Developing Vaccine Literacy for Urban Health Science Students, the Future Health Workforce

The 2019 coronavirus disease pandemic underlined a shift in attitudes against vaccines and a rise in hesitancy among some members of the population, despite the overwhelming evidence that vaccinations are one of the most successful and safe health interventions. Research has shown that vaccine hesitancy is complex and can result from an intersectionality of multiple factors. Research has also shown that to tackle vaccine hesitancy in the community, health care workers play a pivotal role, as they are trusted sources who can provide reliable information and can address vaccination concerns for the public. Unfortunately, health care workers are also susceptible to vaccine hesitancy. Thus, to curb these negative attitudes and doubts against vaccinations, we propose to improve vaccine competency among health science students, who are the future health workforce. Here, we propose a comprehensive pedagogical approach that aims to improve the vaccine literacy in this student population in two urban community colleges. The approach includes the use of high-impact pedagogical interventions to achieve three main objectives: (i) to teach students the nature and process of science to have them become "competent outsiders";(ii) to enhance students' knowledge of the complex science behind emerging infectious diseases and vaccine action, adopting a learner-centered and concept-focused instructional design, and (iii) to address the social, cultural, and historical aspects of vaccine development and the historical and present inequities that characterize this health intervention.

Violent actors and management of the pandemic in Brazil and Mexico: ruptures or continuities in social control?

This work examines the management of the pandemic through the local actions of violent state and non-state actors: the armed forces, the police and criminal groups. To what extent does the configuration of violent actors represent a break with their usual role in social control? We are looking at several cases at the subnational level within Brazil and Mexico. We take a qualitative approach that is based primarily on the analysis of government websites, reports from human rights organizations, media and social networks. The data demonstrate the continuing role of violent actors maintaining social order through coercion. The pandemic has nonetheless encouraged the publicity of such coercive practices, which are historically linked to the precarious and marginalized status suffered by the social groups benefiting from these "philanthropic” actions. © 2022 Institut des Hautes Etudes de l'Amerique Latine (IHEAL). All rights reserved.

Gender and Precariousness of Employment and Care: Consequences of the Pandemic for Female Teachers of Early Childhood and Primary in Chile

In Chile there is a progressive precariousness of the teaching profession (Ruffinelli, 2016) aggravated by the current health crisis COVID 19. In this context, the implementation of distance education has had multiple consequences for teachers (Villalobos Muñoz, 2021) and, particularly for women, who must make their teaching function coexist with domestic and care work, complicating the already difficult reconciliation of work and family. On this basis, the aim of the article is to analyze, this article aims to analyze, from a gender perspective, the precarious situation experienced by early childhood and primary education teachers in Chile and, in addition, to know how this situation has worsened in the context of the pandemic. To achieve this objective, a qualitative study was carried out based on semi-structured interviews with nine early childhood and primary education teachers from the Province of Valparaíso. The main results indicate that the already precarious working condition has been aggravated by the lack of material, technical and procedural resources with which they face online teaching. On the other hand, the blurring of borders between the paid world of work and care, as part of the consequences of teleworking, has generated a physical and emotional overload for teachers. Finally, they realize that the management of educational authorities and schools during the pandemic is seen by those interviewed as inconsistent with reality, both by Chilean teachers and students. © 2022 FahrenHouse. All rights reserved.

Change in Incidence of Central Precocious Puberty Treated with GnRHa During COVID- 19 Pandemic: Single-center Retrospective Review

