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ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection
No full textThe COVID-19 pandemics is posing unprecedented challenges and threats to patients and healthcare systems worldwide. Acute respiratory complications that require intensive care unit (ICU) management are a major cause of morbidity and mortality in COVID-19 patients. Patients with worst outcomes and higher mortality are reported to include immunocompromised subjects, namely older adults and polymorbid individuals and malnourished people in general. ICU stay, polymorbidity and older age are all commonly associated with high risk for malnutrition, representing per se a relevant risk factor for higher morbidity and mortality in chronic and acute disease. Also importantly, prolonged ICU stays are reported to be required for COVID-19 patients stabilization, and longer ICU stay may per se directly worsen or cause malnutrition, with severe loss of skeletal muscle mass and function which may lead to disability, poor quality of life and additional morbidity. Prevention, diagnosis and treatment of malnutrition should therefore be routinely included in the management of COVID-19 patients. In the current document, the European Society for Clinical Nutrition and Metabolism (ESPEN) aims at providing concise guidance for nutritional management of COVID-19 patients by proposing 10 practical recommendations. The practical guidance is focused to those in the ICU setting or in the presence of older age and polymorbidity, which are independently associated with malnutrition and its negative impact on patient survival. © 202
Effects of COVID-19 pandemic on out-of-hospital cardiac arrests: A systematic review
No full textIntroduction: In addition to the directly attributed mortality, COVID-19 is also likely to increase mortality indirectly. In this systematic review, we investigate the direct and indirect effects of COVID-19 on out-of-hospital cardiac arrests. Methods: We searched PubMed, BioMedCentral, Embase and the Cochrane Central Register of Controlled Trials for studies comparing out-of-hospital cardiac arrests occurring during the pandemic and a non-pandemic period. Risk of bias was assessed with the ROBINS-I tool. The primary endpoint was return of spontaneous circulation. Secondary endpoints were bystander-initiated cardiopulmonary resuscitation, survival to hospital discharge, and survival with favourable neurological outcome. Results: We identified six studies. In two studies, rates of return of spontaneous circulation and survival to hospital discharge decreased significantly during the pandemic. Especially in Europe, bystander-witnessed cases, bystander-initiated cardiopulmonary resuscitation and resuscitation attempted by emergency medical services were reduced during the pandemic. Also, ambulance response times were significantly delayed across all studies and patients presenting with non-shockable rhythms increased in two studies. In 2020, 3.9–5.9% of tested patients were SARS-CoV-2 positive and 4.8–26% had suggestive symptoms (fever and cough or dyspnoea). Conclusions: Out-of-hospital cardiac arrests had worse short-term outcomes during the pandemic than a non-pandemic period suggesting direct effects of COVID-19 infection and indirect effects from lockdown and disruption of healthcare systems. Patients at high risk of deterioration should be identified outside the hospital to promptly initiate treatment and reduce fatalities. Study registration PROSPERO CRD42020195794. © 2020 Elsevier B.V
Trends of labor market change in the countries of the european union and russia under conditions of digitalization of the economy
No full textThe aim of the study is to test the hypothesis that the development of the digital economy contributes to a change in the structure of the labor market, the release of part of the labor force, and the growth of demand in the field of information technology. Monographic and statistical research methods, methods of economic analysis, economic and statistical modeling, tabular, graphical methods were used in the work. The research information base was made up of official data from European and Russian statistics, data from the Ministry of Science and Higher Education of the Russian Federation for the period from 2009 to 2018. The proportion of specialists using the Internet for the period from 2009 to 2018 in the countries of the European Union increased from 43 to 55%. However, digitalization is affecting a changing labor market, with a growing percentage of people working part-time. In the EU countries, this indicator increased to 18.5% in 2018, i.e. 1.2 percentage points over ten years. The results of the correlationregression analysis showed that there is a positive relationship between the rate of computer and Internet use by employees in organizations and the percentage of part-time workers is (R2 = 49%). Over the past ten years in the Russian Federation, the total labor force has increased by 6%. Digitalization through entrepreneurial education penetrates almost all spheres of the life of society and helps to increase economic efficiency and increase labor productivity, changing the structure of employment. © 2021, Economic Laboratory for Transition Research. All rights reserved
Respiratory rehabilitation for post-COVID-19 patients [РЕСПИРАТОРНАЯ РЕАБИЛИТАЦИЯ ПОСТ-COVID-19 ПАЦИЕНТОВ.]
