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Research has always been regarded by many as tedious because of the difficulties and challenges associated with doing research such as having to forego certain habits like social life. Doing research became even more difficult, especially with regard to limitation on collecting applicable primary and secondary data due to the COVID-19 pandemic lockdowns. It is to be noted that substantive, thorough, sophisticated literature review and intensive pertinent primary data availability are ncessary for doing quality research relevant to the status quo. Various novel approaches have been adopted by scholars through their diverse academic spheres in conducting internationally acceptable research amidst the COVID-19 pandemic. This research aims to come up with a guidepost to facilitate researchers and other stakeholders with fundamental knowledge and skills in conducting substantive, thorough, sophisticated researches that are of international standards. A comparative and diagnostic analysis method is used for analyzing existing literature and policies developed by higher education institutions and schools for doing research in the advent of the COVID-19 pandemic. The output allowed authors to develop a guidepost with rules on using limited primary and extensive secondary data in doing research. The guidepost consists of various sections explaining on how to do research and write theses and dissertations. These sections include among others research title, statement of the problem, research objectives, theoretical and conceptual frameworks, review of related literature, research methodology, analysis and interpretation of data, and conclusion and recommendations. The guidepost is very significant in doing researches and aids researchers in conducting internationally accepted researches with limited primary data and extensive secondary data in the advent of the COVID-19 Pandemic. The guidepost is flexible and can easily be used by local and international institutions’ researchers through little modification in context of their research fields. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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This study analyses air quality behavior by considering nitrogen dioxide (NO2) as a reference parameter during atypical conditions associated with the COVID-19 pandemic. NO2 concentrations in 31 departmental capital cities of Colombia (South America) were evaluated during four periods according to government dispositions to face the pandemic: (I) before isolation (normal conditions), (II) mandatory isolation (significant traffic and industrial activity reduction), (III) intelligent isolation (return of some commercial activities), and (IV) selective isolation (Increase of authorized commercial activities). A good fit between ground data and satellite information is observed. Results indicate that most of the cities (45%) present a counterintuitive behavior with concentration increments for Period II with respect to Period I. © 2022, Rasayan Journal of Chemistry, c/o Dr. Pratima Sharma. All rights reserved.
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This study assesses the relationship between COVID-19 anxiety and subjective well-being in terms of the mediating role of COVID-19 preventive behaviors. Additionally, the contribution of sociodemographic factors (sex and age) and risk perception on COVID-19 anxiety and its potential measurement invariance was tested in 5655 participants from 12 countries in Latin America and the Caribbean. A mixture of both latent and observable variables were analyzed using a system of structural equations. The Coronavirus Anxiety Scale (CAS), Preventive COVID-19 Infection Behaviors Scale (PCIBS) and single-item measures were used to assess the perceived probability of death, perceived severity and concern about transmitting COVID-19. The results indicated that there is a significant and relevant direct effect of COVID-19 anxiety on participants' well-being. Furthermore, COVID-19 anxiety significantly predicted both preventive behavior (beta = .29, p < .01) and well-being (beta = -.32, p < .01). The effects of COVID anxiety and preventive behavior explained 9.8% of the variance in well-being (R-square = .098);whereas, 8.4% of the variance in preventive behavior was associated with COVID anxiety (R-square = .084). Likewise, perceived likelihood of death from COVID, perceived severity of COVID, and concerns about COVID transmission were positively related to anxiety. Age was negatively related to anxiety, with men being less anxious than women. The results are invariant by country, i.e., the broad relationships found in the combined sample are also present in each individual country. The findings indicate that, although the exact relationships between variables may vary between countries, there are enough similarities to provide useful information about the impact of the COVID-19 pandemic in each of the countries included in the study.
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A significant contributor to the waste stream is the domestic single-use plastic used in households, being the final disposal in most cases the local landfill. There is a significant opportunity to promote resource recovery and efficiency through the introduction of circular economy strategies. However, the knowledge and management of post-consumer plastic waste in the country is poor, and there is a lack of an efficient collection and sorting system. In this context, spatial information on domestic plastic waste generation (DPWG) is essential for recycling decision-making. The integration of Geographic Information Systems (GIS) and the Global Positioning System (GPS) shows an opportunity to collect, mapping, and analyse spatial DPWG issues. Thus, this paper had a double objective. The first was to assess the evolution of eight different types of plastic waste in the city's households and their daily per capita generation between 2019 and 2021. The second objective was to provide a complete geo-referenced information on the quantities and typologies of domestic plastic waste (DPW) produced in Guayaquil and analyse how the flows have shifted throughout the years. The results showed that PET is the most generated, recording 97.76% and 100.00 % of the households who generate this type of plastic for 2019 and 2021, respectively, with an average of 13.08 and 15.13 g/day/c. Following, we had HDPE, PP and PVC occupying the second, third and fourth place for 2019 with 5.86, 3.05, 2.54 g/day/c, respectively. On the other hand, for 2021, PP (7.43 g/day/c), HDPE (5.92 g/day/c), and LDPE (3.99 g/day/c) occupied the second, third and fourth, respectively. According to the spatial maps, the DPW increment is in most of the popular zones. These popular zones are neighborhoods with a considerable quantity of population and limited basic services. Most of these people live in extreme poverty, being a possible relation between the COVID-19 lockdown and the increasement of DPW. © 2022 Elsevier B.V.. All rights reserved.