Objectives To study the incidence of new central precocious puberty (CPP) patients treated with GnRH agonist (GnRHa) in our Endocrinology clinic during Covid. Findings add to literature pertaining Covid pandemic effects on pediatric endocrine conditions, including CPP. Methods We performed a retrospective comparison of the incidence of newly diagnosed CPP with GnRHa treatment during the Covid pandemic (5/2020-4/2021) and pre-covid (5/2018-4/2019). CPP diagnosis was defined by a random LH >0.3 IU/L, a GnRH stimulated LH >5 IU/L, or a GnRH stimulated estradiol >40 pg/mL. Girls had onset of breast development at < 8 years-old, and boys had testicular size >4 ml at <9 years-old. We compared the number of new Endocrinology visits during the time periods. We evaluated time from diagnosis to GnRHa order, and time from GnRHa order to first day of treatment. We compared bone age (BA) and chronological age (CA), BA/CA and BA-CA between treatment windows. Results During pre-Covid year, 28 children (1 boy, 27 girls) were treated with GnRHa for CPP out of 2340 new Endocrinology visits (1.2% of patients seen). During Covid year, 64 children (7 boys, 57 girls) were treated out of 2261 new visits (2.8%). The incidence of new CPP cases on GnRHa during Covid has more than doubled compared to pre-Covid (p<0.01, Chi Square). There were no significant differences between the groups in age at diagnosis, time between diagnosis and treatment order, time between order and treatment, degree of BA advancement, or BMI (Tables 1-2). CPP incidence was consistent between 26-37 cases/year over the past 4 years prior to Covid. The number of cases per month did not correlate with the peaks of Covid cases (Figure). Conclusions CPP cases requiring GnRHa treatment significantly increased during the first year of Covid compared to pre-covid. There was no delay in presentation or treatment initiation during Covid based on bone age advancement. Preliminary data did not show a significant difference in rate of BA progression, time from diagnosis to onset of treatment, or changes in BMI during covid. Factors influencing a higher incidence of CPP during the pandemic are unclear, and likely multifactorial, including lifestyle changes and direct effects of the virus, potentially contributing to disruption of hormonal pathways. Controlled studies in larger cohorts are required to understand the pathogenic factors contributing to higher incidence of CPP during the pandemic.

Strategies to reduce academic stress in postgraduate students in the distance education modality in times of COVID-19

The current context of a pandemic associated with a new remote educational modality has generated various effects on the world population. University students, and specifically postgraduate students, face various challenges to adapt to this new reality, which could generate certain levels of academic stress. This research of mixed nature sought, first, to determine the main frequencies of the dimensions of academic stress in 67 students of the master's degree in Education of a private university of Lima for which the Inventory of Academic Stress SISCO SV adapted to this context was applied. Secondly, it aimed to propose and evaluate strategies aimed at improving the psychological well-being of these students based on a focus group made to the students. In the initial findings, certain stressors perceived by the students were identified, such as the overload of tasks and works, the manner of evaluation of the teachers, and the perception about the limited time to do the works. In addition, among the most recurrent symptoms, are chronic fatigue, drowsiness or increased need for sleep, restlessness, and anxiety. From the application of strategies of an emotional and academic nature, there was an improvement in the perception declared by the students, which favored their psychological well-being. © 2022 IEEE.

Distinguishing In-Groups and Onlookers by Language Use

Inferring group membership of social media users is of high interest in many domains. Group membership is typically inferred via network interactions with other members, or by the usage of in-group language. However, network information is incomplete when users or groups move between platforms, and in-group keywords lose significance as public discussion about a group increases. Similarly, using keywords to filter content and users can fail to distinguish between the various groups that discuss a topic-perhaps confounding research on public opinion and narrative trends. We present a classifier intended to distinguish members of groups from users discussing a group based on contextual usage of keywords. We demonstrate the classifier on a sample of community pairs from Reddit and focus on results related to the COVID-19 pandemic.

