Main Domains Research Articles

Cognitive dysfunction in adolescents with substance use disorder

BackgroundSubstance abuse is a major health problem, associated with multiple clinical correlates. Cognitive dysfunctions were among the most relevant health problems associated with substance abuse among adolescents. The aim of the study is investigate the main cognitive domains affected in a sample of adolescents with substance use disorders. A case-control comparison was performed between 100 substance abusers versus 40 controls. The Mini-International Neuropsychiatric Interview v.5, Addiction Severity Index, Wisconsin Card Sorting Test, socioeconomic scale, and multiple historical variables investigated.ResultsSubstance abusers showed higher mean than control as regard all other WCST domains. The difference between two groups was statistically significant. Cannabis substance mostly affects early conceptualization and problem-solving abilities, while inhalants affect predominantly sustained attention, and alcohol mostly affect cognitive flexibility. Polysubstance use is more harmful to most of the executive function domain than mono substance use.ConclusionsThe substance use disorders are a major health problem accompanied cognitive dysfunction among adolescents and associated with increased rates of executive dysfunction. Cognitive flexibility, sustained attention, problem-solving abilities, and early conceptualization are the most domains affected.

Explaining the role and responsibilities of the National Anti-Coronavirus Headquarters in prevention and emergency response to pandemics in the workplace: a qualitative study on COVID-19 experience in Iran

BackgroundIn recent years, the Coronavirus disease 2019 (COVID-19) have greatly affected the safety of life and the economy. Taking rapid measures to reduce these problems requires effective and efficient decisions by various departments and headquarters in a country. The purpose of this study was to investigate the role and responsibilities of the National Anti-Corona Headquarters (NACH) in the workplace during the pandemic.MethodsThis study was a qualitative study conducted using a triangulation approach. Data were obtained through semi-structured interviews with 18 participants with a purposive sampling technique as well as the review of related documents and records in response to the COVID-19 pandemic. The inductive and deductive approach was used for the content analysis of data in the Plan-Do-Check-Act (PDCA) model of the ISO45001 management system.ResultsBased on the results, four themes (plan, do, check, and act) were considered as the main domains. Subthemes include understanding the needs and expectations of interested parties; specific policy-making for organizations/workplaces; leadership and organizational commitment; addressing risks and opportunities; providing resources; competence of individuals and organizations; awareness; communication; information documentation; emergency response; monitoring, analyze, and evaluate performance; management review; non-compliance and corrective action; and improvement in pandemic control.ConclusionTo ensure the effectiveness and efficiency of organizations to deal with pandemics, the NACH must implement these responsibilities and play a pivotal role in responding to pandemics and using the participation of other government agencies and society. The findings of this study can be useful from national to local levels.

Surface Engineering of Lanthanide Nanoparticles for Oncotherapy.

Surface-modified lanthanide nanoparticles have been widely developed as an emerging class of therapeutics for cancer treatment because they exhibit several unique properties. First, lanthanide nanoparticles exhibit a variety of diagnostic capabilities suitable for various image-guided therapies. Second, a large number of therapeutic molecules can be accommodated on the surface of lanthanide nanoparticles, which can simultaneously achieve combined cancer therapy. Third, multivalent targeting ligands on lanthanide nanoparticles can be easily modified to achieve high affinity and specificity for target cells. Last but not least, lanthanide nanoparticles can be engineered for spatially and temporally controlled tumor therapy, which is critical for developing precise and personalized tumor therapy. Surface-modified lanthanide-doped nanoparticles are widely used in cancer phototherapy. This is due to their unique optical properties, including large anti-Stokes shifts, long-lasting luminescence, high photostability, and the capacity for near-infrared or X-ray excitation. Upon near-infrared irradiation, these nanoparticles can emit ultraviolet to visible light, which activates photosensitizers and photothermal agents to destroy tumor cells. Surface modification with special ligands that respond to tumor microenvironment changes, such as acidic pH, hypoxia, or redox reactions, can turn lanthanide nanoparticles into a smart nanoplatform for light-guided tumor chemotherapy and gene therapy. Surface-engineered lanthanide nanoparticles can include antigens that elicit tumor-specific immune responses, as well as immune activators that boost immunity, allowing distant and metastatic tumors to be eradicated. The design of ligands and surface chemistry is crucial for improving cancer therapy without causing side effects. In this Account, we classify surface-modified lanthanide nanoparticles for tumor therapy into four main domains: phototherapy, radiotherapy, chemotherapy, and biotherapy. We begin by introducing fundamental bioapplications and then discuss recent developments in tumor phototherapy (photodynamic therapy and photothermal therapy), radiotherapy, chemotherapy, and biotherapy (gene therapy and immunotherapy). We also assess the viability of a variety of strategies for eliminating tumor cells through innovative pathways. Finally, future opportunities and challenges for the development of more efficient lanthanide nanoprobes are discussed.

