Efecto de factores sociodemográficos en la mortalidad del COVID-19 en Costa Rica: un enfoque geográfico

Introducción: La enfermedad por coronavirus (COVID-19) se ha extendido entre la población de todo el país y ha tenido un gran impacto a nivel mundial. Sin embargo, existen diferencias geográficas importantes en la mortalidad de COVID-19 entre las diferentes regiones del mundo y en Costa Rica. Objetivo: Explorar el efecto de algunos de los factores sociodemográficos en la mortalidad de COVID-19 en pequeñas divisiones geográficas o cantones de Costa Rica. Métodos: Usamos registros oficiales y aplicamos un modelo de regresión clásica de Poisson y un modelo de regresión ponderada geográficamente. Resultados: Obtuvimos un criterio de información de Akaike (AIC) más bajo con la regresión ponderada (927.1 en la regresión de Poison versus 358.4 en la regresión ponderada). Los cantones con un mayor riesgo de mortalidad por COVID-19 tuvo una población más densa; bienestar material más alto; menor proporción de cobertura de salud y están ubicadas en el área del Pacífico de Costa Rica. Conclusiones: Una estrategia de intervención de COVID-19 específica debería concentrarse en áreas de la costa pacífica con poblaciones más densas, mayor bienestar material y menor población por unidad de salud.

Introduction: The coronavirus disease (COVID-19) has spread among the population of Costa Rica and has had a great global impact. However, there are important geographic differences in mortality from COVID-19 among world regions and within Costa Rica. Objective: To explore the effect of some sociodemographic factors on COVID-19 mortality in the small geographic divisions or cantons of Costa Rica. Methods: We used official records and applied a classical epidemiological Poisson regression model and a geographically weighted regression model. Results: We obtained a lower Akaike Information Criterion with the weighted regression (927.1 in Poisson regression versus 358.4 in weighted regression). The cantons with higher risk of mortality from COVID-19 had a denser population; higher material well-being; less population by health service units and are located near the Pacific coast. Conclusions: A specific COVID-19 intervention strategy should concentrate on Pacific coast areas with denser population, higher material well-being and less population by health service units.

Perfil genético del trastorno bipolar en Panamá: análisis de genes relacionados y otros factores determinantes en una región de alta prevalencia de episodios maníacos en la República de Panamá / Genetic profile of bipolar disorder in Panama: related gene analysis and other determi­ning factors in a high prevalence region of manic episodes in the Republic of Panama

Introducción El Trastorno Bipolar es una enfermedad que causa discapacidad física y cognitiva, afectando tanto a hombres como mujeres, con edad de inicio temprano y con un alto componente hereditario. Objetivo Estimar el comportamiento del Trastorno Bi­polar, variables sociodemográficas, antecedentes y su relación con los genes CACNA1­C (12p13.3) y DAOA (13q34) entre personas de 18 años y más en áreas específicas de la Región de Azuero de Panamá. Metodología La muestra calculada fue de 267 perso­nas de 18 años y más (IC 95%) utilizando un muestreo aleatorio, de distribución propor­cional según sexo. Se utilizaron las variables: "trastorno bipolar" medido a través del cuestionario de trastornos del estado de ánimo (Mood Disorder Questionnaire, MDQ por sus siglas en inglés); "genes asociados a la bipolaridad" (genes CACNA1­C (12p13.3) y DAOA (13q34)); y un cuestionario de datos sociodemográficos y antecedentes persona­les ­ familiares. El análisis genético se realizó con PCR (tiempo real). Se utilizaron por­centajes como medida de frecuencia relativa y se consideró significancia estadística para un valor de p ≤ 0.05. Resultados La prevalencia de bipolaridad en la muestra es­tudiada fue 3.7% (IC 95% 3.5 ­ 4.1), siendo mayor en mujeres, 6.0% (IC 95% 5.9 ­ 6.3). El 74.2% (IC 95% 73.9 ­ 74.4) de los participantes tenía presente el polimorfismo del gen CACNA1­C (12p13.3), y 19.1% (IC 95% 18.9 ­ 19.4) el del gen DAOA (13q34). Para todas las variables de estudio, la presencia del gen CACNA1­C (12p13.3) fue mayor que la del gen DAOA (13q34). De los 10 casos con MDQ+, 3 presentaron el gen CAC­NA1­C. Conclusión Esta es la primera investigación sobre bipolaridad, genes y otros factores asociados en Panamá. El gen CACNA1­C fue más prevalente que el DAOA y se asoció más al MDQ +.

