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Objective: to explore the convergent and discriminant validity of the maslach burnout inventory human services survey (MBI-HSS) and the Spanish Burnout Inventory (SBI) in Mexican population. Method: 483 teachers from 100 basic education schools (primary and secondary) were evaluated in Mexico City. The mexican validated SBI by Gil-Monte, Unda and Sandoval (2009) and MBI-HSS validated in Mexican population by Placencia et al. (2013) were implemented, both are Likert scales that showed acceptable reliability. In the data analysis, a Multi-treat-Multi-method matrix (MTMM) was performed, which is an approach developed by Campbell and Fiske (1959) to analyze convergent and divergent validity. Results: MTMM showed significant positive and non-zero correlations between the same traits measured by different method, enthusiasm toward the job and personal accomplishment (r = 0,40 **) psychic exhaustion and emotional exhaustion (r = 0,87 **), and indolence and depersonalization (r = 0,52 **) which supposes convergent validity, in addition, it can be observed that all cronbach's alphas are acceptable except for depersonalization (subscale of MBI). The MBI-HSS recurrently presents cronbach's alphas lower than 0,70 on the depersonalization subscale, especially in non-English-speaking population. Conclusion: According to the results of this study and the psychometric difficulties presented by the MBI-HSS, the SBI is the recommended instrument for the evaluation of Burnout in the Mexican population. [ABSTRACT FROM AUTHOR]

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Introduction Postacute sequelae resulting from SARS-CoV-2 infections (LONG-COVID) have been reported. The resulting added economic burden from the perspective of healthcare organisations is not clear. Therefore, this study aims to evaluate the additive healthcare costs among COVID-19 recoverees, in a large community-dwelling general population, as incurred by an insurer-provider organisation over time.Methods In this historical cohort study, cost data from Clalit Health Services (CHS) were analysed. The primary endpoint was the direct cost incurred by CHS per month per person. Costs were measured for COVID-19 recoverees and matched controls, from January 2019 to January 2022. Difference in differences (DiDs) were calculated as the difference in mean monthly costs in cases and controls in the post-COVID-19 individual period, deducing their cost difference in a prepandemic 12 months baseline period.Results Among N=642 868 community-dwelling COVID-19 recoverees, 268 948 (40.8%) were 0–19 years old and 63 051 (9.6%) were 60 years or older. A total of 16 017 (2.5%) of recoverees had been hospitalised during the acute phase of the COVID-19 disease. Costs in cases and controls converged after 16 months from recovery. The mean monthly cost incurred by CHS per COVID-19 recoverees over up to 15 months (mean: 8.25) of post-COVID-19 follow-up was higher by 8.2% (US$8.2) compared with matched controls. The excess cost attributable to post-COVID-19 effects (DID) was 7.6% of the cost in controls (US$7.7 per patient per month). Both net and relative DIDs were substantially higher in patients who required hospitalisation during the acute phase of COVID-19 and in older adults. Excess in hospitalisations, primary care physicians and medical specialists’ visits-related costs were observed.Conclusions Long-term effects of SARS-CoV-2 infections translate into excess healthcare costs, months after recovery, hence requiring adjustments of funds allocation. These excess costs gradually diminish after recoveree, returning to baseline differences 16 months after recoveree.

Telehealth has accelerated since the outbreak of the COVID-19 virus. As telephone visits become more common, it is important to examine the challenges involved in using this modality of care. In this study, we examined family physicians’ and pediatricians’ perceptions regarding three aspects of the use of telephone visits: quality of care, safety of care, and physicians’ satisfaction. A total of 342 family physicians and pediatricians responded to an online survey. Respondents were asked to rate their degree of agreement with 17 statements inquiring about quality, safety, and satisfaction with telephone visits on a Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). This was followed by in-depth interviews between January and April 2023 with 26 physicians. Participants expressed satisfaction (3.66 ± 0.80) with the use of telephone visits and lower assessments of safety (3.03 ± 0.76) and quality (2.27 ± 0.76) of care using the telephone modality. Eighty percent of the respondents think combining a face-to-face visit with a telephone visit is recommended, and 51% noted that the inability to examine patients closely affects and impedes a physician’s decision making. Most interviewees indicated that telephone visits are safe only with former patients they had already seen in the clinic. The findings shed light on the perceptions of family physicians and pediatricians regarding telephone visits. The lower assessments of quality and safety compared to the assessment of satisfaction underscore the need for careful use of telephone visits in healthcare. A proper and balanced selection of patients, implementing technological upgrades to the modality, and performing patient education practices are recommended.