Non-beneficial admission to the intensive care unit: A nationwide survey of practices.

In a nationwide survey of practices, we sought to define the criteria, circumstances and consequences of non-beneficial admissions to the intensive care unit (ICU), with a view to proposing measures to avoid such situations. ICU physicians from a French research in ethics network participated in an online survey. The first part recorded age, sex, and years' experience of the participants. In the second part, there were 8 to 12 proposals on each of 4 main domains: (1) What criteria could be used to qualify an ICU stay as non-beneficial? (2) What circumstances result in the admission of a patient whose ICU stay may later be deemed non-beneficial? (3) What are the consequences of a non-beneficial stay in the ICU? (4) What measures could be implemented to avoid admissions that later come to be considered as non-beneficial? Responses were on a 5-point Likert scale ranging from "Strongly disagree" to "Strongly agree". Among 164 physicians contacted, 154 (94%) responded. The majority cited several criteria used to qualify a stay as non-beneficial. Similarly, >80% cited several possible circumstances that could result in non-beneficial admissions, including lack of knowledge of the case and the patient's history, and failure to anticipate acute deterioration. Possible consequences of non-beneficial stays included stress and anxiety for the patient/family, misunderstandings and conflict. Discussing the utility of possible ICU admission in the framework of the patient's overall healthcare goals was hailed as a means to prevent non-beneficial admissions. The results of this survey suggest that joint discussions should take place during the patient's healthcare trajectory, before the acute need for ICU arises, with a view to limiting or avoiding ICU stays that may later come to be deemed "non-beneficial".

Patient Satisfaction With Breast Cancer Care Delivery at the National Cancer Institute of Sri Lanka: Does Language Play a Role?

This study sought to examine whether there was an association between language barriers and patient satisfaction with breast cancer care in Sri Lanka. A telephone-based survey was conducted in the three official languages (Sinhala, Tamil, or English) among adult women (older than 18 years) who had been treated for breast cancer within 6-12 months of diagnosis at the National Cancer Institute of Sri Lanka. The European Organisation for Research and Treatment of Cancer Satisfaction with Cancer Care core questionnaire was adapted to assess three main domains (physicians, allied health care professionals, and the organization). All scores were linearly transformed to a 0-100 scale, and subscores for domains were summarized using means and standard deviations. These were also calculated for the Sinhalese and Tamil groups and compared. The study included 72 participants (32 ethnically Tamil and 40 Sinhalese, with 100% concordance with preferred language). The most commonly reported best aspect of care (n = 25) involved affective behaviors of the physicians and nurses. Ease of access to the hospital performed poorest overall, with a mean satisfaction score of 54 (30.5). Clinic-related concerns were highlighted as the worst aspect of the care (n = 10), including long waiting times during clinic visits. Sixty-three percent of Tamil patients reported receiving none of their care in Tamil and 18% reported experiencing language barriers during their care. Tamil patients were less satisfied overall and reported lower satisfaction with care coordination (P = .005) and higher financial burden (P = 0.014). Ethnically Tamil patients were significantly less satisfied than their Sinhalese counterparts and experienced more language barriers, suggesting there is a need to improve access to language-concordant care in Sri Lanka.