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Study Objectives: Apart from tetanus and rabies vaccines, emergency departments have been minimally involved in vaccination efforts. As the country and the world continues to fight the COVID19 pandemic, determining new methods to deliver vaccines to people are now more important than ever. Moreover, finding ways to reach populations that are less likely to receive vaccines is equally as important. The objective of this study was to implement a screening and delivery protocol for influenza vaccine in an emergency department setting to demonstrate that emergency department vaccination protocols are viable and an effective public health tool. Methods: A screening protocol was developed based on CDC/ACIP guidelines for influenza vaccination. This screening protocol was implemented at two surban academic emergency departments starting 10/01/2020 and ending 01/31/2020. Demographic information was collected through electronic medical records for all patients who were screened. That information was utilized to analyze patients who accepted and those who refused the vaccine and those that ultimately received the vaccine while in the department. Results: During the trial period, 11, 355 patients were screened out of 25, 485 total patients who utilized the participating emergency departments. Of those screened, 5, 056 (45%) stated they had not received the influenza vaccine. Amongst those 5, 056 patients eligible for the vaccine, 1, 156 (22.9%) had an order placed for vaccine and ultimately 441 (8.7%) received the vaccination. The median ED length of stay (LOS) for all patients presenting to the department was 5 hours and 4.7 hours for patients who had the flu shot ordered. After omitting excessive LOS patients - greater than 16 hours, there was no evidence that having a flu shot ordered was associated with a longer ED length of stay (p < 0.05). Amongst the participants, the patients identifying as African American or Hispanic were less likely to have already received the influenza vaccine compared to non-Hispanic white and Asian identifying patients. Patients identifying as African American were the least likely to accept vaccination. Conversely, patients identifying as Hispanic were more likely than those not identifying as Hispanic to accept vaccination. Patients identifying as Asian were the most likely to have already received the vaccine and to accept the vaccine when offered. Conclusions: This study demonstrates that influenza vaccination protocols are both feasible and effective at distributing influenza vaccine in the emergency department without significantly affecting the length of stay. The patient population utilizing the emergency department is more likely to represent medically underserved populations. Influenza vaccination in the emergency department serves as an opportunity to increase vaccination rates among patients who lack other regular access to healthcare. These results should motivate the implementation of vaccination programs in other emergency departments.
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Background. Adding to the current available evidence on the efficacy of exogenous corticosteroids as an adjunct to standard of care in improving the clinical outcomes of COVID-19 patients. This meta-analysis examined the experimental and clinical data supporting this therapeutic intervention in improving clinical outcomes. Objectives. This meta-analysis aimed to assess the efficacy of corticosteroids in improving outcomes in COVID-19 patients. Search methods. Literature searches of electronic databases (PubMed, Cochrane Library, Science Direct, Google Scholar) were performed to identify relevant studies. Data Collection and Analysis. Meta-analysis was performed using Review Manager (RevMan) software, version 5.4.1. Intervention effects were expressed in terms of mean differences and risk ratios for continuous and dichotomous variables, respectively. Fixed-effect or random-effects model was adopted according to heterogeneity. Main Results. A total of seven studies were included in the quantitative synthesis. Analysis of pooled data showed a 12% reduced risk of mortality in COVID patients given corticosteroids (RR 0.88, 95% CI 0.81 to 0.95). Patients who were administered with corticosteroids also had 22% decreased risk of requiring invasive ventilation support (RR 0.78, 95% CI 0.64 to 0.95). Number of adverse events were similar between the two groups (RR 1.10, 95% CI 0.49 to 2.46). Conclusion. Adjunct corticosteroid therapy provided improvements in clinical outcomes such as decreased deaths and decreased need for invasive ventilation support. There was no sufficient evidence of a significant adverse effect, hence it is relatively safe and beneficial to use in COVID19 patients. © 2021, Philippine College of Physicians. All rights reserved.
