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1.
Index de Enfermeria ; 31(2), 2022.
Article in Spanish | EMBASE | ID: covidwho-1935137

ABSTRACT

Objective: To assess the satisfaction of novel nurses with high-fidelity clinical simulation in CPR training, during Covid-19. Methods: Cross-sectional descriptive observational study. Satisfaction Scale in High Fidelity Clinical Simulation was used, a validated 33-item questionnaire with a Likert-type response. Descriptive statistics and non-parametric inferential statistics (Spearman's correlation) were used to analyze the correlation between the variables. Results: N = 35 (100%). The mean overal satisfaction was 4.97 ± 0.17. The items related to the adequacy of the cases to the knowledge of the participants, the ability to provide care to patients, the benefit of simulation and the impact on improving their technical skills were the best scored (mean of 4.97). A positive and strong relationship was found between items: 4-9, and 27-9 (rho = 0.804;p = 0.000). Conclusions: Satisfaction level of novel nurses with the high-fidelity clinical simulation was high, confirming its usefulness in the CPR learning process during Covid-19 or pandemic outbreaks of the same nature.

2.
Global Advances in Health and Medicine ; 11:25, 2022.
Article in English | EMBASE | ID: covidwho-1916565

ABSTRACT

Methods: This 16-week intervention conducted at community health centers combines integrative group medical visits with produce prescriptions. Participating patients are adults diagnosed with chronic conditions including diabetes, hypertension and depression. Virtual integrative group medical visits meet weekly in Spanish or English with health coach support between sessions. Participants also receive weekly doorstep delivery of fresh vegetables grown using regenerative agriculture. Ongoing mixed-methods data collection includes: 1) semi-structured interviews with program staff and patients, and 2) pre-and post-program patient surveys including the 8-Item UCLA Loneliness Scale and the 6-item USDA short form for household food insecurity. Preliminary quantitative analysis uses mixed-effects models to assess the effects of participation in the combined intervention (N=185). Qualitative analysis uses reflexive thematic analysis (N=35). Results: Qualitative interview data explored program implementation and stakeholders' experiences with Recipe4Health during COVID-19. Patients and staff reported that virtual group visits provided social connection and supported mental health. Weekly produce delivery increased food security and provided access to new and familiar foods. Preliminary quantitative analysis included 185 patients: 83% female;51% Latin, 27% Black;61% spoke English as primary language, 39% Spanish. Average loneliness scores decreased from 5.2 to 4.7 (p<.04), despite notable national inc1reases in isolation and loneliness during COVID-19. While food insecurity doubled nationwide, the proportion of study participants reporting food insecurity or marginal food security decreased from 79% to 54% (p<.01). Background: Food insecurity has been associated with social isolation;both have risen dramatically in the US during the COVID-19 pandemic. This project, Recipe4Health, is implementing and assessing the impact of integrative group medical visits and produce prescriptions for low-income adults with chronic conditions. Conclusion: Combining integrative group medical visits and produce prescriptions can improve key patient outcomes including loneliness and food security in a pandemic context.

3.
Diabetes Technology and Therapeutics ; 24(SUPPL 1):A221, 2022.
Article in English | EMBASE | ID: covidwho-1896129

ABSTRACT

Background and Aims: Some bibliography suggest that COVID-19 disease can produce deleterious effects on gestation, for example: preeclampsia, gestational diabetes, preterm births, low birth weight. Aim: to determine if there is an increase in the incidence of gestational diabetes, preeclampsia or alterations in gestational time/birth weight, in those affected by COVID. Methods: Retrospective study, in primary care, analyzing pregnant women assigned to a gynecology service. A representative sample was selected, discriminating those who suffered from COVID during their pregnancy. Results: 135 pregnant women were analyzed. 36 affected by COVID (26.7%). 49 were close contacts, who did not develop COVID disease, and 50 women without a COVID environment. 13 pregnant women (9.6%) had gestational diabetes and 47 were referred to the HOR (high obstetric risk) service. of the COVID free women, a total of 25 suffered from postpartum COVID (18.5%). Comparing the group with/without COVID, statistically significant differences were observed in: gestational period (266.7±51.2 d, vs 278.2±11.9, p = 0.04) as well as in birth weight (3.16±0.62 kg, vs 3.51±0.42;p = 0.03). Not significant differences was appreciated in pregnant woman's previous weight or age. Gestational diabetes was not different in both groups (4 vs 9, p = 0.45) nor was preeclampsia (2 vs 2, p = 0.226). Instead, more COVID patients were referred to HOR (17 vs 37, p < 0.005). Conclusions: Similar prevalences of gestational diabetes and preeclampsia were observed in this sample. Being the birth weight and gestational period significantly lower in COVID cases. Significant increase in referrals to HOR, can be attribuible to the indication to administer heparin as prophylaxis of thrombosis.