Antarctic science in Chile: a bibliometric analysis of scientific productivity during the 2009–2019 period

AbstractThe changes implemented in 2005 in the development strategies of Antarctic science carried out by Chile have had a positive impact on the scientific productivity of the Chilean Antarctic Science Program (PROCIEN). We analysed scientometric indicators from between 2009 and 2019. The bibliographic data were extracted from the Web of Science database using search query keywords. We used multiple correspondence analysis to identify specific trends and also network analyses of international collaboration in VOSviewer. The number of Antarctic science publications in Chile has gradually increased from 21 in 2009 to 95 in 2019. The rise in the number of articles was higher in journals for the first impact factor quartile. Research lines showing increased first-quartile impact factor papers corresponded to Antarctic ecosystems, biotechnology and geosciences. The main geographical domains in which such research activities have been carried out corresponded to in the South Shetland Islands and the Antarctic Peninsula. Fieldwork data are the main sources for the production of scientific articles, and there are three science platforms within which most of these papers concentrate. The diversification of funding sources, the implementation of improvements in the selection process and Chile's alignment with Scientific Committee on Antarctic Research programmes have contributed to improving the science that Chile has developed in Antarctica.

Intricate coupling between the transactivation and basic-leucine zipper domains governs phosphorylation of transcription factor ATF4 by casein kinase 2.

Transcription factors (TFs) play the first and fundamental role in cellular gene expression. TFs possess two main functional domains, transactivation domain (TAD) and DNA binding domain (DBD). Most transactivation domains are known to be largely disordered but play a key role in modulating the transcriptional activity by binding to a variety of coactivators and corepressors. Despite the crucial importance of these domains, the structural and functional basis of transactivation remains poorly understood and that's one of the main reasons why TFs are considered “undruggable”. Here, we focused on activating transcription factor 4 (ATF4), an essential transcription factor for cellular stress adaptation. Using solution nuclear magnetic resonance spectroscopy complemented by a range of biophysical methods, we found that the isolated transactivation domain of ATF4 is predominantly yet not fully disordered in solution. Importantly, we found that the N-terminal region of TAD is involved in transient long-range interactions with its DBD, also known as basic-leucine zipper (bZip) domain. Finally, in vitro phosphorylation assays with the CKII kinase show that the presence of the bZip domain is required for phosphorylation of TAD. This study uncovers the intricate coupling existing between the TAD and DNA binding domains of ATF4, highlighting its potential regulatory significance.

Pharmacist Role in Hypertension Management in the Community Setting: Questionnaire Development, Validation, and Application.

Hypertension is a leading cause of mortality and morbidity globally. Pharmacists can play a substantial role in decreasing the burden of the disease. The primary aim of this study was to develop and validate a scale assessing the pharmacist role in hypertension management in the community pharmacy setting. The secondary aims were to assess the services/interventions in hypertension management that were performed in the real-life setting, as well as the patient satisfaction from these services/interventions. This cross-sectional study was conducted in Egypt. The data were collected using a survey composed of three sections: a general section, the pharmacist role questionnaire section, and the patient satisfaction from the provided interventions/services section. The pharmacist role questionnaire was developed based on the pharmaceutical care practice conceptual model and included 23 questions. The face validity, content validity, reliability testing using Cronbach alpha, and construct validity using exploratory factor analysis were determined. The percentage of the frequency by which each role was reported to be performed was determined. Patient satisfaction from the provided interventions/services was determined by means of an overall rating. The correlation between practiced roles and patient satisfaction with received interventions/services was determined. The questionnaire was valid with a 4-factor structure and a Cronbach alpha >0.75, reiterating the main pharmaceutical care practice domains: medication management, disease-state education, disease-state management, and care plan monitoring. Roles falling in the domains of disease state management and disease state education were significantly more practiced than roles falling in the other domains. Pharmacist practice in hypertension management in the community setting was inclined towards contemporary roles, such as disease state education and management. Patients seem to be satisfied with these roles.

