Behavioral finance: comparison of the level of financial risk aversion among healthcare professionals

Behavioral Finance is considered the new era of finance. Supported by its assumptions, this work aimed to detect and compare the levels of risk aversion in financial decisions of two groups of health professionals: one composed of those exposed to emergency situations (front line in the care of Covid-19 patients) and the other composed of those who work in non-urgent conventional hospital situations. With the application of a questionnaire to professionals from both groups, responses were obtained that made it possible to test the hypothesis that work in emergency situations generates a different influence on the feeling of risk aversion than conventional non-urgent hospital work. The results of the statistical analysis and the chi-square test revealed that there is a small difference in risk aversion between professionals in both groups, without showing, however, statistical significance. The results also revealed evidence that professionals who act/acted on the frontline against Covid19, in situations of gain, accepted to take greater risks, aiming at greater financial reward. The results also revealed evidence that professionals who act/acted on the frontline against Covid19, in situations of gain, accepted to take greater risks, aiming at greater financial reward. In situations involving losses, these same professionals were more risk averse than those in the other group.

Echocardiographic phenotype and prognostic value of relative apical sparing of longitudinal strain pattern in severe aortic stenosis with and without cardiac amyloidosis. The AMYTAVI study

Introduction: It is estimated that 15% of patients with AS have concomitant cardiac amyloidosis (CA). Left ventricular (LV) longitudinal strain (LS) pattern with relative apical sparing (RELAPS>1), shown as bright red in the apical segments on the polar map, has been strongly associated with CA. Its presence and its significance in AS is yet to be determined. Purpose(s): To determine the prevalence of the RELAPS>1 pattern in patients with severe AS with and without concomitant CA, and to analyze the echocardiographic phenotype associated with this strain pattern and its prognostic value. Method(s): Patients with severe symptomatic AS undergoing TAVI were prospectively and consecutively included between Jan-19 and Dec-20. Pre-procedure, a complete echocardiogram was performed that included deformation parameters using Speckle-Tracking. Strain derived Indices accepted for CA screening were calculated: RELAPS: Relative apical LS (average apical LS/average basal+mid LS);SAB: (apical-septal/basal-septal LS);EFSR: (LVEF/GLS). After TAVI, a 99Tc-PYP scintigraphy and a proteinogram were performed to screen for CA. Result(s): 324 patients were included. The mean age was 81 yo, 52% women. Strain analysis could be performed in 243 patients due to acoustic window and covid19 pandemic restrictions. Among those, 111 (46%) presented relative apical sparing (RELAPS>1). There were no differences in clinical characteristics between patients with RELAPS <1 and >1: Similar age, sex, cardiovascular risk factors and funcional class, renal function or NT-proBNP. Among patients with RELAPS>1 there was more frecuently CA with uptake grade 2 and 3 on scintigraphy (15% vs. 4.5%, P=0.006) (Figure 1). RELAPS>1 group showed greater LV hypertrophic remodeling: Thicker myocardial wall with smaller ventricular cavity, especially concentric hypertrophy;LVEF and GLS was similar, however, MAPSE and myocardial contraction fraction (MCF) were worse in RELAPS >1 group, and EFSR was significantly higher (4.2 vs 3.9, p=0.002). RELAPS >1 group had smaller aortic valve area (AVA: 0.6 vs 0.7 cm2, p=0.045), but similar transvalvular gradients due to lower stroke volume. It had larger atria and less left atrial (LA) fractional emptying, as well as higher prevalence of atrial fibrillation (AF: 41% vs 27%, p=0.03). Right ventricle (RV) size were similar, however, RV function was worse in RELAPS >1 group (TAPSE: 19 vs 21 mm, p=0.003;free Wall LS: -24 vs -27%, p=0.008). There was no difference in all-cause mortality at 1 year of follow-up between groups (6.4% vs. 6.3%, p=1). Figure 2 represents the morphological characteristics according to the LS phenotype. Conclusion(s): In severe AS, RELAPS >1 is present in almost half of the patients. It is associated with worse cardiac remodeling, as well as higher prevalence of AF. However, it wasn't associated with higher mortality at 1 year. 1 in 7 patients with AS and RELAPS >1 have concomitant ATTR CA grade 2/3.