4.
Topics in Antiviral Medicine ; 30(1 SUPPL):379-380, 2022.
Article in English | EMBASE | ID: covidwho-1880551

ABSTRACT

Background: Routine medical care was drastically affected by the overwhelming irruption of COVID-19 pandemic. We comprehensively assessed the impact of the COVID-19 pandemic on the prevention and care for HIV and other sexually transmitted infections at a large reference hospital providing preventive and clinical services for HIV infection and other sexually transmitted infections. Methods: We retrospectively compared clinical and laboratory data from March to December 2020 (first ten months of the SARS-CoV-2 epidemics in Spain) vs. the same period 2019 in the setting of Hospital Clínic of Barcelona which provides preventive and clinical services for HIV infection and other sexually transmitted infections for the region of Catalonia and is the largest of its kind in Spain. Monthly clinical data on HIV pre-exposure and post-exposure prophylaxis users and on adults with HIV infection were retrieved from the administrative hospital database. Monthly tests for HIV, hepatitis B and C, Treponema pallidum, Neisseria gonorrhoeae, and Chlamydia trachomatis, and plasma lipids and glucose were recovered from the laboratory database. De novo HIV, hepatitis B, or hepatitis C diagnosis were considered whenever a person had a first known positive laboratory test. Results: There were less (28% reduction) but more advanced (mean [SD] CD4 cell counts per mm3 at HIV diagnosis 305 [167] vs. 370 [170], P<0.001;26 (18%) persons had AIDS-defining conditions at HIV diagnosis vs. 20 (10%), P=0.03) HIV cases and more gonorrhea (39% increase, P<0.001) and chlamydia (37% increase, P<0.001) infections in 2020 vs. 2019. In people with HIV, rates of viral load above the level of detection remained stable (11% vs 11%, P=0.147) despite less scheduled visits (25% reduction, P<0.001). However, they had less antiretroviral prescription changes (10% reduction, P=0.018), worse plasma lipids (mean total cholesterol 190 vs 185 mg/dL, P<0.001;mean LDL cholesterol 114 vs 110 mg/dL, P<0.001;mean triglycerides 136 vs 125 mg/dL, P<0.001;mean HDL cholesterol 47 vs 48 mg/dL, P=0.006), and an excess of mortality (29 deaths vs 11, 264% increase, P=0.006) due in great part to COVID-19 (n=11) but also to other non-COVID-19 causes. Conclusion: In the setting of a large Spanish reference hospital, SARS-CoV-2 epidemics was associated with an increase of some prevalent sexually transmitted infections, with less but more advanced de novo HIV infections, and with worse non-virologic healthcare outcomes and higher mortality in people living with HIV.