The Efficacy of Cognitive-Communicative Intervention in Subjective Cognitive Decline: A Systematic Review and Meta-Analysis

Purpose: Subjective cognitive decline (SCD) is a risk factor for mild cognitive impairment and Alzheimer’s disease, highlighting the need for identifying and ranking effective cognitivecommunication interventions.Methods: Databases were searched since 2005 to identify randomized controlled trials evaluating interventions for SCD. I reviewed systematically twenty researches and proposed the evidence based data, including their effect sizes using a meta-analysis method. Outcome measures included the domains of 12 cognitions and three communications.Results: The main findings were as follows. Firstly, intervention programs were designed diversely in a session or mode. Their main domains were general cognition, memory, language, etc. Secondly, the average effect size of cognitive-communication interventions was significant. Thirdly, most cognitive domains like processing speed, memory, working memory, and executive function were very effective and significant in the results of treatment. Lastly, naming and comprehension in communication had the significant effect sizes.Conclusion: These results provide evidence-based information to support cognitive-communication intervention for individuals with SCD. Given this, it is possible to facilitate the preventive interventions for SCD in clinical settings, warranting further research into effective elements of their approaches.

‘Thin labourism’: Ideological and policy comparisons between the Australian, British, and New Zealand labour parties

Centre–left political parties are undergoing an identity crisis. This article is a comparative analysis of how the three sister labour parties in the United Kingdom, Australia and New Zealand are refurbishing their agendas. We integrate Barrientos and Powell’s framework, with Freeden’s concept of ideological morphology, to systematically map the three parties across three main domains: their discourse and values, their political economy, and their social policy agendas. We then apply four different analytical frames to better understand the ideological and policy trajectories of our cases. These frames comprise ‘values, not ideology’, ‘quietism’, ‘third way’, and ‘thin labourism’. We argue that the frame of ‘thin labourism’ best captures the recent developments of these modern labour parties. In sum, the parties are still rooted in a recognisable centre–left tradition, but they operating from a narrower base of core values.

Community perception and acceptance of patients with prosthetic devices after disabilities in Saudi Arabia

Objectives: It is well-known that prostheses help people with special needs to adapt and have a better quality of life; however, the community’s perception and acceptance of patients with prosthetic devices have not been fully assessed. This study aimed to measure the community’s perception and acceptance of patients with prostheses in Riyadh, Saudi Arabia. Methods: A cross-sectional study was conducted using a self-developed questionnaire. The questionnaire included 20 questions to assess three main domains; marriage, employment, and friendship. The questionnaire was distributed for around 4 months to achieve the required sample size. The assessment of community acceptance of people with prostheses was measured by the Prosthesis Acceptance Assessment Test, which is 20 items on a five-point Likert scale. A score of 60 and above indicate a high acceptance rate for a participant. Results: A total of 526 participants responded to the questionnaire, of which only 68 (12.9%) participants knew someone with a prosthesis. Most participants were female (n = 292, 55.5%) and bachelor’s degree holders (n = 90, 26.1%). The acceptance rate was higher in females (n = 78, 26.7%) than males (n = 58, 24.8%), with most participants (n = 390, 74.1%) not accepting people with prostheses. Conclusion: Most participants in the study were not socially accepting people with a disability using prostheses. Reasons were not explored as there was no age, gender, or educational status differences that may have potentially explained the low acceptance rate.

Hand Grip Strength Relative to Waist Circumference as a Means to Identify Men and Women Possessing Intact Mobility in a Cohort of Older Adults with Type 2 Diabetes.

Possessing intact mobility in older adults assures their continued independence. The early identification of reduced mobility in older adults with type 2 diabetes (T2DM) is paramount for preventing their future physical deterioration. Hand grip strength (HGS), relative to body size, is associated with mobility in older T2DM patients. This study aims to identify an HGS index that best identifies mobilityintact older T2DM patients, along with its optimal cut-off point. The baseline data are from a cohort of 122 older T2DM patients (59% women) (mean age of 70.2 ± 4.4 years). Three mobility tests encompassing three main mobility domains were measured, including usual gait speed (UGS), timed up and go (TUG), and a two-minute walk test (2MWT). Passing scores were defined as those either above the established cut-off points or above the 25th percentile of population norms. Passing all three tests was considered as possessing intact mobility. Receiver operating characteristic (ROC) curves of the most relevant HGS indices were constructed to determine the area under the curve (AUC) that best identifies patients with intact mobility. In a sample of 122 older adults with T2DM, 63.9% of women and 60% of men were found to possess intact mobility. HGS relative to waist circumference (WC) was found to have the strongest association with intact mobility, presenting the highest AUC in both men (0.78) and women (0.72) for discriminating mobility status, with an optimal cut-off of 0.355 (kg/cm) and 0.245 (kg/cm) in men and women, respectively. HGS relative to WC best differentiated between mobility-intact older adults with T2DM and those with mobility limitations, especially in men. Using HGS/WC as a simple and safe screening mode for mobility in a clinical setting could potentially identify older patients with T2DM that require therapeutic interventions.