IMPACT in PRENATAL EVALUATION of PREGNANT WOMEN with RHEUMATIC DISEASES by the SARS-COV2 PANDEMIC

Background: Due to the SARS-CoV-2 pandemic, an increase in stress, anxiety, and depression has been seen, as well as greater use of substances and a decrease in prenatal care in pregnant women. (1) Women of childbearing age with autoimmune rheumatic diseases (ARDs) experience greater psychological stress, which can negatively influence behavior. (2) Objectives: This study aims to compare changes in prenatal laboratory and ultrasound tests by trimester, as well as the detection of anxiety and depression in pregnant women with ARDs due to the SARS CoV-2 pandemic. Methods: This study was carried out on pregnant patients with ARDs from the Pregnancy and Rheumatic Diseases clinic of the rheumatology department of the University Hospital 'Dr. José Eleuterio González' during the period from February 2018 to August 2021. Two standardized evaluations of anxiety and depression were carried out using the Inventory of Trait and State Anxiety (IDARE) and the Edinburgh Postpartum Depression Scale (EPDS) respectively in the third trimester of pregnancy. Maternal report of alcohol consumption during any trimester of pregnancy, as well as adherence to routine laboratory studies such as structural ultrasound and gesta-tional diabetes screening, was addressed. Positive COVID-19 nasopharynx PCR results were evaluated during pregnancy beginning in the pandemic period (March 2020). The pre-pandemic recruited group was compared with the pandemic group. The comparison of the groups was carried out using the Chi-Square and Fisher tests. A significant value of p < 0.05 was considered. Statistical analysis was performed using the IBM SPSS v.25 program. Results: 50 pregnant patients with ARDs were recruited, of which 24 were included in the pre-pandemic group and 26 in the pandemic group. Compared with the pre-pandemic group, pregnant women recruited during the pandemic had a statistically signifcant higher positivity for state anxiety (p=0.023), likewise trait anxiety, depression, and suicidal ideation were detected more frequently, but the difference was not statistically signifcant, a higher rate of adherence to laboratory and cabinet studies was found, being signifcant for laboratories performed in the 1st and 2nd trimesters (0.005 and 0.025 respectively). See Table 1. Conclusion: A higher frequency of positivity for state anxiety was demonstrated in pregnant women with ARDs recruited during the pandemic, as well as higher trait anxiety, depression, and suicidal ideation, although this increase was not statistically signifcant. On the other hand, concern about the pandemic and health status could positively influence better adherence to screening and routine studies during pregnancy.

Monitoring SARS-CoV-2 in wastewater during New York City's second wave of COVID-19: sewershed-level trends and relationships to publicly available clinical testing data

New York City's wastewater monitoring program tracked trends in sewershed-level SARS-CoV-2 loads starting in the fall of 2020, just before the start of the city's second wave of the COVID-19 outbreak. During a five-month study period, from November 8, 2020 to April 11, 2021, viral loads in influent wastewater from each of New York City's 14 wastewater treatment plants were measured and compared to new laboratory-confirmed COVID-19 cases for the populations in each corresponding sewershed, estimated from publicly available clinical testing data. We found significant positive correlations between viral loads in wastewater and new COVID-19 cases. The strength of the correlations varied depending on the sewershed, with Spearman's rank correlation coefficients ranging between 0.38 and 0.81 (mean = 0.55). Based on a linear regression analysis of a combined data set for New York City, we found that a 1 log(10) change in the SARS-CoV-2 viral load in wastewater corresponded to a 0.6 log(10) change in the number of new laboratory-confirmed COVID-19 cases per day in a sewershed. An estimated minimum detectable case rate between 2-8 cases per day/100 000 people was associated with the method limit of detection in wastewater. This work offers a preliminary assessment of the relationship between wastewater monitoring data and clinical testing data in New York City. While routine monitoring and method optimization continue, information on the development of New York City's wastewater monitoring program may provide insights for similar wastewater-based epidemiology efforts in the future.