Introduction Bipolar disorder is a disease that causes physical and cognitive disability, affecting both men and women, with an early onset age and a high hereditary compo­nent. Objective To estimate Bipolar Disorder demeanor, sociodemographic variables, antecedents and its relationship with CACNA1­C (12p13.3) and DAOA (13q34) genes among people aged 18 years and over in specific areas of the Azuero Region of Pana­ma. Methodology The calculated sample was 267 people aged 18 and over (95% CI) using random sampling, proportional distribution according to sex. The variables were used: "bipolar disorder" measured through the Mood Disorder Questionnaire (MDQ); "genes associated with bipolarity" (CACNA1­C (12p13.3) and DAOA (13q34) genes); and a sociodemographic data questionnaire and personal ­ family background. The ge­netic analysis was performed with PCR (real time). Percentages were used as a re of relative frequency and statistical significance was considered for a value of p ≤ 0.05. Results The prevalence of bipolarity in the studied sample was 3.7% (CI 95% 3.5 ­ 4.1), being higher in women, 6.0% (CI 95% 5.9 ­ 6.3). 74.2% (CI 95% 73.9 ­ 74.4) of the participants were aware of the polymorphism of the CACNA1­C gene (12p13.3), and 19.1% (CI 95% 18.9 ­ 19.4) of the DAOA gene (13q34). For all study variables, the pre­sence of the CACNA1­C gene (12p13.3) was greater than that of the DAOA gene (13q34). Of the 10 cases with MDQ +, 3 presented the CACNA1­C gene. ConclusionThis is the first research on bipolarity, genes and other associated factors in Panama. The CACNA1­C gene was more prevalent than DAOA and was more associated with MDQ +.

Fatores associados à percepção de aliança terapêutica por pacientes em psicoterapia psicanalítica / Factors associated with patient's perception of therapeutic alliance in psychoanalytic psychotherapy

A percepção do paciente sobre a relação com seu psicoterapeuta é determinante para a sua permanência em tratamento e para o sucesso da psicoterapia. Estabelecer preditores de aliança terapêutica pode ter o potencial de auxiliar os psicoterapeutas a utilizar formas de intervenção durante as fases iniciais do tratamento. O objetivo do estudo foi investigar a associação entre fatores sócio-demográficos e clínicos do paciente e do terapeuta e a forma como o paciente percebe a aliança terapêutica. Trata-se de um estudo transversal que avaliou a qualidade da aliança em pacientes adultos atendidos em psicoterapia psicanalítica em um ambulatório de saúde mental. A amostra foi constituída por 118 pacientes que chegaram até a quarta sessão de psicoterapia psicanalítica. Os resultados apontam para a influência da intensidade dos sintomas de psicoticismo e do gênero do paciente na percepção da aliança terapêutica.(AU)

The patient's perception of the relationship with their therapist is determinant for their treatment adherence and for the success of psychotherapy. Establishing predictors of therapeutic alliance may potentially help psychotherapists to use forms of intervention during the early stages of treatment. This study aimed to investigate the association between socio-demographic and clinical factors of both patient and therapist and the way in which the patient perceives the therapeutic alliance. It is a cross-sectional study that evaluated the quality of the alliance in adult patients attended in psychoanalytic psychotherapy in a mental health outpatient clinic. The sample consisted of 118 patients who reached the fourth session of psychoanalytic psychotherapy. The results suggest that the intensity of psychoticism symptoms and patient gender influence the perception of the therapeutic alliance.(AU)

Características sociodemográficas, culturales y estado nutricional de los niños menores de cinco años de edad en la comunidad el Naranjo, municipio de Jinotega, Nicaragua, Octubre 2015 / Sociodemographic, cultural and nutritional status of children under five years of age in the El Naranjo community, Jinotega municipality, Nicaragua, October 2015

