ABSTRACT
This article aims to empirically measure the factors that influence student satisfaction with online education. By taking as a reference the results obtained with a questionnaire used during the class period among undergraduate students at the Quevedo State Technical University (UTEQ) of Ecuador in the period Covid-19. The instrument consists of 35 questions classified into six factors: student-content interaction, student-teacher relationship, use of SGA platform and other digital tools, evaluation of online education, technological resources and evaluation of online education. To this, the study of demographic characteristics and academic background is added. This study uses the statistical methodology of causal analysis, by means of structural equations (SEM) and the AMOS 26.0 software, based on a conceptual research model. The results obtained show that the proposed theoretical model is acceptable, which was confirmed by estimating it using the maximum likelihood method, establishing that the factors that predominantly affect student satisfaction in online education are: student-content interaction, student-teacher relationship and technological resources. © 2022, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.
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Background: The recent widespread of COVID-19 led to a marked increase in the number of CT chest examinations. This led to frequent encounters of associated incidental findings as thyroid nodules. Thyroid imaging reporting and data system (TI-RADS) using variable ultrasound feature-allowed systematic reproducible approach for diagnosis and management of thyroid nodules. Objective: This study aimed to detect the prevalence of incidental thyroid nodules in CT chest for COVID-19 cases as well as the percentage of malignant nodules among them and the concordance of TI-RADS classification with fineneedle aspiration cytology (FNAC) results. Patients and methods: This retrospective study included 895 patients with CT findings of COVID-19 pneumonia. 203 patients were excluded due to absent PCR confirmation of COVID-19, lack of ultrasound confirmation of thyroid nodules or lack of FNAC results, so our study included 692 patients with confirmed COVID-19 pneumonia. Results: A solitary thyroid nodule was discovered in 134 CT chest scans of 692 patients with confirmed COVID-19 pulmonary pneumonia, with a 19.4% incidence. These patients underwent ultrasound evaluation for the thyroid nodule. The nodules with TI-RADS 1-3 score were considered benign yet those with 4-5 score were classified as malignant. The results of the FNAC were compared to the thyroid TI-RADS classification, with nodules classified as Bethesda II-III being benign and those classified as Bethesda IV to VI being malignant. Conclusion: Incidental thyroid nodule discovered during CT chest examination is an important finding and should be investigated and categorized using the TI-RADS system as even though the incidence of malignancy is not high, early diagnosis of thyroid malignancy can have a huge effect on the patient outcome. [ FROM AUTHOR] Copyright of Egyptian Journal of Hospital Medicine is the property of Egyptian Journal of Hospital Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
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Background: The COVID19 pandemic has affected persons dietary habits and life style, with effects on body weight. We have assessed the effect of the pandemic on the liver health by quantifying the changes in liver enzymes, hepatic steatosis and fibrosis in patients with chronic liver disease. Methods: This is a multi-center US study that included 3 tertiary clinical centers. Patients with chronic liver disease (51 NAFLD, 8 with resolved hepatitis C, 3 chronic hepatitis B, 5 primary biliary cholangitis and 36 combination of chronic liver disease), without evidence of an acute process (e.g. alcoholic hepatitis, alcohol abuse or new decompensation of cirrhosis), were enrolled. Patients were assessed between January and March 2020 and January and March 2021. Assessment included laboratory tests and controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) on vibration transient elastography (VCTE). Results: 103 patients were assessed twice during the two periods. Baseline mean alanine aminotransferase (ALT) was 37 ± 36 (SD) U/L;aspartate aminotransferase (AST) 30 ± 18 U/L;total bilirubin 0.6 ± 0.31 mg/dL;albumin, 4.2 ± 0.72 g/dL;CAP score 293 ± 70 dB/m;and LSM on VCTE 8.1 ±6.2 kPa. Weight gain occurred in 54% of the population, whereas 39% lost weight, and 7% had no weight change. LSM increased by >20% in 30% of subjects;decreased by 20% in 27%;and remained within the 20% range in 43%. LSM increase by 20% was associated with significant weight gain and ALT increase (+2.3 ± 6.5 kg, and +17 ± 49.U/L (p<0.05)), in comparison to subjects who had their LSM changes within 20% range (+1.1 (3.7) kg, and -5.3 ±22.0 U/L) or had >20% decrease in LSM (-0.3 ±5.8 kg, and -6.0 ±21 U/L). CAP score median change was -2.9 ±85 dB/m in those who had LSM increase by >20%, whereas the score changed by 0.0 ± 44 dB/m in those who had LSM changes within 20% or 1.0 ± 58 dB/m in those >20% decrease. Conclusion: During the COVID 19 pandemic in this U.S. population, more than half of subjects with chronic liver disease gained weight, but others had no change or decreased weight. Adverse liver changes (LSM>20% and increased ALT) occurred in one-third of the population.
