Understanding Uncertainty Shocks in Uruguay Through VAR Modeling

This study introduces a first set of uncertainty indexes for Uruguay (a newspaper-based index and a composite index-based) to analyze how economic uncertainty impacts domestic variables in a small and open economy such as Uruguay, which is exposed to international, regional, and local uncertainty. The analysis covers approximately 15 years and uses the vector autoregressive methodological framework. The main findings suggest that economic uncertainty significantly impacts the real economy and does not impact the nominal variables. These findings which differentiate from other results found in the empirical literature, can be associated with the stability of the Uruguayan economy and the strong institutions, which may help mitigate external shocks. To assess the capability of the proposed uncertainty model to predict macroeconomic variables, we evaluate its predictive performance within the last major uncertainty shock due to the COVID-19 pandemic. © 2023, The Author(s), under exclusive licence to Springer Nature Switzerland AG.

FORMACIÓN E INSERCIÓN DE PERSONAS DOCTORADAS EN CIENCIAS SOCIALES Y HUMANAS EN AMÉRICA LATINA

Aunque con diferencias en cada caso nacional, se trata de un proceso que se intensifica a mediados de la década de 1990 y en los años 2000 en el caso de los doctorados, como indican estudios sobre el tema.1 Esa tendencia se asocia a tres factores clave vinculados a las políticas públicas para el sector: apoyo a la formación doctoral, principalmente a través de becas nacionales provenientes de los organismos de gobierno de la educación superior y/o de los sistemas científico-tecnológicos;institucionalización de regulaciones basadas en dispositivos nacionales de evaluación de la calidad educativa, con avances en los procesos y procedimientos de acreditación, evaluación de la calidad y categorización de programas, que posibilitaron la institucionalización de una cultura evaluativa para el doctorado;y estrategias de internacionalización promovidas -con distintas intensidades en cada caso nacional- por las instituciones de educación superior y las políticas de evaluación y fomento, que las consideran un requisito para la excelencia académica. Así, es posible afirmar que los doctorados comienzan a ocupar un espacio mayor en la agenda de investigación, con la consecuente ampliación de temas que abordan. También las desigualdades de género, geopolíticas y/o socioeducativas, que condicionan las trayectorias doctorales, ganan mayor expresión en la producción científica sobre el tema. Sin embargo, los déficits y diferencias que presentan las informaciones de las estadísticas nacionales en cada caso resultan en un obstáculo importante a ser enfrentado por quienes invierten en ese tipo de producciones (De la Fare;Rovelli, 2021;Unzué;Emiliozzi, 2013). Además, en el escenario social y educativo reconfigurado a partir de la pandemia de la COVID-19, los programas y la formación doctoral enfrentan nuevos desafíos en el marco de situaciones que dieron mayor visibilidad a las desigualdades educativas y a los obstáculos de la implementación de una virtualidad improvisada para el amplio conjunto de estudiantes.

Analysis of the Features of Sustainable Development of the Mercosur Countries in the Context of the Covid-19 Pandemic

Purpose: The purpose of this article is to identify the features of sustainable development of the MERCOSUR countries in the context of the COVID-19 pandemic. Design/methodology/approach: The authors use comparative and retrospective analysis to identify the distinguishing characteristics of countries meeting the sustainable development goals. The objects of research are the MERCOSUR countries. Findings: It has been established that Uruguay is the undisputed leader in sustainable development in the context of COVID-19. Two countries: Brazil and Venezuela slowed down the pace of implementation of national sustainable development strategies due to the pandemic and other reasons. Originality/value: According to the results of the analysis, it was revealed that countries that have long-term national strategies for sustainable development are more stable in achieving sustainable development goals. The size of a national economy does not guarantee that it can successfully overcome an external shock such as the lockdown caused by the COVID-19 pandemic. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

EFFECT OF THE COVID-19 PANDEMIC ON THE CLINICAL EVOLUTION OF ACUTE APPENDICITIS AND ACUTE CHOLECYSTITIS: A URUGUAYAN EXPERIENCE

