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The purpose of this article is to analyze how the covid-19 pandemic affected the perceptions and uses of time of domestic workers in Spain, focusing, in particular, on the cities of Granada and Zaragoza. Our work derives from the project "El cuidado importa. Impacto de género en las cuidadoras/es de mayores y dependientes en tiempos de la Covid-19” (CUMADE) coordinated by Universidad Rovira I Virgili de Tarragona-Cataluña (Spain), and run by interdisciplinary research teams from ten Spanish universities between the months of September 2020 and January 2021. The research is qualitative, based on in-depth interviews, and designed to investigate the impact of covid-19 on the care of the elderly and dependents and, more specifically, on the domestic workers' sector. Temporality, so severely affected by the uncertainty and unpredictability of the new situation, provides an interesting axis for qualitative analysis of the discourses of women workers on the way in which the pandemic has conditioned their daily lives. To undertake this analysis, we base ourselves on the work of Ramón Ramos on las imágenes sociales del tiempo (the social images of time). This approach represents an original and novel analysis of the reality of domestic workers, while at the same time dialoguing with other recent work on this issue. The images of time as a resource, scenario, or horizon serve to analyze the discourse of our interviewees and show how time, understood as a social category, has structured and organized their lives. We consider what they have been able to do and what they have not been able to do, the distribution and intensification of tasks, their plans for the future, and the physical and emotional impact of the pandemic. © 2023, Universidad de los Andes, Bogota Colombia. All rights reserved.
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Introduction: In this study, we share the results of immunosuppressed patients who suffered from acute respiratory distress syndrome (ARDS) secondary to COVID-19 pneumonia managed in our ICU. Method(s): We tracked all patients admitted to ICU of a Tertiary Hospital diagnosed with severe SARS-COV2 pneumonia from March 1, 2020 to January 31, 2022. The definition of Immunocompromised patient is based on history of transplantation, active neoplasia, autoimmune diseases or HIV. Collected data includes: sex, age, type of immunosuppression, vaccination, mechanical ventilation, ECMO VV, incidence of superinfections and mortality. Result(s): From a cohort of 425 patients, 55 met the inclusion criteria. 33% were women and 67% male. The average age was 58 years for women and 62 years for men. Out of these patients, 27% had solid organ transplants. 40% suffered from neoplasic disease. 27% had autoimmune diseases and were under treatment with immunosuppressants. 3 had HIV. Only the 29% had received at least 1 dose of COVID 19 vaccine. 80% required orotracheal intubation. 3.64% (2) required Veno-Venous ECMO. 61% presented bacterial superinfection, with the most frequent germs being Pseudomonas aeruginosa and Enterococcus. 36% had viral superinfection, being cytomegalovirus the most frequent one. 32% had fungal superinfection, mainly by Aspergillus fumigatus. 27% did not suffer any superinfection. 40% of the total sample died. After logistic regression, in our model (AUC 83,4% (Se 57.1%, Sp 87.9%), we identified need of intubation as independent variable of mortality (OR 27,06 IC95% 1.76-415.55, p = 0.018). Conclusion(s): Immunocompromised patients with ARDS secondary to COVID-19 pneumonia present high mortality, with statistically significant difference when mechanical ventilation is needed. The most frequently isolated germs causing superinfection in this group of patients are bacterias. We believe that this group of patients require special care in our ICU units and an in-depth analysis and study to optimize their prognosis.
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The objective of this paper is to carry out an analysis of the effects of COVID-19 on the management of R&D projects derived from the linking, extension and research activities of HEIs in the Dominican Republic, during the period 2020-2021 We will make a comparison of the resilience capacity of the different HEIs in the country to manage this type of project. The effects of the pandemic on the management of these projects in HEIs are little known. With this research we seek to determine if the pandemic has affected the development of these projects in HEIs in the Dominican Republic. If so, we identify what type of actions have been carried out by HEIs to minimize the effects of the pandemic on these projects. For this, we consult primary and official sources. Interviews were also conducted with a representative sample of actors. This study involves advancing knowledge about the management of R&D projects in HEIs under situations of uncertainty and health alert. Our work compiles lessons learned on how to act on contingencies in pandemic situations so that they allow the development of this type of crucial projects in health alert situations. © 2022 by the authors. Licensee AEIPRO, Spain.
