Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection

El desarrollo profesional docente en el estado de las autonomías : descripción y evaluación

Estudiar la situación del desarrollo profesional docente en las Comunidades Autónomas. Acentuar el carácter exploratorio de la situación de la formación permanente en el estado de las autonomías a partir de los siguientes organizadores lógicos: agentes, condiciones, participantes, diseño, ejecución, tendencias y modelo evaluativo. Discernir en estudios multicaso el mundo interior de los agentes y participantes situados en contextos diferenciados de las distintas Comunidades Autónomas. Se proponen hipótesis. Docentes pertenecientes a 50 centros formativos de las distintas Comunidades Autónomas. Se presenta el marco teórico de la formación permanente del profesorado en España. Se proponen hipótesis y se selecciona la muestra. Se realiza un estudio cuantitativo y otro cualitativo. En el estudio cuantitativo, se realizan análisis descriptivos y análisis de varianza, y en el estudio cualitativo se analizan los discursos. Para la recogida de datos se utilizan cuestionarios y entrevistas. Se presentan los resultados para cada Comunidad Autónoma. Porcentajes. Se concluye que las razones que dan los profesores para participar en actividades de formación son: la actualización en conocimientos científicos de su área y disciplina, el perfeccionamiento en métodos y técnicas de enseñanza, el aprendizaje de nuevas tecnologías de la información y la comunicación, y el trabajo en equipo con compañeros. Un 62 por ciento de los encuestados considera que los ponentes están cualificados para desarrollar actividades de formación. Las actividades formativas desarrollas responden a los principios pedagógicos de la LOGSE, se gestionan democráticamente, son participativas y cumplen los calendarios y horarios previstos. Por último, el modelo de evaluación no permitió diagnosticar las habilidades y debilidades curriculares de los participantes, no incluía un abanico amplio de instrumentos y no evaluaba el grado de satisfacción de los participantes con las actividades realizadas.Ministerio Educación CIDEBiblioteca de Educación del Ministerio de Educación, Cultura y Deporte; Calle San Agustín, 5 - 3 Planta; 28014 Madrid; Tel. +34917748000; Fax +34917748026; [email protected]

DIÁLOGO DE SABERES desde las Ciencias Económicas, Administrativas y Contables II Vol. 2

Los contextos académicos en los cuales se mueven los diálogos de saberes, favorecen sin duda la producción de conocimiento de manera in terdisplinaria. Este es un espacio realmente enriquecedor toda vez que se conjugan ideas, experiencias y formación como una triada indisoluble que aumenta su complejidad en la cotidianidad que se desarrollan tantos profe sores como estudiantes en su espacio natural, la universidad. El hecho de entender que ha habido una ruptura con las formas tra dicionales de producir y socializar el conocimiento, permite flexibilizar este ejercicio y dar a conocer de manera más expedita y en tiempos reales las nuevas construcciones de conocimiento tanto empíricas como teóricas que se desarrollan durante el quehacer de la academia desde distintas miradas, métodos y argumentaciones. Esta realidad, nos pone en el compromiso permanente de seguir aportando al conocimiento de manera conjunta. Es por ello, que hoy con beneplácito, traemos a todos ustedes, este nuevo número de Diálogo de Saberes donde se pone en evidencia la in terdisplinariedad, las diferentes perspectivas de análisis, y la pluralidad de metodologías y métodos en el manejo de la información, lo que devela que no existe una sola mirada de los objetos de investigación que aquí se han convocado; donde los temas que se tratan dan cuenta de las realidades y los contextos que inquietan y responden de forma contundente a las nece sidades que afloran en los espacios académicos de sus investigadores

Diseño, desarrollo y evaluación preclínica de SOBERANA®02: una vacuna cubana contra COVID-19

International audienc

El derecho a los derechos : infancias y adolescencias en Cuba

«El derecho a los derechos. Infancias y adolescencias en Cuba», constituye un título atractivo y seductor, en el que se ofrece al lector una mirada crítica a retos, problemáticas y cuestiones teórico-prácticas en la protección integral de los niños, niñas y adolescentes. Profesionalidad, originalidad, impronta y opinión personal de cada uno de los autores signaron la concepción del libro. De igual forma, un lenguaje apropiado que se sustrae de tecnicismos barrocos y excesivos para facilitar la lectura. Es una obra pensada desde la academia para impactar la realidad social. (...) engrosa los estudios sobre infancia y adolescencia existentes, es expresión de un saber especializado, tanto a nivel de la investigación científica como de la práctica y la gestión institucional estatal y de la sociedad civil. No busca ser meta, punto de llegada, al contrario, es una propuesta que invita permanentemente al debate, la discusión teórica, la reflexión, al examen de las formas de hacer y al pensamiento crítico. Dr. Yuri Pérez Martíne

