Technological Devices and Digital Competences: A Look into the Digital Divides for University Continuity during the COVID-19 Pandemic

Virtual education has gained great relevance in recent years, due to the pandemic. The access to electronic devices and services represents an urgent necessity and thus the concern for acquiring digital competences, which allow a proper interaction within the teaching–learning process. Recent studies have demonstrated the importance of having digital resources and the adaptability of their use from the university students' homes during the pandemic crisis. This research intends to identify the relevant challenges regarding the accessibility to technological devices and digital competences that university students had to face to obtain suitable learning during the lockdown, due to the pandemic. The sample information consisted of 9326 Peruvian university students. The data was obtained from the National Homes Survey from the Statistics and Information National Institute, and it was distributed in twenty-five regions (in groups of five macro-regions) over a period of three years (2019–2021). The results showed significant differences in the number of students with internet access from home: between 40% and 60% access classes with a desktop or laptop, and digital competences have improved in the last year. This is evidence that digital divides set limits on the opportunities for a quality education.

El rol de la agencia de viajes ante la nueva situación post Covid-19: decálogo de propuestas para su recuperación

El impacto de la pandemia del Covid-19 está siendo devastador para el sector turístico. Las consecuencias de la pandemia empiezan a verse en forma de fusiones, cierres o adquisiciones que dejarán tras de si un nuevo panorama en el subsector de las agencias de viajes. El presente estudio tiene por objeto analizar la situación de las agencias de viajes en España y, en base a este análisis, proponer un manual de buenas prácticas para su recuperación. Mediante una encuesta en línea se contactó a un total de 726 agentes de viajes. El estudio demuestra que se percibe la situación actual como un punto de inflexión a partir del cual se debe producir un cambio en el mercado que abarca desde la innovación tecnológica hasta la comercialización de productos más sostenibles, pasando por un posible cambio de modelo de negocio. Tras la observación participativa en el sector y analizar los resultados obtenidos se propone un manual de buenas prácticas articulado en forma de decálogo que, llevado a la práctica, ayudará a garantizar el futuro de las agencias de viajes ya de por si afectado ante los cambios producidos por la aparición de nuevos actores en el área de la intermediación turística.Alternate : The Covid-19 pandemic is having a devastating impact on the travel industry. The consequences of the virus are beginning to be seen in the form of mergers, closures or acquisitions that will leave behind a new landscape in the travel agency sub-sector. This study analyses the situation of Spanish travel agencies and, on the basis of this research, proposes a manual of good practices for their recovery. A total of 726 travel agents were contacted through an online survey. The study shows that the current situation is perceived as a turning point from which a change must take place in the market, ranging from technological innovation to the marketing of more sustainable products, including a possible change of business model. After participatory observation in the sector and analysis of the results obtained, a manual of good practices is proposed in the form of a decalogue which, when put into practice, will help to guarantee the future of travel agencies, already affected by the changes brought about by the appearance of new players in the area of tourism intermediation.Alternate : A pandemia de Covid-19 está a ter um impacto devastador na indústria das viagens. As consequências do vírus começam a ser vistas sob a forma de fusões, encerramentos ou aquisições que irão deixar para trás uma nova paisagem no subsector das agências de viagens. Este estudo analisa a situação das agências de viagens espanholas e, com base nesta investigação, propõe um manual de boas práticas para a sua recuperação. Foi contactado um total de 726 agências de viagens através de um inquérito em linha. O estudo mostra que a situação actual é vista como um ponto de viragem a partir do qual uma mudança deve ter lugar no mercado, desde a inovação tecnológica até à comercialização de produtos mais sustentáveis, incluindo uma possível mudança de modelo de negócio. Após observação participativa no sector e análise dos resultados obtidos, é proposto um manual de boas práticas sob a forma de um decálogo que, quando posto em prática, ajudará a garantir o futuro das agências de viagens, já afectadas pelas mudanças provocadas pelo aparecimento de novos intervenientes na área da intermediação turística.