Background: The World Health Organization declared a worldwide Coronavirus (COVID-19) pandemic on March 11, 2020. In Uruguay, unlike most countries, a mandatory confinement was not declared. On the contrary, an extensive education and prevention campaign was carried out associated with measures to reduce social mobility, such as prohibiting meetings and closing bars.Objectives: The aim of the present study was to evaluate the COVID-19 pandemic in Uruguay and its repercussion on the clinical evolution of the two most common surgical pathologies: acute appendicitis (AA) and acute cholecystitis (AC).Methods: A retrospective comparative cohort study was performed at the Emergency Department of the University Hospital "Hospital de Clinicas Manuel Quintela,” the most important tertiary referral hospital in the city of Montevideo, capital of Uruguay. Two cohorts were identified: 13th of March 2019 to 13th of June 2019 [Pre-Covid period (PCP)] and the same period in 2020 [Pandemic Covid period (PCVP)]. Demographic and clinical data were analyzed.Results: A total of 118 cases were registered in 2019 and 109 in 2020. There were 43 cases (36.4%) of acute appendicitis in the pre-Covid period and 42 cases (36.5%) in Pandemic Covid period (p = 0.745). Acute cholecystitis cases differed significantly between cohorts, with a raise of cases in the Pandemic Covid period (14 vs 25) (p = 0.027). The surgical approach (Laparoscopy vs Open) did not change significantly (p = 0.207). A significant increase in complicated cases (AA + AC) was found during the pandemic (PCP 57 cases vs PCVP 67 cases) (p < 0.001). The sub-analysis of AA and AC showed a significant increase in AA's complicated cases during PCVP (14 vs 25;p < 0.001) and no significant changes in the AC group (p = 0.99).Conclusion: An increase of complicated cases of AA was observed with maintenance of the number of consultations that might be explained by the excellent pre-hospital care system and absence of lock-down measures. The results are contradictory in some aspects, which calls for a deeper analysis, comparing different realities and longer periods of time in order to be able to draw conclusions that are representative for the Coronavirus pandemic in Uruguay.

KEY FACTORS IN THE RESPONSE TO THE COVID-19 PANDEMIC IN URUGUAY

Background: The response to the COVID-19 pandemic was comprehensive in Uruguay, leading to lower mortality and lethality compared to other Latin American countries.Objectives: Identify key factors that contributed to the comprehensive response to the Covid-19 pandemic in Uruguay.Methods: Participant observation, analysis of data, interviews with key stakeholders, and review of secondary sources from the moment of the appearance of the first case on March 13 until December 2020.Results: We identified nine key factors that contributed to the comprehensive response to the COVID-19 pandemic in Uruguay and the favorable effects on the reduction of morbidity and mortality.Conclusions: The simultaneous existence of the nine factors facilitated the preparation, control, and remediation of the COVID-19 pandemic in Uruguay.

COVID-19 PANDEMIC IN URUGUAY AND THE NEED FOR A PERSON AND SOCIAL CENTERED MEDICINE

Background: During the COVID-19 pandemic, the Uruguayan government decided to call for an attitude of responsible freedom of the population and created an Honorary Scientific Advisory Group (GACH). The intention was to report the scientific evidence available on the health situation with transparency and technical independence and to recommended interventions. This paper aims (1) to analyze the strategy to combat the COVID-19 pandemic used in Uruguay from the perspective and principles of person-centered medicine (PCM), (2) to report and examine from a broad perspective the policy regarding health authorities, scientific evidence and population, and (3) to discuss the importance of mental health and behavioral monitoring for identifying vulnerable groups that require special attention and care. Methods: Retrospective and narrative analysis of the creation of a socioeconomic and behavioral observatory [OSEC], critical evaluation of key data collection on population mental health, and assessment of the influence of OSEC in the context of the pandemic in Uruguay. T-test was used to assess mean differences of mental health trends in the general population using GHQ-12 panel data. The article presents the results obtained on the country's mental health data through the analysis of a helpline consultations and a digital panel survey of a representative sample of the Uruguayan population. Screening instruments were used, which allowed for an identification of risk groups. Results: The evidence shows the impact of the pandemic on the emotional distress of the population, indicating that the population discomfort decreased significantly when the pandemic situation began to improve. In addition, differences according to socioeconomic status and age groups were observed, showing that the most disadvantaged had significantly higher levels of emotional distress than those of the middle and upper class, at all times of analysis. Conclusions: Apparently, it is possible to extend the principles of beneficence, autonomy, and justice applied at the individual level to the level of collective health policies. This is essential to achieve the active participation of the population in their self-care and to promote greater and more transparent communication with the health and scientific fields. It is also necessary to adopt a holistic, biopsychosocial perspective, which makes it possible to identify the vulnerable sectors of society and the areas in which special attention is required.

