Effectiveness of a telerehabilitation intervention using ReCOVery APP of long COVID patients: a randomized, 3-month follow-up clinical trial.

The main objective of this study is to analyze the clinical efficacy of telerehabilitation in the recovery of Long COVID patients through ReCOVery APP for 3 months, administered in the Primary Health Care context. The second objective is to identify significant models associated with an improvement in the study variables. An open-label randomized clinical trial was conducted using two parallel groups of a total of 100 Long COVID patients. The first group follows the treatment as usual methods established by their general practitioner (control group) and the second follows the same methods and also uses ReCOVery APP (intervention group). After the intervention, no significant differences were found in favour of the group intervention. Regarding adherence, 25% of the participants made significant use of the APP. Linear regression model establishes that the time of use of ReCOVery APP predicts an improvement in physical function (b = 0.001; p = 0.005) and community social support (b = 0.004; p = 0.021). In addition, an increase in self-efficacy and health literacy also contribute to improving cognitive function (b = 0.346; p = 0.001) and reducing the number of symptoms (b = 0.226; p = 0.002), respectively. In conclusion, the significant use of ReCOVery APP can contribute to the recovery of Long COVID patients. Trial Registration No.: ISRCTN91104012.

The emotional well-being of Long COVID patients in relation to their symptoms, social support and stigmatization in social and health services: a qualitative study.

BACKGROUND: Long COVID patients have experienced a decline in their quality of life due to, in part but not wholly, its negative emotional impact. Some of the most prevalent mental health symptoms presented by long COVID patients are anxiety, depression, and sleep disorders. As such, the need has arisen to analyze the personal experiences of these patients to understand how they are managing their daily lives while dealing with the condition. The objective of this study is to increase understanding about the emotional well-being of people diagnosed with long COVID. METHODS: A qualitative design was created and carried out using 35 patients, with 17 participants being interviewed individually and 18 of them taking part in two focus groups. The participating patients were recruited in November and December 2021 from Primary Health Care (PHC) centers in the city of Zaragoza (Northern Spain) and from the Association of Long COVID Patients in Aragon. The study topics were emotional well-being, social support networks, and experience of discrimination. All an inductive thematic content analyses were performed iteratively using NVivo software. RESULTS: The Long COVID patients identified low levels of self-perceived well-being due to their persistent symptoms, as well as limitations in their daily lives that had been persistent for many months. Suicidal thoughts were also mentioned by several patients. They referred to anguish and anxiety about the future as well as a fear of reinfection or relapse and returning to work. Many of the participants reported that they have sought the help of a mental health professional. Most participants identified discriminatory situations in health care. CONCLUSIONS: It is necessary to continue researching the impact that Long COVID has had on mental health, as well as to provide Primary Health Care professionals with evidence that can guide the emotional treatment of these patients.

Posttraumatic stress disorder after COVID-19: A scoping review

Introduction: Post-traumatic stress disorder occurs among subjects exposed to traumatic or threatening situations. The current COVID-19 pandemic has both physical and mental repercussions for patients. Objective: Explore the current medical evidence on post-COVID-19 post-traumatic stress disorder. M ethodology: Scoping review including databases such as PubMed and Scopus, considering observational studies published in English and Spanish, with data on post-traumatic stress disorder among survivors of SARS-CoV-2 infection. Results: Some 23 documents were included: prospective cohort studies (n = 10), cross-sectional studies (n = 8), retrospective cohort studies (n = 4) and a prospective cohort study and retrospective (n = 1);the total sum of patients evaluated in the studies included in this review was 186 707. Conclusion: Patients surviving COVID-19 present an increased incidence of symptoms such as excessive stress, anxiety, and depressive mood. These symptoms present mostly in patients with a history of mental illness, long hospital stays, and females. © 2022 Academia Nacional de Medicina. All rights reserved.

Usability of mobile applications for home orders. COVID-19 and health emergency in Guayaquil

The article proposes an analysis of the usability of the most used mobile applications for home orders in the Ecuadorian city of Guayaquil, in the face of the health emergency and mobility restriction generated by COVID-19. The study applies the six indicators established by the ISO/IEC 25010 standard to determine the degree of usability of a product. An exploratory research was conceived within the quantitative and qualitative perspectives, which used the deductive theoretical method and the empirical method of inquiry. As data collection techniques, surveys were applied to a sample of 280 users, residents in the northern sector of Guayaquil, and interviews with experts. It was concluded that the studied applications comply with the usability standards proposed by the ISO/IEC 25010 standard.

