Assessment of the Level of Physical Activity and Physical Fitness in a Sample of University Students. Comparison after the Covid-19 Pandemic

The transition from secondary education to university education has become a critical moment for the lifestyle of young people, especially for the practice of physical activity. Therefore, the main objective of the present study was to assess the levels of physical activity in university students, by correlating the results of the IPAQ-SF and the different physical fitness variables (Eurofit). The sample consisted of 194 students of the Primary Education Degree, with a mean age of 21.37 +/- 2.66 years. The main results obtained reflect the direct relationship between the practice of physical activity in general, and vigorous physical activity in particular, and optimal physical fitness of university students, linked above all to the strength component. As for the comparison between prepandemic ( 18/19) and post-pandemic (21/ 22) university students, the increase in physical activity after the pandemic did not show substantial differences in the physical fitness components. In conclusion, these results should lead us to reflect on the influence of an active lifestyle on physical fitness, which has an impact on overall health status and quality of life.

Implementing a Curriculum on Disaster Behavioral Health in a Psychiatry Residency Program

Background: Disasters are broadly defined as “encounters between forces of harm (hazards), and a vulnerable human population in harm's way, that create demands exceeding the coping capacity of the affected community,” (Shultz, 2014). Disasters predictably produce behavioral and psychosocial consequences;in fact, more survivors are affected psychologically than are harmed physically. Type of disaster event, severity and duration of exposure, geographic scope, and extremity of resource losses contribute to distress and diagnosable psychopathology. For persons currently undergoing treatment for disease, injury, or life-changing medical condition, exposure to a disaster may complicate their care, exacerbate their condition, threaten their survival, and trigger psychological reactions. The ongoing COVID-19 pandemic has increased baseline population prevalence rates of common mental disorders worldwide, thereby compounding risks for psychopathology among persons whose communities are affected by disaster. The current era, marked by layered stressors, creates a compelling impetus to train upcoming psychiatrists on skills to support disaster survivors, including those with special needs. We are designing and implementing a curriculum to teach the principles of disaster behavioral health to our psychiatry residents based aligned with national guidelines (Flynn and Morganstein, 2020). Method: An electronic survey was distributed to psychiatry residents to assess their current knowledge and skill levels for performing key actions when dealing with disaster survivors, post-impact. Residents were asked to rate their current knowledge regarding disaster behavioral health principles, their confidence for providing psychological support to disaster survivors, and their interest in evidence-based disaster behavioral health training, grounded on national recommendations. Interested residents will participate in an expert-led lecture series that will include pre- and post-training assessment of disaster behavioral health knowledge and skills. Results: The initial interest survey garnered a 40% resident response rate. Apart from rating their ability to “gather information in a disaster situation” at 4-of-5, most residents rated their current knowledge levels and confidence in their skills to provide support to disaster survivors at 2-of-5 or below. Regarding interest in a disaster behavioral health lecture series, 86% indicated they would be interested. Pre- and post-training assessment are pending the delivery and completion of the lecture series. Discussion: Initial resident survey results demonstrate limited knowledge of disaster behavioral health principles, low levels of confidence in skills to support the psychological needs of survivors, and strong interest in receiving training. Conclusion: We will proceed to develop a robust disaster behavioral health training curriculum for our residents, starting with a lecture series featuring experts in the field and rapidly expanding to skills training and real-world disaster deployment/response opportunities. References: 1. Flynn BW, Morganstein JC. Curriculum Recommendations for Disaster Health Professionals: Disaster Behavioral Health, Second Edition, 2020. 2. https://www.usuhs.edu/sites/default/files/media/ncdmph/pdf/ncdmph_csts_revised.pdf 3. Shultz JM. Perspectives on disaster public health and disaster behavioral health integration. Disaster Health. 2014;2(2):69-74.

Academic Satisfaction of Internal Medicine Postgraduate Students during the SARS-CoV-2 Pandemic

Introduction: During the SARS-CoV-2/COVID-19 pandemic, adjustments to academic activities have been implemented, in order to include virtual components. The impact on student satisfaction regarding their medical education is unknown, especially in postgraduate programs. Objective: To assess the satisfaction of residents in relation to theoretical and practical components, as well as their perception of change. Methods: The Department of Internal Medicine of Pontifical Xavierian University and San Ignacio University Hospital, in Bogotá, Colombia, have changed multiple theoretical academic activities into virtual modalities. They modified healthcare activities and used technological platforms that allowed the remote participation of residents or professors. A survey was designed for assessing the satisfaction of residents in relation to the theoretical and practical components, as well as their perception of change. Results: Forty-eight residents answered the survey. More than 72% reported being partially or totally satisfied with organization, with the content of the activities, with the interdisciplinary approach, and with the opportunity to discuss topics for theoretical activities. Regarding assessment of healthcare activities, 21.9% of the residents manifested that they were not satisfied with the training that they received for clinical practice and professional life, while 31.3% manifested their dissatisfaction with the interdisciplinary approach or with the time allotted to discuss cases. 72.9% were satisfied with the technological tools used. The level of perceived stress worsened for 62.5% of the respondents, while the opportunity to develop and practice skills worsened for 64.6% of those surveyed. Conclusions: Despite the high satisfaction with the theoretical activities and the technological tools used, residents consider that the implementation of remote academic activities is associated with higher levels of stress and fewer opportunities to develop and practice clinical skills. © 2021, Editorial Ciencias Medicas. All rights reserved.