Coverage of cervical cancer screening in Uruguay, 2018 / Cobertura de tamizaje de cáncer de cuello de útero en Uruguay, 2018 / Cobertura do rastreamento do câncer do colo do útero no Uruguai, 2018

Introducción: el cáncer de cuello uterino (CCU) causa una significativa pérdida de años por discapacidad y muerte prematura en el mundo. Se relaciona fuertemente, por su etiología, a las inequidades socioeconómicas. Alcanzar una cobertura del 80% del tamizaje poblacional a través de la colpocitología oncológica constituye una de las principales estrategias para disminuir la morbimortalidad por este cáncer. Objetivos: describir la cobertura de tamizaje en CCU de las mujeres de 21 a 64 años, usuarias del Sistema Nacional Integrado de Salud (SNIS) de Uruguay en el año 2018 y explorar su comportamiento según edad, lugar de residencia, características socioeconómicas y culturales del territorio. Métodos: estudio descriptivo, en base a fuentes de datos secundarios, con una muestra que alcanzó el 95% del universo. La técnica de tamizaje considerada fue la colpocitología oncológica de (PAP) con vigencia de hasta 3 años al 30/9/2018. Resultados: la cobertura de tamizaje en CCU en 2018 fue del 57%, siendo menor en las primeras y últimas edades consideradas, variando por zona geográfica, encontrándose menor porcentaje de PAP vigente en las mujeres residentes en departamentos con menores índices de desarrollo humano y con mayor porcentaje de hogares por debajo de la línea de pobreza. Conclusiones: la cobertura de tamizaje en CCU en Uruguay debe aumentar para disminuir la morbimortalidad por este cáncer. Se requiere implementar acciones para reducir la heterogeneidad entre edades y departamentos de residencia. Esta estimación constituye una línea de base que permite comparar la situación país pospandemia COVID-19 replicando la misma metodología.

Summary: Introduction: cervical cancer causes a significant loss of years due to disabilities and early deaths around the world. Due to its etiology, it is closely linked to socio- economic inequalities. Cervical cancer screening coverage of 80 % of the population through and pap smear constitutes one of the main strategies to reduce morbimortality of this kind of cancer. Objectives: to describe cervical cancer screening coverage in women between 21 and 64 years old, users of the National Integrated Health System (SNIS) in Uruguay in 2018 and explore their behavior according to age, place of residence, socio-economic and territorial cultural characteristics. Method: descriptive study, based on secondary data sources of a sample representing 95% of the universe. The screening technique considered in the study was a pap smear, valid for up to three years on September 30, 2019. Results: cervical cancer screening coverage in 2018 was 57%, lower in the first and last ages considered and it varied depending on the geographical area. A lower percentage of valid smear tests was found in women who were residents of provinces with lower human development index and a higher percentage of homes below the poverty line. Conclusions: cervical cancer screening coverage in Uruugay needs to increase in order to reduce morbimortality. The implementation of actions aimed at reducing differences between ages and places of residence is required. This estimation may be taken as a baseline that allows for a comparison with the post-COVID 19 pandemic situation, by replicating the same method.

Introdução: o câncer do colo do útero (CCU), causa uma perda significativa de anos por incapacidade e morte prematura no mundo estando fortemente relacionada, por sua etiologia, às iniquidades socioeconômicas. Uma das principais estratégias para reduzir a morbimortalidade por esse câncer é alcançar 80% de cobertura de rastreamento populacional por meio da colpocitologia oncológica. Objetivos: descrever a cobertura do rastreamento do CCU em mulheres de 21 a 64 anos, usuárias do Sistema Nacional Integrado de Saúde (SNIS) do Uruguai em 2018 e analisar seu comportamento de acordo com idade, local de residência, características socioeconômicas e culturais do território. Métodos: estudo descritivo, baseado em fontes de dados secundárias de uma amostra que atingiu 95% do universo. A técnica de rastreamento considerada foi a colpocitologia oncológica (PAP) válida por até 3 anos a partir de 30/09/2018. Resultados: a cobertura de rastreamento no CCU em 2018 foi de 57%, sendo menor nas primeiras e últimas idades consideradas, variando por área geográfica, encontrando menor percentual de PAP atual em mulheres residentes em departamentos com menores índices de desenvolvimento humano e com maior percentual de famílias abaixo da linha de pobreza. Conclusões: deve-se aumentar a cobertura de rastreamento no CCU no Uruguai para reduzir a morbimortalidade por esse câncer. É necessário implementar ações para reduzir a heterogeneidade entre idades e departamentos de residência. Essa estimativa constitui uma linha de base que permite comparar a situação do país pós-pandemia por COVID-19, replicando a mesma metodologia.

