Preocupación por el contagio de la COVID-19 y carga laboral como predictores del malestar psicológico durante la emergencia sanitaria en personal de salud de Perú

Introducción: Durante la emergencia sanitaria, preocupan las repercusiones en la salud mental que pudieran estar experimentando los trabajadores sanitarios peruanos, quienes representan la primera línea de atención contra la COVID-19. Objetivo: Determinar si la preocupación por la COVID-19 y la carga laboral predicen el malestar psicológico en personal de salud. Métodos: Estudio predictivo en 367 trabajadores (enfermeros, médicos, técnicos en enfermería, obstetras, odontólogos, psicólogos, nutricionistas, entre otros) de ambos sexos en 12 redes de salud de la región de Puno, seleccionados a través de un muestreo no probabilístico intencional. Los datos se recogieron a través de la Escala de malestar psicológico de Kessler, la Escala de preocupación por el contagio de la COVID-19 y la Escala de carga de trabajo (ECT). Resultados: Se encontró que no hay diferencias significativas entre varones y mujeres en el malestar psicológico, la preocupación por el contagio de la COVID-19 y la carga laboral; además, se hallaron correlaciones muy significativas entre las variables de estudio (p < 0,01). El análisis de regresión múltiple demostró un ajuste adecuado para el modelo (F = 94,834; p < 0,001), en el que la preocupación por la COVID-19 (ß =-0,436; p < 0,01) y la carga laboral (ß = 0,239; p < 0,01) son variables que predicen significativamente el malestar psicológico (R2 ajustado = 0,33). Conclusiones: La preocupación por la COVID-19 y la sobrecarga de trabajo predicen el malestar psicológico en el personal sanitario de la región de Puno.

Introduction: During the health emergency, there is concern about the mental health repercussions that Peruvian health workers, who represent the front line of care for COVID-19, may be experiencing. Objective: To determine whether concern about COVID-19 and workloads predict psychological distress in healthcare workers. Methods: Predictive study in which 367 workers (nurses, doctors, nursing assistants, obstetricians, dentists, psychologists, nutritionists, among others) from 12 health networks in the Puno region participated, selected through intentional non-probabilistic sampling. The data were collected via the Kessler Psychological Distress Scale, the COVID-19 Scale of Concern and the Workload Scale. Results: It was found that there are no significant differences between men and women in psychological discomfort and concern about COVID-19 infection and workload. Furthermore, highly significant correlations were found between the study variables (p <0.01). Multiple regression analysis showed an adequate adjustment for the model (F = 94.834; p <0.001), where concern about COVID-19 (ß = -0.436; p <0.01) and workload (ß = 0.239; p <0.01) are variables that significantly predict psychological discomfort (adjusted R2 = 0.33). Conclusions: Concern about COVID-19 and work overload predict psychological distress in health personnel in the Puno region.

Análisis factorial de la Escala Situacional de Empatia Emocional en una muestra universitaria chilena

La preocupación empática y angustia personal son los componentes emocionales de la empatía según los modelos más utilizados. Estos componentes pueden conceptualizarse en forma disposicional o situacional. Los análisis previos tienden a considerar escalas disposicionales con escasa evidencia para las situacionales. El presente estudio analizó la estructura factorial de la Escala Situacional de la Empatía Emocional, compuesta por la preocupación empática y angustia personal. En una muestra a conveniencia de estudiantes universitarias/os chilenos/as (N = 539), se analizó el ajuste de primer y segundo orden de la escala mediante análisis factorial. Los resultados indicaron un buen (X2/gl = 4.189, CFI = .964, ТЫ = .932, sRMR = .042, RMSEA = .086, AIC = 12041.418, BIC = 12097.185) y mejor ajuste del modelo de segundo orden Cfdiferenda(1) = 16.689,p .01, -ΔAIC- = 211.633 > 10, y -ΔBIC- = 207.342 > 10), mientras que el de un orden no mostró un buen ajuste (X2/gl = 20.878, CFI = .727, ты = .544, SRMR = .118, RMSEA = .224, AIC = 12253.051, BIC = 12304.527). Los resultados fueron consistentes con la literatura. Se discute la necesidad de nuevas evidencias de validez y el uso de muestras más representativas.

Empathic concern and personal distress are the emotional components of empathy according to most utilized models. These components can be conceptualized in a dispositional or situational form. Previous analyzes tend to consider dispositional scales, with little evidence for situational ones. The present study analyzed the factor structure of a situational scale of emotional empathy, composed of empathic concern and personal distress. In a convenience sample of Chilean university students (N = 539), the one-order and second-order fit of the scale was analyzed using factor analysis. The results indicated a good (X2/gl = 4.189, CFI = .964, ТЫ = .932, SRMR = .042, RMSEA = .086, AIC = 12041.418, BIC = 12097.185) and better Ct2 difference(1) = 16.689, p .01, -ΔAIC- = 211.633 > 10, y -ΔBIC- = 207.342 > 10) second-order fit while one-order did not show a good fit (X2/gl = 20.878, CFI = .727, ты = .544, SRMR = .118, RMSEA = .224, AIC = 12253.051, BIC = 12304.527). The results were consistent with the literature. The need for new types of validity and the use of more representative samples was discussed.