Effect of Working Fluid-Filling Ratio Combination on Thermosyphon Performance as Add-In Enhancer for Indoor Air Conditioning Devices

An experimental study is presented to account for the implementation of a two-phase closed thermosyphon pipe, for energy-saving purposes, in air conditioning systems in the context of COVID-19. The experimental setup consisted of a 0.5 m ×0.0127 m type L copper pipe which was employed as the body of the heat exchanger;an electric resistance heater of 0.1 m length located at the bottom;and a 0.25 m length water-cooled concentric condenser located at the top. The evaluation was conducted employing acetone, ethanol, and distilled water as working fluids;ranging the heat supplied at the evaporator from 25 to 125 W and the filling ratio from 20% to 40% of the total inner volume of the thermosyphon. From the data obtained, it was found that ethanol is the working fluid most susceptible to changes in operation conditions. Contrarily, distilled water was found to deliver consistent performance, up to a point that, for the analysed setup, it is considered to be independent of both, heat flow supplied at the evaporator and thermosyphon filling ratio. Meanwhile, acetone was found to be the only fluid tested that displays a directly proportional behaviour between heat absorption and dissipation. From compiling experimental data, response surfaces were constructed and used as direct and rough optimization tools. The information provided by this approach is considered to be particularly useful and is introduced for modelling and design purposes. Based on the results, it was found that acetone, within operation ranges of 34%<ϕ<40% and 75 W<Q˙Evap<125 W, was the most suitable working fluid to use in a two-phase closed thermosyphon for energy-saving purposes in air conditioning applications.

COVID-19 mRNA vaccine effectiveness against hospitalisation and death in veterans according to frailty status during the SARS-CoV-2 delta (B.1.617.2) variant surge in the USA: a retrospective cohort study.

Background: Studies have shown that COVID-19 vaccination is effective at preventing infection and death in older populations. However, whether vaccination effectiveness is reduced in patients with frailty is unclear. We aimed to compare vaccine effectiveness against hospitalisation and death after COVID-19 during the surge of the delta (B.1.617.2) variant of SARS-CoV-2 according to patients' frailty status. Methods: In this retrospective cohort study, we used data derived from the US Veterans Health Administration (VHA) facilities and the US Department of Veterans Affairs (VA) COVID-19 Shared Data Resource, which contains information from the VA National Surveillance Tool, death certificates, and National Cemetery Administration. We included veterans aged 19 years or older who tested positive for SARS-CoV-2 using RT-PCR or antigen tests between July 25 and Sept 30, 2021, with no record of a previous positive test. Deaths were identified through VHA facilities, death certificates, and National Cemetery Administration data available from VA databases. We also retrieved data including sociodemographic characteristics, medical conditions diagnosed at baseline, frailty score, and vaccination information. The primary outcomes were COVID-19-associated hospitalisations and all-cause deaths at 30 days from testing positive for SARS-CoV-2. The odds ratio (OR) for COVID-19-associated hospitalisation and hazard ratio (HR) for death of vaccinated patients compared with the unvaccinated patients were estimated according to frailty categories of robust, pre-frail, or frail. Vaccine effectiveness was estimated as 1 minus the OR for COVID-19-associated hospitalisation, and 1 minus the HR for death. Findings: We identified 57 784 veterans (mean age 57·5 years [SD 16·7], 50 642 [87·6%] males, and 40 743 [70·5%] White people), of whom 28 497 (49·3%) were categorised as robust, 16 737 (29·0%) as pre-frail, and 12 550 (21·7%) as frail. There were 2577 all-cause deaths (676 [26·2%] in the vaccinated group and 1901 [73·8%] in the unvaccinated group), and 7857 COVID-19-associated hospitalisations (2749 [35·0%] in the vaccinated group and 5108 [65·0%] in the unvaccinated group) within 30 days of a positive SARS-CoV-2 test. Vaccine effectiveness against COVID-19-associated hospitalisation within 30 days of a positive SARS-CoV-2 test was 65% (95% CI 61-69) in the robust group, 54% (48-58) in the pre-frail group, and 36% (30-42) in the frail group. By 30 days of a positive SARS-CoV-2 test, the vaccine effectiveness for all-cause death was 79% (95% CI 74-84) in the robust group, 79% (75-83) in the pre-frail group, and 68% (63-71) in the frail group. Interpretation: Compared with non-frail patients (pre-frail and robust), those with frailty had lower levels of vaccination protection against COVID-19-associated hospitalisation and all-cause death. Future studies investigating COVID-19 vaccine effectiveness should incorporate frailty assessments and actively recruit older adults with frailty. Funding: Miami VA Healthcare System Geriatric Research Education and Clinical Center.

