ABSTRACT
The construction industry has been highly disrupted by the pandemic as the development of construction projects must be adapted due to policies to minimize the spread of COVID-19, such as social distancing. As the construction industry contributes approximately 7% of Chilean GDP, it is important to identify and understand the impacts the construction industry has suffered due to the pandemic context. This study aims to identify the impacts of COVID-19 on Chilean construction projects. This study is enabled by data from 40 semi-structured interviews collected between May and November 2020 with multiple stakeholders working on projects during the pandemic, namely construction managers, construction engineers, and laborers of construction work. This study's results are obtained by categorizing the impacts of COVID-19 on Chilean construction projects, performing content analysis to the data collected. We found that the impacts of COVID-19 on construction projects can be classified in nine categories, being the categories with the most coded responses the following: economic impacts, productivity, and the stop and delay of construction projects. Additionally, the impacts from COVID-19 were identified to reach multiple levels, namely at the company, project, workers, and suppliers and subcontractors' levels. The most coded excerpts regarding the impacts of COVID-19 were found at the project and workers' levels. This study is a first step that identifies the impacts suffered by the construction industry due to pandemic conditions;understanding these impacts may guide the most appropriate plans and policies of decision-makers in the fight against COVID-19 in the construction industry. © 2023, Canadian Society for Civil Engineering.
ABSTRACT
The construction industry has been highly disrupted by the pandemic as the development of construction projects must be adapted due to policies to minimize the spread of COVID-19, such as social distancing. As the construction industry contributes approximately 7% of Chilean GDP, it is important to identify and understand the impacts the construction industry has suffered due to the pandemic context. This study aims to identify the impacts of COVID-19 on Chilean construction projects. This study is enabled by data from 40 semi-structured interviews collected between May and November 2020 with multiple stakeholders working on projects during the pandemic, namely construction managers, construction engineers, and laborers of construction work. This study’s results are obtained by categorizing the impacts of COVID-19 on Chilean construction projects, performing content analysis to the data collected. We found that the impacts of COVID-19 on construction projects can be classified in nine categories, being the categories with the most coded responses the following: economic impacts, productivity, and the stop and delay of construction projects. Additionally, the impacts from COVID-19 were identified to reach multiple levels, namely at the company, project, workers, and suppliers and subcontractors’ levels. The most coded excerpts regarding the impacts of COVID-19 were found at the project and workers’ levels. This study is a first step that identifies the impacts suffered by the construction industry due to pandemic conditions;understanding these impacts may guide the most appropriate plans and policies of decision-makers in the fight against COVID-19 in the construction industry. © 2023, Canadian Society for Civil Engineering.
ABSTRACT
Introduction: The global pandemic due to Covid-19 has constituded a challenge in the follow up and monitoring of cardiac rehabilitation's programs. The State of alarm declared last year in Spain, led to strict home confinement that could have had an impact in the progress of patients Aim: To analyze the effect of home confinement on the managment of cardiovascular risk factors (CVRF) in patients included in phase III of a cardiac rehabilitation program (CRP) and also to evaluate the self-care education received during CRP. Methods and materials: Descriptive, comparative and retrospective analysis of patients in phase III of a CRP. The sample was divided into two groups: Post-Covid group (consecutive CRP patients with follow up one year after the cardiac event from 6/21/2020 [date of end of home confinement in Spain] to 12/31/2020) and Group Pre-Covid (consecutive CRP patients with follow up one year after the cardiac event from 6/21/2019 to 12/31/2019). Demographic and CVRF data from end of phase II consultation were compared with those from the phase III consultation (one year after the event) for both groups. The SPSS statistics v23 program was used for statistical analysis. Results: 283 patients, 137 patients from the pre-Covid group and 146 patients from the post-Covid group. No statistically significant differences were found between the two populations (Table 1). No statistically significant differences were found in the achievement of the CVRF target values: systolic blood pressure <140mmHg (94 vs 107;p=0.216), diastolic blood pressure <90mmHg (121 vs 130, p=0.276), LDL-c <70 mg/dl (86 (71.7%) vs 89 (73.6%);p=0.743), LDL-c <55 mg/dl (41 (34.2%) Vs 47 (38.8%);p=0.451), HbA1c figure <7% (106 vs 111;p=0.478), baseline fasting blood glucose <110 mg/dl (103 vs 107;p=0.970). Regarding the variation of the CVRF figures between the final consultation of phase III and that of phase II, no statistically significant differences were found between the two groups: difference in LDL-c figure for phase III consultation with respect to phase II (-0.5±20.3 mg/dl in pre- Covid group vs -5.3±24.4 mg/dl in post-Covid group;p=0.102), difference in HDL-c (4.6±26.1 mg/dl pre-Covid group vs -0.6±24.9 mg/dl post-Covid group;p=0.113), difference in total cholesterol level (4.6±26.1 mg/dl vs -0.6±24.9 mg/dl;p=0.113), difference in HbA1c (0.1±0.3% in pre-Covid group vs 0.1±0.6% in group post-Covid), Table 2. Conclusions: Home confinement has not contribute to a worsening in CVRF control in patients in a phase III of a CRP, in our study. The education given in a CRP concerning to the management of CVRF is the essential factor that grant an adequate patient control in extraordinary circumstances. (Figure Presented).