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Objective: To determine lifestyle changes, such as physical activity, nutrition, and sleep in an Argentinean university population, caused by confinement during the COVID-19 pandemic. Methods: Cross-sectional study via web survey. 1021 the Argentinean university population (women, n = 645 and men, n = 376) aged between 18-70 years old was participate. Survey was utilized to measure participant physical activity behavior, nutrition, and sleep April to May 2020. Results: The main findings revealed that 4.3% of the sample showed obesity;the highest proportion of the sample stayed more than 6 hours in a sedentary status;21.74% reported bad sleep quality;a reduction in good feeding pattern;and an increase in subjects who do not perform physical activity. According to sociodemographic and anthropometric factors, being a student (OR 2.19, CI95% 1.18 - 4, p= .012), overweight (OR 1.71, CI95% 1.19 - 2.44, p= .003), obesity (OR 4.45, CI95% 2.27 - 8.7, p< .001), and have been confined more than 45 days was associated with bad feeding. Likewise, low physical activity levels were associated with obesity (OR 3.2 CI95% 1.66 - 6.18, p= .001), being female (OR 1.61, CI95% 1.14 -2.28, p= .006) and get married (OR 1.72, CI95% 1.14 - 2.61, p= .009). Moreover, being a student was associated with poor sleep quality (OR 43.6, CI95%5.4 - 350, p< .001). Conclusion: This study suggests that confinement decreased healthy living habits such as good nutrition and physical activity and affected the quality of sleep in young subjects. © 2021 Federacion Espanola de Docentes de Educacion Fisica. All rights reserved.
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The ongoing epidemic of COVID-19 first found in China has reinforced the need to develop epidemiological models capable of describing the progression of the disease to be of use in the formulation of mitigation policies. Here, this problem is addressed using a metapopulation approach to consider the inhomogeneous transmission of the spread arising from a variety of reasons, like the distribution of local epidemic onset times or of the transmission rates. We show that these contributions can be incorporated into a susceptible-infected-recovered framework through a time-dependent transmission rate. Thus, the reproduction number decreases with time despite the population dynamics remaining uniform and the depletion of susceptible individuals is small. The obtained results are consistent with the early subexponential growth observed in the cumulated number of confirmed cases even in the absence of containment measures. We validate our model by describing the evolution of COVID-19 using real data from different countries, with an emphasis in the case of Mexico, and show that it also correctly describes the longtime dynamics of the spread. The proposed model yet simple is successful at describing the onset and progression of the outbreak, and considerably improves the accuracy of predictions over traditional compartmental models. The insights given here may prove to be useful to forecast the extent of the public health risks of the epidemics, thus improving public policy-making aimed at reducing such risks.
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INTRODUCTION: The coronavirus disease 2019 (COVID-19) caused a collapse situation in many hospitals around the world. The aim of this study is to analyse the utility of the electroencephalogram (EEG) in the management of the neurological patient during the COVID-19 pandemic. PATIENTS AND METHODS: The Clinical Neurophysiology Department of the Hospital Central de la Defensa Gomez Ulla was dissolved due to the hospital collapse situation. Therefore, the EEG was performed exceptionally in those cases with the greatest probability of providing a benefit in its management. We describe seven patients (four in ICU and three hospitalized) diagnosed with COVID-19, who underwent through an EEG. RESULTS: The EEG showed abnormalities in all cases, including one case of brain death. The EEG resulted in a change in clinical management in four of the patients (57%) and helped the clinician provide information to the family. In the other three cases, a toxic-metabolic origin was suspected before the EEG was performed, so it did not imply a change in the clinical management already proposed, although it facilitated a prognostic orientation. Slow polymorphic waves were evident in five cases. Five patients were unresponsive. Currently, one patient remain hospitalized and four have died. CONCLUSIONS: The EEG was useful and facilitated decision making in COVID-19 patients in whom it was requested. It guided the diagnosis in cases where CT was non-contributory and led to a change in therapeutic management in most patients. The most frequent findings were signs of encephalopathy and epileptiform discharges.
