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The experiences that higher education students have with technology and learning with the support of technological resources can generate feelings of stress and anxiety. Understanding whether or not students are ill-adapted to technology is of utmost importance to understand the extent to which changes are needed in the teaching and learning process. With this purpose, the students' perceptions about the technology, namely its familiarity, the ease of use, the utility of technological resources, levels of satisfaction with learning from remote learning, and levels of technostress during the confinement period due to the COVID-19 pandemic were evaluated. Several statistical methods were applied, including the multiple correspondence analysis and the k-means clustering algorithm, in order to obtain a partition of students based on their perceptions and experiences in the course of remote learning. The results revealed three distinct profiles concerning students' perceptions about their relationship with technology. Copyright © 2022, IGI Global.
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INTRODUCTION AND OBJECTIVE: In 2016 we began offering optional same-day discharge (SDD) to all robotic prostatectomy (RP) patients with increasing acceptance that accelerated during the COVID pandemic. Our resulting 98% SDD rate for RP after COVID facilitated initiation of an ambulatory surgery center (ASC) robotic urology program without overnight capability and planned SDD in all patients. We assessed our outcomes with planned outpatient RP in all patients in both the hospital and ASC settings. METHOD(S): We reviewed one year of consecutive RPs performed by a single surgeon at either a free-standing ASC or one of three hospitals between October 2021-October 2022. Pelvic lymphadenectomy was performed in all patients. Assignment to ASC versus hospital RP was based primarily on insurance eligibility. ASC policy for robotic or non-robotic procedures alike excluded history of severe cardiac disease, difficult airway, malignant hyperthermia, or BMI >45kg/m2 with no additional limitations applied to robotic surgery. All patients were instructed to expect same-day discharge (SDD) directly from the recovery room regardless of ASC or hospital location with overnight stay only for unexpected complications or side effects of anesthesia. RESULT(S): Among 359 RP cases (162 ASC and 197 hospital), 356 (99%) were successfully discharged the same day as surgery with 3 overnight stays in the hospital group and none in the ASC group. Patients in the ASC group were younger (61.4yrs vs 67.1yrs, p<001) with no statistically-significant difference in BMI (29.2 kg/m2 vs 29.3 kg/ m2, p=0.3), preoperative Gleason Score (p=0.1), operative time (131min vs 134min, p=0.2) or blood loss (87.5cc vs 84.8cc, p=0.71). Excluding the three overnight patients in the hospital group, the mean postoperative recovery room stay among SDD patients was shorter in the ASC group (1.7hrs vs 2.3hrs, p<0.0001). The 90-day readmission rate was 2.5% in both groups (4/162 and 5/197, p=0.93). No readmissions occurred within 24 hours of surgery and only one within the first week. CONCLUSION(S): Same day discharge as a routine following robotic prostatectomy is feasible and safe with readmission rates no higher than series with overnight stays. SDD may enable ASC RP when overnight stay capabilities are not available at an ASC with minimal risk of need for hospital transfer.
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The present work addresses the challenges of pedagogical practice in the period of the covid-19 pandemic, it aims to verify the training process and the challenges faced by teachers and pedagogical coordinators in the face of a "new" teaching modality, Emergency Remote Teaching, also addressing the difficulties expressed by those responsible for the students in the learning process. Thus, questionnaires were applied to teachers, coordination and parents of students from Elementary I classes in a school in the urban area of Breves-Para, seeking to access their perception about remote teaching and how it was applied. With the research, it is clear that the challenges of teachers go far beyond training and professional qualification, involving the creation and application of public policies aimed at improving the public educational system, with investment in equipment and technological resources.