Analysis of Public Transportation in Montevideo, Uruguay During the COVID-19 Pandemic

This article presents the analysis of the demand and the characterization of mobility using public transportation in Montevideo, Uruguay, during the COVID-19 pandemic. A urban data-analysis approach is applied to extract useful insights from open data from different sources, including mobility of citizens, the public transportation system, and COVID cases. The proposed approach allowed computing significant results to determine the reduction of trips caused by each wave of the pandemic, the correlation between the number of trips and COVID cases, and the recovery of the use of the public transportation system. Overall, results provide useful insights to quantify and understand the behavior of citizens in Montevideo, regarding public transportation during the COVID-19 pandemic. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

WCN23-1206 Glomerulopathies Biobank in Uruguay. Description of the first 110 patients enrolled

Introduction: The incidence of glomerular diseases varies across different countries and criteria for kidney biopsy has changed over time. In Uruguay, glomerular diseases (GD) are a frequent cause of end stage kidney disease (ESKD) and renal replacement therapy with an annual incidence of 25.0 patients per million population according to data from the Uruguayan Dialysis Registry (UDR, year 2020). Since 1970, the Uruguayan Registry of Glomerulopathies has been recording the incidence, epidemiology and evolution of patients with GP in our country. In 2018, the Glomerulopathies Biobank (GB) began to operate including all patients with a native kidney biopsy performed at the Nephrology Department of the teaching hospital Hospital de Clinicas in Montevideo, Uruguay. The purpose of the BG is to record the phenotype (clinical and paraclinical) of patients with GD diagnosed by renal biopsy and at the same time store blood, urine, renal tissue and DNA samples. The aim of this report is to communicate the first 110 patients enrolled in the BG, which started in February 2018. Method(s): The BG protocol includes the collection of patronymic data, personal history, and clinical and paraclinical features of renal pathology. Plasma, urine and cell samples are stored for subsequent DNA extraction at the time of the kidney biopsy. In our country, all renal biopsies are performed by nephrologists. The Glomerular Biobank project is funded by the Nephrology Research Fund (School of Medicine, University of the Repubic) and was approved by the Ethics Committee of the Hospital de Clinicas and the Regulatory Verification Unit of the National Institute of Donation and Transplantation. The results are presented as mean and standard deviation (SD) for the continuous variables;and qualitative variables are described with percentages. Result(s): Patient recruitment began in February 2018 and we have recruited 110 patients. The mean age at the time of biopsy was 38.3+/-16.1 (min:16;max:78) years. Regarding sex distribution, the female sex slightly predominated (55.3%). Plasma creatinine was 2.1+/-1.45 mg/dL, proteinuria was 3.1+/-3.7 gr/dL and albuminaemia was 3.2+/-1.0 mg/dL. Microhaematuria was present in 61% of patients in the sediment study. Figure 1 shows the negative impact of the COVID 19 pandemic on the incidence of patients undergoing kidney biopsy. IgA nephropathy (13,8%)was the most frequent primary glomerular disease, followed by d focal and segmental glomerulosclerosis and membranous nephropathy. Consernig the glomerulopathies secondary to a systemic disease, the most frequent diagnosis was lupus nephritis (34,5%) followed by vasculitis, amyloidosis and diabetes. Conclusion(s): Having a prospective cohort of patients with glomerular disease, including reliable data and biological samples, will allow us to perform clinical and epidemiological analyses quickly and reliably in the future. The data and aliquots of biological material are available to any local nephrologist who proposes a hypothesis and has the approval of the corresponding ethics committee. The medium-term objective is to incorporate other national reference institutions in the care of patients with glomerular diseases. The data collected by the Glomerular Biobank will be a valuable input to the process of continuous improvement, and will serve as a basis for future nephrological research of excellence. No conflict of interestCopyright © 2023

Respiratory Outcomes in COVID-19 patients 3-6 months after admission to Public Health Hospital Maciel. Montevideo, Uruguay. A Follow up Cohort Study