TITLE: Utilidad y valor pronóstico del electroencefalograma en la COVID-19 y la encefalopatía: patrones electroencefalográficos en una serie de casos.Introducción. La enfermedad por coronavirus 2019 (COVID-19) causó el colapso de muchos hospitales. El objetivo de este estudio es analizar la utilidad del electroencefalograma (EEG) en el tratamiento del paciente neurológico durante la pandemia de COVID-19. Pacientes y métodos. El Servicio de Neurofisiología Clínica del Hospital Central de la Defensa Gómez Ulla fue disuelto debido a la situación de saturación hospitalaria. En consecuencia, se realizó un EEG excepcionalmente a los pacientes a los que tenía mayor probabilidad de aportar un beneficio en su tratamiento. Se describen siete pacientes (cuatro en cuidados intensivos y tres hospitalizados) diagnosticados con COVID-19 a quienes se les realizó un EEG. Resultados. El EEG mostró anormalidades en todos los casos, incluyendo un caso de muerte cerebral. El EEG supuso un cambio en el tratamiento clínico en cuatro de los pacientes (57%) y ayudó al clínico a informar a la familia. En los otros tres casos, se sospechó un origen tóxico-metabólico previo al EEG, por lo que no implicó un cambio en el tratamiento ya propuesto, aunque facilitó una orientación pronóstica. Se evidenciaron ondas lentas polimorfas en cinco casos. Actualmente, un paciente permanece hospitalizado y cuatro han fallecido. Conclusiones. El EEG fue de utilidad y facilitó la toma de decisiones en los pacientes con COVID-19 en los que se solicitó. Orientó al diagnóstico en casos en los que la tomografía computarizada no contribuyó y supuso un cambio en el tratamiento terapéutico en la mayoría de los pacientes. Los hallazgos más frecuentes fueron signos de encefalopatía y descargas epileptiformes.
Subject(s)
COVID-19/physiopathology , Electroencephalography , Encephalitis, Viral/diagnosis , SARS-CoV-2/isolation & purification , Aged , COVID-19/complications , COVID-19/diagnosis , COVID-19 Nucleic Acid Testing , Comorbidity , Consciousness Disorders/etiology , Consciousness Disorders/physiopathology , Encephalitis, Viral/etiology , Female , Heart Arrest , Humans , Male , Middle Aged , Movement Disorders/etiology , Movement Disorders/physiopathology , Nasopharynx/virology , Pandemics , Prognosis , Retrospective StudiesABSTRACT
Study Objectives: The COVID-19 pandemic placed enormous stress on hospital infrastructure, particularly with regard to bed availability. We adopted a novel clinical pathway to discharge mild to moderately ill patients with Telehealth Follow-up and Remote Patient Monitoring (TFRPM). The objective was to describe the impact of a novel clinical pathway for outpatient telehealth follow-up of patients with presumptive or confirmed COVID-19 discharged from the emergency department (ED). Methods: The clinical pathway allowed patients with presumptive or confirmed COVID-19 disease to be discharged home if they had in-home support and consented to early telehealth follow-up with remote patient monitoring. Patients were eligible for TFRPM if they had a RR<22 AND an exertional oxygen saturation (eO2sat) of 90% or above after treatment and observation. Telehealth visits were performed at least once daily for up to seven days. Patients with an eO2sat of between 92% and 95% were discharged with pulse oximeters (PO) and those with eO2sat between 92% and 90% were given PO and oxygen concentrators (OC) (FIO2 up to 3 l/m). All telehealth visits were performed by providers trained to gauge both subjective and objective measures of disease progression (symptoms, O2 sat, HR, RR). Patients were followed until disease resolution or referral to the ED. We performed a retrospective review of data collected for quality assurance purposes. Trained abstractors performed chart review and data collection. The primary outcome measure was ED revisit. Secondary measures included: disease course, hospital LOS, ICU requirements, respiratory support, mortality and loss to follow-up (LTFU). Descriptive statistics were used to analyze the extracted data. 10% of charts were reviewed by an independent reviewer for data quality assurance. We report a sensitivity analysis accounting for those lost to follow-up and projected cost-effectiveness. Results: From March-April of 2020, we discharged 488 presumed or confirmed COVID-19 patients with TFRPM. Of these patients, 155 were discharged with PO, and 86 were discharged with PO+OC for home use. First (12-24 hour) telehealth contact was successful in 81.7%, 90.3% within 3 days and 9.7% were LTFU. There was a total of 1,431 telehealth follow-up visits. Ninety patients (18.4%) returned or were referred to an ED a median of 3 days (IQR: 2.0 to 6.0 days) after index visit;43 (8.8%) were admitted to the hospital’s general medical floor. Two of these patients were transferred to ICU within 24 hours and both died 5 days after admission;5 others were transferred to ICU and intubated more than 24 hours into their hospitalization and 4 expired (1 patient 9 days later, 2 patients 10 days later, and 1 patient 23 days later). The last patient recovered and was discharged after 7 days of ICU care. The mortality rate for this cohort was 1.2%. The telehealth program cumulative costs of were $621,800, including charges attributed to their actual admissions, were substantially less than the projected cumulative mitigated hospitalization charges of $6,718,296 (IQR: $4,767,344;$9,902,496). Conclusion: Implementing a novel discharge and telehealth follow-up protocol for patients with presumed or confirmed COVID-19 was able to decompress our overburdened inpatient units. The addition of remote patient monitoring and oxygen support appears to be a safe alternative in mild-moderate risk discharges and may serve as an alternative to hospital admission during a crisis of pandemic proportion.