ABSTRACT
Introduction: SARS-CoV-2 has affected the whole world as a global health pandemic in 2020. A nationwide home confinement was declared in our country by beginning of March. Cardiac rehabilitation programs (CRP) had to adapt to new health requirements and the impact of these changes is unknown. Purpose: To analyse the impact of COVID-19 pandemic in improvement of cardiopulmonary exercise test (CPET) with maximal oxygen consumption uptake (VO2max) and control of cardiovascular risk factors in patients with cardiovascular established disease (coronary heart disease, heart failure or cardiac surgery) included in the phase II of our centre CRP. Methods: 510 consecutive patients were evaluated. A maximal CPET was performed for each patient from the beginning and at the end of phase II of CRP. Enrolled patients were divided in two groups: from March 2019 to March 2020 (before Covid pandemic) and second one, from the beginning of the pandemic in March 2020 until February 2021. Results: 296 patients were studied in preCovid group and 214 patients were studied in Covid group. There were no statistically significant differences between these two groups in reference to cardiovascular risk factors and medical treatment (Figure 1). 82.7% of patients completed a hospital-based program in preCovid group vs 36% in Covid (p=0.001). Comparing the percentage of patients that accomplished the risk factors control targets between pre- and Covid group, statistically significant differences have been seen referring to systolic BP <140mmHg (85.1 vs 95.4%, p=0.001) and cLDL <70 mg/dl (67.2 vs 77.7%, p=0.003). However, in terms of glucose control (fasting blood glucose <110 mg/dl: 78.4 vs 82.2%, p=0.612;HbA1c <7%: 90.7 vs 92.7%, p=0.464) and weight control (BMI: 27.8±4.69 kg/m2 vs 27.3±4.07 kg/m2, p=0.299) this could not be established. There were no differences in psychological attention demand (27 vs 23.3%, p=0.695). Statistical differences between two groups were found in terms of VO2max at the beginning phase II CPET (22.7±7 vs 20±5 ml/min/kg, p=0.006) and ending phase II CPET (24±7 vs 21±6, p=0.001). Nevertheless, no differences were found in the final phase II CPET improvement between both groups (1.4±4.1 ml/kg/min vs 0.81±2.9 ml/kg/min;p=0.221) (Figure 2). Conclusions: SARS-CoV-2 changed our practice from an in-hospital based phase II CRP to a home-based phase II CRP. COVID-19 pandemic had no negative impact in the control of risk factors in our phase II patients. In our experience, despite preCovid phase II patients have a better functional capacity in terms of VO2max, the improvement in VO2max after phase II CRP persists in the SARS-CoV-2 era. This might show that an accurate structure of home-based program could also have great results. (Figure Presented).
