Comprehensive micropollutant characterization of wastewater during Covid-19 crisis in 2020: Suspect screening and environmental risk prioritization strategy.

Micropollutants monitoring in wastewater can serve as a picture of what is consuming society and how it can impact the aquatic environment. In this work, a suspect screening approach was used to detect the known and unknown contaminants in wastewater samples collected from two wastewater treatment plants (WWTPs) located in the Basque Country (Crispijana in Alava, and Galindo in Vizcaya) during two weekly sampling campaigns, which included the months from April to July 2020, part of the confinement period caused by COVID-19. To that aim, high-resolution mass spectrometry was used to collect full-scan data-dependent tandem mass spectra from the water samples using a suspect database containing >40,000 chemical substances. The presence of > 80 contaminants was confirmed (level 1) and quantified in both WWTP samples, while at least 47 compounds were tentatively identified (2a). Among the contaminants of concern, an increase in the occurrence of some compounds used for COVID-19 disease treatment, such as lopinavir and hydroxychloroquine, was observed during the lockdown. A prioritization strategy for environmental risk assessment was carried out considering only the compounds quantified in the effluents of Crispijana and Galindo WWTPs. The compounds were scored based on the removal efficiency, estimated persistency, bioconcentration factor, mobility, toxicity potential and frequency of detection in the samples. With this approach, 33 compounds (e.g. amantadine, clozapine or lopinavir) were found to be considered key contaminants in the analyzed samples based on their concentration, occurrence and potential toxicity. Additionally, antimicrobial (RQ-AR) and antiviral (EDRP) risk of certain compounds was evaluated, where ciprofloxacin and fluconazole represented medium risk for antibiotic resistance (1 > RQ-AR > 0.1) in the aquatic ecosystems. Regarding mixture toxicity, the computed sum of toxic unit values of the different effluents (> 1) suggest that interactions between the compounds need to be considered for future environmental risk assessments.

ANALYSIS of the ACCEPTANCE and USEFULNESS of A NON-PRESENTIAL CONSULTATION, in PATIENTS with CHRONIC INFLAMMATORY JOINT DISEASES USING A DIGITAL PLATFORM

Background: The Covid-19 pandemic has meant a modifcation of the patterns of the doctor-patient relationship, favoring online visits and reducing face-to-face visits. Likewise, the implementation of Patient-Reported Outcomes (PROs) that do not require the intervention of the doctor in our clinical practice and that given their close relationship with the clinical activity of chronic infammatory joint diseases (CIJD) has favored an empowerment of patients and can allow the development of the online visit. Objectives: Know the use and acceptance of patients with CIJD: rheumatoid arthritis (RA), psoriatic arthritis (PsA) and spondyloarthropathies (SpA) of a non-face-to-face online visit, through a digital environment. Methods: Patients were included in a platform called Rheumanet for access by username and passwords (https://www.laconsultacercadetI.com/). At the time of inclusion, demographic variables were collected: date of birth, sex, level of education (primary education, secondary education, vocational training, further education and higher education), distance from the hospital to the patient's home, and clinical variables such as diagnosis: RA, PsA or SpA, as well as the duration of the disease. Prior to the appointment, patients were encouraged to complete a PRO survey to assess their clinical situation: Routine Assessment of Patient Index Data 3 (RAPID3) for RA, Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) for SpA and RAPID3 and/or BASDAI for the PsA. Both the RAPID3 and BASDAI were scored for the patient's knowledge and assigned to a color scale based on disease activity in green (remission or low activity), orange (moderate activity) or red (severe activity). Likewise, they were ordered to express through a free text what they would tell us as if they were in a face-to-face consultation. Complementary tests (analytical, radiological studies and others) are obtained simultaneously from the medical records and a joint assessment of the visit is carried out. Results: Between September 1, 2020 and January 31, 2022, a total of 248 patients (113 RA, 53 SpA and 82 PsA) were included in the platform. 172 (69.3%) patients used the digital platform and made at least one non-face-to-face visit during follow-up. The number of online visits made by each patient ranged from 1 to a maximum of 13 visits. 80 patients (70.7%) suffered from RA, 40 (75.4%) from SpA and 52 (63.4%) from PsA. The number of patients who made non-face-to-face visits was 38 (72.3%) for a disease duration of <5 years and 137 (64.5%) for >5 years. When the ages of the patients were analyzed, the number of patients who made visits was 75 (73.5%) between 18 and 30 years old, 50 (67.7%) between 30 and 50 and 47 (66.4 %) from 50 years. According to the degree of activity of the disease, 75 patients were in remission or low activity at some point during the visits, 63 patients with moderate activity and 34 with severe activity. The distribution according to level of education was: 11 (6.3%) primary education, 21 (12.2%) secondary education, 37 (21.5%) vocational training, 63 (36.6%) further education and 40 (23.2%)higher education. The number of online visits was higher in patients who lived at a distance of 50 km or more from the hospital, reaching 100% of the visits in this subgroup of patients. Conclusion: The online visit through a digital platform through PROs is well accepted by our population with CIJD, especially in the young population, with a higher cultural level and whose home is far from the hospital. The online visit was made by patients regardless of the severity of their disease activity. Speed and ease of use using PROs already known to the patient and clinician is an important consideration for rheumatolo-gists working in healthcare systems where patient contact time is limited. It would be interesting to obtain this information in non-pandemic situations such as COVID-19, which would make it possible to assess actual acceptance and its use in this type of patient in circumstances in which fear of contagion is not a variabl to consider.