No full textIn the presented clinical review, we evaluated the possibilities of drug and non-drug strategies for eliminating and preventing pathophysiological changes in the respiratory system of post-COVID-19 patients. We offer up-to-date rehabilitation algorithms based on the assessment of the severity of clinical manifestations of COVID-19, the possibilities of rehabilitation techniques and the patient’s personal compliance with their implementation. © Russian Archives of Internal Medicine.All right reserved
Appearance of Acute Inflammatory State Indicates Improvement in Atopic Dermatitis Cases Under Classical Homeopathic Treatment: A Case Series
No full textThe Continuum theory and the Levels of Health theory propound the idea that return of efficient acute inflammation (high fever) heralds true improvement in chronic inflammatory states. We present 6 cases of atopic dermatitis (AD), which had stability in their improvement for 1 year or more, under classical homeopathy. The cases were retrospectively assessed with selected based on the Hanifin Rajka atopic dermatitis diagnostic criteria and the follow ups evaluated according to changes on SCORing Atopic Dermatitis scale (SCORAD) scale. The pictures are presented as evidence. Modified Naranjo Criteria for assessing causal attribution of clinical outcome to homeopathic intervention was used to assess the effect of homeopathy in these cases. All the cases improved and stabilised with complete skin clearance (those that relapsed within 1 year were not included). These patients had not suffered high fevers/acute inflammatory diseases since onset/aggravation of AD. Five of the 6 cases developed acute inflammatory diseases as the chronic condition improved. The last case showed return of an old, lesser pathology. The control cases – which were selected for non-improvement under classical homeopathy also showed remarkable skin clearance when there was appearance of acute inflammatory states. In this study, there is a mutually exclusive relationship between efficient acute inflammation and chronic inflammation, which is in accordance with the 2 theories considered here. Further scientific studies are necessary to establish the phenomenon at tissue level. © The Author(s) 2021
Shock digitalisation of education: The perception of participants of the educational process [Шоковая цифровизация образования: восприятие участников образовательного процесса]
No full textIntroduction. The relevance of the study is determined both by the importance of the problem of digital transformation of education in general, and by the specific conditions, which arose during the crisis caused by COVID-19. The long-term consequences of the emergency transition of Russian education to the distance format, taking into account the ongoing pandemic, have yet to be assessed, but the reaction of the participants in the educational process to the first period of the total distance learning should be analysed immediately as a basis for future management decisions. Aim. The aim of the present research is a comprehensive analysis of the perception of the experience of an emergency transition to a distant education format by the main participants in the educational process. Methodology and research methods. Online survey based on Google forms was employed as the main method. The respondents to the survey included participants in the educational process, mostly permanently residing in the Sverdlovsk region (99% of the respondents). The survey was conducted in September - October 2020. The survey participation was voluntary and completely anonymous. As a result of the survey conducted, more than 24,500 original responses were received and processed. The data obtained were compared with the results of secondary studies (primarily, with the monitoring studies of the Higher School of Economics). Results. The research findings demonstrate a number of significant shortcomings in the strategy of digital transformation of education, such as the insufficient development of the digital communication infrastructure in the regions, the technological and competence-based digital inequality, the lack of well-developed methods of using digital educational tools, the lack of high-quality content, the lack of full-fledged integrated educational resources on the market. The shortcomings mentioned above apparently led to a decrease in the quality of education during the period of self-isolation and provoked a reaction of rejection of digital educational forms and an increase in technological pessimism among a significant part of the respondents. The results are presented in correlation with secondary studies, which confirms the reliability of the general conclusions. Scientific novelty. The scientific novelty of the research lies in the attraction, systematisation and analytical generalisation of original material on the urgent problem of digital transformation of education, collected in one of the largest and technologically advanced regions of the Russian Federation. Practical significance. The current article makes it possible to more accurately assess the situation in regional education and provides reference points both for conducting longitudinal research and for making current and strategic management decisions in Russian education at the regional and federal level. © 2021 Russian State Vocational Pedagogical University. All rights reserved
