Background: The current coronavirus disease (COVID-19) has a great impact worldwide. Healthcare workers play an essential role and are one of the most exposed groups. Information about the psychosocial impact on healthcare workers is limited.Methods: 3109 healthcare workers completed a national, internet-based, cross-sectional 45-item survey between 9 and 19 April 2020. The objective is to assess the psychological impact of the COVID-19 pandemic in Spanish healthcare workers. A Psychological Stress and Adaptation at work Score (PSAS) was defined combining four modified versions of validated psychological assessment tests (A) Healthcare Stressful Test, (B) Coping Strategies Inventory, (C) Font-Roja Questionnaire and (D) Trait Meta-Mood Scale.Results: The highest psychosocial impact was perceived in Respiratory Medicine, the mean (S.D.) PSAS was 48.3 (13.6) and Geriatrics 47.6 (16.4). Higher distress levels were found in the geographical areas with the highest incidence of COVID-19 (>245.5 cases per 100 000 people), PSAS 46.8 (15.2); p < 0.001. The least stress respondents were asymptomatic workers PSAS, 41.3 (15.4); p < 0.001, as well as those above 60 years old, PSAS, 37.6 (16); p < 0.001. Workers who needed psychological therapy and did not receive it, were more stressed PSAS 52.5 (13.6) than those who did not need it PSAS 39.7 (13.9); p < 0.001.Conclusions: The psychological impact in healthcare workers in Spain during COVID-19 emergency has been studied. The stress perceived is parallel to the number of cases per 100 000 people. Psychotherapy could have a major role to mitigate the experimented stress level.

Purpose of review: Optimal treatment requires a thorough understanding of all factors contributing to pain in the individual patient. In this review, we investigate the influence of cultural frameworks on pain experience and management. Recent Findings: The loosely defined concept of culture in pain management integrates a predisposing set of diverse biological, psychological and social characteristics shared within a group. Cultural and ethnic background strongly influence the perception, manifestation, and management of pain. In addition, cultural, racial and ethnic differences continue to play a major role in the disparate treatment of acute pain. Summary: A holistic and culturally sensitive approach is likely to improve pain management outcomes, will better cover the needs of diverse patient populations and help reduce stigma and health disparities. Mainstays include awareness, self-awareness, appropriate communication, and training.

Objective: To assess the diagnostic accuracy of peripheral capillary oxygen saturation (SpO₂) while breathing room air for 5 min (the ‘Air-Test’) in detecting postoperative atelectasis. Design: Prospective cohort study. Diagnostic accuracy was assessed by measuring the agreement between the index test and the reference standard CT scan images. Setting: Postanaesthetic care unit in a tertiary hospital in Spain. Participants: Three hundred and fifty patients from 12 January to 7 February 2015; 170 patients scheduled for surgery under general anaesthesia who were admitted into the postsurgical unit were included. Intervention: The Air-Test was performed in conscious extubated patients after a 30 min stabilisation period during which they received supplemental oxygen therapy via a venturi mask. The Air-Test was defined as positive when SpO₂ was ≤96% and negative when SpO₂ was ≥97%. Arterial blood gases were measured in all patients at the end of the Air-Test. In the subsequent 25 min, the presence of atelectasis was evaluated by performing a CT scan in 59 randomly selected patients. Main outcome measures: The primary study outcome was assessment of the accuracy of the Air-Test for detecting postoperative atelectasis compared with the reference standard. The secondary outcome was the incidence of positive Air-Test results. Results: The Air-Test diagnosed postoperative atelectasis with an area under the receiver operating characteristic curve of 0.90 (95% CI 0.82 to 0.98) with a sensitivity of 82.6% and a specificity of 87.8%. The presence of atelectasis was confirmed by CT scans in all patients (30/30) with positive and in 5 patients (17%) with negative Air-Test results. Based on the Air-Test, postoperative atelectasis was present in 36% of the patients (62 out of 170). Conclusion: The Air-Test may represent an accurate, simple, inexpensive and non-invasive method for diagnosing postoperative atelectasis. Trial Registration: NCT02650037.