5.
Topics in Antiviral Medicine ; 30(1 SUPPL):19, 2022.
Article in English | EMBASE | ID: covidwho-1880234

ABSTRACT

Background: Little is known regarding global COVID-19 vaccination rates in people with HIV (PWH), a population with significant morbidity from COVID-19. The Randomized Trial to Prevent Vascular Events (REPRIEVE) is a global primary cardiovascular prevention trial among PWH (N=7770) with representation from >100 sites across twelve countries (Brazil, Botswana, Canada, Haiti, India, Peru, Spain, South Africa, Thailand, Uganda, USA, Zimbabwe). Data collected on COVID-19 vaccination rates in REPRIEVE afford a unique opportunity to assess such rates among PWH across global regions. Methods: We assessed cumulative COVID-19 vaccination rates from January through July 2021 among 6952 active participants and compared rates to region-and country-specific vaccination data among the general population, determined from publicly available datasets (CDC, World Bank). Secondarily, within the REPRIEVE cohort, demographic, cardiovascular, and HIV-specific data were compared among those vaccinated vs not via Kaplan-Meier. Results: The cumulative probability of COVID-19 vaccination through the end of July 2021 was 47% among REPRIEVE participants, with rates varying substantially by global burden of disease (GBD) super-region and specific countries. Cumulative vaccination rates (Figure) were highest in the High-Income super-region (64%), followed by Latin America and the Caribbean (51%), Southeast/East Asia (36%), South Asia (16%) and Sub-Saharan Africa (12%). Country-specific rates varied dramatically, with vaccination rates highest in the United States, Peru, and Brazil, 67%, 60%, and 55%, and lowest in South Africa, Uganda, and Haiti with 11%, 3%, and 0%, respectively. Overall factors associated with COVID-19 vaccination among PWH included age, White race, natal male sex, BMI, and higher burden of cardiovascular risk factors, with important differences across GBD super-regions by log-rank test. Vaccination rates among PWH in REPRIEVE were largely comparable to the general population, in most GBD super-regions (Figure), though differences were observed in comparison to the general population in specific countries (data not shown). Conclusion: Global inequities in COVID-19 vaccine access among PWH are apparent, with highest vaccination rates observed among those residing in high-income regions. In addition to region, factors associated with vaccination among PWH included White race, natal male sex, and higher burden of CVD risk factors. Efforts are needed to increase global and regional vaccine rates for PWH.

6.
Topics in Antiviral Medicine ; 30(1 SUPPL):349, 2022.
Article in English | EMBASE | ID: covidwho-1879935

ABSTRACT

Background: Effective, safe, and affordable antivirals are needed for COVID-19. Several lines of reseach suggest that tenofovir may be effective against COVID-19 but no large-scale human studies with appropriate adjustment for comorbidities have been conducted. We describe the incidence, clinical severity and mortality of laboratory-confirmed SARS-CoV-2 infection by antiretroviral therapy (ART) among HIV-positive individuals with virological control adjusting for key potential confounders including hypertension, diabetes, chronic renal disease, cardiovascular disease, and treatment with immunosuppressants or corticosteroids. Methods: We studied HIV-positive individuals on ART in 2020 at 69 HIV clinics in Spain from February 1 to December 31. These 69 clinics serve approximately 44% of all persons on ART with virological suppression in Spain. We collected data on sociodemographics, ART, CD4-cell count, HIV-RNA viral load, comorbidities and the following outcomes: laboratory-confirmed SARS-CoV-2 infection, COVID-19 hospitalization, intensive care unit (ICU) admission and death. We compared 48-week risks, relative risks, relative differences and 95% confidence intervals (CI) for individuals receiving tenofovir disoproxyl fumarate (TDF)/emtricitabine (FTC), tenofovir alafenamide (TAF)/FTC, abacavir (ABC)/lamivudine (3TC), and other regimes. All estimates were adjusted for clinical and sociodemographic characteristics via inverse probability weighting. Results: Of 51,558 eligible individuals, 39.6% were on TAF/FTC, 11.9% on TDF/FTC, 26.6% on ABC/3TC, 21.8% on other regimes. There were 2,402 documented SARS-CoV-2 infections (425 hospitalizations, 45 ICU admissions, 37 deaths). Compared with TAF/FTC, the estimated risk ratios (RR) (95% CI) of hospitalization were 0.66 (0.43, 0.91) for TDF/FTC and 1.29 (1.02, 1.58) for ABC/3TC, the RRs of ICU admission were 0.28 (0.11, 0.90) for TDF/FTC and 1.39 (0.70, 2.80) for ABC/3TC, and the RRs of death were 0.37 (0.23, 1.90) for TDF/FTC and 2.02 (0.88-6.12) for ABC/3TC. The corresponding RRs of hospitalization for TDF/FTC were 0.49 (0.24, 0.81) in individuals ≥50 years and 1.15 (0.59, 1.93) in younger individuals. Conclusion: Our findings suggest that, compared with other antiretrovirals, TDF/FTC lowers COVID-19 severity among HIV-positive individuals with virological control. This protective effect may be restricted to individuals aged 50 years and older. Confirmatory randomized trials of TDF/FTC for the prophylaxis and early treatment of COVID-19 are warranted.