To date, millions of people worldwide have recovered from COVID19, but concern remains on long-term impairment. We aimed to determine 3-6 months respiratory outcomes in a Latin American Public Health Hospital. Method(s): COVID-19 patients referred (April-June 2021,gamma variant breakdown) were enrolled, recalling epidemiology, demographic, comorbidities, laboratory, radiology, treatment and outcomes, performing spirometry, lung volumes, diffusing capacity (DLCO), walking test (6MWT);values< 80% of predicted were considered abnormal. Logistic regression analysis were performed to evaluate covariates associated with DLCO abnormality. Result(s): 56 patients followed 6 months make up the cohort. 56,9 +/- 13,0 years, 58,9% female,46,4% ever smokers, 42,9% obesity (BMI >30), 37,5% hypertension, 23,2% diabetes, 16,1% heart disease, 16,1% asthma. 64% dyspnea (MRC>1), 50% fatigue, sit to stand Sp02% 94,7 +/- 3,9. Lymphocites103 /muL 413,3 +/- 625,7,D-dimer ng/ml 3050,9 +/-7226,1,ferritin ng/ml 641,8 +/- 1173,4, 21.4% radiology abnormality, 35.7% admitted to ICU, days stay 17,1 +/- 10,5. 3 vs 6 months: TLC 5,3 +/- 1,9 vs 5,16 +/- 2,3 p=0.05;FVC 3,10 +/- 0,9 vs 3,16 +/- 1,0 p=0.04;DLCO:17,2 +/- 6,0 vs 17,8 +/- 6,2 7 p=0.006;Sp02% in 6MWT 90,1 +/- 98,2 vs 91,1 +/- 3,6 p=0.05. 6 months: dyspnea 28.6%, fatigue 26.8%, abnormality in: FVC 12,5%,FEV1 16,1%,DLCO 58,9%,distance 6MW 28,6%. Abnormal DLCO correlations: age > 65 p=0.02,smoking p=0.04,heart disease p=0.04,dyspnea MRC>1 p=0.002, persistent fatigue p=0.05. Conclusion(s): At 6 months some COVID-19 patients maintain symptoms and impaired DLCO and are the main target for further follow up and intervention.

When Lockdowns Force "Everyone” to Work From Home: Inequalities in Telework During COVID-19 in Uruguay

Working from home (WFH) arrangements have been on the rise globally throughout the 21st century. Despite this trajectory, developing economies have trailed developed countries in adopting such arrangements. However, because of COVID-19 lockdowns and social distancing measures, countries such as Uruguay, where teleworking was scarce and unregulated, were forced to adopt this practice to ensure business continuity. Under such conditions, preexisting organizational and individual disparities stratified the likelihood of WFH during the pandemic. Conventional wisdom holds that the main determinants potential-to-telework stems almost exclusively from the nature of jobs themselves. This article expands the traditional understanding of telework determinants by showing that during the first stages of the pandemic, individual features of the worker, and organizational and managerial features of the employer, were both determinative of the likelihood that a given worker would work from home. We conducted a secondary data analysis of the March 2020 wave of the Work Monitor, a web-based survey of 847 employed Uruguayan adults. We fitted several multivariate regression models predicting (a) the odds of working for a company which adopted COVID-19-related teleworking policies at least for some workers and (b) the odds of WFH as a consequence of COVID-19. As the adoption of telework was largely unplanned and abrupt, results show that disparities on organizational adoption of teleworking policies were related to pre-pandemic differences across organizations in terms of preparedness, technological investment, and management practices. Results also show that employers' willingness to enable WFH policies was the strongest predictor, at any level, of the likelihood of individuals to telework during the national emergency. Individual disparities in terms of human capital also have a great impact on the likelihood of teleworking during lockdowns, but their effect depends on the existence of organizational teleworking policies. Findings' implications for the present and future of telework in developing countries are discussed. © 2023 SAGE Publications.

