was reported. It is necessary to dignify the EOL situation in the COVID-19 pandemic, and appropriate psychosocial attention is needed to try to minimize future complications in grief processes and mitigate PGD.

COVID-19 pandemic effects in people with Autism Spectrum Disorder and their caregivers: Evaluation of social distancing and lockdown impact on mental health and general status.

Among the difficulties associated with Autism Spectrum Disorder (ASD) are those related to adaptation to changes and new situations, as well as anxious-depressive symptoms frequently related to excessive environmental requirements. The main objective of this research is to study the psychological impact of the lockdown due to the social emergency situation (COVID-19) in children/adolescents and adults diagnosed with ASD. Participants were 37 caregivers of children/adolescents with ASD, also 35 ASD adults and 32 informants. Evaluation was conducted through a web survey system and included standardized clinical questionnaires (CBCL and SCL-90-R), which were compared with results before lockdown start, and a brief self-reported survey addressing the subjective perception of changes in daily functioning areas. The results revealed a reduction of psychopathological symptoms in both age groups, but only reaching statistical significance in the adult group, except for Somatization, Anxiety, and Obsessive-Compulsive domains. ASD severity Level 2 showed greater improvement after lockdown onset in the children/adolescent group when compared to ASD Level 1 participants. Younger adults (18-25 yoa) reported greater improvement than older adults (=>25 yoa). Survey results indicate an improvement of feeding quality and a reduction in the number of social initiations during the lockdown. Adult ASD participants perceived a decrease in stress levels after the lockdown onset, whereas caregivers reported higher stress levels at the same point in both age groups. Limitations included the small number of participants and a heterogeneous evaluation window between measures. Pyschopathological status after two months of social distancing and lockdown seems to improve in ASD young adult population.

Ad-hoc group consensus recommendations on the evaluation and quality control of molecular and serological diagnostics tests for SARS CoV-2 human infection

Resumen Se formulan recomendaciones de un grupo de consenso de expertos sobre los criterios para evaluar el desempeño diagnóstico (tamaño y selección de muestras para sensibilidad y especificidad analíticas, criterios para establecer límites de detección, criterios para establecer el estándar de oro para las serologías) que deberían ser tenidos en cuenta al evaluar y validar las pruebas diagnósticas para SARS CoV-2. Con el propósito de asegurar la calidad de las pruebas serológicas a utilizar en el país, se recomienda la participación en un programa de control de calidad externo, que garantice la idoneidad y desempeño en la realización de las pruebas diagnósticas serológicas y moleculares durante esta pandemia, ya que su uso tiene profundas implicaciones para las medidas de intervención clínicas individuales y de seguimiento y control en salud pública. We formulate recommendations from a consensus working group on the criteria to evaluate the diagnostic performance (size and criteria of selection of samples to determine sensitivity, analytical specificity, criteria for limit of detection, criteria for gold standard to evaluate serological assays) that should be taken into account during the evaluation and validation/verification of diagnostic tests for SARS CoV-2 infection. A national external quality control program should be established to guarantee the suitability and performance of these diagnostic serological and molecular tests during this pandemic, that will have deep implications for decisions on clinical and public health.

Ad-hoc group consensus recommendations on the evaluation and quality control of molecular and serological diagnostics tests for SARS CoV-2 human infection

Resumen Se formulan recomendaciones de un grupo de consenso de expertos sobre los criterios para evaluar el desempeño diagnóstico (tamaño y selección de muestras para sensibilidad y especificidad analíticas, criterios para establecer límites de detección, criterios para establecer el estándar de oro para las serologías) que deberían ser tenidos en cuenta al evaluar y validar las pruebas diagnósticas para SARS CoV-2. Con el propósito de asegurar la calidad de las pruebas serológicas a utilizar en el país, se recomienda la participación en un programa de control de calidad externo, que garantice la idoneidad y desempeño en la realización de las pruebas diagnósticas serológicas y moleculares durante esta pandemia, ya que su uso tiene profundas implicaciones para las medidas de intervención clínicas individuales y de seguimiento y control en salud pública. We formulate recommendations from a consensus working group on the criteria to evaluate the diagnostic performance (size and criteria of selection of samples to determine sensitivity, analytical specificity, criteria for limit of detection, criteria for gold standard to evaluate serological assays) that should be taken into account during the evaluation and validation/verification of diagnostic tests for SARS CoV-2 infection. A national external quality control program should be established to guarantee the suitability and performance of these diagnostic serological and molecular tests during this pandemic, that will have deep implications for decisions on clinical and public health.

Pandemic COVID-19: A reflection on the impact for preparedness on the control of infectious diseases in Colombia / Pandemia COVID-19: Reflexiones sobre su impacto para la preparación en el control de enfermedades infecciosas en Colombia

La Organización Mundial de la Salud finalmente declaró al brote por el coronavirus SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) como una pandemia el 11 de marzo de 2020 . Al momento de escribir este editorial (Abril 4 de 2020) el mundo sobrepasó el millón de infectados y el número de muertes registraba cerca de 70 mil, con múltiples países sufriendo más de mil muertes diarias . Las características propias de este coronavirus, a pesar de ser similar a otros, como el SARS y el MERS, hace que existan interrogantes sobre su impacto en países de regiones y condiciones socioeconómicas y culturales diferentes.

The World Health Organization finally declared the SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) outbreak a pandemic on March 11, 2020 . At the time of writing this editorial (April 4, 2020) the world surpassed one million infected and the number of deaths was close to 70,000, with multiple countries suffering more than one thousand deaths per day. The specific characteristics of this coronavirus, despite being similar to others, such as SARS and MERS, raise questions about its impact in countries of different regions and socioeconomic and cultural conditions.