Polidimensionalidad social y laboral de los determinantes de la salud ante el Sars-CoV-2 / Social and occupational multidimensionality of the determinants of health in the face of Sars-CoV-2

Tras el advenimiento de un nuevo patógeno denominado Sars-CoV-2, los esfuerzos iniciales centraron su atención en la contención del virus a fin de disminuir su transmisibilidad, contrarrestando los efectos patológicos, disminuyendo el impacto psicosocial. Al ser un peligro emergente de alcance global, que afectó todos los estratos y entornos de la sociedad, pueden existir determinantes polidimensionales emergentes, en lo social y laboral, que aún pueden ser desconocidas, las cuales pueden repercutir en la esperanza de vida de una población. Se realizó una búsqueda sistemática y posterior caracterización de las polidimensiones sociales y laborales que emergieron de forma directa o indirecta a consecuencia del Sars-CoV-2, y a la declaración de pandemia Covid-19, la cual impuso el aislamiento generalizado de la población mundial, como primera barrera de contención para evitar el contagio masivo, e indujo profundas transformaciones en todos los ámbitos y determinantes de la salud del ser humano. La dimensión social, conformada por los factores modo de vida, circunstancias materiales y relaciones humanas, presentó múltiples desafíos y cambios para adaptarse a las nuevas circunstancias de la vida en pandemia. De igual manera, la dimensión laboral, ampliamente afectada por la desestabilización de los mercados y la crisis económica circundante, tuvo que modificar sensiblemente cada uno de sus factores constituyente para sobrellevar el efecto del confinamiento generalizado, afectando la productividad de las organizaciones, los riesgos de transmisibilidad del virus, las alteraciones en los social, familiar, personal y de salud y las múltiples interacciones con sus factores determinantes(AU)

After the advent of a new pathogen called Sars-CoV-2, the initial efforts focused on containing the virus in order to reduce its transmissibility, counteracting the pathological effects, and reducing the psychosocial impact. Being an emerging danger of global scope, which affected all strata and environments of society, there may be emerging multidimensional determinants, in the social and labor spheres, which may still be unknown, and may affect the life expectancy of a population.A systematic search and subsequent characterization of the social and labor polydimensions that emerged directly or indirectly as a result of Sars-CoV-2, and the declaration of the Covid-19 pandemic, which imposed the generalized isolation of the world population, was carried out as the first containment barrier to prevent massive contagion, and induced profound transformations in all areas and determinants of human health. The social dimension, made up of lifestyle factors, material circumstances, and human relationships, presented multiple challenges and changes to adapt to the new circumstances of life in a pandemic. Similarly, the labor dimension, widely affected by the destabilization of the markets and the surrounding economic crisis, had to significantly modify each of its constituent factors to withstand the effect of generalized confinement, affecting the productivity of organizations, the risks of transmissibility of the virus, alterations in social, family, personal and health conditions and the multiple interactions with its determining factors(AU)

Construção e evidências de validade da Escala Multidimensional de Empatia para Crianças / Construction and evidence of validity of the Multidimensional Empathy Scale for Children / Construcción y evidencias de validez de la Escala Multidimensional de Empatía para Niños

Este trabalho objetivou construir a Escala Multidimensional de Empatia para Crianças (EMEC) e avaliar indicadores de validade desse instrumento. Uma equipe de pesquisadores elaborou 69 itens para mensurar cinco dimensões da empatia, partindo de diferentes fontes teóricas e empíricas. Após testagem da validade semântica e de conteúdo, uma versão da EMEC com 30 itens foi administrada a 373 crianças (7 a 12 anos; M = 10,07 ± 1,42), assim como outra escala de avaliação da empatia e uma de agressividade. Uma análise fatorial exploratória apontou para uma solução trifatorial com 24 itens, que explica 48,25% da variância. Observaram-se indicadores de validade convergente e divergente da EMEC e diferenças relacionadas ao sexo e à idade. Os resultados sugerem adequação da EMEC para mensurar diferentes componentes da empatia em crianças, a partir de uma perspectiva multidimensional, o que representa um avanço em relação a outros instrumentos disponíveis no Brasil. (AU)

The aims of this work were to construct the Multidimensional Empathy Scale for Children (MESC) and to assess validity indicators for this instrument. A team of researchers developed 69 items to evaluate five dimensions of empathy. After testing the semantic and content validity, a version of the MESC with 30 items was applied with 373 children (ages between 7 and 12 years; M = 10.07 ± 1.42). Another scale for evaluation of empathy and one for measuring aggression were used. Exploratory Factor Analysis suggested a three factor solution with 24 items, which explained 48.25% of the variance. Indicators of the convergent and divergent validity of the MESC, and differences related to sex and age were observed. The results indicate that the MESC is appropriate for measuring different components of empathy in children, from a multidimensional perspective, which represents an advantage for this scale, compared to other instruments available in Brazil. (AU)