Kidney Replacement Therapy in Latin America, 2020 Data

Introduction: The Latin American Dialysis and Renal Transplantation Registry (LADRTR), founded in 1991, has collected data and reports on patients receiving kidney replacement therapy (KRT) since 1993. The main goals of the LADRTR is to promote the development of national registries, consolidate a data system for KRT in Latin America (LA), return the data provided by nephrologist to the different stakeholders that participate in the decision making process, while contributing to the universal knowledge of prevention, incidence and evolution of the disease in the region. This summarizes the registry data for 2020. Method(s): Participating countries complete an annual survey collecting aggregated data on incident and prevalent patients on KRT in all modalities. The different treatment modalities considered were hemodialysis (HD), peritoneal dialysis (PD) and living functioning kidney graft (LFG). National gross domestic product per capita (GDP, expressed in US dollars) and life expectancy at birth (LEB) corresponding to the year 2020 were collected from the World Bank Data Bank. Prevalence and incidence were compared with previous years and were also correlated with GDP and LEB. Result(s): On 31 December 2020 the prevalence of KRT in LA was 848 per million population (pmp), which shows a drop in the rate compared to the previous year (Figure 1). The prevalence ranged from 2129 pmp in Puerto Rico to 111 pmp in Nicaragua. Eight countries had a rate >700 pmp (Argentina, Brazil, Chile, Colombia, Ecuador, Panama, Puerto Rico and Uruguay). The states of Mexico, Jalisco and Aguas Calientes, also had a rate >700 pmp (Figure 2). Regarding treatment modality, 67,0% of the prevalent patients were treated with HD (n= 290 099) and 9.3% with PD (n= 40 450) while 23,6% of the patients had an LFG (n= 102772). The total unadjusted incidence rate of patients that started KRT was 158 pmp. The majority of the patients started KRT with HD modality, while only 6,08% used PD, varying the rate of incidence from 477 pmp in Jalisco and Aguas Calientes to 2 pmp in Bolivia. The kidney transplant rate in the region was 15 pmp, showing a drop from the previous year, and 89% of KT were from a deceased donor (Figure 3). The total prevalence of KRT correlated positively with GDP per capita (r 2 = 0.6, P < 0.01) and LEB (r 2 = 0.27, P < 0.05). The overall unadjusted mortality rate was 18%, cardiac disease was the leading cause of death (31%), followed by infectious diseases (21%) and other causes (16%). [Formula presented] [Formula presented] [Formula presented] Conclusion(s): For the first time in the last decade the overall prevalence and kidney transplant rate decreased, being this associated with COVID-19 pandemic. Although the incidence and prevalence of KRT in the LA region have increased over the years, there is still a need to improve accessibility to KRT, develop programs that facilitate better control of risk factors, early diagnosis and the treatment of chronic kidney disease, as well as the implementation of an effective kidney transplant program, to reduce the gap that exists between the countries of LA. No conflict of interestCopyright © 2023

Interstitial Lung Diseases Virtual Clinics: a novel medicaleducation method during pandemic times

Introduction: SARS-COV-2 pandemic challenged the medical education face-to-face meetings. ILD Virtual Clinics(ILD-VC) were thought as a non-traditional medical education model to address topics about a holistic managementof ILDs. Weekly videoconferencing interviews with local experts and Q&A from the public were developed. Objective(s): To describe a virtual medical education model with an innovative format through interviews with experts indifferent ILD topics as a best practice.Implementation: 20 episodes of ILD-VC were carried out with an audience of pulmonologists, rheumatologists andgeneral physicians from Argentina, Paraguay and Uruguay. Each 60 minutes duration episode with the presence ofthe coordinators and an expert in a specific topic for each episode recognized as an unmet need. The main objectivewas to discuss ILD management from different points of view and create a digital library with advices from thechosen experts. Some of the topics were: antigen searching for HP;determining progression in PF-ILDs;amongothers. The number of virtual assistants was 217 per episode (average) with a maximum of 382 and more de 4300connections in total. A third season in planned for 2022. Conclusion(s): This innovate format provided a better understanding of ILD holistic management. Disclosures: The authors meet criteria for authorship as recommended by the International Committee of Medical Journal Editors (ICMJE). The authors did not receive payment related to the development of the abstract. Boehringer Ingelheim (BI) was given the opportunity to review the manuscript for medical and scientific accuracy as well as intellectual property considerations. The study was supported and funded by BI.