Concern about COVID-19 infection and workload as predictors of psychological distress during the health emergency in Peruvian healthcare personnel.

INTRODUCTION: During the health emergency, there is concern about the mental health repercussions that Peruvian health workers, who represent the front line of care for COVID-19, may be experiencing. OBJECTIVE: To determine whether concern about COVID-19 and workloads predict psychological distress in healthcare workers. METHODS: Predictive study in which 367 workers (nurses, doctors, nursing assistants, obstetricians, dentists, psychologists, nutritionists, among others) from 12 health networks in the Puno region participated, selected through intentional non-probabilistic sampling. The data were collected via the Kessler Psychological Distress Scale, the COVID-19 Scale of Concern and the Workload Scale. RESULTS: It was found that there are no significant differences between men and women in psychological discomfort and concern about COVID-19 infection and workload. Furthermore, highly significant correlations were found between the study variables (P < .01). Multiple regression analysis showed an adequate adjustment for the model (F = 94.834; P < .001), where concern about COVID-19 (ß = -0.436; P < .01) and workload (ß = 0.239; P < .01) are variables that significantly predict psychological discomfort (adjusted R2 = 0.33). CONCLUSIONS: Concern about COVID-19 and work overload predict psychological distress in health personnel in the Puno region.

Validation of a new strategy for the identification of SARS-CoV-2 variants by sequencing the spike gene by Sanger.

INTRODUCTION: The emergence of multiple variants of SARS-CoV-2 during the COVID-19 pandemic is of great world concern. Until now, their analysis has mainly focused on next-generation sequencing. However, this technique is expensive and requires sophisticated equipment, long processing times, and highly qualified technical personnel with experience in bioinformatics. To contribute to the analysis of variants of interest and variants of concern, increase the diagnostic capacity, and process samples to carry out genomic surveillance, we propose a quick and easy methodology to apply, based on Sanger sequencing of 3 gene fragments that code for protein spike. METHODS: Fifteen positive samples for SARS-CoV-2 with a cycle threshold below 25 were sequenced by Sanger and next-generation sequencing methodologies. The data obtained were analyzed on the Nextstrain and PANGO Lineages platforms. RESULTS: Both methodologies allowed the identification of the variants of interest reported by the WHO. Two samples were identified as Alpha, 3 Gamma, one Delta, 3 Mu, one Omicron, and 5 strains were close to the initial Wuhan-Hu-1 virus isolate. According to in silico analysis, key mutations can also be detected to identify and classify other variants not evaluated in the study. CONCLUSION: The different SARS-CoV-2 lineages of interest and concern are classified quickly, agilely, and reliably with the Sanger sequencing methodology.

Validación de una nueva estrategia para la identificación de variantes de SARS-CoV-2 mediante secuenciación del gen espiga por Sanger / Validation of a new strategy for the identification of SARS-CoV-2 variants by sequencing the spike gene by Sanger

Introducción: La aparición de múltiples variantes del SARS-CoV-2 durante la pandemia de COVID-19 es motivo de gran preocupación mundial. Hasta el momento, su análisis se ha centrado principalmente en la secuenciación de nueva generación. Sin embargo, esta técnica es costosa y requiere equipos sofisticados, largos tiempos de procesamiento y personal técnico altamente cualificado con experiencia en bioinformática. Para contribuir al análisis de variantes de interés y de preocupación, aumentar la capacidad diagnóstica y procesar muestras para realizar vigilancia genómica, proponemos una metodología rápida y fácil de aplicar, basada en la secuenciación Sanger de 3 fragmentos del gen que codifica para la proteína espiga. Métodos: Se secuenciaron 15 muestras positivas para SARS-CoV-2 con un valor de umbral de ciclo inferior a 25 por metodologías Sanger y secuenciación de nueva generación. Los datos obtenidos fueron analizados en las plataformas Nextstrain y PANGO Lineages. Resultados: Ambas metodologías permitieron identificar las variantes de interés reportadas por la OMS. Se identificaron 2 muestras como alfa, 3 gamma, una delta, tres mu, una ómicron y 5 cepas cercanas al aislado inicial del virus Wuhan-Hu-1. Según el análisis in silico, también se pueden detectar mutaciones clave para identificar y clasificar otras variantes no evaluadas en el estudio. Conclusión: Los diferentes linajes de interés y preocupación de SARS-CoV-2 se clasifican de forma rápida, ágil y fiable con la metodología de secuenciación de Sanger.(AU)

Introduction: The emergence of multiple variants of SARS-CoV-2 during the COVID-19 pandemic is of great world concern. Until now, their analysis has mainly focused on next-generation sequencing. However, this technique is expensive and requires sophisticated equipment, long processing times, and highly qualified technical personnel with experience in bioinformatics. To contribute to the analysis of variants of interest and variants of concern, increase the diagnostic capacity, and process samples to carry out genomic surveillance, we propose a quick and easy methodology to apply, based on Sanger sequencing of 3 gene fragments that code for protein spike. Methods: Fifteen positive samples for SARS-CoV-2 with a cycle threshold below 25 were sequenced by Sanger and next-generation sequencing methodologies. The data obtained were analyzed on the Nextstrain and PANGO Lineages platforms. Results: Both methodologies allowed the identification of the variants of interest reported by the WHO. Two samples were identified as Alpha, 3 Gamma, one Delta, 3 Mu, one Omicron, and 5 strains were close to the initial Wuhan-Hu-1 virus isolate. According to in silico analysis, key mutations can also be detected to identify and classify other variants not evaluated in the study. Conclusion: The different SARS-CoV-2 lineages of interest and concern are classified quickly, agilely, and reliably with the Sanger sequencing methodology.(AU)

Scale of concern about COVID-19 infection in Peruvian Health Care Workers.