OBJETIVO: Describir las características socio demográficas y culturales de los padres y tutores y el estado nutricional de los niños menores de cinco años de edad en la comunidad El Naranjo, Jinotega, Octubre 2015. DISEÑO METODOLÓGICO: Descriptivo, transversal, muestra 73 Niños menores de cinco años y 73 padres o tutores. RESULTADOS: Estado nutricional normal 53%, deficiente 34%, edad madres 14 a 30 años, padres de 31 a más, niños 1 día/60 meses, sexo de niños masculino y femenino, escolaridad materna/paterna, iletrada y primaria, estado civil padres casados/solteros, madres empleadas 56.16%, padres empleados 89.55%, ingresos económicos menor C$ 3000, 60.27%, 73.97% dos a mas hijos, agua potable 61.64%, letrina 75.34%, energía eléctrica 84.93%, 47.94% tienen tabú sobre alimentación, 50.68% niños no tienen patologías, 49.32% si, 64.38% agricultores, 57.45% utilizan semillas criollas en cultivos y 42.55% semillas hibridas, 55.32% comercializa sus cultivos, 63.83% también para el consumo, 69.86% niños bajo tutela de los padres, 95.89% de los niños se alimentan 3 veces o más al día, alimentación es lactancia materna y sucedáneos 56.16%, alimentos que consume la familia el 43.84%. CONCLUSIONES: Mitad de los Niños con estado nutricional normal y otra mitad con estado nutricional deficiente, características socio demográficos y culturales de padres y niños son: edad materna 14 a 30 años, paterna 31 a más, niños 1 día a 60 meses, sexo de menores femenino y masculino, escolaridad materna y paterna iletrada y primaria, estado civil de padres casados y solteros, con empleo, ingresos económicos menores a C$ 3000 mensuales, tienen dos a más hijos, tienen agua potable, letrina y energía eléctrica, tienen tabú sobre alimentación, no tienen patologías, se dedican a agricultura, utilizan semillas criollas, utilizan sus cultivos para el comercio y consumo, los niños se alimentan de 3 a más veces al día y es lactancia materna y sucedáneos

Síndrome de Desgaste Ocupacional (Burnout) y su Relación con Salud y Riesgo Psicosocial en Funcionarios Públicos que Imparten Justicia en México, D.F. / Occupational Wear Syndrome (Burnout) and its Relationship to Health and Psychosocial Risk in Public Officials who Administer Justice in Mexico City

Los propósitos de este estudio fueron conocer la prevalencia de riesgo psicosocial en importantes funcionarios públicos que imparten justicia en México, D.F., así como identificar la relación entre variables socio-demográficas, desgaste ocupacional (burnout) y trastornos psicosomáticos. Se obtuvo información de 75 trabajadores que imparten justicia en México, D.F. (n=75) mediante la Escala de Desgaste Ocupacional de Uribe-Prado (2010). Los resultados mostraron que el burnout es la mejor variable para pronosticar trastornos psicosomáticos en términos de factores psicosociales en el trabajo; los análisis de este trabajo se discuten en términos de la importancia de conocer el riesgo psicosocial para efectos de prevención, diagnóstico e intervención a partir de la respuesta al estrés crónico. Se utilizaron correlaciones, análisis de varianza, regresiones y un modelo estructural para ajustar las variables en términos estructurales. El alfa de Cronbach para las variables evaluadas se ubico entre .63 y .83 de confiabilidad. Se enfatiza la importancia de que secretarios, jueces y magistrados que imparten justicia desempeñen su trabajo en términos de salud ocupacional.

The purposes of this study were to determine the prevalence of psychosocial risk in major public officials who administer justice in Mexico City, and to identify the relationship between socio-demographic variables, occupational wear (burnout) and psychosomatic disorders. Information of 75 workers who administer justice was obtained in Mexico, DF (n = 75) by the Occupational Scale Wear of Uribe-Prado (2010). The results showed that burnout is the best variable to predict psychosomatic disorders in terms of psychosocial factors at work; analyzes of this study are discussed in terms of the importance of understanding the effects of psychosocial risk prevention, diagnosis and intervention from the response to chronic stress. Correlations, analysis of variance, regressio'ns and a structural model to adjust the variables used in structural terms. Cronbachs alpha for the evaluated variables was located between .63 and .83 reliability. The importance of secretaries, judges and magistrates to administer justice undertake their work in terms of occupational health is emphasized.

