Non-invasive mechanical ventilation in patients admitted to a provisional center for moderate COVID-19 patients

Introduction:Non-invasive mechanical ventilation is a ventilatory alternative for COVID-19 cases. Background:To describe the characteristics and evolution of non-invasive mechanical ventilation (NIMV) in patients discharged from Provisional Center for moderate COVID-19 patients in Figali, Panama. Methods:A descriptive, retrospective, longitudinal stu was carried out in all adult patients discharged from June to July 2021 and who received non-invasive mechanical ventilation. A questionnaire was used using the digital individual medical record as primary source. Descriptive statistics techniques were used. Results:35.9% of the patients (78/217) who were admitted required non-invasive mechanical ventilation on the ninth day of symptoms and the second day after admission. 62.8% (49/78) were obese and 29.5% (23/78) hypertensive. The respiratory rate 30 and the decrease in the PaO2/FiO2 ratio decided the begining of non-invasive mechanical ventilation in 56.4% (78/217) of those admitted. 62.8% (49/78) had moderate-severe acute respiratory distress syndrome, and the severity was related to ventilation failure out of the total number of ventilated patients. Ventilation was successful in 65.4% (51/78). PaO2/FiO2 <150 (62.9%), respiratory rate 30 (55.6%) and physical exhaustion (51.85%) decided ventilation failure. Conclusions:Non-invasive mechanical ventilation is an effective procedure in COVID-19 patients and moderate or severe respiratory distress;although its success is related to the less severe forms. Low PaO2/FiO2, together with symptoms, were key indicators to assess the begining, success or failure of NIMV;not so the values of PaO2, PaCO2 and SpO2.

ECMO in acute fulminant myocarditis in pediatrics

Objectives: To describe our experience in ECMO for acute myocarditis Methods: Descriptive, retrospective study (2018-2022) of a cohort of 8 patients < 16 years with acute myocarditis who were assisted on ECMO. Result(s): 8 patients were collected, (6 females), with a mean age 7;8 years [range 0;1-13;8]. In 7/8, the reason for cannulation was hemodynamic instability refractory to medical treatment, with a mean inotropic score of 70 [range 10-122]. Sixty-two percent presented cardiorespiratory arrest prior to cannulation and 2 of them needed ECRP. The mean precannulation troponin level was 1498 ng/ml [range 89-6212]. Primary transport was performed in 4 patients. ECMO was peripheral veno-arterial in 100%, jugulo-carotid in 2/8 and femoro-femoral in 6/8. All patients underwent atrioseptostomy. They received treatment with levosimendan, immunoglobulins, corticoids and carnitine. In 4 acute infectious etiology was confirmed (parvovirus, influenza and SARSCoV2), another one was due to PIMS-TS and in 3 no etiology was found. Six patients underwent myocardial biopsy and 5 of them showed inflammatory infiltrates. The mean time on ECMO was 8 days [range 3-14], 2 of them requiring 2 ECMO courses. The mean length of PICU stay was 21 days [range 10-50]. Two were transferred to a heart transplant center. The main complications were arterial hypertension (88%), bleeding (63%), neurological (50%), arrhythmias (38%), coagulopathy (38%) and infectious (38%). One patient required renal replacement therapy. 1 patient died, 2 had moderate neurological sequels. Conclusion(s): ECMO is a therapeutic option in patients with fulminant myocarditis refractory to medical treatment and may help improve their prognosis.

Impact of confinement on the development of the physical education in primary and secondary education

Due to the COVID-19 pandemic, the state of alarm and home confinement, teaching became virtual in a matter of a few days and teachers had to adapt all their work inexorably. Faced with this totally unprecedented situation in the history of our educational system, this research has been used to investigate and describe the impact of the period of confinement on the school curriculum of physical education in primary and compulsory secondary education. The instrument used was a questionnaire made in Google Forms using the Delphi technique. The sample consisted of 100 teachers of the Primary Education (PE) and Secondary Education (SE) stages in Spain, specifically in the autonomous community of Andalusia. Among the main conclusions we highlight that the teachers considered that the objectives of health and physical condition were the most worked objectives in the area. The teachers consider that they did not manage to carry out the established motor times, nor the programming, but they did get the students to carry out a weekly task with an involvement of approximately one hour. It was concluded that the impact on learning was great because not all the contents were worked on and the tasks set were not evaluable.