Peculiarities of the influenza and ARVI viruses circulation during epidemic season 2019–2020 in some regions of Russia [Особенности циркуляции вирусов гриппа и ОРВИ в эпидемическом сезоне 2019–2020 гг. в отдельных регионах России]
No full textIntroduction. The surveillance of influenza viruses in ARVI structure and study of their properties in epidemic season 2019–2020 in Russian Federation are actual for investigations due to tasks of Global Influenza Strategy initiated by WHO in 2019. Material and methods. The data of epidemiological surveillance on influenza- and ARVI-associated morbidity and hospitalization in different age groups of population were analyzed; virological, genetic and statistical methods were used. Results. Preschool children were involved in epidemic the most. Meanwhile, the highest rate of hospitalization was observed in patients of 18–40 years old. Influenza A(H1N1)pdm09 virus dominated in etiology of ARVI in hospitalized patients and pneumonia. The role of respiratory viruses in severe cases of pneumonia and bronchoalveolar syndrome in children was shown. The differences in spectrum of circulating viruses caused ARVI in different regions of Russia were found. Influenza A(H1N1)pdm09 and B/Victoria-like viruses were the main etiological agents that caused of epidemic; its activity among all ARVI was 7.3 and 8.0%, respectively. The differences in antigenic properties of influenza A(H3N2) and B epidemic strains compared to vaccine viruses were found. The populations of epidemic strains were presented by following dominant genetic groups: 6B1.A5/183P for A(H1N1)pdm09, 3С.2а1b+137F for A(H3N2) and V1A.3 line B/Victoria-like for B viruses. The good profile of epidemic strains susceptibility to anti-neuraminidase inhibitors has been saved. The most of the studied influenza strains had the receptor specificity characteristic of human influenza viruses. Conclusions. Obtained results identified the peculiarities of viruses caused the influenza and ARVI in epidemic season 2019–2020 in different regions of Russia. These results suggested the important role of influenza A(H1N1) pdm09 in severe cases and pneumonia in adults 18–40 years old. The continuing drift in influenza viruses was found, which, apparently, could not but affect the efficacy of vaccine prophylaxis and was also considered in the recommendations of WHO experts on the composition of influenza vaccines for the countries of the Northern Hemisphere in the 2020–2021 season. © 2020 Izdatel'stvo Meditsina. All rights reserved
Socio-psychological predictors of belief in conspiracy theories of the origin of COVID-19 and involvement in social media [Социально-психологические предпосылки веры в конспирологические теории происхождения COVID-19 и вовлеченность в сетевые коммуникации]
No full textObjective. Search for socio-psychological antecedents for the individual’s belief in conspiracy theories of the origin of the pandemic. Revealing the dynamics of Internet users’ attitudes to the coronavirus pandemic in March-early June 2020. Background. As part of the study of the psychological mechanisms of the impact of the pandemic on the individual and society, an increasingly urgent task is to clarify the socio-psychological prerequisites of belief in conspiracy theories of the COVID-19 pandemic, as well as the relationship between attitudes towards the pandemic and the involvement of the individual in the use of social media. Study design. The paper presents the results of two online surveys conducted in March-April and May-June 2020 to study the dynamics of Russians’ belief in conspiracy theories of the origin of the CO-VID-19, taking into account involvement in social media and gender differences. Participants. The first study involved 668 people (78.2% women) aged 17 to 80 years (M=30; SD=12.7); the second survey involved 986 people (56.9% — men) aged 18 to 76 years (M=36.63; SD=10.2). The survey geography covered various regions of Russia. Measurements. The basic tool in both studies was developed by T.A. Nestik questionnaire “Attitude towards the epidemiological threat”. The first study additionally measured the social axioms (SAS), moral foundations (MFQ), belief in the justice of the world and trust in social institutions. The second study additionally measured involvement in social media communications. Results. The 1st study found a connection between conspiracy beliefs and belief in a just world, low self-efficacy, moral foundations of ingroup/loyalty and authority/respect, low institutional trust, and social cynicism. In the 2nd study, it was shown that, compared to March-April, the level of belief of social media users in conspiracy theories of the origin of the pandemic, the severity of distrust in the health care system and skepticism about vaccinations significantly increased; both the fear of infection and the controllability of the threat have become less, but fears of a recurrence of epidemics have increased. It is shown that involvement in social media increases anxiety about the consequences of the coronavirus crisis, which in turn intensifies the search for conspiracy explanations of pandemic. Conclusions. Low social trust and the experience of an uncontrollable threat increase the susceptibility of social media users to belief in conspiracy theories of the origin of the pandemic. © 2020 Moscow State University of Psychology and Education. All right reserved