Este trabajo tuvo como objetivos construir la Escala Multidimensional de Empatía para Niños (EMEN) y evaluar los indicadores de validez para este instrumento. Un equipo de investigadores desarrolló 69 ítems para evaluar cinco dimensiones de la empatía desde diferentes fuentes teóricas y empíricas. Después de probar la validez semántica y de contenido, se administró una versión de la EMEN con 30 ítems a 373 niños (edades entre 7 y 12 años; M = 10,07 ± 1,42). Además, se utilizó otra escala de evaluación de la empatía y una escala para medir la agresividad. Un Análisis Factorial Exploratorio apuntó una solución trifactorial con 24 ítems, lo que explica la varianza de 48.25%. Se observaron indicadores de validez convergentes y divergentes de la EMEN y diferencias relacionadas con el sexo y la edad. Los resultados indican la idoneidad de la EMEN para medir diferentes componentes de la empatía en los niños, desde una perspectiva multidimensional, lo que representa una ventaja de esta escala en comparación con otros instrumentos disponibles en Brasil. (AU)

Aproximación a una propuesta metodológica para evaluar la sostenibilidad en el entorno de la vivienda social en Medellín / An Approach to a Methodological Proposal for Evaluating Sustainability in the Setting of Social Housing in Medellín

Resumen La gran mayoría de las alternativas y soluciones propuestas, adolecen de un enfoque holístico, que permita enfrentar el problema desde una óptica integradora como consecuencia, no se cuenta en la actualidad en la ciudad de Medellín, con una alternativa que permita suplir el déficit de vivienda digna, segura, económica y sostenible. La duplicación de esfuerzos, el despilfarro de recursos y la ineficiencia en los procesos, se han convertido en una constante permanente de los proyectos que termina ofreciendo el Estado, el rechazo por parte de la comunidad y los usuarios ante las soluciones propuestas, genera un impacto social de grandes proporciones, que termina agudizando el problema existente.

Abstract The vast majority of the alternatives and solutions proposed, suffer from a holistic approach, which allows to tackle the problem from an integrative perspective as a consequence, currently, in the city of Medellín there does not exist, an alternative, which allows to supply the deficit of a dignified, safe, economic and sustainable housing. The duplication of efforts, the waste of resources, and the inefficiency in the processes have become a permanent constant of the projects, which the State ends up offering, the rejection by the community, and the users in the light of the proposed solutions. It generates a social impact of great proportions, which ends up sharpening the existing problem.

Acerca da multidimensionalidade da categoria sofrimento / On the multidimensionality of the suffering category / Sobre la multidimensionalidad de la categoría sufrimiento / A propos de la multi-dimensionnalisé de la catégorie souffrance

O sofrimento constitui uma realidade complexa, devendo ser distinguido da dor e demandando um tratamento interdisciplinar. São nele identificáveis dimensões várias, nomeadamente físicas, psíquicas, culturais, políticas e socioeconómicas, sendo todavia plenamente legítimo considerá-lo um fato social. As tendências para a tecnologização das respostas ao sofrimento, nomeadamente a psiquiatrização, impõem elas próprias uma abordagem de pendor sociológico, nalguns casos vincando mesmo diversos traços estritamente políticos. Tanto os aspectos atinentes à cultura e à vida religiosa quanto as questões relativas à economia são relevantes na consideração dessa problemática. Em particular, torna-se necessário sublinhar a importância do consumo competitivo e sinalizador de status. Esse relevo do consumo pode, nalguns casos, contribuir para reforçar as desigualdades sociais, do que por sua vez se ressente o bem-estar social geral. Esse reconhecimento, porém, não constitui garantia de que medidas de redistribuição igualitárias sejam consideradas desejáveis, mesmo do ponto de vista dos seus beneficiários.

Suffering is a complex reality, which we ought to distinguish from pain. Various dimensions, namely physical, psychological, cultural, political and socioeconomic, being identifiable, an interdisciplinary treatment is thus required. It is fully legitimate to consider it a social fact. Trends towards rendering responses to suffering a merely technical issue, namely psychiatrization, impose themselves a sociologically inclined approach, and in some cases even the consideration of strictly political traits. Both cultural aspects (including those related to religious life) and the economic facets are relevant to the consideration of this problem. Particularly, it is necessary to underline the importance of competitive consumption as a form of status signalization. This importance of consumption may, in some cases, contribute to reinforce social inequalities, which in turn may have negative repercussions in the general social welfare. This recognition, however, does not warrant that egalitarian redistribution measures are perceived as desirable, even from the point of view of its beneficiaries.

