Influence of Previous Mental State on Psychological Outcomes of Spanish Out-of-Hospital Professionals during the COVID-19 Pandemic.

This study aimed to describe factors relating to the psychological distress of healthcare workers (HCWs) in Spanish out-of-hospital emergency medical services (EMS), according to the previous or non-use of psychotropic drugs or psychotherapy. A multicentre, cross-sectional descriptive study was designed. The study population were all physicians, nurses, and emergency medical technicians (EMTs) working in any Spanish out-of-hospital EMS between February and April 2021. The main outcomes were the levels of stress, anxiety, depression, and self-efficacy, assessed by DASS-21 and G-SES. Differences in levels of stress, anxiety, depression, and self-efficacy, according to sex, age, previous use of psychotropic drug or psychotherapy, work experience, professional category, type of work, and modification of working conditions were measured using the Student's t-test for independent samples, one-way ANOVA, Pearson's correlation, or 2-factor analysis of covariance. A total of 1636 HCWs were included, of whom one in three had severe mental disorders because of the pandemic. The interaction of the previous or non-use of psychotropic drugs or psychotherapy with the rest of the factors considered did not modify the levels of stress, anxiety, depression, and self-efficacy. However, HCWs with a history of psychotropic drug or psychotherapy use had a more intense negative emotional response and lower self-efficacy, regardless of their sex, professional category, type of work, or change in the working conditions. These HCWs are considered particularly vulnerable to the development or recurrence of new disorders or other comorbidities; therefore, the implementation of monitoring and follow-up strategies should be a priority.

Higher education teachers' and students' perceptions of open-book and proctored examinations in the COVID-19 pandemic

En los primeros días de la pandemia de COVID-19, la educación superior se vio obligada a revisar sus procesos de evaluación. Se debían asegurar el logro competencial y la honestidad académica en las evaluaciones online. En el Master de Tecnología Educativa y Competencias Digitales de una universidad española se implantó el modelo de examen a libro abierto para responder a la nueva situación considerando las características de la evaluación auténtica (adaptada a los estudiantes, intelectualmente desafiante, relacionada con la practica, coherente con la metodología didáctica, dificulta el plagio). Hemos querido analizar la pertinencia de este cambio en la evaluación. El objetivo principal es analizar las diferencias entre los exámenes presenciales tradicionales de antes de la pandemia y los exámenes de libro abierto con y sin supervisión según la percepción de profesores y alumnos. La investigación es de carácter empírico y enfoque cuantitativo y se basa en las respuestas de 66 profesores y 301 alumnos a un cuestionario con validez suficiente (chi-2/ GI: 2.453, RMSEA:.069, CFI:.993 y TLI: .991), y un coeficiente de fiabilidad omega de .882. Se realizaron comparaciones entre modelo A: examen tradicional presencial, modelo B: examen a libro abierto con proctoring, modelo C: examen a libro abierto sin proctoring. Los resultados muestran que para profesores y alumnos los exámenes con libro abierto con o sin supervisión no presentan diferencias significativas y se ajustan más a una evaluación auténtica que los exámenes presenciales. Se concluye que los exámenes de libro abierto con o sin supervisión son adecuados para realizar una evaluación auténtica en línea en la educación superior. Se recomienda contrastar Ios resultados en otros cursos universitarios online e incentivar la evaluación auténtica en las instituciones de educación superior.Alternate :In the early days of the COVID-19 pandemic, higher education was forced to review its assessment processes. Competency achievement and academic honesty should be ensured in online assessments. In the Master of Educational Technology and Digital Competences of a Spanish University, the open-book examination model was implemented to respond to the new situation considering the characteristics of authentic assessment (adapted to students, intellectually challenging, related to practice, coherent with the didactic methodology, makes plagiarism difficult). We wanted to analyze the relevance of this change in evaluation. The main objective is to analyze the differences between traditional face-to-face exams from before the pandemic and open-book exams with and without proctoring according to the perception of teachers and students. The research is of an empirical nature and quantitative approach and is based on the responses of 66 teachers and 301 students to a questionnaire with sufficient validity (chi-2/Gl: 2.453, RMSEA: .069, CFI: .99 and TLI: .99), and an Omega reliability coefficient of .882. Comparisons were made between model A: traditional faceto-face examination, model B: open-book examination with proctoring, model C: open book examination without proctoring. The results show that for teachers and students open-book exams with or without proctoring had no significant differences and are more in line with an authentic assessment than face-to-face exams. It is concluded that open-book exams with or without proctoring are suitable for authentic online assessment in higher education. It is recommended to contrast the results in other online university courses and to encourage authentic assessment in higher education institutions.