Factores presentes en la deserción universitaria en la Facultad de Psicología de la Universidad De San Buenaventura, sede Bogotá en el periodo comprendido entre 1998-2009 / Factors related to the college dropout in the Faculty of Psychology at San Buenaventura University Bogotá in the period 1998-2009

El objetivo del presente estudio fue describir los factores socio demográficos y las categorías del modelo psicológico de Ethington, presentes en la deserción universitaria, evaluados por medio de una encuesta telefónica diseñada con base en estas categorías y validada por jueces. Los participantes tenían entre 16 y 32 años, solteros, de estratos 3 y 4. Los resultados descriptivos permiten concluir que existen diversas causas para que se presente la deserción en la Facultad de Psicología de la Universidad San Buenaventura, sede Bogotá. Dificultades tales como incompatibilidad del horario de estudio con el horario de trabajo, escasa información respecto al programa elegido al ingresar a la Universidad y dificultades de salud. Es importante destacar que la categoría que presentó el porcentaje más alto fue la de apoyo económico familiar con un 95%.

The purpose of this study was to describe the categories as well as the socio-demographic aspects of Ethington's psychological model, present in the university dropout. In order to do that, those aspects were assessed using a telephone survey validated by judges. Participants were between 16 and 32 years, single, from 3 and 4 social stratum. The results show that there are various reasons for dropout in the Faculty of Psychology at the University of San Buenaventura, such as: incompatibility between study and work schedules, unsuitable or insufficient information when going to University and finally, health difficulties.

Valores y factores sociodemográficos en estudiantes universitarios: un estudio comparativo / Values and socio demographic- factors in university students: a comparative study / Valores e fatores sócio-demográficos nos estudantes universitários: um estudo comparativo

El objetivo de este trabajo fue comparar los valores de los estudiantes de una institución universitaria en función de las variables socio demográficas género, procedencia (colegio: privado - público y religioso - no religioso), religión (católica - no católica) y edad. Para la investigación se diseñó una escala autoaplicada de 55 valores, que se administró mediante una selección intencional a 3.384 estudiantes. De la escala de valores se derivaron cinco dimensiones: Cosmopolitas, Sociales, Instrumentales, Morales y Conservadores. Los resultados indicaron que las mujeres presentaron mayor valoración de las dimensiones valores Morales, Sociales y Conservadores, mientras que los hombres valoraron más la dimensión Cosmopolitas. Los estudiantes provenientes de colegios religiosos valoraron más la dimensión valores Conservadores. La variable socio demográfica de mayor influencia en las preferencias axiológicas fue el género y la dimensión de valores diferenciada por mayor cantidad de los factores socio demográficos evaluados fue aquella representada por valores conservadores.

The purpose of this study was to compare the values of university students as a function of socio-demographic variables such as: gender, kind of school (religious vs. non-religious; private vs. public), religion (Catholic - Non Catholic) and age. A self-administered scale of 55 values was designed for this research and it was used with a sample of 3.384 students selected intentionally. The values scale showed five dimensions: Cosmopolitan, Social, Instrumental, Moral and Conservative. Results indicated that women presented a higher appreciation of Moral, Social and Conservative values, whereas men valued more the Cosmopolitan values. The students that attended religious schools valued more the Conservative dimension. The socio demographic variable of major influence in the axiological preferences was gender and the value dimension differentiated by most socio-demographic factors was the Conservative.

Neste artigo comparam-se os valores dos estudantes de uma instituição universitária em função das variáveis sócio-demográficas género, procedência (colégio, privado, público; religioso, no religioso) e idade. Desenhou-se uma escala auto-aplicada de 55 valores, administrada a uma seleção intencional de 3.384 estudantes. Da escala de valores, determinaram-se cinco valores: Cosmopolitas, Sociais, Instrumentais, Morais e Conservadores. Os resultados revelaram que as mulheres mostraram maiores valorações nas dimensões Morais, Sociais e Conservadores, em quanto os homens valoraram mais a dimensão Cosmopolitas. Os estudantes provenientes de colégios religiosos valoraram mais a dimensão Conservadores. A variável sócio-demográfica de maior influencia nas preferências axiológicas foi o gênero; a dimensão de valores diferenciada por maior quantidade dos fatores sócio-demográficos avaliados foi Conservadores.