Prior studies found reduced incidences of cardiovascular diagnoses and treatments in the initial phase of the COVID-19 pandemic. However, these studies included a limited number of outcomes and did not consider pre-pandemic trends. This study aimed to describe trends in the incidence of cardiovascular diagnoses and treatments over the years 2012–2021 in Israel and to compare the two years of the COVID-19 period with the preceding 8 years. In this retrospective, population-based study, carried out within Clalit Health Services, the incidence rates of cardiovascular outcomes were calculated for individuals aged ≥ 25 (~2.7 million adults per year) during the first (Y1, 3/2020–2/2021) and second (Y2, 3/2021–2/2022) years of COVID-19 and the 8 years prior (3/2012–2/2020). Declines were observed in Y1 compared to 2019 in all diagnoses and treatments: STEMI (−16.3%; 95% CI: −16.6, −16.1), non-STEMI (−16.4%; −16.6, −16.2), AF (−14.1%; −14.2, −14.0), CHF (−7.8%; −7.9, −7.7), CVA (−5.0%; −5.0, −4.9), catheterization (−64.7%; −65.2, −64.2), CABG (−77.7%; −79.2, −76.2), ablation (−21.2%; −22.0, −20.4), pacemaker implantation (−39.3%; −40.7, −37.9), and defibrillator insertion (−12.5%; −13.1, −12.0). Compared with expected rates based on pre-pandemic trends, observed rates were within expected ranges (CHF, CVA, and ablation), less than expected (STEMI, non-STEMI, AF, catheterization, CABG, and pacemaker insertion), or more than expected (defibrillator insertion). In Y2, STEMI, catheterization, and CABG returned to expected rates; non-STEMI and AF were lower than expected; and CHF, CVA, ablation, and pacemaker and defibrillator implantations were higher than expected. Several cardiovascular diagnoses and treatment trends were interrupted by COVID-19. The long-term consequences of these changes should be considered by health policymakers.

Introduction Previous studies have shown disruption of glycometabolic control and new diabetes mellitus (DM) diagnosis among patients with COVID-19. It is still unclear how the association of COVID-19 and new-onset DM may be modified by disease severity or vary over time, during acute and post-acute phases.Research design and methods In this retrospective matched cohort study, 157 936 patients with COVID-19 (aged ≥25 years, diagnosis date between March 01, 2020 and August 31, 2021) were compared with individuals without COVID-19, separately for non-hospitalized, hospitalized, and severe hospitalized patients. Stratified Cox proportional hazards models, with changing baseline time (starting at the date of COVID-19 diagnosis, and at 1, 2, 3, and 4 months afterwards), were used to evaluate the occurrence of new DM in relation to COVID-19 infection in different time frames—from each landmark date until end of study.Results During mean follow-up time of 10.9 months, there were 1145 (0.72%) new diagnoses of DM compared with 1013 (0.64%) in the individuals without COVID-19 (p=0.004). Non-hospitalized patients with COVID-19 were not at higher risk of new DM neither during the acute phase nor afterward. Hospitalized patients with COVID-19 had a higher risk of developing DM, with the highest risk among severe hospitalized patients. This risk among hospitalized patients was highest in the acute phase (HR 2.47 (95% CI 1.86 to 3.29)), attenuated over time, but remained significant at 4-month landmark analysis (HR 1.60 (95% CI 1.12 to 2.29)).Conclusions Acute and post-acute COVID-19 were associated with new DM only among hospitalized patients, with the highest risk among those hospitalized with severe disease. Those patients should be followed and monitored post-discharge for new DM. Patients who were not hospitalized did not have higher risk of new-onset DM.