The Economic Impact of COVID-19 around the World

This article provides an account of the worldwide economic impact of the COVID-19 shock. In 2020, it severely impacted output growth and employment, particularly in middle-income countries. Governments responded pri-marily by increasing expenditure, supported by an expansion of the supply of money and debt. These policies did not put upward pressure on prices until 2021. International trade was severely disrupted across all regions in 2020 but subsequently recovered. For 2021, we find that the adverse effects of the COVID-19 shock on output and prices were significant and persistent, especially in emerging and developing countries.

Corporate Social Responsibility in Times of Epidemic Outbreaks: A Case Study from the Hospitality Industry in Spain

Corporate social responsibility (CSR) is increasingly seen as a key aspect of business management. The rapid spatial spread of the COVID-19 outbreak led to border closures and mandatory mass quarantine. In this context, sectors such as the hospitality industry have been actively involved in various CSR activities, providing infrastructure and resources to help governments and societies cope with the pandemic. This study examines the different effects of CSR activities in the context of the COVID-19 outbreak, both from a business and institutional perspective. A qualitative research design has been chosen for this purpose, based on the analysis of in-depth qualitative interviews with the CEO and senior executives of three international hotel chains in Spain. The results reveal that CSR activities have contributed to containing the pandemic by helping to reduce the collapse of healthcare, as well as improving the organization's performance in terms of reputation and image. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Psychological effects of confinement by COVID-19 in rowing competitors

The period of confinement due to the Covid-19 virus has not only affected the general population, but also sport in general. The objective of this study was to investigate the emotional and adaptive consequences of rowers who compete nationally and internationally. A quantitative descriptive study was carried out with a non-probabilistic sample, based on convenience sampling, known as a snowball. One hundred and ninety-three rowers who competed nationally and internationally participated in the study, with an average age of 19.49 years. The results showed that the rowers reacted with more unpleasant moods than the rowers. It was also found that stressful thoughts were associated with states of greater anxiety, anger or depressive feelings, while the best training conditions and the acceptance of confinement rules were inversely associated with negative mood states. Linear regression analysis showed that stressful thoughts, along with behavior and motivation problems during lockdown, predicted the level of total mood disturbance.

RETENTION IN CARE AMONG PERUVIAN MSM AND TGW IN A REAL-WORLD HIV PrEP PROGRAM

Background: Tenofovir-based daily oral HIV pre-exposure prophylaxis (HIV PrEP) is a highly efficacious HIV prevention modality, but sustained use over time is needed for continued protection among individuals at high risk for HIV exposure. Suboptimal adherence and retention in care threaten to diminish the impact of HIV PrEP on reducing HIV burden. PrEP PERU is an ongoing, multi-site, prospective cohort study evaluating HIV PrEP implementation among adult men who have sex with men (MSM) and transgender women (TGW) accessing care at non-government health centers in Peru. We sought to evaluate HIV PrEP adherence and retention in care among PrEP PERU participants prior to the onset of COVID-19 service disruptions. Method(s): We analyzed baseline and follow-up data from the PrEP PERU study through 3/15/2020, the first day of Peru's COVID-19 lockdown. MSM and TGW >=18 years of age with at least one HIV risk factor were eligible for enrollment. After the first follow-up visit at 4 weeks, TDF/FTC refills and clinic visits occur quarterly, at the discretion of the prescribing clinician. The medication is provided free of charge, but participants pay for laboratory testing plus a small service fee for clinic visits. Data is collected at baseline and quarterly follow-up visits on sexual risk behaviors and HIV PrEP use. We used bivariate analysis to evaluate the association between baseline factors and 6-month HIV PrEP retention in care. As a proxy for adherence, pharmacy dispensation records were used to calculate the proportion of days covered (PDC) by TDF/FTC. Result(s): Overall, 351 participants started TDF/FTC at four study sites in Lima from 1/23/2017 to 3/15/2020. Of this analysis population, 94% were cisgender men, 10% identified as bisexual, and median age was 31 (interquartile range [IQR], 27 - 38). Among those with at least 6 months of observation time (n=302), 91% attended >=1 follow-up visit and 77% attended >=2 follow-up visits during the 6 months after enrollment. The proportion with favorable adherence (PDC >=0.8) was 85%. There were 6 confirmed HIV seroconversions in the analysis period (1.2 per 100 person-years). Conclusion(s): In this analysis of HIV PrEP outcomes among MSM and TGW prior to COVID-19 pandemic disruptions in Peru, over 3/4 of the population remained in care and had favorable measures of adherence during the first 6 months after.

