RESUMO
Globally, the COVID-19 (coronavirus disease 2019) pandemic has resulted in abrupt shifts in ecological and social environments, including school contexts, which became predominately virtual. This study (1) examines the role of the COVID-19 pandemic (transitioning to college prior to vs. during the COVID-19 pandemic) on cortisol awakening response (CAR) - a biological marker of chronic psychosocial stress - and university belonging among Latinx and Black first-year college students; and (2) explores whether university belonging serves as a mediator in the relationship between the COVID-19 pandemic and CAR. Latinx and Black students who were in their first semester at a four-year public university in Los Angeles County - one of the United States' hot spots for COVID-19, were recruited for this study. Across two separate cohorts (fall 2019, fall 2020), participants (N = 136) completed an online survey and provided salivary samples to assess for morning cortisol levels. Findings revealed that students who transitioned to college during the COVID-19 pandemic exhibited a flatter CAR and lower levels of belonging than students who transitioned to college prior to the COVID-19 pandemic. Implications for intervention, programs and policies aimed at fostering positive transitions to college during the COVID-19 pandemic and beyond are discussed.
RESUMO
OBJECTIVE: To evaluate the burden of diabetic foot complications amongst inpatients in Peru. MATERIALS AND METHODS: Cross-sectional multicenter study, performed in public hospitals, in one-day enrollment between October and December 2018. RESULTS: We included 8346 patients from 39 national hospitals. Diabetic foot (DF) inpatient point prevalence was 2.8% (CI 95% 2.4-3.1), and DF point prevalence among Diabetes Mellitus (DM) inpatients was 18.9% (CI 95% 16.7-21.1). DF prevalence was higher in jungle and coastal hospitals than highlands ones, and there was no difference according to its care complexity level. Of the 234 patients with DF, 73% were males, age average was 62 ± 12 years, with DM mean time duration of 15 ± 9.9 years. Regarding to DF etiology, 91% and 68% had some degree of peripheral neuropathy and peripheral artery disease, respectively. According to the Infectious Diseases Society of America criteria, 61% presented moderate to severe infections, and 40% had bone involvement. Debridement within 48 h was performed in 36% of sepsis cases. CONCLUSION: Peru has a substantial burden of DF disease, with a greater share of that burden falling on less equipped hospitals in the country's jungle and coastal regions. Interdisciplinary teams and pathways may improve the time of surgical debridement in the highest risk patients.