Abstract The COVID-19 pandemic is the most significant global health event of the past century. The profound and unexpected changes that it brought about have forced healthcare organizations to make far-reaching adjustments to accommodate the new reality. With the outbreak of the pandemic in Israel and the understanding of its consequences, Clalit Health Services (Clalit), the largest healthcare organization in Israel, rapidly mobilized in order to provide the best response possible from the perspective of both its patients and its employees. In the short term, four designated workgroups were established just days into the pandemic. Their task was to prepare operational work plans to achieve the following goals: providing the best possible treatment for COVID patients; maintaining the level of care for non-COVID patients; protecting healthcare personnel without compromising their competence and level of functioning; and beginning the process of post-crisis planning. In the context of the long term, and with the understanding that the changes in healthcare brought about by the COVID-19 pandemic would be long-lasting and irreversible, and would act as a catalyst in Clalit’s preparations for the future, Clalit has carried out the called-for modifications in its organizational strategy. This was based on the need to shift service and treatment foci from the hospitals to the community and the patient’s home and his cellular device, by means of strengthening Clalit’s strategic abilities to become more proactive, more digital and more home-based. In this article, we present a survey of Clalit’s preparations for the new reality in the short and medium terms, as well as the leveraging of insights gained during the first wave of the pandemic, with goal of revising Clalit’s long-term strategic plan. We conclude and point out the organizational abilities required for optimal response to future large-scale emergencies: The ability to quickly identify the need for change, respond quickly while harnessing the various parts of the organization in order to provide an agile and adaptive response, and facilitate long-term planning activity in parallel to providing an operational response in the short and medium terms.

Background: Until coronavirus disease 2019 (COVID-19) drugs specifically developed to treat COVID-19 become more widely accessible, it is crucial to identify whether existing medications have a protective effect against severe disease. Toward this objective, we conducted a large population study in Clalit Health Services (CHS), the largest healthcare provider in Israel, insuring over 4.7 million members. Methods: Two case-control matched cohorts were assembled to assess which medications, acquired in the last month, decreased the risk of COVID-19 hospitalization. Case patients were adults aged 18 to 95 hospitalized for COVID-19. In the first cohort, five control patients, from the general population, were matched to each case (n=6202); in the second cohort, two non-hospitalized SARS-CoV-2 positive control patients were matched to each case (n=6919). The outcome measures for a medication were: odds ratio (OR) for hospitalization, 95% confidence interval (CI), and the p-value, using Fisher’s exact test. False discovery rate was used to adjust for multiple testing. Results: Medications associated with most significantly reduced odds for COVID-19 hospitalization include: ubiquinone (OR=0.185, 95% CI [0.058 to 0.458], p

Air pollution impacts human health and the environment, especially in urban cities with substantial industrial activities and vehicular traffic emissions. Despite increasingly strict regulations put in place by regulatory agencies, air pollution is still a significant environmental problem in cities across the world. The objective of this study was to evaluate the environmental pollution from stationary and mobile sources using real-time monitoring and sampling techniques to characterize size-segregated particulate matter (PM), black carbon (BC), and ozone (O3) at the Port of Albany, NY. Air pollution monitoring was carried out for 3 consecutive weeks under a 24-hour cycle in 2018 at the New York State Department of Environmental Conservation (NYSDEC) site within the Port. Sampling was done with an AEROCET 531, optical particle sizer (OPS), ozone monitor, and MicroAeth AE51. Higher mass and number concentrations of size-segregated particles were observed during the daytime. PM2.5 and PM10 concentrations ranged from 1 to 271 micrograms per cubic meter (µg/m3) and 1 to 344 µg/m3, respectively. While these values do not exceed the level of the USEPA 24-hour standards, frequent sharp peaks were observed at higher concentrations. Size-segregated PM at sizes 0.3 µm and 0.374 µm recorded maximum concentrations of 101,631 particle number per cubic centimeter (#/cm3) and 43,432 #/cm3, respectively. Wide variations were observed in the particle number concentrations for 0.3 µm, 0.374 µm, and 0.465 µm sizes, which ranged from 1521 to 101,631 #/cm3; 656 to 43,432 #/cm3; and 311 to 29,271 #/cm3, respectively. BC concentration increased during morning and evening rush hours with the maximum concentration of 11,971 ng/m3 recorded at 8:00 AM. This suggests that mobile sources are the primary contributor to anthropogenic sources of BC within the Port. Episodic elevations in the concentrations of size-segregated PM and BC confirmed the contribution of industrial and vehicular activities around the Port of Albany. This study underscores the importance of measuring particles on a size-segregated basis in order to more fully understand the contributions of the multiple sources present within and surrounding a port environment.

