A través del siguiente artículo, deseamos socializar los resultados alcanzados en la Evaluación del Servicio de Orientación Educativa y Profesional a distancia "Psico-Orienta-Universidad", brindado a jóvenes cubanos en transición académica a la universidad durante el curso escolar 2019-2020. Este servicio se implementó mediante la plataforma social WhatsApp, en el contexto de la pandemia por COVID-19. Para la evaluación se utilizó la metodología cualitativa. Como resultado de la evaluación, del análisis realizado por cada una de las dimensiones, se constató que el servicio brindado fue pertinente, y el proceso de implementación del servicio, favorable, orientado al cumplimiento exitoso de cada uno de los objetivos previstos. En cuanto a los resultados alcanzados, se concluyó que hubo una adecuada aprehensión de los contenidos trabajados, que influyeron en alguna medida a favor de los resultados académicos de los jóvenes, y por ende, en la consecución del proyecto de ingresar en las aulas universitarias, a la par de logros favorables desde el punto de vista psicológico. Sobre la sostenibilidad del servicio, se consideró que este puede permanecer en el tiempo, y replicarse no solo ante una emergencia, sino desde la práctica habitual, pero contar con una fuente de financiamiento sería lo más adecuado.
El imperativo de la COVID-19 hizo que muchos psicológos desplegaran múltiples acciones en beneficio de la población, tal es el caso de Psico Orienta Universidad. Este surge como grupo temático para dar acompañamiento, contención, apoyo y orientación educativa y profesional a aquellos jóvenes de todo el país que aspiraban a matricular en la Educación Superior. El tránsito de la enseñanza media superior a la universidad es un momento importante para la vida de los jóvenes y desde la propagación del virus ha estado marcado por una gran incertidumbre. El objetivo del artículo es relatar esta experiencia de orientación profesional a distancia en tiempos de coronavirus, por su novedad, por los retos que implicó y porque de ella se pueden identificar aprendizajes valiosos para la actuación profesional en futuras etapas.
Introduction For some individuals infection with SARS-CoV-2 leading to COVID-19 can result in a life-threatening multi-system disease. Multiple potential pathophysiological mechanisms for the development of cardiovascular complications have been postulated [1]. Early reports suggested that more than a third of hospitalised patients undergoing TTE had evidence of LV impairment [2]. Purpose To ascertain the incidence of ventricular impairment among critically ill adults with COVID-19 admitted to the intensive care unit (ICU). Methods Retrospective analysis of transthoracic echocardiograms (TTE) performed on patients admitted to ICU with COVID-19 between 10th March and 10th May 2020. Archived studies were reviewed by accredited professionals. Studies were performed according to a modified British Society of Echocardiography (BSE) Level 1 protocol [3], with the addition of right ventricle (RV) focused apical 4 chamber, as well as apical 2 and 3 chamber views, and without ECG synchronisation as per infection control protocols. In the majority of patients the left ventricular ejection fraction (LVEF) was estimated from biplane Simpson's method. The RV function was assessed using the TAPSE in most patients. In the remaining patients the LV or RV function was visually assessed. Results Of 179 patients admitted to ICU, 85 (47.5%) had at least one TTE of diagnostic quality. Studies were performed a median of 7 days after ICU admission (IQR 3–17 days). Baseline and clinical characteristics and key echocardiographic measurements are summarised in table 1. The majority of patients were undergoing mechanical ventilation at the time of the scan (94.1%). One hundred and fifty-nine patients (89%) had elevated Troponin T (≥14ng/L) on the day of the study. LV systolic impairment (LVSD) was present in 5 patients (6.0%). This was known to be chronic in 3 patients (1 with coronary artery disease, 1 with chemotherapy induced cardiomyopathy and 1 with dilated cardiomyopathy of unknown aetiology), whilst pre-morbid cardiac function was unknown in the other 2 patients. No patient had severe LVSD (LVEF ≤35%). RV systolic dysfunction (RVSD) was found in 25 patients (31.3%). Amongst patients receiving mechanical ventilation there was no significant difference in Positive End Expiratory Pressure (PEEP) between patients with and without RVSD (9.4cmH2O vs. 9.8cmH2O, p=0.64), however there was a non-significant trend towards lower PaO2/FiO2 (P/F ratio) amongst patients with RVSD (18.9kPa vs 25.7kPa, p=0.07). Conclusions In contrast to other studies which have reported high frequency of LV impairment amongst hospitalised patients with COVID-19 [3], de novo LVSD was rarely found in this study, occurring in just 2 patients (2.4%), and being severe in neither. RV dilatation and systolic impairment were commonly found. A trend towards lower P/F ratios in patients with RVSD suggests severity of lung injury may be a factor in developing RV impairment. FUNDunding Acknowledgement Type of funding sources: None.
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