8.
Diabetes Technology & Therapeutics ; 24:A221-A221, 2022.
Article in English | Web of Science | ID: covidwho-1848497
9.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-333778

ABSTRACT

Emergence of novel variants of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) underscores the need for next-generation vaccines able to elicit broad and durable immunity. Here we report the evaluation of a ferritin nanoparticle vaccine displaying the receptor-binding domain of the SARS-CoV-2 spike protein (RFN) adjuvanted with Army Liposomal Formulation QS-21 (ALFQ). RFN vaccination of macaques using a two-dose regimen resulted in robust, predominantly Th1 CD4+ T cell responses and reciprocal peak mean neutralizing antibody titers of 14,000-21,000. Rapid control of viral replication was achieved in the upper and lower airways of animals after high-dose SARS-CoV-2 respiratory challenge, with undetectable replication within four days in 7 of 8 animals receiving 50 microg RFN. Cross-neutralization activity against SARS-CoV-2 variant B.1.351 decreased only ~2-fold relative to USA-WA1. In addition, neutralizing, effector antibody and cellular responses targeted the heterotypic SARS-CoV-1, highlighting the broad immunogenicity of RFN-ALFQ for SARS-like betacoronavirus vaccine development. SIGNIFICANCE STATEMENT: The emergence of SARS-CoV-2 variants of concern (VOC) that reduce the efficacy of current COVID-19 vaccines is a major threat to pandemic control. We evaluate a SARS-CoV-2 Spike receptor-binding domain ferritin nanoparticle protein vaccine (RFN) in a nonhuman primate challenge model that addresses the need for a next-generation, efficacious vaccine with increased pan-SARS breadth of coverage. RFN, adjuvanted with a liposomal-QS21 formulation (ALFQ), elicits humoral and cellular immune responses exceeding those of current vaccines in terms of breadth and potency and protects against high-dose respiratory tract challenge. Neutralization activity against the B.1.351 VOC within two-fold of wild-type virus and against SARS-CoV-1 indicate exceptional breadth. Our results support consideration of RFN for SARS-like betacoronavirus vaccine development.

10.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-333760

ABSTRACT

The emergence of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants stresses the continued need for next-generation vaccines that confer broad protection against coronavirus disease 2019 (COVID-19). We developed and evaluated an adjuvanted SARS-CoV-2 Spike Ferritin Nanoparticle (SpFN) vaccine in nonhuman primates (NHPs). High-dose (50 micro g) SpFN vaccine, given twice within a 28 day interval, induced a Th1-biased CD4 T cell helper response and a peak neutralizing antibody geometric mean titer of 52,773 against wild-type virus, with activity against SARS-CoV-1 and minimal decrement against variants of concern. Vaccinated animals mounted an anamnestic response upon high-dose SARS-CoV-2 respiratory challenge that translated into rapid elimination of replicating virus in their upper and lower airways and lung parenchyma. SpFN's potent and broad immunogenicity profile and resulting efficacy in NHPs supports its utility as a candidate platform for SARS-like betacoronaviruses. ONE-SENTENCE SUMMARY: A SARS-CoV-2 Spike protein ferritin nanoparticle vaccine, co-formulated with a liposomal adjuvant, elicits broad neutralizing antibody responses that exceed those observed for other major vaccines and rapidly protects against respiratory infection and disease in the upper and lower airways and lung tissue of nonhuman primates.

12.
International Journal of Morphology ; 40(1):46-50, 2022.
Article in English | Web of Science | ID: covidwho-1766696

ABSTRACT

The Covid-19 pandemic has disrupted long-standing educational practices. In Colombia, online learning depends on academic and non-academic factors, and this dependence makes e-learning even more difficult. This paper aimed to study the students' viewpoint of Anatomy teaching at Universidad del Norte, Colombia, during the Covid-19 pandemic. One hundred sixteen students answered a questionnaire about their opinions on several topics related to online learning of Anatomy. The strongest correlation observed showed that the students agree that online anatomy classes make the subject more difficult to learn when compared to face-to-face lectures. Negative attitudes toward motivation, lack of personal contact with classmates, and complaints about being taught without laboratory sessions with cadavers were among the principal negative attitudes in students. After almost one year, motivation to participate in online classes went down;however, students improved their judgment about remote anatomy learning and their views about using authentic anatomy images during online sessions and substituting real anatomy images for apps. Anatomy sessions will have to adapt their learning tools to e-learning as time constraints allow, creating a new environment for students to participate, learn, and take advantage of this change.