Benefits of early use of high-flow-nasal-cannula (HFNC) in patients with COVID-19 associated pneumonia☆ Beneficio del empleo precoz de la oxigenoterapia nasal de alto flujo (ONAF) en pacientes con neumonía por SARS-CoV-2

Introduction Severe COVID-19 is associated with hypoxemic bilateral pneumonia that leads to mechanical ventilation in a considerable proportion of patients. To the best of our knowledge, there are no recommendations about the best time to initiate high flow nasal cannula (HFNC). Patients and methods Retrospective study of all patients admitted for COVID-19 pneumonia who required HNFO between March 2020 and February 2021. Patients were grouped in early HNFC or late HNFC, according to the modified Kirby index. Results 53 patients were included. Forty-four of them were included in the early HFNC and 9 in late HNFC. There were no statistically significant clinical-epidemiological differences. Early use of HFNC was associated with a decrease in the need for intubation (29.5 vs. 66.6%, p = 0.044), hospital stay (18.8 d vs. 36 d, p = 0.022) and mortality (22.7 vs. 55.5%, p = 0.061). Conclusions Early HFNC use is associated with a decrease in the need for intubation, mortality and overall hospital stay.

Benefits of early use of high-flow-nasal-cannula (HFNC) in patients with COVID-19 associated pneumonia.

Introduction: Severe COVID-19 is associated with hypoxemic bilateral pneumonia that leads to mechanical ventilation in a considerable proportion of patients. To the best of our knowledge, there are no recommendations about the best time to initiate high flow nasal cannula (HFNC). Patients and methods: Retrospective study of all patients admitted for COVID-19 pneumonia who required HNFO between March 2020 and February 2021. Patients were grouped in early HNFC or late HNFC, according to the modified Kirby index. Results: 53 patients were included. Forty-four of them were included in the early HFNC and 9 in late HNFC. There were no statistically significant clinical-epidemiological differences. Early use of HFNC was associated with a decrease in the need for intubation (29.5 vs. 66.6%, p = 0.044), hospital stay (18.8 d vs. 36 d, p = 0.022) and mortality (22.7 vs. 55.5%, p = 0.061). Conclusions: Early HFNC use is associated with a decrease in the need for intubation, mortality and overall hospital stay.

Introducción: La COVID-19 grave se asocia con una neumonía bilateral hipoxemiante, que desemboca en la necesidad de ventilación mecánica en un considerable número de pacientes. Hasta la fecha no existen recomendaciones acerca del momento óptimo para el inicio de la ONAF. Pacientes y métodos: Estudio retrospectivo de todos los pacientes ingresados por neumonía por COVID-19 y que precisaron ONAF entre marzo de 2020 y febrero de 2021. Se agruparon los pacientes en función del momento de inicio de la ONAF de acuerdo con la PaFi modificada. Resultados: Se incluyeron 53 pacientes, en 44 se inició la ONAF precozmente y en nueve de ellos se inició tardíamente. No existieron diferencias clínico-epidemiológicas significativas. La utilización precoz de la ONAF se asoció con una disminución de la necesidad de intubación (29,5 vs. 66,6%, p = 0,044), de la estancia hospitalaria (18,8 d vs. 36 d, p = 0,022) y de la mortalidad (22,7 vs. 55,5%, p = 0,061). Conclusiones: El empleo precoz de la ONAF se asocia con una disminución de la necesidad de intubación, de la mortalidad y de la estancia hospitalaria global.

Gap in Willingness and Access to Video Visit Use Among Older High-risk Veterans: Cross-sectional Study.

BACKGROUND: The recent shift to video care has exacerbated disparities in health care access, especially among high-need, high-risk (HNHR) adults. Developing data-driven approaches to improve access to care necessitates a deeper understanding of HNHR adults' attitudes toward telemedicine and technology access. OBJECTIVE: This study aims to identify the willingness, access, and ability of HNHR veterans to use telemedicine for health care. METHODS: WWe designed a questionnaire conducted via mail or telephone or in person. Among HNHR veterans who were identified using predictive modeling with national Veterans Affairs data, we assessed willingness to use video visits for health care, access to necessary equipment, and comfort with using technology. We evaluated physical health, including frailty, physical function, performance of activities of daily living (ADL) and instrumental ADL (IADL); mental health; and social needs, including Area Deprivation Index, transportation, social support, and social isolation. RESULTS: The average age of the 602 HNHR veteran respondents was 70.6 (SD 9.2; range 39-100) years; 99.7% (600/602) of the respondents were male, 61% (367/602) were White, 36% (217/602) were African American, 17.3% (104/602) were Hispanic, 31.2% (188/602) held at least an associate degree, and 48.2% (290/602) were confident filling medical forms. Of the 602 respondents, 327 (54.3%) reported willingness for video visits, whereas 275 (45.7%) were unwilling. Willing veterans were younger (P<.001) and more likely to have an associate degree (P=.002), be health literate (P<.001), live in socioeconomically advantaged neighborhoods (P=.048), be independent in IADLs (P=.02), and be in better physical health (P=.04). A higher number of those willing were able to use the internet and email (P<.001). Of the willing veterans, 75.8% (248/327) had a video-capable device. Those with video-capable technology were younger (P=.004), had higher health literacy (P=.01), were less likely to be African American (P=.007), were more independent in ADLs (P=.005) and IADLs (P=.04), and were more adept at using the internet and email than those without the needed technology (P<.001). Age, confidence in filling forms, general health, and internet use were significantly associated with willingness to use video visits. CONCLUSIONS: Approximately half of the HNHR respondents were unwilling for video visits and a quarter of those willing lacked requisite technology. The gap between those willing and without requisite technology is greater among older, less health literate, African American veterans; those with worse physical health; and those living in more socioeconomically disadvantaged neighborhoods. Our study highlights that HNHR veterans have complex needs, which risk being exacerbated by the video care shift. Although technology holds vast potential to improve health care access, certain vulnerable populations are less likely to engage, or have access to, technology. Therefore, targeted interventions are needed to address this inequity, especially among HNHR older adults.