Targeting of Hmo1 to subcompartments of the budding yeast nucleolus.

The nucleolus is a multilayered, membraneless organelle made up of liquidlike biogenesis compartments surrounding an array of ribosomal RNA genes (rDNA). Biogenesis factors accumulate in the outer compartments through RNA binding and phase separation promoted by intrinsically disordered protein regions. In contrast, the nucleolar localization of rDNA-binding proteins, which reside in the central chromatin compartment, is less well characterized. To gain mechanistic insight, we analyzed the localization, mitotic segregation, nucleic acid binding, and nuclear dynamics of the budding yeast rDNA-binding protein Hmo1. Deletion of the main DNA-binding domain, the HMG boxB, compromised Hmo1 transfer to daughter cells in mitosis and transcription-independent rDNA association but still allowed nucleolar localization. The C-terminal lysine-rich region turned out to be a combined nuclear and nucleolar localization sequence (NLS-NoLS). Its integrity was required for maximal enrichment and efficient retention of Hmo1 in the nucleolus and nucleolar localization of the ΔboxB construct. Moreover, the NLS-NoLS region was sufficient to promote nucleolar accumulation and bound nucleic acids in vitro with some preference for RNA. Bleaching experiments indicated mobility of Hmo1 inside the nucleolus but little exchange with the nucleoplasm. Thus, a bilayered targeting mechanism secures proper localization of Hmo1 to the nucleolus.

Comparative transcriptome analysis provides insight into the molecular targets and signaling pathways of deer TGF-1 regulating chondrocytes proliferation and differentiation.

Chondrocytes are the only cell components in the cartilage, which has the poor regeneration ability. Thus, repairing damaged cartilage remains a huge challenge. Sika deer antlers are mainly composed of cartilaginous tissues that have an astonishing capacity for repair and renewal. Our previous study has demonstrated the transforming growth factor β (TGF-β1) is considered to be a key molecule involved in rapid growth, with the strongest expression in the cartilage layer. However, it remains to be clarified whether deer TGF-β1 has significantly different function from other species such as mouse, and what is the molecular mechanism of regulating cartilage growth. Primary chondrocytes was collected from new born mouse rib cartilage. The effect of TGF-β1 on primary chondrocytes viability was elucidated by RNA sequencing (RNA-seq) technology combined with validation methods such as quantitative real-time polymerase chain reaction (qRT-PCR) and immunofluorescence assay (IFA). Differential expression genes were identified using the DEGseq package. Our results demonstrated that the overexpression of deer TGF-β1 possibly promoted chondrocyte proliferation and extracellular matrix (ECM) synthesis, while simultaneously suppressing chondrocyte differentiation through regulating transcription factors, growth factors, ECM related genes, proliferation and differentiation marker genes, such as Comp, Fgfr3, Atf4, Stat1 etc., and signaling pathways such as the MAPK signaling pathway, inflammatory mediator regulation of TRP channels etc. In addition, by comparing the amino acid sequence and structures between the deer TGF-β1 and mouse TGF-β1, we found that deer TGF-β1 and mouse TGF-β1 proteins are mainly structurally different in arm domains, which is the main functional domain. Phenotypic identification results showed that deer TGF-β1 may has stronger function than mouse TGF-β1. ​These results suggested that deer TGF-β1 has the ability to promote chondrogenesis by regulating chondrocyte proliferation, differentiation and ECM synthesis. This study provides insights into the molecular mechanisms underlying the effects of deer TGF-β1 on chondrocyte viability.