Serological Assessment of the Effectiveness of Osteopathic Manipulative to Augment the Covid-19 Vaccine Immune Response

Purpose of Study: Previous Osteopathic manipulative treatment (OMT) research has shown evidence of increased lymphatic movement resulting in increased leukocyte and cytokine flow. One study even showed increased antibody titer response in patients when used in conjunction with the Hepatitis B vaccine. Given previous studies, our group conducted a year-long longitudinal randomized controlled clinical trial to evaluate the ability of OMT to improve the COVID-19 vaccine immune response. Methods Used: Subjects were randomized into either the control arm or OMT intervention arm. OMT consisted of myofascial release of the thoracic inlet, pectoral traction, diaphragm release with MFR, splenic pump, and thoracic pump applied the day of and the day following each vaccination session. All subjects in each group received the Pfizer mRNA COVID-19 vaccine. All subjects had blood drawn on day 0 (1st vaccine), day 7, day 21 (2nd vaccine), days 28, 90, 210, and 365. Anti-spike IgG immunoglobulin titers (AS IgG) were measured at all time points for all subjects. Side effects, adverse events, and medication usage in response to the vaccines or OMT was documented. Breakthrough cases with symptomology and medication usage was documented for both groups. The study was approved by the WesternU IRB committee, protocol #FB21/IRB026. Summary of Results: Data for 91 subjects were analyzed with 41 male (45.1%) and 50 female (54.9%). Age distribution was comparable between the two groups. Side effects and medication usage reported by the subjects was similar between groups (p>0.1). AS IgG measured at baseline distinguished between previously infected individuals and those naive to COVID-19, regardless of OMT treatment. For all time points measured, the average AS IgG in subjects trended higher in OMT group than control group. Two-way ANOVA analysis showed statistical significance at 1 week after 2nd injection (p<0.001) in the COVID-19 naive population. 13 symptomatic breakthrough infections were reported in the control group and 12 in the OMT group. Length of symptoms were reported as 8.36 +/- 4.60 days (control) and 4.62 +/- 2.60 days (OMT) (p<0.05). Length of medication usage was 3.64 +/- 3.58 days (control) and 1.23 +/- 1.24 days (OMT) (p<0.1). Conclusion(s): Both groups had comparable side effects after COVID-19 vaccination with no adverse events linked to OMT, indicating that OMT is a safe adjunct that can be used with COVID-19 vaccination. The data showed an enhanced immune response by OMT, as evidenced by increased levels of AS IgG in previously naive subjects. Although both control and OMT groups had similar rates of symptomatic breakthrough infection, the OMT data shows reduced length of symptoms and medication duration in this population when compared to control breakthrough infections. This study is underpowered for statistical significance at each time point and future vaccination studies should recruit more patients to confirm the trends seen here.

Return to exercise after COVID-19. Statement of the Mexican Society of Cardiology / Retorno al ejercicio después de COVID-19. Posicionamiento de la Sociedad Mexicana de Cardiología

The coronavirus disease 2019 (COVID-19) was declared a pandemic on March 11, 2020; one consequence has been the increase in sedentary lifestyle and reduction of sports activity. Exercise benefits the immune defense system especially in older adults; it is recommended to keep a distance of 1.5 meters between people, and if walking or jogging is carried out, the space must be up to 5 and 10 meters respectively. The reported cases are mostly mild up to 80% and can be critical in up to 4.7%; the risk factors are well known, hypertension, diabetes and previous heart disease. Severe or critical cases present as symptoms of acute respiratory distress syndrome, and in the case of cardiovascular disease, they mainly occur as myopericarditis, acute coronary syndromes, cardiogenic shock, thrombotic events, among others. Returning to exercise after recovery from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is always recommended, however it will depend on the clinical picture what measures should be taken prior to its onset, and it is in moderate cases and especially in the severe ones where the evaluation and prescription prior to returning to exercise or sport should be guided by medical personnel experts in cardiopulmonary rehabilitation, especially in athletes.