13.
Open Forum Infectious Diseases ; 8(SUPPL 1):S383-S384, 2021.
Article in English | EMBASE | ID: covidwho-1746435

ABSTRACT

Background. Large mortality rates have been reported in the Mexican public health system, however in the experiences of private hospitals that have resources and infrastructure this is lower compared to the national average. Methods. Descriptive and retrospective study. Adult patients treated for pneumonia due COVID-19 from April to December 2020 are entered into the study. Its general characteristics such as gender and age, comorbidities, influenza vaccination history, clinical characterization, laboratory and tomographic diagnosis of sars cov2 pneumonia are studied, as well as the drug and oxygen therapy treatments received and finally, its evolution and clinical outcome. Results. 132 patients were studied, of which 51% were female. The main age groups affected were 65 and over (43.9%), 50-59 years (20.4%) and 25-44 years (16.6%). The main comorbidities found were: arterial hypertension (43.9%), Diabetes mellitus 2 (33.3%), heart disease (11.3%) and obesity (10.6%). 95.4% of the patients were not vaccinated against influenza. The main symptoms reported were: fever (92%), cough (87%), dyspnea (76%) and headache (52%). The diagnosis was confirmed with RT-PCR in 63%, reporting negative RT-PCR in 36%;the antigen test was positive in 1%. Regarding the findings of the chest computed tomography, CORADS 5 was reported in 30%, CORADS 6 in 3% and CORADS 4 in 20%. The main treatments used in patients with severe inflammatory pneumonia were: steroids (98%), enoxaparin (100%), tocilizumab (20%), baricitinib (60%), direct oral anticoagulants (10%), fibroquel (5%). 60% were treated with a combination of two or more drugs. The main oxygenation contributions were: 20% nasal tips - mask/reservoir, 60% high flow nasal cannula, 20% mechanical ventilation. In 95% the prone position was indicated. Regarding the clinical evolution, 65.1% were towards improvement, 17.4% died, 12.1% requested transfer to another unit and 5.3% requested voluntary discharge. Overall mortality was 17%. Conclusion. A hospital strategy that has the necessary resources and infrastructure as well as openness to the use of medication with emergency approvals for its use or off-label indications, can help limit morbidity and mortality in vulnerable populations and manifest risk factors such as Mexican population.

14.
Open Forum Infectious Diseases ; 8(SUPPL 1):S384, 2021.
Article in English | EMBASE | ID: covidwho-1746434

ABSTRACT

Background. The zoonotic emergence of SARS-CoV-2 quickly developed into a global pandemic. Multiple vaccine platforms have been advanced to clinical trials and emergency use authorization. The recent emergence of SARS-CoV-2 virus variants with Spike receptor-binding domain (RBD) and N-terminal domain (NTD) mutations, highlights the need for next-generation vaccines that can elicit immune responses that are resilient against Spike mutations. Methods. Using a structure-based vaccine design approach, we developed multiple optimized SARS-CoV-2 nanoparticle immunogens that recapitulate the structural and antigenic profile of the SARS-CoV-2 prefusion spike. We assessed these immunogens in murine immunogenicity studies and in a K18-hACE2 transgenic mouse model with a SARS-CoV-2 challenge. Immune sera from vaccinated mice were assessed for SARS-CoV-2 binding, and neutralization against SARS-CoV-2, variants of concern, and the heterologous SARS-CoV-1 virus. Results. In combination with a liposomal-saponin based adjuvant (ALFQ), these immunogens induced robust binding, ACE2-inhibition, and authentic virus and pseudovirus neutralization. A Spike-Ferritin nanoparticle (SpFN) vaccine elicited neutralizing ID50 titers >10,000 after a single immunization, while RBD-Ferritin (RFN) nanoparticle immunogens elicited ID50 titer values >10,000 values after two immunizations. Purified antibody from SpFN- or RFN-immunized mice was transfused into K18-ACE2 transgenic mice and challenged with a high-dose SARS-CoV-2 virus stock. In order to understand the breadth of vaccine-elicited antibody responses, we analyzed SpFN- and RBD-FN-immunized animal sera against a set of heterologous SARSCoV-2 RBD variants and SARS-CoV RBD. High binding titers with ACE2-blocking activity were observed against SARS-CoV-2 variants and the heterologous SARSCoV-1 RBD. Furthermore, both SpFN- and RFN-immunized animal sera showed SARS-CoV-1 neutralizing ID50 titers of >2000. Conclusion. These observations highlight the importance of SARS-CoV-2 neutralizing antibody levels in providing protection against emerging SARS-like coronaviruses and provide a robust platform for pandemic preparedness. Structure-based design enables development of a SARS-CoV-2 nanoparticle immunogen.