Total variation‐based ultrasound image despeckling using method noise thresholding in non‐subsampled contourlet transform

AbstractMedical diagnostics rely heavily on ultrasound imaging since it is non‐invasive, inexpensive, and able to provide images in real time. However, the inherent existence of a kind of signal‐dependent noise in these images diminishes the use of ultrasound imaging systems. Speckle noise is inherently present in ultrasound images. Its inherent presence occurs during the image acquisition phase. It decreases the diagnostic usefulness of this imaging modality since it interferes with and reduces the image resolution and contrast. Speckle noise is multiplicative in nature. This multiplicative nature of speckle noise causes adverse effects on ultrasound imaging because it distorts the image quality and causes a loss of the patient's informative content in ultrasound imaging. This causes difficulty in tissue characterization. A lot of research has been done in this field to remove speckle noise while preserving medical information in the image. To handle this issue, research has been grouped into multiple domains. The two main domains include homomorphic and non‐homomorphic filtering. The homomorphic filtering uses a logarithmic transform that converts this multiplicative nature into an additive nature and uses any additive image restoration model to do a despeckling task. Non‐homomorphic filtering encompasses all methods that do not employ a logarithmic transform. Since the presence of speckle noise in ultrasound imaging is an inherent property. Therefore, the despeckling of medical ultrasound images is a mandatory task that cannot be avoided or ignored. This paper proposes a two‐step hybrid and homomorphic despeckling technique, where modified total variation method is applied as step one for speckle reduction purposes. Step two implements method of noise thresholding in the non‐subsampled contourlet transform (NSCT) domain using the bivariate shrinkage rule for edge preservation. The effectiveness and reliability of the proposed method are tested by comparing it with some of the latest methods based on qualitative and quantitative analyses. This paper will help the new researchers understand various problems and their solutions related to ultrasound image despeckling.

Immunologic, metabolic and genetic impact of diabetes on tuberculosis susceptibility.

Due to the increasing prevalence of diabetes mellitus (DM) globally, the interaction between DM and major global diseases like tuberculosis (TB) is of great public health significance, with evidence of DM having about a three-fold risk for TB disease. TB defense may be impacted by diabetes-related effects on immunity, metabolism, and gene transcription. An update on the epidemiological aspects of DM and TB, and the recent trends in understanding the DM-associated immunologic, metabolic, and genetic mechanisms of susceptibility to TB will be discussed in this review. This review highlights gaps in the incomplete understanding of the mechanisms that may relate to TB susceptibility in type 2 DM (T2DM). Understanding these three main domains regarding mechanisms of TB susceptibility in T2DM patients can help us build practical treatment plans to lessen the combined burden of the diseases in rampant areas.

Caregivers experiences of caring for people with intellectual disability and dementia: a qualitative evidence synthesis

PurposeA systematic review of the literature was completed to examine the needs of those who provide care to people with intellectual disability and dementia. The purpose of this paper was to develop an understanding of the complexities, challenges and support available to meet the needs of an ageing population.Design/methodology/approachA qualitative evidence synthesis was used to appraise 12 studies. An evidence synthesis approach was used to better understand the challenges caregivers experience in caring for a person with intellectual disability and dementia. Aggregating and integrating findings from multiple studies allowed to identify inconsistencies, quality, relationships and trends to enhance the awareness of gaps in care provision.FindingsThere were six main domains identified from the available literature which included: gaps in knowledge and skills, early identification of dementia and associated difficulties, managing behaviour, coping, burden of care and Impact on confidence.Originality/valueTo the best of the authors’ knowledge, this is the first paper to use qualitative evidence synthesis to understand the challenges of caring for a person with intellectual disability and dementia.

Artificial intelligence in atherosclerotic disease: Applications and trends.