Edward Krasiński’s gesture of assimilating people, objects and walls using blue masking tape remained esoteric throughout the past decades. The practice was often described by methods that offered symbolic political readings. This article aims to understand Krasinski’s tape as a material, as well as its formal effect as a separator and assimilator. The work is investigated in relationship to Krasiński’’s interests in photography and with a perspective of the work’s relevance to the crisis of the photograph as an object today. The photograph shares with the masking tape the mechanism of assimilation and separation as well as mechanical repetition. An effort is made to understand the blue tape as a portrait of the photograph written in by subtraction. This paper examines Krasiński’s blue tape as a liminal organ, a recording device and a warning sign. The gesture of applying the tape over people is finally investigated in relationship to Ohad Naharin’s gesture of taping in Last Show.

Brain-machine interfaces (BMI) allows individuals to control an external device by controlling their own brain activity, without requiring bodily or muscle movements. Performing voluntary movements is associated with the experience of agency ("sense of agency") over those movements and their outcomes. When people voluntarily control a BMI, they should likewise experience a sense of agency. However, using a BMI to act presents several differences compared to normal movements. In particular, BMIs lack sensorimotor feedback, afford lower controllability and are associated with increased cognitive fatigue. Here, we explored how these different factors influence the sense of agency across two studies in which participants learned to control a robotic hand through motor imagery decoded online through electroencephalography. We observed that the lack of sensorimotor information when using a BMI did not appear to influence the sense of agency. We further observed that experiencing lower control over the BMI reduced the sense of agency. Finally, we observed that the better participants controlled the BMI, the greater was the appropriation of the robotic hand, as measured by body-ownership and agency scores. Results are discussed based on existing theories on the sense of agency in light of the importance of BMI technology for patients using prosthetic limbs.

Background: A decline in cardiovascular hospitalizations was observed during the initial phases of the COVID-19 pandemic. We examine the continuous effect of the COVID-19 pandemic in reducing cardiovascular hospitalization and associated mortality rates during the first year of the pandemic in Israel. Methods: We conduct a retrospective cohort study using the data of Clalit Health Services, the largest healthcare organization in Israel. We divide the Corona year into six periods (three lockdowns and three post-lockdowns) and compare the incidence rates of cardiovascular hospitalizations and 30-day all-cause mortality during each period to the previous three years. Results: The number of non-STEMI hospitalizations during the first year of the pandemic was 13.7% lower than the average of the previous three years (95% CI 11–17%); STEMI hospitalizations were 15.7% lower (95% CI 13–19%); CHF (Congestive heart failure) hospitalizations were 23.9% lower (95%, CI 21–27%). No significant differences in 30-day all-cause mortality rates were observed among AMI (acute myocardial infarction) patients during most of the periods, whereas the annual 30-day all-cause mortality rate among CHF patients was 23% higher. Conclusions: AMI and CHF hospitalizations were significantly lower during the first year of the pandemic relative to 2017–9. Mortality rates were higher in the case of CHF patients but not in the case of AMI patients, possibly due to a change in the clinical acuity of patients arriving at the hospitals. We conclude that targeted public health messaging should be implemented together with proactive monitoring, in order to identify residual disability in patients who may have received non-optimal treatment during the pandemic.

Traumatic cervical spondyloptosis is an uncommon and severe form of facet joint dislocation that commonly leads to severe neurological damage. Decision making regarding the reduction and fixation technique is challenging, especially when a patient is neurologically intact, since an undiagnosed prolapsed disk at the involved level may lead to severe neurological consequences during reduction. A 24-year-old male was admitted after sustaining a severe direct axial blow to his head. Computed tomographic and magnetic resonance imaging scans revealed an acute C6C7 fracture dislocation with spondyloptosis of C6 vertebra and a large disk fragment posterior to C6 vertebral body. The patient was neurologically intact, apart from mild bilateral numbness over C6 distribution. The patient underwent C6 corpectomy to avoid acute cord compression related to the large sequestered disk behind C6 vertebra. Following C6 corpectomy, we were unable to exert enough axial pull to reduce the facet dislocation through the anterior approach. Therefore, the reduction was performed through a posterior approach with C5T1 posterior fusion, followed by anterior cage placement and C5-7 anterior fusion (front-back-front approach). At postoperative follow-up of 24 months, the patient demonstrated a full and pain-free cervical range-of-motion and remained neurologically intact. Follow-up radiographs of the cervical spine demonstrated good instrumental alignment with solid fusion at 6-month follow-up.