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Introduction: There is a physiological plausibility for obstructive sleep apnoea (OSA) being a factor to long COVID-19 symptoms: OSA activates the renin-angiotensin-aldosterone system and angiotensinconverting enzyme 2, which is the entry receptor SARS-CoV-2 in the cells. The aim of this study is to identify the incidence of obstructive sleep apnea in long COVID-19 patients. Method(s): Observational cohort, cross-sectional study of post- COVID-19 symptomatic patients, admitted in the out patient post COVID-19 clinic in Portimao Hospital (Portugal), from july 2021 to december 2021. Inclusion criteria: >=18 years;previous COVID-19 at least six months before the initial study protocol evaluation, confirmed by a positive real-time reverse-transcription polymerase chain reaction on a nasopharyngeal swab.;persistent symptoms after cure criteria defined by WHO. Exclusion criteria: Patients who had a concomitant neurological disorder;patients who were on invasive mechanical ventilation and patients with persistent fatigue symptoms in the 6 months before SARS-CoV 2 infection. The OSA diagnosis was assessed using portable monitoring device type III (in-home polygraphy), between the 6-7th months after the diagnosis of COVID-19. The OSA severity was performed using the American Academy of Sleep Medicine scoring criteria. Result(s): A total of 88 patients attended the post-COVID-19 consultation, 24 patients meet the exclusion criteria and 64 patients were enrolled: 28,1% (18) had mild COVID-19, 17,2% (11) moderate and 54,7% (35) severe acute disease. The average age was 56 years, the BMI was 29 Kg/m2 and 56% were men. We found a OSA incidence of 75% (48). The distribution of OSA severity was: 50% (24) mild, 29% (14) moderate and 21% (10) severe. In this group of post COVID-19 patients with OSA, the median age and BMI was the same of the total enrolled patients, and 58% were men. Conclusion(s): There is a high incidence of OSA, in long COVID-19 patients. The knowledge of this risk is essential to establish the follow up and investigation protocol for postcovid-19 patients.
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Background: Patients with COVID-19 have a high incidence of acute kidney injury (AKI), which is associated with mortality. The objetive of our study is to know the factors associated with AKI, to manage the level of care and health resources according to risk. Method(s): We design an observational retrospective cohort study in 2 hospitals in Bogota, Colombia. Adults hospitalized for > 48 hours between March 2020 and March 2021, with confirmed SARS-CoV-2 infection. The main outcome was incidence of AKI during the first 28 days from admission. A descriptive analysis of the sociodemographic and clinical characteristics of the study population was performed. Univariate and bivariate analysis and multivariate logistic regression model was conducted for the outcome AKI. Result(s): We included 1584 patients, 60.4% male, 46.8% older than 65 years. The incidence of AKI was 46.5%, stage 1 in 60.7%, Stage 2 in 15.7%, and stage 3 in 23.6%. Renal replacement therapy was performed in 11.1% of patients with AKI. Table 1 summarizes cohort characteristics and the bivariate analysis. In the multivariate analysis, sex, age, hypertension, CKD, treatment with oral antidiabetics, diuretics, statins, qSOFA, platelet count, CRP, D-dimer, treatment with vancomycin, piperacillin tazobactam, requirement of vasopressor support were realated with AKI. The interactions antihypertensive /diuretics, PAFI /Requirement of invasive mechanical ventilation, Hypertension /antihypertensives, were associated with AKI (P value <0.5). Hospital crude mortality for AKI was 45.5% versus 11.7% without AKI (p<0.0001) Conclusion(s): AKI is frequent in patients hospitalized with COVID 19, conventional risk factors are the rule, we denote other known markers of severity for COVID-19 in association with AKI. These results allowed us to manage the hospital resource.
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Whether intertwined through wifi or plugged desktops, teenagers and young people are increasingly immersed in the ciberspace, due to the presence TDIC becoming ubiquitous. This study aims to comprehend how students from a public school in Bahia's countryside feel about having their lives more effectively in this space, as to relate socially, affectively, politically and so on in this pandemic context. It is an exploratory approach, with theoretical and methodological orientations that follow the New Studies of Literacies. The construction of the narratives happened through episodic interviews and the mining of the information over the Voyant Tools interface. From this interaction, it was possible to observe that some intermittences have provoked other sociocommunicatives becomings at the same time that some reverberations undertake that the participants of the research are in physical, but not social distancing, since sociability, too, happens over the virtual sphere.