La enfermedad por coronavirus 2019 (COVID-19) fue declarada pandemia el 11 de marzo de 2020; una consecuencia ha sido el incremento en el sedentarismo y la reducción de la actividad deportiva. El ejercicio beneficia el sistema inmunitario de defensa, especialmente en adultos mayores. Se recomienda guardar distancia de 1.5 metros entre personas, y si se realiza caminata o trote, el espacio debe ser de hasta 5 y 10 metros respectivamente. Los casos reportados son en su mayoría leves hasta en un 80%, y pueden ser críticos hasta en 4.7%; los factores de riesgo son bien conocidos: hipertensión, diabetes y enfermedad cardiaca previa. Los casos graves o críticos se presentan como cuadros de síndrome de distrés respiratorio agudo y ante afección cardiovascular cursan principalmente como miopericarditis, síndromes coronarios agudos, choque cardiogénico y eventos trombóticos, entre otros. El ejercicio después de la recuperación de infección por coronavirus 2 del síndrome respiratorio agudo grave (SARS-CoV-2) siempre está recomendado, sin embargo, dependerá del cuadro clínico qué medidas se deben tomar previo a su inicio, y es en casos moderados y especialmente en los graves donde la evaluación y prescripción previa al retorno al ejercicio o deporte debe ser guiada por personal médico experto en rehabilitación cardiopulmonar, en especial en deportistas.

Integrated vector management program in the framework of the Covid-19 pandemic in Medellin, Colombia

Introduction: The COVID-19 pandemic pressured health care systems to remain alert and active in their vector-borne disease control and prevention programs, leading to changes in vector control strategies in urban areas affected by dengue, Zika and chikungunya. Objective: To describe the adaptations made to the vector control and surveillance program in Medell??n during the COVID-19 health emergency. Materials and methods: Once the health emergency started,biosecurity protocols were developed. Entomological surveillance was strengthened from the institutional environment instead of homes. Data was collected in Medell??n from 2018 to 2021 during the vector control and surveillance program activities, which included epidemiological and entomo-virological surveillance, entomological index survey, ovitrap monitoring, community mobilization, search and elimination of mosquito breading sites, and chemical control. These actions were adapted and/or increased to promote self-care among communities in total and partial confinement, and to develop prevention and control measures. Results: Mosquito monitoring was increased by 40% using ovitraps, entomological -virological surveillance showed an increase in 2020 of 34,4% compared to 2019 and virtual media was used to keep and improve contact with the community. Conclusion: The COVID-19 pandemic had a significant impact on arbovirus prevention and control programs. The city of Medell??n quickly adapted its entomo-virological surveillance activities, control measures, and the contact with the community during the pandemic, which allow the Integrated Vector Management program to remain active in the city.

Caracterización de la población con fracaso renal agudo durante la hospitalización por COVID-19 en España: tratamiento renal sustitutivo y mortalidad. Datos del Registro FRA-COVID SEN Characterization of hospitalized patients with acute kidney injury associated with COVID-19 in Spain: renal replacement therapy and mortality. FRA-COVID SEN Registry Data