Reduction of cardiac imaging tests during the COVID-19 pandemic: The case of Italy. Findings from the IAEA Non-invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Background: In early 2020, COVID-19 massively hit Italy, earlier and harder than any other European country. This caused a series of strict containment measures, aimed at blocking the spread of the pandemic. Healthcare delivery was also affected when resources were diverted towards care of COVID-19 patients, including intensive care wards. Aim of the study: The aim is assessing the impact of COVID-19 on cardiac imaging in Italy, compare to the Rest of Europe (RoE) and the World (RoW). Methods: A global survey was conducted in May–June 2020 worldwide, through a questionnaire distributed online. The survey covered three periods: March and April 2020, and March 2019. Data from 52 Italian centres, a subset of the 909 participating centres from 108 countries, were analyzed. Results: In Italy, volumes decreased by 67% in March 2020, compared to March 2019, as opposed to a significantly lower decrease (p &lt; 0.001) in RoE and RoW (41% and 40%, respectively). A further decrease from March 2020 to April 2020 summed up to 76% for the North, 77% for the Centre and 86% for the South. When compared to the RoE and RoW, this further decrease from March 2020 to April 2020 in Italy was significantly less (p = 0.005), most likely reflecting the earlier effects of the containment measures in Italy, taken earlier than anywhere else in the West. Conclusions: The COVID-19 pandemic massively hit Italy and caused a disruption of healthcare services, including cardiac imaging studies. This raises concern about the medium- and long-term consequences for the high number of patients who were denied timely diagnoses and the subsequent lifesaving therapies and procedures

International Impact of COVID-19 on the Diagnosis of Heart Disease

Background: The coronavirus disease 2019 (COVID-19) pandemic has adversely affected diagnosis and treatment of noncommunicable diseases. Its effects on delivery of diagnostic care for cardiovascular disease, which remains the leading cause of death worldwide, have not been quantified. Objectives: The study sought to assess COVID-19's impact on global cardiovascular diagnostic procedural volumes and safety practices. Methods: The International Atomic Energy Agency conducted a worldwide survey assessing alterations in cardiovascular procedure volumes and safety practices resulting from COVID-19. Noninvasive and invasive cardiac testing volumes were obtained from participating sites for March and April 2020 and compared with those from March 2019. Availability of personal protective equipment and pandemic-related testing practice changes were ascertained. Results: Surveys were submitted from 909 inpatient and outpatient centers performing cardiac diagnostic procedures, in 108 countries. Procedure volumes decreased 42% from March 2019 to March 2020, and 64% from March 2019 to April 2020. Transthoracic echocardiography decreased by 59%, transesophageal echocardiography 76%, and stress tests 78%, which varied between stress modalities. Coronary angiography (invasive or computed tomography) decreased 55% (p &lt; 0.001 for each procedure). In multivariable regression, significantly greater reduction in procedures occurred for centers in countries with lower gross domestic product. Location in a low-income and lower–middle-income country was associated with an additional 22% reduction in cardiac procedures and less availability of personal protective equipment and telehealth. Conclusions: COVID-19 was associated with a significant and abrupt reduction in cardiovascular diagnostic testing across the globe, especially affecting the world's economically challenged. Further study of cardiovascular outcomes and COVID-19–related changes in care delivery is warranted

Impact of COVID-19 on Diagnostic Cardiac Procedural Volume in Oceania: The IAEA Non-Invasive Cardiology Protocol Survey on COVID-19 (INCAPS COVID)

Objectives: The INCAPS COVID Oceania study aimed to assess the impact caused by the COVID-19 pandemic on cardiac procedure volume provided in the Oceania region. Methods: A retrospective survey was performed comparing procedure volumes within March 2019 (pre-COVID-19) with April 2020 (during first wave of COVID-19 pandemic). Sixty-three (63) health care facilities within Oceania that perform cardiac diagnostic procedures were surveyed, including a mixture of metropolitan and regional, hospital and outpatient, public and private sites, and 846 facilities outside of Oceania. The percentage change in procedure volume was measured between March 2019 and April 2020, compared by test type and by facility. Results: In Oceania, the total cardiac diagnostic procedure volume was reduced by 52.2% from March 2019 to April 2020, compared to a reduction of 75.9% seen in the rest of the world (p&lt;0.001). Within Oceania sites, this reduction varied significantly between procedure types, but not between types of health care facility. All procedure types (other than stress cardiac magnetic resonance [CMR] and positron emission tomography [PET]) saw significant reductions in volume over this time period (p&lt;0.001). In Oceania, transthoracic echocardiography (TTE) decreased by 51.6%, transoesophageal echocardiography (TOE) by 74.0%, and stress tests by 65% overall, which was more pronounced for stress electrocardiograph (ECG) (81.8%) and stress echocardiography (76.7%) compared to stress single-photon emission computerised tomography (SPECT) (44.3%). Invasive coronary angiography decreased by 36.7% in Oceania. Conclusion: A significant reduction in cardiac diagnostic procedure volume was seen across all facility types in Oceania and was likely a function of recommendations from cardiac societies and directives from government to minimise spread of COVID-19 amongst patients and staff. Longer term evaluation is important to assess for negative patient outcomes which may relate to deferral of usual models of care within cardiology