Pandemic and virtuality in higher education: Study of initial expectations in university students

The study was carried out to determine differences in relation to expectations of virtuality due to pandemic in students of a public university. The results show significant differences taking into account gender (women indicated a greater inclination for visual tools), semester (students from the first and last semester had higher expectations compared to their colleagues from intermediate semesters) and level (there was more preference for educational tools linked to social networks in undergraduate students). This demonstrates the importance of adapting the training according to the needs, desires and interests of the students for a greater success of the process. © GKA Ediciones, authors. Creative Commons Reconocimiento-NoComercial-SinObraDerivada.

Bachelor of science students' perception of online classes during COVID-19 pandemic. A look at the e-learning process in Chile

The arrival of covid-19 in Chile caused an enormous change in its education system, strict confinement measurements were taken by the government which obligated students to continue their studies from in-person classes to online classes. The purpose of this study is to reveal the Bachelor of Science students' perception of their online education prosses during 2020 and 2021 at the University Santo Tomás. A qualitative questionary of 32 questions was used to obtain and quantify the results. The results show that online education during pandemic times generated a range of factors such as stress, internet connection problems, access to technology and a lack of learning. © GKA Ediciones, authors.

Postnational Genres: A “Story” of Lyricism From North America to the Iberian Peninsula Heretofore: A Study of Anne Carson and Julio Llamazares

This chapter discusses how lyricism is present in contemporary prose and identifies rhythms and repetitions in Cassandra Float Can by Anne Carson from North America and Primavera extremeña by Julio Llamazares from the Iberian Peninsula, to show their key role in enabling a synchronic process in the recalling and calling of memory, both personal and historical, in the context of the COVID-19 pandemic. It claims that lyricism’s fundamental presence is increasingly free from national boundaries and literatures. © 2022 selection and editorial matter, Christopher J. Castañeda and Miquel Bota;individual chapters, the contributors. All rights reserved.

European Criminal Bar Association statement of principles on the use of video-conferencing in criminal cases in a Post-Covid-19 World1

This is a statement by the European Criminal Bar Association on the use of Video-Conferencing in Criminal Cases in a Post-Covid-19 World. It addresses the topic using a two-fold distinction between the use of remote hearings in domestic and in cross-border cases, on one hand, and the use of such of remote technology for conducting interviews of the suspect or accused in the pre-trial stages or at trial hearings, on the other hand. Recognising that these distinctive settings impact differently upon the seriousness of the interference with the fair trial rights and the rights of defence of the suspect or accused, and also upon the circumstances that must be weighed in order to assess whether restrictions are proportionate, adequate and necessary, the European Criminal Bar Association assesses whether the use of remote technologies in those different settings is acceptable and outlines proposals for further action in the field. © The Author(s) 2021.

The utilization of Landsat imagery for valuing forest environmental service in controling pneumoia incidence rate under the scenario of global warming: study at Lampung Province_sumatera

Since the last decade, prior to the emergence of COVID-19, the incidence of pneumonia, pneumonia in Indonesia has steadily increased (Minister of Health RI, 2020) along with deforestation phenomenon (Adhyaksa et al, 2019) and global warming (Mirsaeidi et al, 2016). Forest recovery ecosystem is a must to negate this disease. This research was conducted on determining the economic value of the ecosystem service to compensate reforestation program. This research was conducted in Lampung Province started from May to October 2021, by utilizing of Landsat imagery series of 2009, 2012, 2015, 2018, and 2019 for detecting forest covers. The effect on the incidence of pneumonia was determined using multiple linear regression models and to make some simulations work for estimating the reforestation costs. The results prove that the increasement air temperature, and the changes area of state forests, people's forests, bare land, plantations, and urban areas affect the incidence of pneumonia significantly. The determination of the value of environmental services for public costs is required at IDR 942,227,915,- from the maintenance cost of IDR 249,216,000, the cost of reforestation at the state forest area of 5,907,792 Ha and the people's forest of 6,040,689 Ha in case the air temperature increase up to 2 degrees C as the way to mitigate the global warming.