Psychological Impact of the COVID-19 Pandemic on Out-of-Hospital Health Professionals: A Living Systematic Review.

Health professionals (HPs), especially those working in the front line, have been one of the groups most affected by the COVID-19 pandemic. The objective of this study is to identify the best available scientific evidence on the impact of the COVID-19 pandemic on the mental health of out-of-hospital HPs in terms of stress, anxiety, depression, and self-efficacy. A living systematic review of the literature was designed, consulting the electronic online versions of the CINHAL, Cochrane Library, Cuiden, IBECS, JBI, LILACS, Medline PyscoDoc, PsycoINFO, Scopus, and Web of Science databases in November 2021. Original research was selected, published in either English, Spanish, French, Italian, or Portuguese. In total, 2082 publications were identified, of which 16 were included in this review. The mental health of out-of-hospital HPs was affected. Being a woman or having direct contact with patients showing suspicious signs of COVID-19 or confirmed cases were the factors related to a greater risk of developing high levels of stress and anxiety; in the case of depressive symptoms, it was having a clinical history of illnesses that could weaken their defenses against infection. Stopping unpleasant emotions and thoughts was the coping strategy most frequently used by these HPs.

Schools as a Framework for COVID-19 Epidemiological Surveillance of Children in Catalonia, Spain: A Population-Based Study.

Objective: We describe and analyze the childhood (<18 years) COVID-19 incidence in Catalonia, Spain, during the first 36 weeks of the 2020-2021 school-year and to compare it with the incidence in adults. Methods: Data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests were obtained from the Catalan Agency for Quality and Health Assessment. Overall, 7,203,663 SARS-CoV-2 tests were performed, of which 491,819 were positive (6.8%). We collected epidemiological data including age-group incidence, diagnostic effort, and positivity rate per 100,000 population to analyze the relative results for these epidemiological characteristics. Results: Despite a great diagnostic effort among children, with a difference of 1,154 tests per 100,000 population in relation to adults, the relative incidence of SARS-CoV-2 for <18 years was slightly lower than for the general population, and it increased with the age of the children. Additionally, positivity of SARS-CoV-2 in children (5.7%) was lower than in adults (7.2%), especially outside vacation periods, when children were attending school (4.9%). Conclusions: A great diagnostic effort, including mass screening and systematic whole-group contact tracing when a positive was detected in the class group, was associated with childhood SARS-CoV-2 incidence and lower positivity rate in the 2020-2021 school year. Schools have been a key tool in epidemiological surveillance rather than being drivers of SARS-CoV-2 incidence in Catalonia, Spain.

Household Severe Acute Respiratory Syndrome Coronavirus 2 Transmission and Children: A Network Prospective Study.

BACKGROUND: The role of children in household transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains unclear. We describe the epidemiological and clinical characteristics of children with coronavirus disease 2019 (COVID-19) in Catalonia, Spain, and investigate the household transmission dynamics. METHODS: A prospective, observational, multicenter study was performed during summer and school periods (1 July 2020-31 October 2020) to analyze epidemiological and clinical features and viral household transmission dynamics in COVID-19 patients aged <16 years. A pediatric index case was established when a child was the first individual infected. Secondary cases were defined when another household member tested positive for SARS-CoV-2 before the child. The secondary attack rate (SAR) was calculated, and logistic regression was used to assess associations between transmission risk factors and SARS-CoV-2 infection. RESULTS: The study included 1040 COVID-19 patients. Almost half (47.2%) were asymptomatic, 10.8% had comorbidities, and 2.6% required hospitalization. No deaths were reported. Viral transmission was common among household members (62.3%). More than 70% (756/1040) of pediatric cases were secondary to an adult, whereas 7.7% (80/1040) were index cases. The SAR was significantly lower in households with COVID-19 pediatric index cases during the school period relative to summer (P = .02) and compared to adults (P = .006). No individual or environmental risk factors associated with the SAR. CONCLUSIONS: Children are unlikely to cause household COVID-19 clusters or be major drivers of the pandemic, even if attending school. Interventions aimed at children are expected to have a small impact on reducing SARS-CoV-2 transmission.