Uso de alcohol, tabaco y drogas en población Mexicana, un estudio de cohortes

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Summary: Introduction. The availability of drugs and its impact upon our society is undeniably a public concern; the question that remains is to what extent is the population affected. Different sources of information suggest that drug use in Mexico is increasing, especially among the adolescent population. As it has been thirty years since the first epidemiological study of drug use was conducted in Mexico in the 1970's, this is an opportune moment to evaluate the problem by age cohort. This research addresses the question of whether changes in substance use have differentially affected the younger population in terms of the evolution of ages of onset and the socio-demographic determinants of lifetime consumption. Method. This study is a part of the World Mental Health Surveys Initiative from the WHO which was undertaken simultaneously in 30 countries. The target population was taken from uninstitutionalized persons with a fixed residence, between 18 and 65 years of age, and living in urban areas (as defined by more than 2500 inhabitants). The survey is based on a probabilistic, multistage design, stratified by six geographic areas at the national level. Eligible respondents were defined as persons, aged 18 to 65 at the time of the survey, who normally eat, sleep and prepare meals in the household and limited to those that speak Spanish. A total of 5826 individuals were interviewed with a weighted individual response rate of 76.6%. The computer assisted version of the World Mental Health Composite International Diagnostic Interview (WMH-CIDI)was administered. The interview length varied from a minimum of 20 minutes to a maximum of nine hours in four sessions. Fieldwork was carried out by 34 lay interviewers with prior experience in survey data collection and trained by professionals certified by the WHO in the use and training of the CIDI. Standard errors of the estimated prevalences were calculated by the Taylor linearization method using the SUDAAN 2002 statistical package. Kaplan Meir survival curves were generated for the ages of onset using the SAS 2001 software. Logistic regressions were performed to study the demographic correlates of substance use. Estimates of standard errors of odds ratio (ORs) from logistic regression coefficients were also obtained by SUDAAN, and 95% Confidence Intervals (CI) have been adjusted to design effects. Results. Alcohol is the most used substance with less variation by age; 86% of those interviewed report alcohol consumption at some time in their life. The prevalence of alcohol use is followed by tobacco use. Sixty percent of the population report having used tobacco, reaching the greatest proportion of the population in the 45 to 54 year old age group (63%). The non-medical use of drugs, including illicit drugs and legal drugs without a medical prescription, reaches 10% of the population. The illegal use of drugs, including the non-medical use of legal drugs and illicit drugs, in particular marijuana and cocaine, is more frequent among the young and prevalence diminishes with age. Beginning in adolescence, there is a growing prevalence of those reporting the use of these substances, stabilizing shortly before the age of 30. A discrete time survival analysis to estimate the variation in the lifetime prevalence by cohort showed variations in drug use by cohort for all the substances studied, even for alcohol consumption. In all cases, compared to the oldest cohort, the younger cohort are at greater risk of substance use and the greatest risks are concentrated always in the youngest cohort. The cohort differences in probability of substance use is greatest for cocaine, with increases of up to 100 times the risk for those between 18 and 29 years of age. Results of a logistic regression model demonstrate that age continues to be an important risk factor for non-prescription medical substance use, marijuana and cocaine, but not for alcohol and tobacco. For all substances, use is substantially lower for females as well as for the homemaker category of employment. There are no consistent differences for the other demographic variables across the five types of substances. Discussion. This report documents an increase in the risk for substance abuse problems among today's youth, greater than the risk faced by their parents or grandparents at the same age. Use begins increasing during adolescence and stabilizes shortly before the age of 30. There are variations by type of drug such that marijuana has maintained an early age of onset in the different age cohorts while for the use of other substances new cases of onset are found after this age; the substance that shows the greatest proportion of new onset at later ages is cocaine. Even so, the risk of cocaine use is considerably greater in younger cohorts. Survival analysis confirms that compared to older cohorts, the younger have greater risk of substance use and these risks are particularly striking for cocaine use, with as much as 100 times the risk for those between 18 and 29 years of age. These findings coincide with those reported in previous studies in that alcohol and tobacco use surpass by far the use of other substances, with greater use of alcohol than tobacco and both above any other substance. The rate of tobacco and alcohol use is similar throughout the lifespan signifying that this is an endemic problem in our country. On the other hand, findings regarding the use of illegal drugs, in particular marijuana and cocaine, and non-prescription medical drugs show a preponderance of use in the young. These findings reflect the tendencies already reported in other studies. Marijuana use is not new, and has a long tradition throughout the country for which it is not surprising that these results show cases of consumption in all age groups and that the age of onset is similar in all age cohorts, around 17 years of age. However, the growth of marijuana use is reflected by greater lifetime prevalence in the young, three times greater among those now currently 18 to 29 years of age than those of the same age in the 1970's. The use of cocaine before that decade was limited to isolated groups as a socially sophisticated diversion; there is a resurgence in the 1990's when an important increase in use is reflected in all the available surveillance systems. This is reflected in our results by the lower exposure to this drug in the older cohorts. While the risk of marijuana use is 16 times lower in the older cohort than the younger, the risk of cocaine use is 100 times lower in the older cohort than the younger. Our findings suggest that age continues to be an important risk factor for the use of illegal drugs and medical drugs without a prescription, but not for alcohol or tobacco. For all substances, use is lower for females as well as for homemakers indicating that double standards between the genders are still applied. For alcohol there are slightly lower risks for those with lesser educational attainment. This is consistent with other studies which have documented that alcohol consumption increases with buying power which is in turn associated with increased education. These results suggest the need to undertake further research which would allow us a more in depth understanding of the role that social position, including marital status, plays in substance use and abuse. Conclusions. These findings support the hypothesis that the younger generation of today has a greater risk of substance use when compared to their parents when they were young. This point out to the need of increasing actions aimed at reducing the negative impact of this phenomena upon health and society.