15.
Journal of Crohn's and Colitis ; 16:i525, 2022.
Article in English | EMBASE | ID: covidwho-1722346

ABSTRACT

Background: Treatment with anti-TNF agents and thiopurines has been associated with an impaired immune response to some vaccines. SARSCoV- 2 vaccination is very effective in healthy individuals, but studies in inflammatory bowel disease (IBD) populations are scarce, especially regarding T cell response. We aimed to evaluate the T cell and antibody response in a cohort of IBD patients on anti-TNF and thiopurine treatment who received two doses of the SARS-CoV2 mRNA vaccine. Methods: An observational, prospective study was carried out at our IBD clinic. We included Crohn's disease (CD) and Ulcerative colitis (UC) patients receiving anti-TNF as monotherapy or anti-TNF + thiopurine (combo) or thiopurines only for at least six months at inclusion. Blood samples were drawn for interferon-gamma release assay (IGRA) and antibody determination six (+/- 2) weeks after the second vaccine dose. The specific T cell response to SARS-CoV-2 was determined by IGRA using Qiagen® QuantiFERON® SARS-CoV-2 RUO tubes with a patented Spike protein combination. Interferon-gamma was measured by CLIA using the LIAISON® QuantiFERON-®TB Gold Plus assay. As there is no validated cut-off point, we used those obtained in a cohort of 20 healthy health professionals published by our group (doi. org/10.1016/j.medcli.2021.09.013). Antibodies to the Spike (S) SARSCoV- 2 protein were analyzed by CLIA. Adverse events (AEs) and clinical activity were recorded. Results: We recruited 148 IBD patients, 57 treated with anti-TNF monotherapy, 53 with combo, and 38 with thiopurine only. Seventy percent had CD, and 60% were male. Using the cut-off value of the cohort mentioned above, the T-cell response was positive in 92% of anti-TNF monotherapy, 83% in combo, and 87% of the thiopurine group (p=ns). The anti-S antibodies were positive in 100% of our cohort. There were no changes in disease activity rates after the second vaccination, nor were severe AEs detected. Conclusion: SARS-CoV-2 mRNA vaccination was very effective in IBD patients receiving anti-TNF (combo or monotherapy) or thiopurine treatment as measured by both T cell and antibody response. IGRA-specific tests may constitute a valuable tool in assessing cellular immunity in immunocompromised patients.

16.
PubMed; 2021.
Preprint in English | PubMed | ID: ppcovidwho-329534

ABSTRACT

The emergence of SARS-CoV-2 variants of concern (VOC) requires adequate coverage of vaccine protection. We evaluated whether a spike ferritin nanoparticle vaccine (SpFN), adjuvanted with the Army Liposomal Formulation QS21 (ALFQ), conferred protection against the B.1.1.7 and B.1.351 VOCs in Syrian golden hamsters. SpFN-ALFQ was administered as either single or double-vaccination (0 and 4 week) regimens, using a high (10 mug) or low (0.2 mug) immunogen dose. Animals were intranasally challenged at week 11. Binding antibody responses were comparable between high- and low-dose groups. Neutralizing antibody titers were equivalent against WA1, B.1.1.7, and B.1.351 variants following two high dose two vaccinations. SpFN-ALFQ vaccination protected against SARS-CoV-2-induced disease and viral replication following intranasal B.1.1.7 or B.1.351 challenge, as evidenced by reduced weight loss, lung pathology, and lung and nasal turbinate viral burden. These data support the development of SpFN-ALFQ as a broadly protective, next-generation SARS-CoV-2 vaccine.

