Attitudes, Practices and Knowledge of Honduran Physicians in the Prescription of Antibiotics in Covid-19

Intro: Antimicrobial resistance has been considered a global health problem, being one of the 10 most important public health problems worldwide. During the COVID-19 pandemic, a large number of antibiotics were used without any control, both on an outpatient basis and in hospitalization, which can have serious consequences. Method(s): Prior informed consent, a cross-sectional descriptive study was conducted with a sample of 322 physicians. A survey was carried out in Google forms, and it was shared by telephone messages and social networks. Finding(s): 322 physicians, 60.9% women and 39.1% men, mean age 33.4 years, 85.9% general practitioners, 11.5% specialist physicians. 47.2% work in private institutions, 36% in public centers. Antibiotic policies in institutions: 50.3% do not have regulations for the use of antibiotics in COVID-19, only 29.5% work with policies to control the use of antibiotics and control measures against antibiotic resistance, 73.9% lack a committee for infection control and prevention of antibiotic resistance. Use of antibiotics: only 20.8% never used antibiotics in COVID-19, 45.6% used antibiotics in severe COVID-19, 40.4% hospitalized patients, and 33.5% outpatients. The most used antibiotics were azithromycin (67.1%), levofloxacin (53.4%), ceftriaxone (53.4%), and amoxicillin plus clavulanic acid (34.8%). 43.2% consider that using antibiotics can reduce mortality in moderate and severe COVID-19, 50.3% believe antibiotics should be suspended if there is clinical improvement, 96.3% believe there is an increase in self-medication of antibiotics, 59.8% consider that they used antibiotics inconrrectly at some point, 58.1% consider antibiotic resistance to be a problem in their workplace. 86.3% currently make less use of antibiotics in patients with COVID-19. Conclusion(s): In Honduras, there are deficiencies in policies for the use of antibiotics and control of antimicrobial resistance. Most doctors consider that they have used antibiotics incorrectly, including antibiotics that can generate resistance.Copyright © 2023

Disposition of Patients with Significant Steatosis at a Primary Care Clinic: A Five-Year Follow-Up

Background: Fatty liver is a well-recognized health risk and epidemic. It is associated with obesity, diabetes mellitus, and metabolic syndrome. Transient elastography is a quick and simple, non-invasive tool, validated across a range of liver diseases for the assessment for fibrosis and steatosis. Using Fibroscan, liver fibrosis is assessed by liver stiffness measured (LSM) in kilopascals (kPa) and steatosis is estimated using controlled attenuation parameter (CAP). In 2017 we initiated and reported on a screening program for fatty liver and liver fibrosis using FibroScan in a primary care facility in Southern California. Aim(s): To report on the 5-year disposition of the patients who had participated in the 2017 screening program and the outcome of their management in a primary care setting in the context of COVID-19 pandemic. Method(s): Between March, 2017 and June, 2017 958 individuals attending a primary care clinic, who had no known history of liver disease agreed to be screened and had an evaluable Fibroscan. Pts were followed and managed per standard of care in the primary care setting including annual check-ups, FibroScan assessments and referral to specialists as indicated. Result(s): Of the 958 pts, 79 were lost to follow-up, 14 pts declined follow-up, and 749 are in the process of being contacted for the 5-year follow-up check. The subjects of this analysis are 116 pts who returned for follow-up. 73.2% were females;mean age was 56.1 +/-11.6years and 88.8% Hispanic. There was no significant change in Hemoglobin A1c, ALT, and AST values. However, over the 5-year period, there was an increase of more than 25% in the number of pts diagnosed with two or more metabolic syndrome risk factors including hypertension, diabetes, hyperlipidemia, and/or fatty liver. Refer to table 1 for the 5-year change in FibroScan measurements and BMI. Conclusion(s): In a pre-dominantly Hispanic community patient population with no known history of liver disease attending a primary care clinic, over 70% had significant fat infiltration of the liver;23% had significant liver fibrosis at baseline. Only 55% of pts continued to follow regularly with primary care. Over 5years with at minimum annual follow-up visit, 1) there was no change in the fat infiltration, 2) there was increase in liver stiffness measure, 3) there was significant worsening in the metabolic syndrome presentation and risk factors. Further analysis is underway to determine the impact of the COVID-19 pandemic in leading to worsening BMI, LSM, and metabolic syndrome, especially with the 2-year quarantine, isolation, TeleHealth visits. Educational programs are urgently needed to increase the awareness of patients, community, the Primary Care practices on the epidemic of fatty liver and its consequences.

Understanding COVID-19 Epidemic in Costa Rica Through Network-Based Modeling

As a result of the critical health situation caused by COVID-19, governments and researchers have acknowledged the significance of epidemic models for understanding a transmissible disease and assessing public policies, in order to determine which ones are truly effective in mitigating its propagation. We apply a modified SEIR model to characterize the behavior of the COVID-19 epidemic in the context of Costa Rica, employing a contact network to simulate the social connections among the inhabitants. Then, we use this model to weigh up the impact of important sanitary restrictions by simulating different scenarios associated to vaccination, authorization for organizing social events, and reopening of the school system. Our validation tests show that the obtained model is precise. In the scenario evaluation, simulations estimate that a constant vaccination reduces the reported cases by 45% and deaths by 42% in the best case where the infection dies out. In contrast, opening the schools with the totality of students increases the number of reported cases by 46% and deaths by 39% in the worst case. Finally, our model predicts that allowing social events causes an increase of 24% in reported infections and 17% more deaths, specially if people gather with close contacts. © 2022, Springer Nature Switzerland AG.