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Introduction: COVID-19 has been a challenge for healthcare, mainly in elderly patients in Nursing Homes (NHs) and Long-Term Care Facilities (LTCFs). We present a pioneering novel experience in addressing healthcare of elderly patients with COVID-19 in these facilities by a re-conversion of a NH in a medicalized NH. Method(s): All patients admitted to the center were included, recording clinical and epidemiological variables. We conducted a descriptive analysis and a multivariate analysis to identify variables linked to mortality and persistence of positive PCR test. Result(s): 84 patients were included (40% men), women presented more symptomatology. We found a positive correlation between the duration of symptoms and the days required to obtain a negative PCR test (r=0.512, P<0.001). We also found an independent and significant association between as-thenia (OR=2.58;IC95% 1.22-5.46) and mutism (OR=5.21;IC95% 1.58-17.15) and a longer time to achieve a negative PCR test. All patients, except contraindication, were treated with hydrox-ychloroquine and azithromycin, which was the recommended treatment during the period of the study. The early start of corticoid treatment (within the first 72 hours since the start of symptoms) was linked to a lower mortality in patients with moderate-severe symptoms. Mortality was lower than expected (which was higher than 20% in that period and group of age), reaching 14%, the main factors linked to mortality were the presence of mutism (OR=19;IC95% 3.4-108;P=0.001) and dyspnea (OR=12;IC95% 1.3-111;P=0.029). Conclusion(s): An alternative system was presented for the care of these patients through the recon-version of a basic NH in a medicalized one, which showed a significant reduction in the expected mortality.Copyright © 2021 Bentham Science Publishers.
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During the last years, the way of teaching classes was impacted by modifying almost 100% of the university courses to digital mode, this modified the academic space for the learning and development of competencies of the students, including collaborative learning. Collaborative work helps students to exchange knowledge, solving doubts between them and complementing their skills when they are solving problems or challenges. This paper presents an analysis of the development of competencies through collaborative learning using virtual communication channels. For this purpose, the following transversal competencies were evaluated: critical thinking, scientific thinking, leadership and reasoning for complexity. The question that seeks to answer this work is from the perception of the students, if their development of competencies and their performance in collaborative learning, has been affected due to the pandemic and the permanent online connection. The statistical test used was the paired t-test, since the same population was evaluated at different times, a survey was carried out on students at the beginning of the semester and at the end of the semester. The results showed that the lockdown situation modified the compromise of most of the students to work on teams as well as their ability to stay focused. Therefore, only the competencies that involve self-work (scientific work, reasoning of complexity) or multidisciplinary work, were increased during the lockdown. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.
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1. Introduction: Asthma causes significant morbidity and mortality worldwide. COVID-19 scenario has revealed lacks in the current model of asthma management in Primary Care (PC). 2. Aims and objectives: The aim was to build a reference framework and address patients' needs to help asthma management improvement in a COVID-19 scenario. 3. Method(s): A scientific committee from the Spanish Respiratory Group in PC (GRAP) defined an evidence-based gold standard model for asthma care pathway including: suspected asthma, confirmed asthma, asthma follow-up, asthma exacerbations and special situations in asthma. Multidisciplinary teams (family doctors, PC nurses, practice clerks, and community pharmacists) were recruited from 17 PC settings in 7 Spanish regions to characterise their local asthma care pathway and to identify room for improvement in different areas according to previously defined gold-standards. A national online Digital Innovation Laboratory was held with representatives of the local teams to prioritise areas of improvement in terms of clinical impact and to co-design action plans. 4. Result(s): 43 to-be-improved areas in asthma care pathways were identified, classified into different categories. Continuing care, collaborative work between Primary and Secondary care, availability of qualified healthcare staff, data recording and management, digital transformation and patient empowerment were some of the areas to prioritize. 5. Conclusion(s): Multidisciplinary pre-structured team work with Digital Innovation Laboratory support could help to redesign the asthma patient's pathway and to improve the effective asthma management in a COVID-19 scenario.
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This paper is driven both by a growing appetite for solo female travel;as well as a knowledge gap in the market and literature. The aim is to identify generational differences in women's solo travel motivations, characterize the generational differences in their preferred destination attributes, and ascertain any generational differences in their perceived inhibiting factors to travelling solo post the COVID-19 pandemic. By using the push–pull framework theory as the overarching framework, a survey was administered and 1576 responses from experienced solo female travellers were analysed. The findings revealed the different generations of solo female travellers and their distinctive travel needs (push factor/motivation, pull factor/destination preference, and inhibiting factors/risk & constraint) during the COVID pandemic. © 2023 Informa UK Limited, trading as Taylor & Francis Group.