17.
Revista Cubana de Educacion Medica Superior ; 35(3), 2021.
Article in Spanish | Scopus | ID: covidwho-1695074

ABSTRACT

Introduction: Teaching through virtual modality was adopted as a preventive measure against the COVID-19 spread. For Cuban medical education, it has implied a challenge regarding the reorganization of study programs. For this purpose, the subject Physiology II was redesigned and implemented in virtual modality, in order to guarantee continuity in the training of Clinical Neurophysiology residents. Objective: To assess the development of the subject Physiology II in its virtual modality from the perspective of the students of the Clinical Neurophysiology specialty. Methods: Exploratory, nonexperimental and cross-sectional study. Through a questionnaire made up of closed questions and one open question (positive and negative aspects), the development of the subject in virtual modality was assessed in relation to the variables subject syllabus, professors’ performance, platform scenario, and technological support. Results: The subject Physiology II in virtual modality had a high acceptance by the students. The aspects identified as positive were those related to individual time management, as well as the subject’s applicability and structure;while the negative ones were oriented towards internet connectivity problems and the study environment. Conclusions: The successful experiences obtained in the development of Physiology II as a virtual subject lay the foundations for using this type of design in the specialty of Clinical Neurophysiology and the possibility of extending it to other subjects of the study plan. © 2021, Editorial Ciencias Medicas. All rights reserved.

18.
Nutricion Clinica Y Dietetica Hospitalaria ; 41(4):150-160, 2021.
Article in Spanish | Web of Science | ID: covidwho-1689773

ABSTRACT

Introduction. The emergence of a pandemic leads to the modification of people's lifestyles, as well as behavioral and human behavior modifications. Objectives. Describe the knowledge, attitudes and practices of the population about food during confinement due to the COVID-19 pandemic in the capitals of Ecuador and Peru. Methods. Non-experimental, cross-sectional study. 875 individuals participated, residents of the cities of Quito and Lima. For data collection, an online form was developed where knowledge, attitudes and practices around food during confinement by COVID-19 were explored, all participants read the information and provided their informed consent. For the descriptive analysis, measures of central tendency and dispersion, number, percentage and confidence intervals were calculated. To establish an association between variables, the Chi-square statistical test was used. To establish statistically significant differences, a p-value <0.05 was considered. Results. The data of 875 adults between 18 and 74 years old, residing in the city of Quito (46.97%) and in the city of Lima (53.03%) were analyzed. 60.91% think that coronavirus disease can be prevented by eating a healthy diet and 82.97% think that a healthy diet can help in the treatment of this disease. 18.51% and 17.49%, respectively, have started to consume some nutritional supplement and / or some medicinal plant because they consider it to be beneficial for the prevention or treatment of coronavirus disease. The main source of information about foods that can help in the prevention or treatment of coronavirus disease has been social networks (54.26% Quito and 55.60% Lima, p>0.05). Conclusions. The mandatory confinement by COVID-19 has induced changes in the knowledge, attitudes and practices of the population in the capital cities of Ecuador and Peru.