El sufrimiento constituye una realidad compleja, debiendo ser distinguido del dolor y demandando un tratamiento interdisciplinario. En él se identifican varias dimensiones en particular físicas, psíquicas, culturales, políticas y socioeconómicas, siendo plenamente legítimo considerarlo un hecho social. Las tendencias para la tecnología de las respuestas al sufrimiento, en particular la psiquiatrización, imponen por si mismas un enfoque de pendiente sociológico, en algunos casos viniendo incluso a varios rasgos estrictamente políticos. Tanto los aspectos relativos a la cultura y la vida religiosa como las cuestiones relativas a la economía son relevantes en la consideración de esta problemática. En particular, es necesario subrayar la importancia del consumo competitivo y el indicador de estado. Este relieve del consumo puede, en algunos casos, contribuir a reforzar las desigualdades sociales, de lo que a su vez se resiente el bienestar social general. Este reconocimiento, sin embargo, no garantiza que las medidas de redistribución igualitarias se consideren deseables, incluso desde el punto de vista de sus beneficiarios.

La souffrance constitue une réalité complexe qui doit être distinguée de la douleur et qui demande un traitement interdisciplinaire. On y identifie plusieurs dimensions, à savoir physiques, psychiques, culturelles, politiques et socioéconomiques. Néanmoins il est parfaitement légitime de la considérer comme un fait social. Les tendances pour rendre les réponses à la souffrance technologiques, telles que celles de la psychiatrie, imposent elles-mêmes une approche de penchant sociologique, dans certains cas marquant même plusieurs traits strictement politiques. Les aspects liés à la culture et à la vie religieuse, ainsi que les problèmes liés à l'économie, sont des questions majeures pour l'examen de ce problème. En particulier, il devient nécessaire de souligner l'importance de la consommation compétitive et qui sert à signaler le statut. Cet accent mis sur la consommation peut, dans certains cas, contribuer à renforcer les inégalités sociales dont, à leur tour, le bien-être social général éprouve les conséquences. Cette reconnaissance, cependant, n'est pas une garantie que des mesures de redistribution égalitaires seront considérées comme souhaitables, même du point de vue de leurs bénéficiaires.

Violencia juvenil delincuencial en latinoamérica: un desafío ético de las sociedades del siglo xxi / Youth violence in latinoamérica delinquency: a challenge ethical companies of the century

Producto de la reflexión desde la óptica del Enfoque Integrador Transcomplejo, se realizó un ensayo sobre la multidimensionalidad ética de la violencia juvenil delincuencial en Latinoamérica, que parte de hacer una revisión histórica de la magnitud y naturaleza del problema en la región, haciendo posteriormente una revisión teórica contextualizada de los resultados de las investigaciones relacionadas con la violencia juvenil delincuencial en América Latina, donde finalmente a partir de la aproximación hermenéutica a las representaciones sociales de los jóvenes violentos, se concluye reflexionando sobre la necesidad de trascender hacia una ética en la investigación que rebase los niveles de exigencia de lo cotidiano de la ética utilitarista o de la consecuencial y se eleve a un estrato racional de lo cuántico, de lo subjetivo, de lo relacional y multiverso, es decir de lo transcomplejo. Esto implica el abandono de la lógica positivista, de la norma, de la deontología, en la búsqueda de lo reflexivo conciencial, lo interpretativo fenomenológico, lo emergente-vivencial, así como lo dialéctico relacional.

Product of reflection from the perspective of Focus Integrator Transcomplejo, an essay on ethics multidimensionality of youth violence criminal in Latin America was held, that part of making a historical review of the extent and nature of the problem in the region, subsequently making a review theoretical contextualized the results of research related to youth violence criminal in Latin America, where finally from the hermeneutical approach to social representations of youth violent conclude by reflecting on the need to transcend to a research ethics that levels exceeding the daily requirement of utilitarian ethics or consequential damages and rise to a rational layer of the quantum, of the subjective, relational and multiverse, that is what transcomplejo. This implies abandoning the positivist logic of the rule of ethics in the pursuit of the reflective conciencial, the interpretive phenomenological, the pop-experiential and relational dialectical.

A fé: Bion e Kierkegaard / Faith: Bion and Kierkegaard

O artigo aborda o significado que toma o termo fé no campo da psicanálise, tal como introduzido por Bion no contexto de seu pensamento a partir do livro Transformações. Para penetrar a penumbra de significados do termo, a autora se dirige à concepção religiosa de fé, usando subsídios do pensamento de Søren Kierkegaard. O artigo procede a uma aproximação dos dois vértices numa ilustração clínica do conceito de fé.