[Benefits of early use of high-flow-nasal-cannula (HFNC) in patients with COVID-19 associated pneumonia]. / Beneficio del empleo precoz de la oxigenoterapia nasal de alto flujo (ONAF) en pacientes con neumonía por SARS-CoV-2.

INTRODUCTION: Severe COVID-19 is associated with hypoxemic bilateral pneumonia that leads to mechanical ventilation in a considerable proportion of patients. To the best of our knowledge, there are no recommendations about the best time to initiate high flow nasal cannula (HFNC). PATIENTS AND METHODS: Retrospective study of all patients admitted for COVID-19 pneumonia who required HNFO between March 2020 and February 2021. Patients were grouped in early HNFC or late HNFC, according to the modified Kirby index. RESULTS: 53 patients were included. Forty-four of them were included in the early HFNC and 9 in late HNFC. There were no statistically significant clinical-epidemiological differences. Early use of HFNC was associated with a decrease in the need for intubation (29.5 vs. 66.6%, p = 0.044), hospital stay (18.8 d vs. 36 d, p = 0.022) and mortality (22.7 vs. 55.5%, p = 0.061). CONCLUSIONS: Early HFNC use is associated with a decrease in the need for intubation, mortality and overall hospital stay.

O group is a protective factor for COVID19 in Basque population.

ABO blood groups have recently been related to COVID19 infection. In the present work, we performed this analysis using data from 412 COVID19 patients and 17796 blood donors, all of them from Gipuzkoa, a region in Northern Spain. The results obtained confirmed this relation, in addition to showing a clear importance of group O as a protective factor in COVID19 disease, with an OR = 0.59 (CI95% 0.481-0.7177, p<0.0001) while A, B and AB are risk factors. ABO blood groups are slightly differently distributed in the populations and therefore these results should be replicated in the specific areas with a proper control population.

Frailty and COVID 19 Infection in Hospitalized Veterans: A Case Series

Frailty, a clinical syndrome characterized by vulnerability to stressors resulting from loss of physiological reserve across multiple systems. In patients with COVID 19 infection, the presence of frailty may place older adults at higher risk for poor clinical outcomes including hospitalizations and mortality. The aim of this case-series study was to describe the characteristics of patients with frailty and COVID-19 who were hospitalized at a VA Medical Center. A VA Frailty Index (VA-FI) was generated at baseline as a proportion of variables from electronic health records. The VA-FI categorized Veterans into non-frail (FI&lt;.21) and frail (FI≥.21). We calculated the VA-FI for Veterans admitted at the time of COVID-19 admission date. We compared the characteristics of frail and non-frail Veterans. A total of 137 veterans were admitted, 96.3% (n=132) were male, mean age 66.81 (SD=13.87) years, and 65.7% (n=90) were frail. When comparing Veterans who were frail versus non-frail, there were no differences in age, race, ethnicity, BMI, rates of cardiopulmonary resuscitation, ICU admissions, use of vasopressors or length of stay. There were significant differences in rates of intubation (frail n=10, vs. non-frail n=0), p = 0.018 and non-invasive respiratory support (frail n=9 vs non-frail n=0), p=.025. There were 13 and 7 readmissions in the frail and non-frail groups respectively. Eleven Veterans died during hospitalization, all of whom were frail. Frailty is associated with poor clinical outcomes in hospitalized Veterans with COVID 19 infection. Recognition of frailty may help to optimize the management of COVID 19 related complications.