Plexiglass: how power, policy and politics create a mirage of equitable family engagement

Purpose: Power, policy and politics set the landscape for technocratic approaches in the educational system. Efficiency and money-saving initiatives that adhere to a one-size-fits-all approach drive the response to complex and multifaceted challenges within education. This has been made apparent through the COVID-19 pandemic and its aftermath. This paper aims to explore one of the most pronounced and gaping realities that became evident during this crisis in how the system dehumanizes those in the margins. By not centralizing the biographies of families served in the schools, particularly culturally and linguistically diverse families, the system has failed to capitalize on the assets and affirm their wisdom. Design/methodology/approach: This conceptual paper juxtaposes the technocratic and humanistic approaches of family engagement and provides alternative narratives rooted in authentic cariño (Bartolomé, 2008;Herrera et al., 2020;Valenzuela, 1999) and radical kinship (Boyle, 2017). Findings: Currently, the educational system has sought to address complex issues by attending to the structures (i.e. plexiglass) and instructions (i.e. technology) as a way of responding to life-altering events that are in need of humanistic approaches. Originality/value: The authors ask educators to reflect on the ways that power, policy and politics often stifle opportunities to move outside what is known to transform educational contexts. The authors conclude with critical questions to create new pathways guided by empathy and hope. © 2021, Emerald Publishing Limited.

Public school and COVID-19: socio-family difficulties of education in confinement

The crisis produced by the COVID-19 pandemic led to the closure of educational centers, shifting teaching from schools to homes. Distance education posed a challenge for families, which, at times, were strained, striving to meet scholastic demands. Therefore, the main objective of this study is to explore the specific factors that made it difficult for the families of Primary Education students to adapt to remote learning. In order to meet said objective, statistical analyses were carried out of the responses to a questionnaire by 236 relatives of public-school students in our country, created and validated, ad hoc, as a quantitative data collection system. A qualitative analysis of more than 600 comments provided by the 236 relatives to an open-ended question was also conducted. The results indicate that almost half of the families experienced difficulties adapting to remote teaching, with a lack of resources, knowledge, and organizational problems generating negative feelings. These struggles were even more acute in the homes of students with relative unemployed during the lockdown. Finally, a need was detected to undertake actions that bolster communications between schools and families, and that close the digital divide due to socio-family conditions.

Covid-19: Adaptation of a model to predict healthcare resource needs in valle del Cauca, Colombia

Background: Valle del Cauca is the region with the fourth-highest number of COVID-19 cases in Colombia (>50,000 on September 7, 2020). Due to the lack of anti-COVID-19 therapies, decision-makers require timely and accurate data to estimate the incidence of disease and the availability of hospital resources to contain the pandemic. Methods: We adapted an existing model to the local context to forecast COVID-19 incidence and hospital resource use assuming different scenarios: (1) the implementation of quarantine from September 1st to October 15th (average daily growth rate of 2%);(2-3) partial restrictions (at 4% and 8% growth rates);and (4) no restrictions, assuming a 10% growth rate. Previous scenarios with predictions from June to August were also presented. We estimated the number of new cases, diagnostic tests required, and the number of available hospital and intensive care unit (ICU) beds (with and without ventilators) for each scenario. Results: We estimated 67,700 cases by October 15th when assuming the implementation of a quarantine, 80,400 and 101,500 cases when assuming partial restrictions at 4% and 8% infection rates, respectively, and 208,500 with no restrictions. According to different scenarios, the estimated demand for reverse transcription-polymerase chain reaction tests ranged from 202,000 to 1,610,600 between September 1st and October 15th. The model predicted depletion of hospital and ICU beds by September 20th if all restrictions were to be lifted and the infection growth rate increased to 10%. Conclusion: Slowly lifting social distancing restrictions and reopening the economy is not expected to result in full resource depletion by October if the daily growth rate is maintained below 8%. Increasing the number of available beds provides a safeguard against slightly higher infection rates. Predictive models can be iteratively used to obtain nuanced predictions to aid decision-making.

Teaching medicine in pandemic times: an experience from mental health rotation

Introduction: The COVID-19 pandemic led to the implementation of diverse safety measures in various aspects of society. Traditional in-person classes were canceled under this premise at all levels of education in Colombia, causing medical students to stop assis-ting to hospitals for their clinical practices. Objectives: Describe educational strategies applied to continue clinical rotations, securing the development of the necessary competences in the mental health program. Methods: The Medicine School’s clinical rotation on mental health started being instructed virtually and remotely using diverse technological tools after the Colombian government decreed a preventive loc-kdown. Mixed modality activities with real patients restarted once lockdown was partially lifted. We per-formed synchronous and asynchronous activities that included learning using technological resources, te-lesimulation, seminaries, workshops, case develop-ments, and journal clubs, among others. Results: Virtual instruction generated personalized tutorship spaces, the design of adapted teaching strategies and novel evaluation mechanisms while main-taining the quality of learning. Conclusion: The change from traditional in-person education to a virtual learning produced multiple personal and technical lessons with the implementation of new methodologies and technological tools, obtaining favorable results in execution, evaluation, and psychiatry teacher’s and student’s satisfaction. © 2022, Universidad de Antioquia. All rights reserved.