SARS-CoV-2 ANTIBODY RESPONSES in INDIVIDUALS FOLLOWING mRNA BOOSTER VACCINATION

Background: Two years after its onset, the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains difficult to control despite the availability of several vaccines. Progress in controlling the pandemic is complicated by the emergence of variants with antibody-resistance. Methods: Here we report on the evolution of antibody and memory B cell responses in a cohort of SARS-CoV-2 naïve individuals who received two doses of the Moderna (mRNA-1273) or Pfizer-BioNTech (BNT162b2) vaccines against SARS-CoV-2 and were boosted with a third mRNA vaccine dose thereafter. Results: Plasma neutralizing antibody titers in individuals vaccinated with two mRNA vaccines doses decrease over time, but can be restored by a third, i.e., a booster dose. A third vaccine dose also results in dramatically increased plasma neutralizing activities against viral variants, including the delta and omicron variants. Boosting vaccinated individuals also increases the number of RBD-specific memory B cells, which display clonal turnover after the third dose of the vaccine. The mononclonal antibodies generated by those cells have greater somatic hypermutation and increased neutralizing activity when compared to antibodies generated after the second dose, indicative of continued evolution of the humoral response to SARS-CoV-2. A substantial fraction of the monoclonal antibodies isolated after the third dose of an mRNA vaccine are able to neutralize pseudoviruses representing the delta and omicron variants, at low antibody concentrations. Conclusion: The data suggest that boosting vaccinated individuals with mRNA vaccines provides dramatically increased and broadened plasma neutralizing activity. This is the result of antibody evolution and the consequent production of potent and broadly active neutralizing antibodies.

Dentistry in the COVID-19 environment. adaptation of the dental health units in Madrid's public primary health centres

The COVID-19 respiratory manifestations go from mild symptoms similar to those of a common cold to severe pneumonia with respiratory distress syndrome, septic shock and multiorgan failure. The disease is caused by the SARS-CoV-2 virus, whose transmission mechanism most relevant to dentistry is through respiratory droplets and possibly also aerosols, as well as direct contact with mucous membranes of the nose, mouth or eye via contaminated hands or objects. The professionals of the dental health units have a high risk exposure since they work at short distances (less than 1 m from the head of the patient) in the oral cavity, where a maximal expression of possible cell receptors for the virus has been reported. Also, most procedures in the dental cabinet imply aerosol generation. Cross-infection is possible during dental care, not only with diagnosed COVID-19-positive patients but also with patients who remain undetected due to asymptomatic or presymptomatic disease. For all these reasons, dental care in the primary health setting has had to change in order to adapt to the pandemic. The changes affect both the appointment scheduling and the care itself and imply the establishment of general and specific barrier protections as well as measures related to ventilation, cleaning, disinfection and sterilization, reinforced with additional infection prevention and control measures. This article summarizes.

Autopsy and medical death certificates in deaths related to COVID-19

Introduction: The COVID-19 pandemic has been the largest in the current century and the reason for numerous scientific works. In Cuba, the Temporary Group of Pathological Anatomy has been established to study the autopsies of those who died from COVID-19 (more than 400). The medical death certificates, documents of inestimable value, in Cuba are repaired according to the results of the autopsies, to raise their quality. Objectives: To evaluate the results of autopsies with COVID-19 diagnoses, compared to medical death certificates. Methods: The diagnoses of causes of death of 65 autopsies of the year 2020 were evaluated with their medical death certificates. The diagnoses were processed in the Automated System for the Registration and Control of Pathology. Direct causes of death, basic causes of death, intermediate causes of death, and contributing causes of death were analyzed. The total agreement of both diagnoses was defined, partial agreement, diagnostic mismatch or discrepancy, and insufficient data. Results: Diagnostic discrepancies of basic and direct cause of death are 46.2 % and 60.0 % of all cases and 19.4 % and 64.5 % when COVID-19 was basic cause of death. The high figures for diagnostic discrepancies correspond to those reported in previous studies, both in clinical diagnoses and in medical death certificates. Conclusions: There are high numbers of diagnostic discrepancies compared with the results of autopsies with COVID-19 diagnoses, compared to medical death certificates. © 2021, Editorial Ciencias Medicas. All rights reserved.

[Evolution and quality of life at three months after hospitalization for COVID pneumonia]. / Evolución y calidad de vida a los tres meses tras hospitalización por neumonía COVID.