SARS-CoV-2 in animals used for fur farming: GLEWS+ risk assessment (20 January 2021)

SARS-CoV-2 was first identified in humans in December 2019 and has since affected almost 68 million people causing over 1.5 million deaths worldwide. Animal-to-human and animal-to-animal transmission has been documented within farmed minks in several countries. SARS-CoV-2 has been identified in a farmed mink population in a number of countries. Some of the affected farms reported also workers SARS-CoV-2 infection and it is hypothesized that the mink farms were infected through human-mink transmission proving SARS-CoV-2 capability of reverse zoonosis. This Tripartite Risk Assessment, as a joint effort under the GLEWS+ initiative, completed with the Food and Agriculture Organization (FAO), the World Health Organization (WHO), and the World Organisation for Animal Health (OIE), evaluates the risk of introduction and spread of SARS-CoV-2 within fur farming systems as well as whether farmed fur animals could play a significant role in the spread of SARS-CoV-2 to humans via spillover. Additionally, using a One Health approach, the Tripartite evaluated the risk of the escaped minks leading to the establishment of a viral reservoir in susceptible wildlife populations. This work provides guidance to Members on this newly emerging threat.

National stroke management plan in Uruguay: Challenges and opportunities.

Stroke accounts for 5.5% of the national Global Burden of Disease (GBD) and ~2,000 deaths per year in Uruguay. To respond to this medical emergency, the Ministry of Public Health (MPH) of Uruguay devised the National Stroke Plan (NSP). Scientific associations, universities, scholars, and patient organizations, both at the national and international levels, took part in the process, which ended with the generation of the national stroke management guidelines, including measures based on the best evidence available. This was accompanied by presidential regulatory decrees and several ordinances that set the foundations of the legal framework for their implementation as of 2020. Forty-two Stroke Ready Centers (SRC) and seven Comprehensive Stroke Centers (CSC) were strategically established and interlinked to ensure compliance with international accessibility recommendations, offering, in turn, the required training for their healthcare teams. A pre-hospital care protocol was also created for all countrywide mobile units. For NSP assessment, stroke was included as a "Care Goal (objective)" for the whole health system, providing the involved healthcare organizations with a financial incentive for compliance with the basic objectives related to the treatment of hyper acute stroke. The NSP came into force during the COVID-19 pandemic and, considering the special circumstances imposed, it made it possible to maintain hyper acute medical care and increase population access to recanalization treatment, particularly mechanical thrombectomy. The purpose of this article is to share our experience in the development of the NSP by describing some preliminary outcomes.

Psychology, psychosocial processes and rural scenarios *

Emigration of rural Chilean youth to the cities has not provided an answer or a way out of poverty;on the contrary, this territorial uprooting is considered one of the main problems of increasingly depopulated and aging rural areas. [...]an alternative to address poverty in rural Chile has been to encourage the return of young people, understanding their leadership and work as a practice that stimulates local economies at the rural level (FUNASUPO, 2021). Since health and social crisis resulting from COVID 19 pandemic, it has been detected the beginning of a trend to return to rural areas by young people, sons and daughters, grandsons and granddaughters of rural-urban migrants. According to Fundación Superación de la Pobreza (2021), these returning decisions respond to individual choices of their protagonists and, in practice, they have little support from the governmental-social context, having to face a myriad of odds and obstacles. Latin American Psychology has rarely stopped to think about the specificities of rural areas, both in relation to the knowledge it generates and its professional practices. [...]findings of research and psychological work, in general, tend to be transferred uncritically from urban to rural contexts without a proper discussion of their scope and contextual relevance, which implies a naive assumption that human beings are identified with urban.

Gender and teleworking: The case of the workers of the Uruguay Crece Contigo program

Aims The following objectives are addressed: to analyze the working conditions during telework of UCC program workers who also do unpaid care work;to study the conditions given for the exercise of the rights to care, and to understand the mechanisms for the redistribution of care work between men and women during voluntary confinement. Method & procedures Based on the contact with the UCC Program management, an intentional sample of UCC program workers was selected and in-depth interviews were conducted and a content analysis was performed. Conclusion The costs assumed by the workers of UCC Program both in relation to the provision of their private resources to sustain the implementation of a public program, as well as the problematic working conditions that teleworking, care and domestic work meant for them were high and show an absence of risk management by the State through public policies.