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Background: The COVID-19 pandemic and its control measures, which have not been experienced in the world in the last hundred years, have impacted academic scientific production, which, in Brazil, was already in the process of progressive erosion of its foundations. Thus, scientific initiation during medical graduation, which depends on funding and institutional structure, and extremely beneficial to the graduation process, was jeopardized due to restrictive measures. Objective: This article aims to expose the point of view of undergraduate medical students enrolled in a scientific initiation program about the panorama of Brazilian academic scientific production and the impact of the COVID-19 pandemic in its multiple aspects. Discussion: The lack of an effective scientific initiation is one of the many factors that lead to a decline in the number of medical researchers. The way that scientific initiation is placed, as part of a parallel curriculum, and a whole scrapped public production structure are impairing, chronic and noteworthy features. The apparatus of national scientific production is mostly structured in Higher Education Institutions and research institutions, both public. Within the scope of graduation, it can be didactically subdivided into four pillars: financial support, structure, student proactivity and the advisor’s aptitude. The COVID-19 pandemic has been an additional blow to this weakened and fragile structure. Scientific initiation was thus negatively impacted. Public opinion and political aspects further influence an imbroglio of “scientific denial” and a craving for effective information and solutions to the unprecedented problem of a pandemic of this proportion. Conclusion: It is clear that national scientific production is placed in a survival situation in the face of new challenges posed by the pandemic. Likewise, scientific initiation is less and less stimulating during graduation, even though it is an experience of great value in medical and personal development. © 2021 Faculdade de Medicina de Ribeirao Preto - U.S.P.. All rights reserved.
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In this period of Covid-19 pandemic, in which there were sudden changes in education, with the transition from traditional education to e-learning, it is essential to analyze the impacts related to access and use of technology in the context of e-learning, in the perception of higher education students. In this context, all students were forced to use the technology, so it is relevant to investigate the interrelationships between satisfaction with distance learning and all the components associated with the use and acceptance of technology as a support to their learning. Data were collected through a questionnaire, which includes a set of 26 items that aim to assess students’ perceptions about distance learning using six different subscales: Familiarity, Barriers, Anxiety, Usefulness, Ease of use, and Satisfaction concerning the e-learning. A Structural Equation Model (SEM) analysis was performed using Partial Least Squares (PLS), to test the validity of the constructs and the model hypotheses. The results revealed a statistically significant relationship between Satisfaction concerning the distance learning and the constructs Barriers, Ease of use and Usefulness. Based on the model used, other significant interrelationships were registered, such as familiarity with technology positively affects the ease of use of technological resources and barriers, while anxiety negatively affects the ease of use of these resources and the usefulness for students. A multigroup analysis revealed, among other results, that in the students with a moderate to high autonomy, the familiarity with technology positively affects satisfaction with e-learning comparatively to the students with low autonomy. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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In this paper, we introduce a game that allows one to assess the potential loss of efficiency induced by a decentralized control or local management of a global epidemic. Each player typically represents a region or a country which is assumed to choose its control action to implement a tradeoff between socio-economic aspects and the health aspect. We conduct the Nash equilibrium analysis of this game. Since the analysis is not trivial in general, sufficient conditions for existence and uniqueness are provided. Then we quantify through numerical results the loss induced by decentralization, measured in terms of price of anarchy (PoA) and price of connectedness (PoC). These results allow one to clearly identify scenarios where decentralization is acceptable or not regarding to the retained global efficiency measures. IEEE
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Introduction: The COVID-19 typically presents as a lower respiratory tract infection. Among its various extrapulmonary manifestations is cardiovascular damage, and these are the ones that are most associated with morbidity and mortality. A search for scientific information was carried;resources were obtained from databases PubMed, PubMed Central, SciELO, Ebsco, ClinicalKey, and Scopus. The search strategies formulated were: SARS-CoV-2, COVID-19, Cardiovascular complications;as well as its translations into the English language. Objective: To describe the cardiovascular complications in patients with the COVID-19. Development: There is a wide diversity of criteria in the scientific literature regarding cardiovascular damage in the context of COVID-19 infection. Frequently reported cardiovascular complications are acute myocardial injury, acute myocarditis, cardiac arrhythmias, acute coronary syndrome, acute heart failure, heart valve damage, venous thromboembolic disease, and shock. Conclusions: Cardiovascular complications in COVID-19 carriers were described. SARS-CoV-2 infection causes direct or indirect damage to the myocardium, heart valves and the rest of the cardiovascular system. © 2021, Editorial Ciencias Medicas. All rights reserved.
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Portugal is a country in which the tourism sector assumes great importance, contributing around 15% of the national GDP and with more than 1 million jobs. In this sense, COVID-19 is expected to have a dramatic impact on the Portuguese economy aggravated by the existence of a reduced internal market with low purchasing power and in which there is a high dependence on the external market. This perspective study explores the challenges and opportunities that Portuguese companies in the field of tourism are facing due to the emergence of this pandemic. The challenges faced by companies are both short-term and long-term. In the short term, it is essential to ensure sufficient liquidity to reopen activities and in the long term, it is necessary to be prepared and reactive to disruptive movements that may arise in tourist demand. However, it is also important to recognize that some opportunities can be exploited, such as the quality of the health response, the exploitation of a less mass tourism supply based on the components of social and environmental sustainability, the increase of tourism among the elderly population from countries with greater purchasing power and the acceleration of the digitalization of tourism operations.