OBJECTIVE: Assess clinical evolution and health-related quality of life at three months after discharge in patients who were admitted and diagnosed with COVID-19 pneumonia, evaluated by the Rehabilitation Service and received physiotherapy in Fuenlabrada Hospital. METHODS: Data were collected from 59 patients, separating those who were assessed in ICU (41 patients) from those assessed in the hospital ward (18). Data were obtained from their Electronic Medical Record, and a telephone interview was performed three months after their discharge. Data about their clinical progress during their hospitalization, after discharge, over the next months and their condition at the time of the interview is analyzed. Patients were asked to assess the quality of the physiotherapy received and to answer the SF-36 health-related quality of life questionnaire. RESULTS: These patients had the worst progress of the COVID pneumonia among all patients hospitalized in our hospital, but they had a good functional recovery with the inpatient physiotherapy received, which was positively rated. After three months, 84% have persistent symptoms, with the most common being dyspnoea, fatigue and anxiety/depression, and score worse in the SF-36 questionnaire than the reference population. CONCLUSIONS: Most patients who require rehabilitation during their COVID pneumonia admission have persistent symptoms and perceive a deterioration in their health-related quality of life after three months of discharge.

Evolución y calidad de vida a los tres meses tras hospitalización por neumonía COVID Evolution and quality of life at three months after hospitalization for COVID pneumonia

Objetivo Conocer la evolución y calidad de vida relacionada con la salud a los tres meses del alta, en pacientes que fueron hospitalizados en el hospital de Fuenlabrada con diagnóstico de neumonía por COVID-19, valorados por el Servicio de Rehabilitación y que realizaron fisioterapia. Métodos Se recogen datos de 59 pacientes, diferenciando los que fueron valorados en UCI (41 pacientes), de los valorados en planta de hospitalización (18). Los datos se toman de su historia clínica electrónica, y se realiza una entrevista telefónica tres meses después del alta hospitalaria. Se analizan datos de su evolución durante hospitalización, tras el alta y durante los meses siguientes, y de su situación en el momento de la entrevista. Se pide a los pacientes una valoración de la fisioterapia recibida y que contesten el cuestionario de calidad de vida relacionado con la salud SF-36. Resultados Estos pacientes han tenido la peor evolución de su neumonía COVID de entre los ingresados en nuestro hospital, pero tuvieron una buena recuperación funcional con la fisioterapia intrahospitalaria recibida, la cual fue valorada muy positivamente por los pacientes. Después de tres meses, el 84% tienen síntomas persistentes, siendo los más frecuentes disnea, cansancio y depresión/ansiedad, y tienen peores puntuaciones en SF-36 que la población de referencia. Conclusiones La mayoría de los pacientes que requieren rehabilitación durante su hospitalización por neumonía COVID-19, tienen síntomas persistentes y perciben un deterioro de su calidad de vida relacionada con la salud, tras tres meses del alta hospitalaria.

Fast track triage for COVID-19 based on a population study: The SODA score

Background: Healthcare systems are under prominent stress due to the COVID-19 pandemic. A fast and simple triage is mandatory to screen patients who will benefit from early hospitalization, from those that can be managed as outpatients. There is a lack of all-comers scores, and no score has been proposed for western-world population. Aims: To develop a fast-track risk score valid for every COVID-19 patient at diagnosis. Methods: Single-center, retrospective study based on all the inhabitants of a healthcare area. Logistic regression was used to identify simple and wide-available risk factors for adverse events (death, intensive care admission, invasive mechanical ventilation, bleeding >BARC3, acute renal injury, respiratory insufficiency, myocardial infarction, acute heart failure, pulmonary emboli, or stroke). Results: Of the total healthcare area population, 447.979 inhabitants, 965 patients (0.22%), were diagnosed with COVID-19. A total of 124 patients (12.85%) experienced adverse events. The novel SODA score (based on sex, peripheral O2 saturation, presence of diabetes, and age) demonstrated good accuracy for adverse events prediction (area under ROC curve 0.858, CI: 0.82-0.98). A cut-off value of <2 points identifies patients with low risk (positive predictive value [PPV] for absence of events: 98.9%) and a cut-off of >5 points, high-risk patients (PPV 58.8% for adverse events). Conclusions: This quick and easy score allows fast-track triage at the moment of diagnosis for COVID-19 using four simple variables: age, sex, SpO2, and diabetes. SODA score could improve preventive measures taken at diagnosis in high-risk patients and also relieve resources by identifying very low-risk patients.