Dijital Türk Lirasının (DTL) Kullanım Kabulü: Teknoloji Kabul Modeli (TKM) ve Planlı Davranış Teorisi (PDT) Çerçevesinde Íncelenmesi

Teknolojik cihazların yaygınlaşması birçok ürün ve hizmetin dijitalleşmesini zorunlu hale getirmiştir. Bu dijitalleşmenin önemli sonuçlarından biri de Dijital Türk Lirasıdır (DTL). Mevcut çalışma DTL'nin kullanım kabulünü, niyetini etkileyen faktörlerin incelenmesi üzerine kurulmuştur. Bu baǧlamda kullanıcıların kullanım kabulü literatürdeki TKM ve PDT' ye dayandırılarak yapısal eşitlik modellemesiyle açıklanmaya çalışılmıştır. Önerilen araştırma modeli Smart PLS 3 paket programı ile analiz edilmiştir. Hipotez sonuçları incelendiǧinde ilk olarak PDT kapsamındaki deǧişkenler kullanma niyetini olumlu etkilerken, TKM kapsamındaki güven kullanma kolaylıǧı üzerinden diǧer deǧişkenler ise fayda üzerinden kullanma niyetini pozitif etkilemiştir. Kullanıcıların kripto/dijital paralara göre DTL'yi daha güvenilir bulduǧu tespit edilmiştir. DTL ile Türkiye Cumhuriyet Merkez Bankası arasındaki ilişki bunun nedeni olarak gösterilebilir.Alternate :The increase in technological devices has made the digitalisation of many products and services compulsory. One of the essential results of this digitalisation is the Digital Turkish Lira (DTL). The current study examines the factors affecting the acceptance and intention to use DTL. In this context, the acceptance of use by users has been tried to be explained by structural equation modelling based on TAM and TPB in the literature. The proposed research model was analysed with the Smart PLS 3 package program. When the hypothesis results are examined, firstly, the variables within the scope of TPB have a positive effect on the intention to use. In contrast, the other variables positively impact the intention to use over the ease of use within the scope of TAM. It has been determined that users find DTL more reliable than cryptocurrency /digital money. The relationship between DTL and the Central Bank of the Republic of Turkey can be shown as the reason for this.

A scientific methodology course for advanced medical students: an eight-year perspective.

Background: Exponential increases in the development of medical knowledge, the expansion of areas where medicine develops its activities, the emergence of new pathologies ( e.g., COVID-19), novel diagnostic methods and therapeutic strategies, together with the appearance of multiple communication and information technologies, determined that the education of future physicians required targeted training in scientific methodology. Methods: The design and execution of a course in scientific methodology in the curriculum of Facultad de Medicina, Universidad de la República, Uruguay, is described. The course is carried out at an advanced stage of the medical studies for all the students, in which they develop a 10-month research project supervised by the medical school faculty. Students undergo all stages of a research endeavor: generation of hypothesis, elaboration of a research protocol, submission to the Research Ethics and Animal Welfare Committees, data recollection, analysis, interpretation and publication of the results. Results: The course is undertaken at the Facultad de Medicina, Universidad de la República, Uruguay, the main university of the country, with high numbers of students enrolled. The course involves the participation of 600 students and up to 300 professors per year, which implies a huge institutional effort Conclusions: The scientific methodology course resulted in one of the most important incorporations of the current 2008 curriculum. Local students, faculty and international evaluators have qualified this activity as an educational breakthrough, being a gratifying and productive experience. The course represented the first exposure of medical students to the research methodology, scientific literature and publication rules, and emphasized the dynamic nature of medical knowledge within modern medical education. Moreover, for some students it constituted the onset of academic research careers. An additional positive outcome was the reactivation of some faculty research projects, in a way that largely exceeded the boundaries of the course.

Telehealth in Latin America: Progress, Challenges, and Opportunities in the Face of COVID-19

The COVID-19 pandemic has accelerated the use and importance of telehealth and telemedicine globally. In industrialized countries, stay-at-home measures and changes to government regulations regarding telehealth resulted in an over 100-fold increase in demand within weeks. The COVID-19 has raged across Latin America for most of 2020, with associated high rates of illness and death. The objective of this article is to review some of the successes and challenges of telehealth in Latin America and highlight opportunities for action within the context of COVID-19. We identify several positive trends in telehealth adoption across the region as well as some promising case studies on the use of telehealth platforms for delivering care when needed. We also identify barriers that have limited the scale of telehealth in Latin America during the current phase of the pandemic. Limiting factors include inadequacies in long-term evolution telecommunication availability and access to digital trainings for healthcare workers. In addition, political commitment, legislation, and regulation have yet to catch up with demand. Finally, we present opportunities to more effectively scale these technologies, across Latin America for the current emergency, as well as reducing or controlling healthcare costs, addressing health disparities, and providing improved health care, especially in rural areas.