Factores sociodemográficos relacionados con la práctica de alimentación al seno materno / Sociodemographic factors related to the practice of breastfeeding

La alimentación al seno materno es el recurso alimentario más valioso que tienen las madres para sus hijos durante el primer año de vida, por los beneficios nutricionales, inmunológicos y emocionales; sin embargo se observa una tendencia al abandono de esta práctica. Objetivo: Describir los factores sociodemográficos relacionados con la práctica de la lactancia materna. Material métodos: Estudio descriptivo, transversal, en 220 madres participantes de las unidades, No. 79 y HGZ No. 11 del IMSS de Piedras Negras, Coahuila. Se construyó y validó un instrumento de medición, dividido en tres secciones: datos sociodemográficos, nivel de conocimientos y criterios para medir la práctica de la alimentación al seno materno. Resultados: Las madres de 36 a 45 años ocupan él más alto porcentaje con un 89%; por escolaridad, ocupación y estado civil predomina la alimentación con leche industrializada. En el periodo de alimentación al seno materno, con relación a factores sociodemográficos, hay una distribución más o menos uniforme y el nivel de conocimiento de las madres en su mayoría es bueno. De acuerdo a las características sociodemográfica, hay relación de 67% entre conocimiento y práctica. Conclusiones: Se identificaron factores sociodemográficos y cognitivos relacionados con la práctica de la alimentación al seno materno, así como, para la alimentación con leche industrializada.

Objective: To determine if the sociodemografic factors influence or not in the practice of the feeding to the maternal breast in children that are one year old or less. Material and methods: It is carried out in the pediatric urgencies department of the UMF No. 79 and the HGZ No. 11 of the IMSS of Piedras Negras, Coahuila. The calculation of the size of the surveys is n = 220. The measurement instrument is constructed and validated, divided in thefollowingthreesections: sociodemografic data, in order to measure the knowledge, and the practice of matenal lactancia. Results: The table 2 show us by age the shows, the mothers of 36 to 45 years have the highest percentage with an 89%; by schooling, occupation and civil estate predominases the feeding with industrialized milk. The table 2 shows that in the feeding to the maternal breast period, related with the sociodemografic factors, there's a distribution regulariy uniform. In the table 3 we see that the knowledge of the mothers is good. In the 4th table, in order with the sociodemografics characterstics, the knowledge and the practice is of a 67%. Conclusions: It is not managed to determine if the sociodemografic factors influence in the practice of the feeding lo the maternal breast.