Epidemiological characterization of exposures to chlorine dioxide/sodium chlorite in the context of the COVID-19 pandemic: report of poison control centers in Latin America

The Poison Control Centers in Latin America, in the context of COVID-19 pandemic, received a series of calls for consultations and recommendations related to the use of chlorine dioxide/sodium chlorite, in the treatment or prevention of COVID-19. Under current legislation in Latin America, no pharmaceutical products are registered for use in humans that contain chlorine dioxide or sodium chlorite, nor is there evidence of sanitary registries in Europe, Canada, or the United States for this purpose. This publication compiles the information registered by eight Poison Control Centers that correspond to the same number of Latin American countries. Sex, age, symptoms, circumstance, and degree of severity of the 56 cases of patients poisoned with chlorine dioxide/sodium chlorite registered in the period from March 15th to September 30th, 2020 were identified. The results obtained confirm that the most common cause of poisoning was unintentional misuse, all of which occurred at home or its surroundings, with the highest percentage of registered cases being young adults between 30 and 49 years old. The most frequent symptoms of intoxication were gastrointestinal, followed by cardiovascular and respiratory. The route of exposure in most cases was oral, with some cases reported by inhalation;48.2% of the cases were of moderate, severe, or fatal (3 deaths). This study contributes to the generation of relevant information for different health authorities, ministries of health, entities in charge of inspection, surveillance, and control in countries where these products are illegally marketed through social networks and promoted for use in humans to prevent or cure COVID-19.

The effects of COVID-19 on the reasons for not calling 911 for acute stroke

Objective: Our Stroke Program regularly provides community outreach and stroke education. The stroke team educates on signs and symptoms of stroke, risks factors, and 911 activation. Within a few days of discharge, Neuroscience nurses call stroke patients to ensure patients have obtained their prescription medications, have follow-up appointments, inquire about their satisfaction with our services, and reinforce stroke education. As part of these calls, our team asked why patients/families did not call 911. The purpose of this study was to determine if the COVID-19 crisis influenced the reasons why 911 was not called for possible stroke to better plan for targeted stroke education. Method: Discharge phone survey data from our stroke network was collected from Feb-Jul 2019 and compared to Feb-Jul 2020. Our stroke network includes 1 comprehensive stroke center and 2 primary stroke centers. Emergency Department (ED) stroke activation data was gathered for the same time periods. Discharge phone calls data was based on discharge date, whereas ED stroke alert data was based on admission date. Results: There was a notable decline in stroke volume between 2019 to 2020 with the largest decline occurring during the first peak (Apr 2020) in COVID-19 cases within our state. This decline was driven by a 16% decline in walk-in ED stroke arrivals as compared to a 1% decline in EMS stroke arrivals. Of those who did not call 911 in 2020, there was a 7% increase in failing to recognize stroke symptoms as an emergency, a 6% increase in concern about EMS cost, and 6% decrease in hospital preference. Conclusion: The COVID-19 crisis negatively influenced stroke volumes within our system strokeprogram. Reductions in stroke walk-ins accounted for this decline. COVID-19 affected the reasonswhy 911 was not called. The largest increase was in not recognizing stroke symptoms as anemergency and increased concern about EMS associated costs. Surprisingly, COVID-19 was notlisted as a reasons for avoiding 911. Targeted community educational efforts on these concerns maylead to improved 911 usage for suspected stroke during the COVID-19 pandemic.

Telehealth Simulation of Psychiatric and Chronic Disease Comorbidity: Response to the COVID-19 National Epidemic

Background: Health care education, including simulations, has been disrupted by COVID-19, challenging educators to devise innovative ways to continue instruction. Methods: We conducted a pilot study to explore student perceptions of utilizing telehealth technology to manage the crisis care of psychiatric patients in the COVID-19 pandemic. Students were asked to complete an online open-ended survey on their perspectives regarding the use of telehealth as a delivery mechanism and skill in the telehealth management of comorbidities. Results: Students agreed that telehealth technology is feasible and acceptable. Because of the simulation, nursing students expressed increased openness to, interest in, and confidence in using telemedicine for the management of psychiatric patients. Conclusions: Our study shows that telemedicine simulations can improve nursing students’ comfort with and future use of telemedicine for treating psychiatric patients. © 2021

Impact of COVID-19 confinement on quality of life and mental health

Introduction: The SARS-Cov-2 pandemic has had a negative impact on multiple aspects of human life, both physical, psychological, economic, social and cultural. Quality of life conditions are associated with confinement and freedom to go out, to spend time with friends or family, or to carry out activities;so they are deprived of most of their social interaction. The objective of this present article is to provide information on how confinement and social isolation due to the pandemic affects quality of life and mental health