Antecedentes y objetivos: El desarrollo de lesión renal aguda (FRA) durante la hospitalización por SARS-Cov2 se ha asociado a elevada morbi-mortalidad. El Registro FRA-COVID 19 SEN ha recogido datos de pacientes con este perfil durante los meses de la pandemia. El objetivo de este trabajo fue caracterizar la población española ingresada por COVID-19 que desarrolló FRA, con/ sin necesidades de tratamiento renal sustitutivo (TRS), modalidades terapéuticas utilizadas y resultados en términos de mortalidad Material y método: Estudio retrospectivo de datos procedentes de 30 hospitales españoles, recopilados en el Registro Español FRA COVID-19 desde mayo de 2020 hasta noviembre 2021. Se registraron variables clínicas y demográficas, datos relacionados con la gravedad de la COVID-19, con el FRA y de supervivencia. Mediante estudio de regresión multivariante se analizan los factores relacionados con la necesidad de TRS y con mortalidad. Resultados: Se registraron datos de 730 pacientes. El 71,9% eran hombres, con edad media 70 años (60-78). El 70,1% eran hipertensos, 32,9% diabéticos, 33,3% con enfermedad cardiovascular y 23,9% presentaban algún grado de enfermedad renal crónica. Desarrollaron neumonía el 94,6%, con necesidad de soporte ventilatorio en el 54,2% e ingreso en UCI en un 44,1% de los casos.La mediana de tiempo desde el inicio de síntomas COVID hasta la aparición de FRA fue de 6 días (4-10). En cuanto a la gravedad: 37,1% KDIGO I, 18,3% KDIGO II, 44,6% KDIGO III;requirieron TRS 235 pacientes (33,9%). Las técnicas continuas (TCRR) fueron las más empleadas (155 pac), seguidas de hemodiálisis (HD) intermitente (89 pac), HD diaria (36 pacientes), hemodiafiltración (HDF) 17 pac., y HD expandida (HDexp) en 24 casos. El hábito tabáquico (OR 3,41), la necesidad de soporte ventilatorio (OR 20,2), la cifra de creatinina máxima (OR 2,41) y el tiempo transcurrido desde el inicio de los síntomas hasta la aparición del FRA (OR 1,13) se identificaron como predictores de la necesidad de TRS en nuestra cohorte, mientras la edad se comporta como protector (OR: 0,95). El grupo que no requirió TRS se caracterizó por presentar mayor edad, menor gravedad de FRA y un tiempo de aparición y recuperación de la lesión renal más corto (p<0,05).El 38,6% de la cohorte falleció durante la hospitalización. La gravedad del FRA y la necesidad de TRS fue más frecuente en el grupo de fallecidos. En el análisis multivariante, edad (OR 1.03), enfermedad renal crónica previa (OR 2,21), desarrollo de neumonía (OR 2,89), soporte ventilatorio (OR 3,34) y TRS (OR: 2,28) se comportaron como factores predictores mientras que el tratamiento crónico con ARAII se comportó como factor protector (OR 0,55). Conclusiones: Del análisis del Registro FRA-COVID 19 SEN se deduce que los pacientes que presentaron FRA durante la hospitalización por COVID-19 tenían una edad media elevada, mayores comorbilidades y presentaron un cuadro de infección grave. Definimos dos patrones clínicos diferentes: un FRA de aparición precoz, en pacientes más ancianos que se resuelve en pocos días sin necesidad de TRS;y otro patrón más grave, con mayor requerimiento de TRS, y aparición tardía en el curso de la enfermedad, que se relacionó con mayor gravedad de la misma. La gravedad de la infección, la edad y la presencia de ERC previa al ingreso fueron factores determinantes en la mortalidad de estos pacientes, identificando el tratamiento crónico con ARA II como un factor protector de mortalidad.

Importance of Reflective Practice in the Teaching Profession during the COVID-19 Pandemic

The research aimed to determine the importance of reflective practice in the teaching profession during the COVID-19 pandemic. To obtain the required information, 85 teachers were selected. Teachers from both public and private educational institutions in the city of Azogues, Cañar province. Most of the participants were female and over 40 years of age. The teachers taught their subjects at the General Basic Education level. A demographic analysis was carried out for data collection. A questionnaire was used in which questions were included to determine the degree of application of reflective practice by the educators. The answers were provided based on a Likert scale with 5 response options. The results obtained showed that not all educators apply reflective practice. Teachers who apply reflective practice found it easier to adapt to the needs of students in the context of the pandemic. Difficulties in implementing improvements in pedagogical planning were also recognized. © 2023 Castillo Pinos et al.

Effects of COVID-19 vaccination on chronic urticaria patients: First results of the UCARE COVAC-CU study