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Background: The well-being of oncology providers (OP) is in jeopardy with increasing workload, limited resources, and personal challenges that result from the COVID-19 pandemic. We aim to evaluate the impact of COVID-19 on work-related (WR) satisfaction and fatigue among OP in Latin America. Methods:We conducted an international cross-sectional online survey of OP practicing in Latin America. The survey was administered in English, Spanish, and Portuguese. Data was analyzed using descriptive statistics and Chi-square tests. Results: In August 2020, 704 OP from 20 Latin American countries completed the survey (77% of 913 who started the survey). Table outlines baseline characteristics. Higher frequency of WR fatigue (67% vs. 58%, p=0.010) and exhaustion (81% vs. 70%, p=0.001) were reported by OP who cared for patients with COVID-19, compared to OP who cared for patients without COVID-19. Providers that observed delays in referrals to radiation (p=0.002) and surgery (p=0.04) reported WR fatigue at higher rates than their counterparts. Higher exhaustion (p=0.016) and dissatisfaction (p=0.046) were reported by OP who lacked access to supportive services, as social work. A significantly higher proportion of women reported WR fatigue (72% vs. 56%, p=0.003) and exhaustion (86% vs. 68%, p=0.001), when compared to men. Women were more likely than men to endorse higher current levels of fatigue when compared to pre-COVID-19 (61% vs. 46%, p=0.0001). To reduce stress, women were more likely than men to cut the time spent watching the news (p=0.002). Both genders declined research collaborations and speaking opportunities. Conclusions: Fatigue and dissatisfaction with work-life were prevalent among OP in Latin America. Higher rates of WR fatigue were seen in women, OP caring for patients with COVID-19, and OP with patients who experienced cancer care delays. Our data imply that OP may be a prime target for psychosocial support, particularly as current challenges will continue for the foreseen future. Baseline characteristics (N=704).
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Background: The severe acute respiratory syndrome 2 (SARS-cov-2) virus causing COVID19 has brought great challenges to global health services affecting cancer care delivery, outcomes, and increasing the burden in oncology providers (OP). Our study aimed to describe the challenges that OP faced while delivering cancer care in Latin America. Methods: We conducted an international crosssectional study using an anonymous online survey in Spanish, Portuguese, and English. The questionnaire included 43 multiple choice questions. The sample was stratified by OP who have treated patients with COVID-19 versus those who have not treated patients with COVID-19. Data was analyzed with descriptive statistics and Chi-square tests. Results: A total of 704 OP from 20 Latin American countries completed the survey (77% of 913 who started the survey). Oncologists represented 46% of respondents, followed by 25% surgicaloncologists. Of the respondents, 56% treated patients with COVID-19. A significant proportion of OP reported newly adopting telemedicine during COVID-19 (14% vs 72%, p=0.001). More than half (58%) of OP reported making changes to the treatments they offered to patients with cancer. As shown in the table, caring for patients with COVID-19 significantly influenced practice patterns of OP. Access to specialty services and procedures was significantly reduced: 40% noted significantly decreased or no access to imaging, 20% significantly decreased or no access to biopsies, 65% reported delays in surgical oncology referrals, and 49% in radiation oncology referrals. A vast majority (82%) reported oncologic surgeries were delayed or cancelled, which was heightened among those treating patients with COVID-19 (87% vs 77%, p=0.001). Conclusions: The COVID-19 pandemic has significantly affected the way cancer care is delivered in globally. Although changes to healthcare delivery are necessary as a response to this global crisis, our study highlights the significant disruption and possible undertreatment of patients with cancer in Latin America that results from COVID-19.