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Introduction: With the current reality that we are experiencing with the beginning of the new coronavirus (nCov) pandemic, everyone is dealing with new challenges. Among these, there are medical students, with their practical activities interrupted and many concerns. Objective: This article portrays the experience of medical students attending internship and the impact of the pandemic on medical education. Discussion: Among the multiple issues that students have been experiencing, there is a duality between the desire to engage in the fight against the pandemic and the fear of contamination of their friends and family. Furthermore, there is an increasing offer of online content, such as courses, congresses, and discoveries regarding COVID-19. With the massive adoption of Open and Distance Learning, the student faces the duality between traditional and active teaching methods, in addition to fear about the interruption of practical activities and the question of when they will be re-established. Finally, there are concerns about the students' future: when and how they will complete the medical course, and the preparation for Medical Residency Exams. Conclusion: It is clear that the pandemic is significantly affecting already concerned medical students, in multiple aspects of their lives, about their training and completion of the course.
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Introduction: COVID-19 does not present a distinction of ages, races and sex, children and youth represent a sector of the population that does not escape this reality. Early identification of the disease favors a better prognosis. Objective: To describe general aspects of COVID-19 in pediatric patients. Methods: A bibliographic review was performed, using the databases (PubMed, Scielo, Ebsco and Clinical Key). The search descriptors used were: SARS-CoV-2, COVID-19, and COVID-19 in children. The search yielded 77 articles, of which 47 were discarded for not meeting the inclusion criteria. 30, 100% of the year 2020, were taken to cite the work. The analysis-synthesis, induction-deduction and historical-logical methods were used. Development: To characterize the disease, there are abundant scientific articles worldwide, pediatric patients are equally affected than the rest of the population. The relevance of identifying the disease early, justifies the dispersion existing in the literature. Conclusions: Despite the scientific advances made in multiple investigations, there are still elements of the disease that must be studied in depth. Although pediatric patients generally present a better evolution, probably influenced by the absence of existing comorbidities in the adult population, COVID-19 has similar behavior. © 2020, Editorial Ciencias Medicas. All rights reserved.
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Pheochromocytomas are neuroendocrine tumors capable of synthetizing, storing and releasing catecholaminergic hormones that may lead to lifethreatening hemodynamic instability. The COVID-19 pandemic has increased the risks and perioperative complexity of the patients undergoing pheochromocytoma-associated adrenalectomy. This article discusses the use of adenosine for the management of hypertensive crisis during this intervention, as well as the need to individualize the suitable timing for surgery after recent COVID-19 infection. This article discusses the case of a patient with a finding of right adrenal incidentaloma;further studies determined a metanephrines secreting pheochromocytoma. Following hospital admission for preoperative optimization, the eve of the procedure the patient developed an acute myocardial infarction and subsequently SARS-CoV-2 symptomatic infection. Intraoperatively, hypertensive peaks were managed with continuous adenosine perfusion. The patient was discharged after 48 hours. Preoperative optimization positively influences the intraoperative management of patients with pheochromocytoma. The intraoperative use of adenosine allows for adequate and safe control of hypertensive crises. Each situation must be individualized in patients pending surgery, with a recent COVID-19 infection. Copyright © 2022 Lippincott Williams and Wilkins. All rights reserved.
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OBJECTIVE: to identify the main biosafety measures for preventing COVID-19 in healthcare professionals. METHODS: this is an integrative literature review, with studies published between January and July 2020, on the MEDLINE/PubMed, Scopus, Embase, Web of Science, LILACS, SciELo, Wiley Online Library, Cochrane CINAHL databases. The selection of studies followed the PRISMA recommendations. RESULTS: among the 2,208 publications identified, 12 studies comprised the sample, which enabled the analysis in four thematic categories: The importance of using recommendations about the use of personal protective equipment;The restructuring of new operational and clinical routines and flows in the practice of services;Monitoring professionals, especially testing;Conducting training. CONCLUSIONS: the phenomena involved are innumerable, covering operational management and the training of teams to deal with highly infectious pathogens and disease outbreaks.