Tomato Dice: A Multimodal Device to Encourage Breaks during Work

The COVID pandemic has resulted in many people working from home, blurring lines between work and personal time. In response, the Tomato Dice, a multimodal device, attempts to provide a fun way for people to take more effective breaks amid work through timeboxing. After the dice is rolled, each side plays visual and audio feedback helping users to either work for a set amount of time or take a break away from their work screens. In this paper, we discussed the design process and the different modes of the dice. We also conducted a heuristic evaluation followed by a usability study which revealed that participants were mostly fascinated with the dice and were more likely to use the Tomato Dice to relax than to take breaks. © 2021 ACM.

Management of care teams during the covid-19 pandemic

Introduction: The demand for COVID-19 care has represented a challenge for health systems, especially in nursing. Analyzing and learning from the experiences of managing care teams is a necessary input for improving the quality of care. Objective: Describe the health challenges that the management of care teams has implied in the framework of the COVID-19 pandemic Methods: Exploratory study with quantitative-qualitative analysis. Descriptive analysis of the data reported between April and August 2020 of 1,174 patients treated for COVID-19 at the Hospital of the third level of Soledad, Atlántico was carried out. Descriptive statistics were used to collect the information in absolute and relative frequencies, Microsoft Excel was used for processing. For the documentary analysis, the methodological proposal of Avedis Donabedian was used. Result: In the institution, 1,170 (26.98%) suspected cases have been treated, of which 37.26% were positive for COVID-19. The management of the care teams involved the application of professional judgment in the planning, organization and motivation of the provision of care in the event of an emergency. The leadership of the nursing team is highlighted in a coordinated work with the different areas. Conclusion: The study provides evidence on the experiences of care management in challenging times, highlighting the importance of having competent nursing teams to adapt to changing situations and learn for future similar situations. © 2021, Editorial Ciencias Medicas. All rights reserved.

ANALYSIS OF THE STRATEGIES GENERATED FOR THE HOTEL SECTOR OF COLOMBIA TO OVERCOME THE COVID-19 CRISIS DURING THE PANDEMIC PHASE

COVID-19 is a disease caused by sars-CoV-2 virus;it was declared a global pandemic by the World Health Organization (who) on March 11, 2020. Because of the large number of infections in different countries of the world, national quarantines started to take effect. The industry most affected by this was tourism and hotels. This article has compiled the different measures taken by international organizations, the Colombian Government, and the hotel sector itself to face the crisis in the sector. To conclude, there is an analysis on the effectiveness of the measures taken to support the hotel sector during the quarantine and post-quarantine phases.

New ways of working and public healthcare professionals' well-being: the response to face the COVID-19 pandemic

This research proposes analyzing the influence of new ways of working (NWW) on healthcare professional's well-being and how these may affect work performance and public service motivation. These variables and relationships were important before COVID-19 pandemic, and everything points to the fact that during and after the pandemic their importance will be higher. To buffer the potential negative effects of implementing the NWW, both organizations and employees must identify personal (psychological capital) and job resources (inter-role conflict, psychological empowerment, meaning of work) capable of acting as effective moderators to promote employee well-being and avoid negative experiences at work. This paper aims to shed light on new ways of coping and adapting to uncertain job requirements such as those that have arisen during COVID-19. Moreover, it highlights the great changes that public healthcare needs to face to improve the quality of the service offered to society. It is urgent that public administrators and human resources managers design effective strategies and make effective decisions in which employee well-being and service quality are main priorities.

Supercomputer-Based Ensemble Docking Drug Discovery Pipeline with Application to Covid-19.

We present a supercomputer-driven pipeline for in silico drug discovery using enhanced sampling molecular dynamics (MD) and ensemble docking. Ensemble docking makes use of MD results by docking compound databases into representative protein binding-site conformations, thus taking into account the dynamic properties of the binding sites. We also describe preliminary results obtained for 24 systems involving eight proteins of the proteome of SARS-CoV-2. The MD involves temperature replica exchange enhanced sampling, making use of massively parallel supercomputing to quickly sample the configurational space of protein drug targets. Using the Summit supercomputer at the Oak Ridge National Laboratory, more than 1 ms of enhanced sampling MD can be generated per day. We have ensemble docked repurposing databases to 10 configurations of each of the 24 SARS-CoV-2 systems using AutoDock Vina. Comparison to experiment demonstrates remarkably high hit rates for the top scoring tranches of compounds identified by our ensemble approach. We also demonstrate that, using Autodock-GPU on Summit, it is possible to perform exhaustive docking of one billion compounds in under 24 h. Finally, we discuss preliminary results and planned improvements to the pipeline, including the use of quantum mechanical (QM), machine learning, and artificial intelligence (AI) methods to cluster MD trajectories and rescore docking poses.

Analysis of the measures taken by the governments of Colombia and Ecuador in favor of the tourism industry during the pandemic generated by covid-19

The coronavirus outbreak, called COVID-19, has destabilized the worldwide economy. The evolution of the disease and therewith the measures taken by each of the goverments has affected local economies in an uncertain way, and a priori to the facts, measures have been taken to keep safe one of the most affected sectors such as the tourism. In order to learn about the measures taken by the governments of Colombia and Ecuador, this document analyses the governmental provisions of each country for the sector. In this way, it will be determined whether or not the strategies of each country where correct to mitigate the negative impacts of the pandemic. © 2020, Associacao Iberica de Sistemas e Tecnologias de Informacao. All rights reserved.