19.
Cancer Epidemiology Biomarkers and Prevention ; 31(1 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1677449

ABSTRACT

Background: Native American women experience twice the rate and mortality of cervical cancer compared to nonHispanic white women. This cervical cancer disparity is primarily attributed to a lack of screening and unequal access to healthcare. While infection with high-risk HPV genotypes is a well-established risk factor for cervical cancer, there are likely other factors within the local microenvironment that contribute to cervical carcinogenesis. Therefore, the goal of the pilot project is to address the role of the vaginal microbiome (VMB) and inflammation in cervical cancer pathogenesis among Native American women. In 2019, we partnered with the Native Americans for Community Action (NACA) clinic to implement a culturally-appropriate biospecimen protocol. Unfortunately, the COVID-19 pandemic caused NACA and many clinics nation-wide to limit in-patient services or transition to 100% telehealth. As such, preventative care such as breast and cervical cancer screenings were not conducted during the annual well women's exam. Another hurdle in our pilot project included the resignation of the trained nurse in consenting, enrollment, collection and storage at NACA. Therefore, we needed to quickly adapt to accommodate the clinic's COVID-19 restrictions and train a new nurse on the biospecimen collection protocol. Methods: Adjustments to the protocol included vaginal self-collection rather than physician collection of samples. We also provided new clinic staff a “virtual in-service training” to review all required documents (recruitment, consenting, sample collection, gift cards, specimen storage, etc.). Recruitment was slow during the early stage of the COVID-19 vaccine roll out. Therefore, we developed culturally tailored recruitment flyers that were distributed over social media. In addition, we developed a culturally appropriate video on the significance of the well women's exam through collaboration with the NACA clinic and researchers at the partnership for Native American Cancer Prevention (NACP) that will be disseminated in the upcoming weeks. All amendments were approved by the clinic leadership and appropriate institutional review boards (IRBs). Results: As COVID-19 restrictions lifted, the NACA staff was prepared to immediately begin recruitment. Thus far, the NACA staff successfully enrolled (n=25) participants since March 2020 with survey data entered into REDCap. With continued recruitment efforts and launch of the video, we aim to have at least 50% of participants enrolled by Fall 2021. Survey data analyses are in-progress with expected completion by Spring 2022. Conclusion: In summary, the continued efforts by the NACA staff and research team resulted in successful recruitment for the pilot study during the COVID-19 pandemic. This study will set the foundation to evaluate the role of the VMB and HPV-mediated cancer in Native American women.

20.
Cancer Epidemiology Biomarkers and Prevention ; 31(1 SUPPL), 2022.
Article in English | EMBASE | ID: covidwho-1677445

ABSTRACT

Background: Comprehensive cancer control (CCC) plans are region-specific blueprints that identify cancer priorities and health equity informed strategies to address cancer burden and are supported by the National Comprehensive Cancer Control Program through the Centers for Disease Control and Prevention (CDC). Although CCC plans are created by stakeholder coalitions, few have focused on community engaged approaches, which may diminish their applicability for community members. Thus, in preparation for its forthcoming 2022-2027 CCC plan, the Illinois Comprehensive Cancer Control Program collaborated with the University of Illinois Cancer Center's Community Engagement and Health Equity office to implement a community engagement strategy to address cancer burden. Objective: To describe the development and implementation of a community engagement strategy for the 2022-2027 Illinois CCC plan. Method: The goal of the community engagement strategy was to identify barriers, facilitating factors and recommendations related to cancer burden and equity in Illinois by engaging diverse community stakeholders. A statewide town hall and focus groups (FGs) were implemented in early 2021. Thedevelopment and analysis of the community engagement strategy were guided by the Model for Analysis of Population Health and Health Disparities, CDC's CHANGE Action Guide, and the Community ToolBox. Semistructured guides included questions about fundamental causes of health, social and physical contexts, individual demographics and risk factors, and biologic responses and pathways. The town hall was open to Illinoisians over 18 years of age. FG participants were selected using purposive sampling to maximize group heterogeneity. Eight FGs were held, one each for: rural residents, survivors, young survivors, caregivers, and Spanish speakers, and three that were a mix of community members. Town hall notes and FGs were analyzed using content analysis. Results were synthesized and a final report was included in the forthcoming plan. Results: Town hall and FG (n=8) participants (n=115) included cancer survivors (36%), caregivers (27%), Latinos (17%), African Americans (23%), and rural residents (14%). Throughout the development of the plan, data were continuously reviewed with the coalition developing the CCC Plan. The final report described multi-level factors that contribute to cancer disparities among Illinoisians, proposed recommendations to improve health across the cancer continuum across multiple levels, funding priorities, and the impact of COVID-19 on cancer care. Participant quotes supported strategies throughout the plan. Conclusion: A robust community engagement strategy for the forthcoming 2022-2027 Illinois CCC Plan was implemented through a successful academic-state public health department partnership. This strategy ensures that the plan reflects the expertise and voices of Illinoisians impacted by cancer. This engagement strategy, framed around health determinants that impact cancer risk and outcomes, may be replicated by other coalitions creating CCC plans.

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