Atherosclerotic cardiovascular disease (ASCVD) is the most common cause of death globally. Increasing amounts of highly diverse ASCVD data are becoming available and artificial intelligence (AI) techniques now bear the promise of utilizing them to improve diagnosis, advance understanding of disease pathogenesis, enable outcome prediction, assist with clinical decision making and promote precision medicine approaches. Machine learning (ML) algorithms in particular, are already employed in cardiovascular imaging applications to facilitate automated disease detection and experts believe that ML will transform the field in the coming years. Current review first describes the key concepts of AI applications from a clinical standpoint. We then provide a focused overview of current AI applications in four main ASCVD domains: coronary artery disease (CAD), peripheral arterial disease (PAD), abdominal aortic aneurysm (AAA), and carotid artery disease. For each domain, applications are presented with refer to the primary imaging modality used [e.g., computed tomography (CT) or invasive angiography] and the key aim of the applied AI approaches, which include disease detection, phenotyping, outcome prediction, and assistance with clinical decision making. We conclude with the strengths and limitations of AI applications and provide future perspectives.

El e-portafolio como herramienta para el desarrollo del pensamiento crítico y la profesionalización en jóvenes estudiantes de Trabajo Social

The increasingly competitive and globalized digital society requires professional skills related to reflection and rationality. Taking this setting into account, the article analyzes how tech- nology collaborates with the process of professionalization and development of critical thinking in young social work students in Santiago de Chile. For this purpose, a qualitative content analysis of 40 digital portfolios (e-portfolios) is carried out in which the students express their reflections on the teaching-learning processes of a course taught according to the Service-Learning methodology in light of the ”Model of Professional Skills for Social Intervention” (Razeto y Cortez-Monroy, 2014), which accounts for the main domains in training students in this discipline. For this purpose, the meanings, reflections, learning and ideas that emerged as categories associated with the content of the e-portfolios were identified. The findings show that the e-portfolio favors a reflective process that allows conceptual and practical aspects to be integrated, favoring the use of critical thinking associated with work in the different domains studied (intrapersonal, interpersonal, instrumental- technical and ethical). It concludes that technology is a critical factor in the professionalization process, given the need to incorporate methodologies that make sense and bring students closer to the practice of their future profession. In this, teaching practices supported by a culture of techno- logy and innovation play a central role.

Characteristics of Mid-Term Post-Intensive Care Syndrome in Patients Attending a Follow-Up Clinic: A Prospective Comparison Between COVID-19 and Non-COVID-19 Survivors.

To compare the post-intensive care syndrome (PICS) of COVID-19 acute respiratory distress syndrome and non-COVID-19 (NC) survivors referred to a follow-up clinic at 3 months (M3) after ICU discharge. Adults who survived an ICU stay greater than or equal to 7 days and attended the M3 consultation were included in this observational study performed in a post-ICU follow-up clinic of a single tertiary hospital. Patients underwent a standardized assessment, addressing health-related quality of life (3-level version of EQ-5D), sleep disorders (Pittsburgh Sleep Quality Index [PSQI]), physical status (Barthel index, handgrip and quadriceps strengths), mental health disorders (Hospital Anxiety and Depression Scale and Impact of Event Scale-Revised [IES-R]), and cognitive impairment (Montreal Cognitive Assessment [MoCA]). A total of 143 survivors (86 COVID and 57 NC) attended the M3 consultation. Their median age and severity scores were similar. NC patients had a shorter ICU stay (10 d [8-17.2 d]) compared with COVID group (18 d [10.8-30 d]) (p = 0.001). M3 outcomes were similar in the two groups, except for a higher PSQI (p = 0.038) in the COVID group (6 [3-9.5]) versus NC group (4 [2-7]), and a slightly lower Barthel index in the NC group (100 [100-100]) than in the COVID group (100 [85-100]) (p = 0.026). However, the proportion of patients with abnormal values at each score was similar in the two groups. Health-related quality of life was similar in the two groups. The three MoCA (≥ 26), IES-R (<33), and Barthel (=100) were normal in 58 of 143 patients (40.6%). In contrast, 68.5% (98/143) had not returned to their baseline level of daily activities. In our follow-up clinic at 3 months after discharge, the proportion of patients presenting alterations in the main PICS domains was similar whether they survived a COVID-19 or another critical illness, despite longer ICU stay in COVID group. Cognition and sleep were the two most affected PICS domains.