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The pandemic caused by the Covid-19 virus had great repercussions throughout the world and in all areas. It attacked not only from a health point of view, but also the economy and society, because it litera-lly paralyzed the planet. One of the most sensitive points was education, considering that this sector saw its structure and type of teaching modality com-pletely mutated. Teachers and students were forced to take on the study through virtual classes. This was a problem considering that, due to the characteris-tics of the Ecuadorian population, not everyone has access to the internet or digital media. To analyze the impact of this phenomenon in Ecuador, the city of Babahoyo was taken as a field of study during the period of 2020. The objective of this research was to analyze the consequences of the pandemic in rela-tion to the right to education. The research was de-veloped in the qualitative-quantitative modality, for a critical analysis of the problem presented. The aim is to achieve a degree of citizen awareness that recog-nizes the importance of creating public policies for education, since it is the duty of the State to guaran-tee the right to education.
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Introduction: The COVID-19 pandemic had a significant impact worldwide. Consultations in the Emergency Service of the Hospital Clinic of Barcelona varied in terms of reasons for consultations, psychopathology, and other aspects, before and after the pandemic. Objective(s): To examine changes in the profile of patients admitted before and during the COVID-19 pandemic to our Psychiatric Emergency Service. Method(s): All children, adolescent and adult psychiatric inpatients admitted from December 4th 2019 to March 31st 2021 to the Psychiatric Emergency Service of Hospital Clinic of Barcelona, Spain, were retrospectively included for analysis and divided into two groups -groups 1 or 2- including the first one all patients who attended before lockdown and the second group those who attended during the pandemic. Result(s): A total of 1991 patients were included -1224 in the first group and 767 in the second group. The majority of patients were male (52.08%), with a mean age of 41.21 years (SD 16.53). A proportion significantly higher of men was found in the second group (p<0.05). The proportion of patients consulting with substance use disorders was significantly higher in the second group (p<0.05). Patients from the second group presented a significantly higher proportion of admissions in an acute psychiatric ward (p<0.05), and also a significantly higher proportion of consultations of patients with dementia (p<0.05). Conclusion(s): The COVID-19 pandemic lead to a significant reduction in the overall consultations, with a higher proportion of severe cases. The lack of availability of caregivers and telework might have influenced the increase in consultations of patients with dementia.
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Background: COVID-19 has affected millions of people worldwide over the past two years. SARS-CoV- 2 uses the Spike (S) protein to infect target cells. An active immunothrombotic state has been described in severe stages of infection. Platelets are cells implicated in the pathophysiology of CoVID-19, presumably by contributing to the release of inflammatory cytokines and exhibiting a procoagulant phenotype, although the platelet response in the disease has been studied, information on the cellular response to S protein domains is scarce. Aim(s): To study platelet reactivity response to SARS-CoV- 2 virus Spike protein and RBD domain. Method(s): Blood samples were obtained from healthy volunteers by venipuncture after signing an informed consent form, using 3.2% sodium citrate as anticoagulant. Platelet-rich plasma (PRP) was obtained by slow centrifugation (100 g x 10 minutes). PRP was separated and resuspended in Tyrodes buffer. Platelet stimulation kinetics (1X107 cells/ml) was performed with S full protein and protein S receptor binding domain (RBD) [2 mug/ml], 37degreeC. PRP was also incubated with plasma from COVID-19 patients [20 mul] for different times. Platelet activity was assessed by flow cytometry: CD41-PECy7, CD62-PE and PAC1-FITC. We used ADP 20muM, collagen 0.19 mg/ml and epinephrine 100muM as platelet activation controls. Result(s): We observed platelet reactivity after stimulation with protein S, highest activation was observed at 90 min with full protein and at 120 min with RBD domain when compared to the basal expression of selected markers and is similar to the observed with the positive control agonists. Stimulation of PRP with plasma from COVID-19 patients show the presence of activation markers at 60 min. However, activation is lower than that observed with known activation agonists. Conclusion(s): There is platelet reactivity to Spike protein, the RBD domain and with plasma from COVID-19 affected subjects.
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The objective of the research work was to expose how the legal research process after the covid-19 pandemic has impacted on the solution of social problems and to determine a mechanism for the satisfaction of the actors of the legal research process at the Universidad de los Andes. Therefore, it is proposed to characterize the impact through a bibliographic search in databases of interest and subsequently determine the level of satisfaction of students, professors and certified researchers within the university with the existing legal research system through the application of the IADOV technique. A higher overall satisfaction index was obtained in the sampled analysis groups. It was observed that the group of professors obtained a higher overall satisfaction index than the rest of the two groups. The most important elements for each of the groups were es-tablished, as well as those that enhance and limit the research system. It is recommended to review and analyze the limiting elements detected in order to include them in a continuous improvement plan. © 2022, University of Cienfuegos, Carlos Rafael Rodriguez. All rights reserved.