ABSTRACT
The Rio Grande Valley of Texas has an exceptionally high number of COVID-19 cases and case fatality rate. The region makes up only 3% of the Texas population but, as of April 2021, accounted for 9% of the state's COVID-19 deaths. Additionally, during the summer of 2020, the Rio Grande Valley had one of the highest per capita infection rates in the United States. This paper explores the social-ecological elements that impact health-seeking behaviors in this community using interviews conducted with healthcare personnel and nonprofit leaders in the Rio Grande Valley between 2019 and 2020. Using this data, we found that anti-immigrant rhetoric has increased levels of fear among immigrants and mixed-status families, which has made them less willing to access healthcare. Additionally, we found that changes in the public charge rule has led to a decreasing number of children accessing government-provided health insurance. Our findings suggest that these outcomes likely contributed to the severity of the COVID-19 outbreak in the Rio Grande Valley.
ABSTRACT
The COVID-19 infectious disease pandemic has caused significant fear and uncertainty around the world and had significant adverse psychological impact. Children, adolescents and adults with autism spectrum disorder (ASD) are a particularly vulnerable population, impacted by stay-at-home orders, closures at nonessential services, and social distancing standards. This commentary describes various challenges faced by individuals with ASD in the United States including disruptions caused by educational and vocational changes, challenges to home and leisure routines, limited access to behavioral health services and changes in health services delivery due to the pandemic. We highlight the need for ongoing skills development for individuals and development within systems to better respond to needs of the ASD population in future emergencies.
Subject(s)
Autism Spectrum Disorder , COVID-19 , Adolescent , Adult , Autism Spectrum Disorder/epidemiology , Child , Delivery of Health Care , Humans , Pandemics , SARS-CoV-2 , United States/epidemiologyABSTRACT
Introduction: Headache is one of the most frequent symptoms of coronavirus disease 2019 (Covid-19). Most of the published series and cases described hospitalized patients, which could bias the results because of a more severe Covid-19. Objectives: In the present study we aim to describe the clinical phenotype of headache attributed to Covid-19 (HAC-19) including the full spectrum of patients, including cases managed both in primary care and hospital care. Methods:We screened the presence of headache all consecutive patients with a confirmed diagnosis of Covid-19, since the first hospitalized patient (March 8th, 2020) until April 11th. Patients with headache and capability to describe the headache phenotype were invited to participate. Diagnosis was confirmed by polymerase chain reaction test in all patients. A physician conducted a structured interview including demographic and clinical variables. Local ethics review board approved the study (PI 20- 1738). Results: A total of 138/576 (26.0%) hospitalized patients and 408/1690 (24.1%) primary care patients described headache, being.8 included in the study 105 and 352 of them. Mean age was 52.1±15.6 years, being 329 (72.0%) female, and 151 (33.0%) had pneumonia. Prior history of headache was described by 223 (48%) of patients, being migraine in 83 (18.2%). Headache was the first Covid-19 symptom in 126 (27.6%) patients and the mean duration of headache was 12.8 (16.1) days. The most frequent concomitant symptoms were olfactory disorders in 268 (58.6%) cases, followed by asthenia 335 (73.3%), cough 296 (64.8%), fever 259 (56.7%), and myalgia 223 (48.8%). Headache was the most bothersome Covid- 19 symptom in 69 (15.1%) cases, being the mean intensity 6.9±1.7. Patients estimated that headache allowed them to do 49.1±32.6% of their planned activities because of it. The headache was holocranial in 335 (73.3%), with frontal topography in 244 (53.4%), followed by temporal (121 (26.5%) and periocular in 97 (21.2%). Quality of pain was oppressive in 323 (70.7%) and throbbing in 66 (14.1%). Patients described avoidance of routine physical activity in 288 (63.0%) cases, photophobia in 150 (32.8%) cases, phonophobia in 146 (31.9%), and nausea in 69 (15.1%). The most frequently used symptomatic medication was paracetamol in 379 (82.9%), followed by ibuprofen in 70 (15.3%) and metamizole in 48 (10.5%). Conclusion: Headache is a frequent symptom in Covid- 19 disease. The clinical phenotype combines features from both tension-type headache and migraine, with moderate intensity and significant disability. A quarter of patients described headache as the first Covid-19 symptom.