Background: Chronic urticaria (CU) is a common chronic inflammatory disease. Vaccination against viral infections including COVID-19 can induce increased CU disease activity. As of now, it is unclear how often CU exacerbations occur after COVID-19 vaccination. Method(s): COVAC-CU is an international, multicenter, observational, cross-sectional study of the global network of urticaria centers of reference and excellence (UCAREs). COVAC-CU evaluates the effects of COVID-19 vaccination in patients with CU including rates and risk factors of CU exacerbation. Here, we analyzed 1857 patients with CU who had received at least one COVID-19 vaccination. Data were collected via a questionnaire and retrieved from patient charts. Result(s): Of 1857 patients with CU (median age: 42 years;range: 18-91 years), 72.1% were female and 71.2%, 14.4% and 14.4% had chronic spontaneous urticaria, chronic inducible urticaria, or both, respectively. Most patients had received two doses of COVID-19 vaccine (79.1%), compared to one (9.7%), three (11%), or four (0.3%). Vaccine type included: BTN162b2 (58.4%;BioNTech/Pfizer), ChAdOx1 nCOV-19 (13.8%;AstraZeneca), BBIBP-CorV (8.2%;Sinopharm), Gam-COVID- Vac (8%;Sputnik), mRNA-1273 (5.3%;Moderna), and Ad26.COV 2.5 (4.7%;Janssen/J&J). Less than 10% of patients used premedication, and less than half of patients (44.4%) reported one or more adverse reactions after vaccination. The most common adverse reactions were local injection site reactions (29.6%), fatigue (19.7%), fever (19%), muscle pain (17.9%), headache (14%), and exacerbation of CU (15%). Severe allergic reactions/anaphylaxis were reported by 0.4% of CU patients. In almost all patients who experienced exacerbation of their CU, this occurred within one week after receiving the vaccine, i.e. after 1 to 12 hours (25.8 %), after 12 hours to 48 hours (31.1%) or after 2-7 days (37.9%). Conclusion(s): Most CU patients tolerate COVID-19 vaccination well;severe allergic reaction (anaphylaxis) rates were similar or lower than the self-reported rates reported in the general population. Exacerbation of urticaria was reported in one in five patients, mostly in a week after receiving the vaccine.

SARS-COV-2 infection in workers of health: epidemiological risk analisis in a highly complex institution Bogota, Colombia, 2020.

Objective: To determine the incidence of SARS-CoV-2 infection and its association with sociodemographic, clinical, and occupational characteristics in health workers (HCWs) in the COVID-19 risk area. Material(s) and Method(s): Longitudinal analytical study in a cohort of TS from the "Zafiro" area of patients with suspected or confirmed diagnosis of SARS-CoV-2 infection. The identification of positive cases of SARS-CoV-2 was carried out with the RT-PCR test. Result(s): The cohort was made up of 114 SWs, with an average age of 35.3+/-7.4 years, with positions as general practitioner (26.3%), nursing assistant (21.1%) and nurse (19.3%). The incidence rate of SARS-CoV-2 (31.6%) and reinfection (1.8%) during seven months. The factors jointly associated with SARS-CoV-2: cohabitation with people at high risk of contagion (HR=2.406, 95% CI: 1.225, 4.726, p=0.011), the lowest educational level (HR=2.241, 95% C: 1.051, 4.782, p=0.037) and a higher consumption of sleep medications (HR=4.680, 95% CI: 1.328,16.486, p=0.016). Conclusion(s): The contagion rate of SARS-CoV-2 during seven months of the pandemic, in health workers was high (one in three SW) associated with cohabitation with high-risk people, lower educational level and higher consumption of medications for to sleep. A situation of concern in the HCWs was the suspected cases of SARS-CoV-2 reinfection.Copyright © 2022 Asociacion Colombiana de Infectologia. All rights reserved.

COVID-19 after two years: trajectories of different components of mental health in the Spanish population.

AIMS: Our study aimed to (1) identify trajectories on different mental health components during a two-year follow-up of the COVID-19 pandemic and contextualise them according to pandemic periods; (2) investigate the associations between mental health trajectories and several exposures, and determine whether there were differences among the different mental health outcomes regarding these associations. METHODS: We included 5535 healthy individuals, aged 40-65 years old, from the Barcelona Brain Health Initiative (BBHI). Growth mixture models (GMM) were fitted to classify individuals into different trajectories for three mental health-related outcomes (psychological distress, personal growth and loneliness). Moreover, we fitted a multinomial regression model for each outcome considering class membership as the independent variable to assess the association with the predictors. RESULTS: For the outcomes studied we identified three latent trajectories, differentiating two major trends, a large proportion of participants was classified into 'resilient' trajectories, and a smaller proportion into 'chronic-worsening' trajectories. For the former, we observed a lower susceptibility to the changes, whereas, for the latter, we noticed greater heterogeneity and susceptibility to different periods of the pandemic. From the multinomial regression models, we found global and cognitive health, and coping strategies as common protective factors among the studied mental health components. Nevertheless, some differences were found regarding the risk factors. Living alone was only significant for those classified into 'chronic' trajectories of loneliness, but not for the other outcomes. Similarly, secondary or higher education was only a risk factor for the 'worsening' trajectory of personal growth. Finally, smoking and sleeping problems were risk factors which were associated with the 'chronic' trajectory of psychological distress. CONCLUSIONS: Our results support heterogeneity in reactions to the pandemic and the need to study different mental health-related components over a longer follow-up period, as each one evolves differently depending on the pandemic period. In addition, the understanding of modifiable protective and risk factors associated with these trajectories would allow the characterisation of these segments of the population to create targeted interventions.