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Background: COVID-19 pandemic spread around the world swiftly;there are several diagnostic strategies available. Health workers, especially medical residents (MR), are a high-risk population for acquiring this infection.
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Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection triggers inflammatory clinical stages that affect the outcome of patients with coronavirus disease 2019 (COVID-19). Disease severity may be associated with a metabolic imbalance related to amino acids, lipids, and energy-generating pathways. The aim of this study was to characterize the profile of amino acids and acylcarnitines in COVID-19 patients. A multicenter, cross-sectional study was carried out. A total of 453 individuals were classified by disease severity. Levels of 11 amino acids, 31 acylcarnitines, and succinylacetone in serum samples were analyzed by electrospray ionization-triple quadrupole tandem mass spectrometry. Different clusters were observed in partial least squares discriminant analysis, with phenylalanine, alanine, citrulline, proline, and succinylacetone providing the major contribution to the variability in each cluster (variable importance in the projection >1.5). In logistic models adjusted by age, sex, type 2 diabetes mellitus, hypertension, and nutritional status, phenylalanine was associated with critical outcomes (odds ratio=5.3 (95% CI 3.16-9.2) in the severe vs. critical model, with an area under the curve of 0.84 (95% CI 0.77-0.90). In conclusion the metabolic imbalance in COVID-19 patients might affect disease progression. This work shows an association of phenylalanine with critical outcomes in COVID-19 patients, highlighting phenylalanine as a potential metabolic biomarker of disease severity.
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COVID-19 , Diabetes Mellitus Tipo 2 , Humanos , SARS-CoV-2 , Estudios Transversales , Aminoácidos , FenilalaninaRESUMEN
Background: The impact of the COVID-19 pandemic on multimodal cardiac rehabilitation (CR) programmes has forced a continuous readjustment of clinical practice. Our regional healthcare system was faced with providing quality remote CR to ischaemic heart disease (IHD) patients in a scattered, mostly rural population, for which three new CR modalities replaced the previous in-person CR program: 1) telephone follow-up programme, 2) TELEA online platform for patient follow-up and 3) TELEA online follow-up & online training sessions. Purpose: To study the impact of the COVID-19 pandemic on CR offering and acceptance and the reasons for patient refusal, and to assess the outcome of new remote CR modalities in this setting. Methods: Single center, observational retrospective study from all consecutive patients with IHD eligible for CR from 2015 to 2021. A descriptive analysis of patient baseline characteristics, CR modality, offering and acceptance rates, and reasons for refusal per year was performed. Additionally, a comparative analysis of “pre-COVID period” (Jan 2015–Feb 2020) vs. “COVID period” (Mar 2020–Dec 2021) was performed to assess the impact of the pandemic on patient recruitment and the usefulness of remote CR modalities to enhance participation. Results: N=2626 patients (20% women, 69.7±45.8 years) were offered CR from 2015 to 2021. CR offering decreased from the pre-COVID (78.6%) to the COVID period (52.6%), while participation increased (67.9% and 79.7%, respectively) Figure 1. Reasons for CR refusal significantly changed with an odds ratio (OR) of 5.63 and confidence interval (CI) 95% (3.2–9.9). In the pre-COVID period main reasons for CR refusal was “transportation difficulties” (47%);while during the COVID-19 period, the main reason shifted to “lack of interest” (78.2%) (Table 1). Conclusions: Offering CR decreased during the COVID pandemic possibly due to stricter inclusion criteria. However, the implementation of new remote CR modalities allowed not only to maintain similar levels of acceptance but also to improve it despite the unfavourable setting, and helped to amend transportation difficulties as the leading reason for refusal. Remote CR may be a useful tool, combined with in-person programs, to enhance participation in CR. Funding Acknowledgement: Type of funding sources: None.Figure 1
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Art education provides the human experience with sensitive practices that are signified through internal expressions promoted by emotions, personality, and ability. The research in question analyzes the teaching narratives about the sensitive practice in the educational experiences in an arts subject of the baccalaureate level (upper secondary) in a Mexican public school. The research approach is of a hermeneutic type, whose central research questions are: how is sensitive practice? What is its essence and its way of being? Is it possible to be shown and demonstrated? Sensitive practice is objectified from theater, dance, visual arts, and music, which are instructed through a subject of artistic exploration. The data collection was carried out during July-December 2020, from the virtual mode, due to the context of confinement due to the Covid-19 pandemic. It is recognized that both teachers and students have dispensed with the process of socialization face to face with their peers, so that part of the findings demonstrate the sensitive practice from the current environment and the objective situations in it are determined. Teachers assume their artistic training and objectify themselves in their educational practice.