Methodological Adaptations and Virtual Ethnography in a Research on Psychosocial Professionals in Justice: The Challenges of Learning by Doing

This article analyzes an experience of methodological adaptation, implemented in a research study carried out in the midst of a health crisis caused by the COVID-19 pandemic. The purpose of our study was to analyze the interactions between psychosocial and legal professionals in justice institutions in two Chilean regions, using a face-to-face and in situ ethnographic methodological design. However, as a result of the change in working conditions brought about by the restrictions on people’s mobility and presence in these environments, we found it necessary to evaluate how to continue the ethnographic work under these limitations. Through constant reflection and analysis of our experiences in implementing this research, we designed a virtual ethnography that addressed both synchronous and asynchronous instances. We conclude that the use of virtual methodologies renders the rapport with the informants fundamental for the dialectic reconstruction of the story, where, as suggested by Tim Ingold, field notes are a key factor to build the atmosphere. We also highlight the importance of making methodological instruments more flexible and of constantly considering ways of adapting them to contexts of restricted on-site and face-to-face access. Finally, this article contributes to discussions on virtual ethnographies insofar as it presents a possibility to discover new ways of conducting ethnography in multisite contexts and in crisis. Many of these, we believe, will remain and will be an integral part of research work. © 2022, Universidad de los Andes, Bogota Colombia. All rights reserved.

Service Design to Balance Waiting Time and Infection Risk: An Application for Elections During the COVID-19 Pandemic

The COVID-19 pandemic has caused great disruption to the service sector, and it has, in turn, adapted by implementing measures that reduce physical contact among employees and users;examples include home-office work and the setting of occupancy restrictions at indoor locations. The design of services in the context of a pandemic requires balancing between two objectives: (i) special measures must be implemented to maintain physical separation among people to reduce the risk of infection, and (u) these sanitary measures also reduce process capacity, thereby increasing the waiting times of users. We study this problem in the context of election processes, in which balancing waiting time with public safety is of first order relevance to ensuring voter turnout, using as a real-world application the Chilean 2020 national referendum. Analyzing this problem requires a multidisciplinary approach that consists of integrating randomized experiments to measure how voters weigh infection risk relative to waiting time and stochastic modeling/discrete event simulation to prescribe recommendations for the service design-specifically setting capacity limits to trade off between overcrowding and process efficiency. Overall, our results shows that infection risk is an important factor affecting voter turnout during a pandemic and that capacity limits can be a useful design tool to balance these risks with other service quality measures. Some of these findings were considered in the guidelines that Servel provided to manage capacity and voter arrival patterns at voting centers.