FACTORS ASSOCIATED WITH HIGH LEVELS OF TELEPHONE CARE SATISFACTION AMONG INDIVIDUALS WITH INFLAMMATORY BOWEL DISEASE

Background Individuals with inflammatory bowel disease (IBD) require regular medical follow-up with gastroenterology care providers. Individuals in rural areas face barriers in assessing specialized IBD care. Virtual care (VC) may act as a solution. The coronavirus disease 2019 pandemic increased the use of VC, particularly telephone care (TC) appointments in Saskatchewan, Canada. There is limited evidence around the levels and factors associated with satisfaction with TC among individuals with IBD. Purpose This study aims to measure satisfaction with TC in individuals with IBD who live in Saskatchewan, Canada, and evaluate the factors associated with TC satisfaction. Method A cross-sectional study was conducted among individuals with IBD through an online survey between December 2021 and April 2022 in Saskatchewan. The Telephone Care Satisfaction Questionnaire for individuals with IBD (TCSQ-patient) was a 16-item questionnaire used to measure TC satisfaction on a scale from 1 (very dissatisfied) to 7 (very satisfied). The online survey also included the Quality of Care Through the Patient's Eyes-IBD (QUOTE-IBD) questionnaire, Short Inflammatory bowel disease questionnaire (SIBDQ), and demographic questions. Factors associated with TC satisfaction were explored using linear regression models. A backward model building strategy was used, and 95% confidence intervals (95%CI) were reported. Result(s) In total, 87 individuals with IBD participated in the study. Among the study participants, 54 (64.3%) had Crohn's disease, 53 (61.6%) were female, 60 (69.8%) lived in urban centres, and 37 (43.5%) were between 41-59 years old. The mean satisfaction with TC was 5.70 (SD=0.94). In addition, the means of the QUOTE-IBD and SIBDQ were, respectively, 8.96 (SD=1.70) and 48.14 (SD=13.02). In the bivariate analysis, area of residence (rural vs. urban) and health related quality of life quality (SIBDQ>50 vs SIBDQ<50) were associated with satisfaction with TC, respectively, 0.47 (95%CI 0.02-0.91) and 0.48 (95%CI 0.08-0.88). Adjusting by gender, age group, type of disease, and health care provider managing IBD, we identified that the satisfaction with TC was 0.48 (95%CI 0.02-0.94) higher among individuals with IBD living in rural Saskatchewan in comparison to their urban counterparts. Conclusion(s) Individuals living with IBD in Saskatchewan reported high levels of satisfaction with TC. Rural residence is associated with higher levels of TC satisfaction. These results could help in the promotion of TC utilization and improve access to specialized IBD care, especially among those living in rural areas. Please acknowledge all funding agencies by checking the applicable boxes below Other Please indicate your source of funding;Saskatchewan Health Research Foundation (SHRF) Disclosure of Interest None Declared

ADAPTATION AND VALIDATION OF QUESTIONNAIRES TO MEASURE SATISFACTION WITH TELEPHONE CARE AMONG IBD PATIENTS AND GASTROENTEROLOGY CARE PROVIDERS