Fear of covid-19 in Mexican women with autoimmune rheumatic diseases

Objectives: We aimed to describe the fear of COVID-19 scale in women with autoimmune rheumatic diseases (ARDs) from Mexico. Methods: A cross-sectional study was conducted from September to November 2020 at the Pregnancy and Rheumatic Diseases Clinic from the University Hospital Dr. JoseE. Gonzalez in Monterrey, Mexico. Women with ARDs were invited to participate. The Fear of COVID-19 scale (FCV-19S) was applied. The instrument consists of seven items, each with a five-point Likert scale of options. The maximum possible total is 35 points, with cutoff point score of 16.5. The validated Spanish FCV-19S version was used. Also, sociodemographic data were collected from the medical charts. Results: A total of 83 women were included: 46 were in childbearing age, 32 were postpartum women, 4 were pregnant and 1 was going through menopause. The most frequent diagnosis was rheumatoid arthritis in 41 (49.4%), followed by systemic lupus erythematosus 31 (37.3%), 8 (9.6%) with other diagnosis (Sjogren's syndrome 2, antiphospholipid syndrome 3, and dermatomyositis 2 and psoriatic arthritis 1 patient). The demographic variables are shown in Table 1. The mean level of fear was 18.09 points, which means the fear of COVID-19 screening was highly positive. Regarding the rheumatic diseases group, women in the category of Other diagnoses had a greater mean FCV-19S score (19.0), than patients with systemic lupus erythematosus (17.45) and rheumatoid arthritis (18.8). Also, in the reproductive status classification the postpartum women had the highest mean score (19.68). Only the group of Non diagnostic yet, had a score below the cutoff point. Conclusion: Postpartum women with ARDs had a higher FCV-19S score than women with a different reproductive status. Women with ARDs and especially postpartum women should receive psychological support and be screened for symptoms of depression and anxiety.

Fear of COVID-19 in postpartum women with rheumatic disease

Background: In Mexico, the SARS-CoV-2 pandemic has totaled almost two million cases and exceeded 150,000 deaths (29/01/2021). Currently, COVID-19 has become the leading cause of death in pregnant women in Mexico. COVID-19 has additionally impacted the psychological health of individuals including women with rheumatic diseases. Objectives: The aim of this study is to compare the Fear of COVID-19 Scale (FCV-19S) in postpartum women with and without autoimmune rheumatic diseases. Methods: A cross-sectional, descriptive, and comparative study was conducted. The Spanish FCV-19S version was applied by telephone or e-mail. The instrument consists of seven items, each with a five-point Likert scale of options. The participant must choose the options that best represent their perception about the statements presented. The maximum possible total is 35 points. Sociodemographic information was collected from the clinical charts. The Kolmogorov-Smirnov test was used to determine normality of the data. Statistical analysis was done using the Mann-Whitney U test. Results: Forty-four postpartum women were included (22 from the Pregnancy and Rheumatic Diseases Clinic and 22 from the Obstetrics Department, both groups from the University Hospital Dr. José E. González in Monterrey, México). The mean level of fear found in women with rheumatic disease was 16 (6.6) points versus 14 (4.6) points in the non-rheumatic patients group. No significant difference was found between groups (p=0.65). Regarding the rheumatic diseases group, women in the category of other diagnoses (that included Sjögren's Syndrome, antiphospholipid syndrome, and dermatomyositis) had a greater mean FCV-19S score (20.2), than patients with systemic lupus erythematosus (17.3) and rheumatoid arthritis (15.4). Conclusion: Women with postpartum rheumatic disease had a higher FCV-19S score than postpartum women without rheumatic diseases, although this difference was not statistically significant.

COVID-19: current prevention tools in endoscopy units

In late 2019, SARS-CoV-2, a new coronavirus causing COVID-19, emerged in Wuhan (China). As of April 13 2020 it has caused 1,807,308 infections and 119,410 deaths worldwide. Due to the way this virus is transmitted and considering gastroenterology and digestive endoscopy services are a source of easy dissemination given the constant exposure with aerosols that are emitted during procedures there is an increased risk for both health care professionals and patients undergoing endoscopy. It is of great importance to establish prevention tools within the gastroenterology and digestive endoscopy services, based on the evidence gathered to date and recognizing that we are in a constant search for measures to reduce risk of infection that will provide a safe environment to staff and patients. Pubmed database was searched for the following terms: ("COVID-19" OR "coronavirus" OR "SARS-Cov-2") and ("gastrointestinal" OR "transmission" OR "Intestinal" OR "digestive" OR "endoscopy" OR "esophagogastroduodenoscopy" OR "colonoscopy"). Therefore, all patients brought in to undergo endoscopic procedures should be considered high-risk and current prevention tools will be made known worldwide.