This paper explores the meaning of faith in the field of psychoanalysis, as introduced by Bion in the context of his thoughts since 1965, in his book Tansformations. The author searches the religious concept of faith in the thoughts of Søren Kierkegaard and tries to approximate the two vertices through a clinical illustration of the concept of faith.

Definição de envelhecimento saudável na perspectiva de indivíduos idosos / Successful aging definition in a sample of older adults

O envelhecimento é definido como um processo multidimensional (Baltes & Baltes, 1990). Rowe e Kahn (1998) apresentam três indicadores de envelhecimento saudável: baixo risco de doenças e de incapacidades funcionais; funcionamento mental e físico excelentes; e envolvimento ativo com a vida. Com base nesses pressupostos, o objetivo deste trabalho foi examinar a definição de envelhecimento saudável em uma amostra de idosos da comunidade buscando identificar as multidimensões percebidas pelos mesmos. A amostra foi de 501 idosos com idade entre 60 a 93 anos (M= 72,65; DP= 8,08). Foi realizada análise de conteúdo das respostas abertas sobre envelhecimento saudável. Identificou-se 29 categorias, sendo as mais citadas: saúde física; saúde social e saúde emocional e as menos citadas: envelhecimento como patológico e atividades específicas para idosos. Conclui-se que este estudo confirmou os pressupostos de heterogeneidade e multidimensionalidade do processo de envelhecimento, ao observar-se a variabilidade nas definições dos idosos.

The process of aging is defined as a multidimensional process (Baltes e Baltes, 1990). Rowe and Kahn (1998) present three indicators of successful aging: low risk of disease and disease-related disabilities; high level of mental and physical functions and an active life style. Based on these presumptions, this article presents a research that examined the definition of successful aging from a sample of older adults, seeking to identify the multiple dimensions perceived by them. The sample consisted of 501 older adults between 60 to 93 years old (M=72,65; SD= 8,08). Content analysis of their answers to what successful aging means identified 29 possible categories. The most cited definitions for successful aging were: physical health, social health and emotional health. On the other hand, the least cited answers were: a life of work; aging as a pathological process and specific activities for older adults. In conclusion, this study confirmed the presumptions of heterogeneity and multidimensionality of aging, by observing the various definitions from older adults.

Multi-dimensional Changes in Auditory Verbal Hallucination during Antipsychotic Treatment of Schizophrenic Patients / 신경정신의학

OBJECTIVES: Auditory verbal hallucination (AVH) is knoun for its high prevalence and difficulty in evaluation. Authors hypothesized that it may be possible to find useful dimensions of AVH that reflect the clinical status of schizophrenic patients by assessing the multi-dimensional changes and linguistic forms' of AVH during antipsychotic treatment. METHODS: 33 schizophrenic patients with AVH were selected and periodically assessed with the 11 items of hallucinations subscale of 'The Psychotic Symptom Rating Scales (PSYRATS)'. In addition, to assess the linguistic forms observed in the AVH, the evaluations of sentence structure of AVH reported by the patients were conducted. RESULTS: PSYRATS showed the multidimensionality inherent in AVH. The changes in the quantitative dimensions did not correlate well with patients' subjective distress. However, qualitative changes in the cognitive and emotional dimensions showed more favorable correlation with clinical course of the patient. The sentence structures of AVH showed tendency to change from "sentence" to "non-sentence" type with overall improvement during treatment. CONCLUSION: Multi-dimensional approach to AVH can give us more information about the changing patterns of multi-faceted structure of AVH and clinical status of patients than one-dimensional or categorical approach.

Multi-dimensional Changes in Auditory Verbal Hallucination during Antipsychotic Treatment of Schizophrenic Patients / 신경정신의학

OBJECTIVES: Auditory verbal hallucination (AVH) is knoun for its high prevalence and difficulty in evaluation. Authors hypothesized that it may be possible to find useful dimensions of AVH that reflect the clinical status of schizophrenic patients by assessing the multi-dimensional changes and linguistic forms' of AVH during antipsychotic treatment. METHODS: 33 schizophrenic patients with AVH were selected and periodically assessed with the 11 items of hallucinations subscale of 'The Psychotic Symptom Rating Scales (PSYRATS)'. In addition, to assess the linguistic forms observed in the AVH, the evaluations of sentence structure of AVH reported by the patients were conducted. RESULTS: PSYRATS showed the multidimensionality inherent in AVH. The changes in the quantitative dimensions did not correlate well with patients' subjective distress. However, qualitative changes in the cognitive and emotional dimensions showed more favorable correlation with clinical course of the patient. The sentence structures of AVH showed tendency to change from "sentence" to "non-sentence" type with overall improvement during treatment. CONCLUSION: Multi-dimensional approach to AVH can give us more information about the changing patterns of multi-faceted structure of AVH and clinical status of patients than one-dimensional or categorical approach.