Background People living with inflammatory bowel disease (IBD) require regular medical follow-up, which could be challenging for individuals living in rural areas and those who have limited access to specialized care. Telephone care (TC) could improve health care by increasing access to specialized care. The Covid-19 pandemic resulted in increased use of virtual care, which was predominantly TC in Saskatchewan (SK) , Canada. There are no validated questionnaires to measure satisfaction with TC among IBD patients and gastrointestinal care providers (GCPs). Purpose This study aimed to adapt and validate a questionnaire to evaluate the satisfaction of IBD individuals and GCPs with TC in SK, Canada. Method The Telehealth Usability Questionnaire was adapted to the IBD TC context by a committee of experts, comprised of three IBD GCPs, two IBD-patient partners, and two health care researchers. Two questionnaires were generated -: the Telephone Care Satisfaction Questionnaire (TCSQ) for patients (IBD-TCSQ-patient) and GCPs (IBD-TCSQ-provider). The committee evaluated the content validity of the adapted questionnaires. A pilot assessed the readability and usability of the questionnaire items. Subsequently, individuals living with IBD in SK and GCPs completed an online survey with the TCSQ-patient and IBD-TCSQ-provider questionnaires in the winter of 2022. Data were analysed using descriptive and correlational techniques. Psychometric analyses were conducted to examine the reliability and validity of the TCSQ-patient, but not for the TCSQ-provider due to small sample size. Result(s) The IBD-TCSQ-patient and IBD-TCSQ-provider questionnaires were developed, each with 16 individual items and one question on global TC satisfaction. The pilot demonstrated good readability and usability of the questionnaires. Then, 87 IBD individuals completed the IBD-TCSQ-patient and six GCPs the IBD-TCSQ-provider. The standardized level of TC satisfaction for the 16-item IBD-TCSQ-patient was 5.70 (SD=0.94) on a scale from 1.00-7.00. All items of the IBD-TCSQ-patient were significantly correlated (p<0.001). A strong correlation was observed between the 16-item standardized TC satisfaction and its overall item r=0.85 (p<0.001). The IBD-TCSQ-patient had optimal internal reliability (α=0.96). Two factors were identified in the exploratory factor analysis. Factor 1 focused on TC convenience while factor 2 addressed TC usability. Regarding the IBD-TCSQ-provider questionnaire, the standardized level of TC satisfaction was 5.76 (SD=0.68) on a scale from 1.00 to 7.00. Conclusion(s) We generated questionnaires to measure satisfaction with TC among individuals living with IBD and GCPs. The study results confirmed good validity and reliability of the IBD-TCSQ-patient questionnaire. The IBD-TCSQ-provider questionnaire was adapted;subsequent studies could assess its validity and reliability among GCPs nationally. These questionnaires could help identify opportunities for improvement and utilization of TC among IBD patients and GCPs. Please acknowledge all funding agencies by checking the applicable boxes below Other, None Please indicate your source of funding;Saskatchewan Health Research Foundation (SHRF) Disclosure of Interest None Declared

Attitudes towards COVID-19 vaccine in Spain: correlational and configurational analyses

This study explains attitude towards vaccination against COVID-19. It evaluates four cognitive, affective and normative (CAN) factors: fear of COVID-19 (FCOVID), fear of the vaccine (FVACC), efficacy (EFFICACY), and social influence (SOCINF) and three sociodemographic variables: gender, age, and income level. Ordered logistic regression showed a significant positive influence of FCOVID, EFFICACY and SOCINF and a negative impact of FVACC and income level (INCOME). Configurational analysis allowed observing that all evaluated factors are relevant for explaining the attitude towards vaccination and that the sign of the relationship in configurations between CAN factors and attitude is positive for FCOVID, EFFICACY and SOCINF and negative for FVACC. These variables symmetrically impact on willingness and unwillingness to use the vaccine. INCOME and regarding gender (GENDER) impact asymmetrically to induce acceptance and resistance to vaccination. The results in our paper have clear practical implications. Correlational analysis discovers the average strength of assessed factors on vaccine acceptation and so identifying the most relevant variables. On the other hand, configurational analysis identifies how factors combine to shape profiles of persons with willingness and unwillingness to get vaccinated. These last profiles are of special concern for health policy-makers since their resistance diminishes the effectivity of collective vaccination. © 2023, Intelektual Pustaka Media Utama. All rights reserved.

Applets for teaching financial mathematics

Introduction: the pandemic caused by covid-19, led to the teaching of financial mathematics virtually, motivating the teacher to explore new ways of teaching, the truth to many students, the mere word "Mathematics” causes them fear, worry, anxiety, which hinders learning, even many seek to drop out without starting;Materials and methods: modern teaching has a great commitment, mechanisms must be sought for learning the subject, the student needs to participate in class, ICT offer many tools, we must take advantage of today's young people, they are "visual” everything they see and learn through screens, this work proposes to use Geogebra software which allows creating small programs called Applets, which can be embedded in web pages;Results: all kinds of topics were worked on for the subject of financial mathematics, the program made it easier to build and obtain all kinds of financial calculations and its interpretation was facilitated through the construction of graphs, with this proposal it was possible to encourage work in the classroom, helping the student to build knowledge, facilitating work and learning;Conclusion: at the end, the results were evaluated by means of a questionnaire, obtaining excellent results © 2022, Revista Lasallista de Investigacion.All Rights Reserved.