TIME IN RANGE AFTER 1 YEAR USING TELEHEALTH IN TYPE 1 DIABETES TREATED WITH HYBRID CLOSE LOOP THERAPY DURING THE COVID-19 PANDEMIC

Background and Aims: Literature supports efficacy and safety of Hybrid Close loop (HCL) system in type 1 diabetes (T1D) patients. Limited data are available showing the short and long-term outcomes of telehealth. Our study described efficacy and safety of HCL system at one year of follow-up through telehealth during COVID-19 pandemic. Methods: A prospective observational cohort study including T1D patients previously treated with multiple doses of insulin or sensor augmented pump therapy started on HCL system during COVID-19 pandemic. Virtual training and follow-up were done through telehealth. CGM data were analyzed to compare the time in range (TIR), time below range (TBR) and glycemic variability, GMI at base line, 3,6,9 and 12 months of virtual follow-up. Use of automatic mode (AM) was also evaluated. Results: 134 patients were included (54.9% female, baseline A1c 7.66% ± 1.15). 48.8% hypoglycemia was the main indication of HCL therapy. 32.6% had hypoglycemia unawareness and 40.5% had ≥1 severe hypoglycemia event in the last year. TIR at the end of the virtual training was 78 ± 0.14%. After 3,6,9 and 12 months of follow-up TIR was 78.5%, 77.6%, 76.8% and 77%, respectively. Coefficient of variation was 31.4 ± 6.05% at 12 months. TBR <70mg/dl and <54mg/dl was 2.39 ± 0.14% and 0.54 ± 0.07%, respectively. Use of AM was 80.7 ± 24.7% and percentage of use of sensor was 90.3 ± 7.3%. No severe adverse events were reported. Conclusions: HCL systems allows T1D patients to improve TIR, TBR and glycemic variability independently of previous treatment. Long term follow-up through virtual modality allows to maintain TIR with low TBR and adherence to AM of 80%.

Decreasing Loneliness and Social Isolation during the COVID Pandemic using Cancer Support Services: Case Study of a Geriatric Patient with Diffuse Large B-cell Lymphoma

Background/Purpose: We present a case study demonstrating how cancer support services assisted a patient diagnosed with diffuse large B-cell lymphoma (DLBCL) to cope throughout the COVID-19 pandemic. Perceived social isolation and loneliness were exacerbated for this patient due to the interaction of 1) cancer diagnosis, 2) COVID- 19 social distancing, 3) inability of vaccination to produce immunity to COVID-19, and 4) diminution of her social network due to aging. Methods: We summarize clinical encounters and chart review for an 88-year-old female patient (divorced, living with son) with DLBCL evaluated at a large urban university hospital to illustrate the impact of cancer support service interventions on social isolation and loneliness. Results: Systematic review revealed that interventions such as exercise, mindfulness-based practice, Tai Chi Qigong meditation, and art therapies decrease loneliness and increase perceived social support. The patient consistently observed COVID-19 social distancing precautions throughout the pandemic, receiving Pfizer vaccine immediately once available, and Moderna vaccine thereafter. However, she did not develop antibodies, reinforcing her need to strictly isolate. The patient has participated in a regimen of online cancer support activities: twice-weekly group exercise physiology sessions and gentle chair yoga sessions, twice-monthly individual exercise physiology, weekly music therapy, weekly chaplain meetings, and daily treadmill walking. She recognizes distress and anxiety as temporary feelings and understands how these support activities enhance her repertoire of coping strategies. Despite being restricted to home;she states that regular interaction with her support services team-and attentive care from her son-have decreased feelings of loneliness. Conclusions and Implications: Our patient has demonstrated resilience, overcoming the combined challenges that amplify loneliness and social isolation: DLBCL diagnosis, lack of COVID-19 antibody response, and aging. Although she is unable to socialize in person, her interactions with cancer support services staff and engagement in a suite of activities have mitigated loneliness and isolation.

Change of in-hospital mortality during the first SARS-COV-2 surge in Bogotá, Colombia

Introduction: Mortality secondary to SARS-COV 2 has decreases around the world, however this has not been evaluated in Colombia neither has the correlation between patient characteristics or treatments. Objective: To compare the mortality due to SARS-COV-2, in two periods of time, controlling risk factors associated with mortality. Methodology: Observational retrospective cohort study of patients with SARS- COV-2 treated at the San Ignacio University Hospital in Bogotá (Colombia), from March 19 to November 12, 2020. The in-hospital mortality rate of patients discharged before and after August 21, 2020 (surge mortality in Colombia) was compared. The impact of the moment of attention was analyzed controlled by comorbidities, severity at admission and treatment received using a bivariate and multivariate logistic regression model. Results: 1399 patients (944 before and 455 after August 21) were analyzed. The overall in-hospital mortality rate was similar at both times (17.6%vs16.3percentage, p=0.539). In the multivariate analysis, it was found that the moment of attention was associated with lower mortality (OR 0.66 95% CI0.47;0.93,p=0.018), in contrast to its increase associated with age (OR 1.06 95% CI 1.05;1.07,p=<0.001), male sex (OR 1.84 95%CI 1.33;2.54,p=<0.001), cirrhosis (OR1.89 95%CI 1.24;2.88, p=0.003), kidney disease (OR 1.36 95% CI1.00;1.83,p=0.043) and the use of dexamethasone (OR1.53 95%CI 1.03;2.28,p=0.031). Conclusions: The in-hospital mortality rate fell after August 21 during the first wave of the pandemic in Bogotá-Colombia, possibly associated with an improvement in response capacity, or a lower viral inoculum of infected patients. These findings may change with the saturation of the health system. © 2022 Asociacion Colombiana de Infectologia. All rights reserved.