INTRODUCTION: The global SARS-CoV-2 pandemic has generated concern about contagion, especially among healthcare workers who are on the front line. OBJECTIVE: To design and analyse the evidence of content validity, internal structure and reliability of a measure of concern about the spread of COVID-19 among Peruvian healthcare workers. MATERIAL AND METHODS: Quantitative study and instrumental design. The scale was administered to 321 health science professionals (78 males and 243 females), whose ages ranged from 22 to 64 years (38.12 ±â€¯9.61). RESULTS: Aiken's V-coefficient values were statistically significant. An exploratory factor analysis was performed which indicated the existence of a single factor, and confirmatory factor analysis (CFA) confirmed a satisfactory six-factor model. The CFA solution obtained adequate fit indices (RMSEA = 0.079; P = .05; TLI = 0.967; IFC = 0.980; GFI = 0.971, and AGFI = 0.931), and showed good internal consistency based on Cronbach's alpha coefficient (α = 0.865; CI 95%, 0.83-0.89). CONCLUSIONS: The scale of concern for COVID-19 infection is a valid and reliable brief measure that can be used for research and professional purposes.

Escala de preocupación por el contagio de la COVID-19 en personal de la salud peruano

Introducción: La pandemia mundial producida por el SARS-CoV-2 ha generado preocupación por el contagio, sobre todo en el personal de salud que está en primera línea. Objetivo: Diseñar y analizar las evidencias de validez de contenido, estructura interna y confiabilidad de una medida de preocupación por el contagio de COVID-19 en personal de salud peruano. Material y métodos: Estudio cuantitativo y diseño instrumental. La escala se aplicó a 321 profesionales de ciencias de la salud (78 varones y 243 mujeres) con edades comprendidas entre los 22 y los 64 (38,12 ± 9,61) an os. Resultados: Los valores del coeficiente V de Aiken fueron estadísticamente significativos. Se realizó un análisis factorial exploratorio, que indicó la existencia de un solo factor. El análisis factorial confirmatorio (AFC) confirmó un modelo satisfactorio de 6 ítems en 1 solo factor. La solución del AFC obtuvo índices de ajuste adecuados (RMSEA = 0,079; p = 0,05; TLI = 0,967; CFI = 0,980; GFI = 0,971 y AGFI = 0,931); además; mostró una buena consistencia interna según el coeficiente alfa de Cronbach (a = 0,865; IC95%, 0,83-0,89). Conclusiones: La escala de preocupación por el contagio de la COVID-19 es una medida breve válida y confiable que se puede utilizar para fines de investigación y función profesional.

A B S T R A C T Introduction: The global SARS-CoV-2 pandemic has generated concern about contagion, especially among healthcare workers who are on the front line. Objective: To design and analyse the evidence of content validity, internal structure and reliability of a measure of concern about the spread of COVID-19 among Peruvian healthcare workers. Material and methods: Quantitative study and instrumental design. The scale was administered to 321 health science professionals (78 males and 243 females), whose ages ranged from 22 to 64 years (38.12±9.61). Results: Aiken's V-coefficient values were statistically significant. An exploratory factor analysis was performed which indicated the existence of a single factor, and confirmatory factor analysis (CFA) confirmed a satisfactory six-factor model. The CFA solution obtained adequate fit indices (RMSEA = 0.079; p = 0.05; TLI = 0.967; IFC = 0.980; GFI = 0.971, and AGFI = 0.931), and showed good internal consistency based on Cronbach's alpha coefficient (a = 0.865; CI 95%, 0.83-0.89). Conclusions: The scale of concern for COVID-19 infection is a valid and reliable brief measure that can be used for research and professional purposes.

Transmisión del SARS-CoV-2 en escolares durante el primer trimestre del curso 2021/2022 en la provincia de Albacete: incidencia e impacto de las nuevas variantes / Transmission of SARS-CoV-2 in schoolchildren during the first quarter of the 2021/2022 academic year in the province of Albacete: incidence and impact of the new variants

Objetivo: Conocer la evolución de la pandemia COVID-19 en ámbito escolar y los efectos derivados de la incursión de nuevas variantes. Diseño: Estudio observacional descriptivo longitudinal el primer trimestre del curso académico 2021/22. Emplazamiento: Atención comunitaria. Participantes: Alumnado escolarizado en educación infantil, primaria, ESO y bachillerato. Intervenciones: estudio observacional. Mediciones principales: Se calcularon incidencia acumulada porcentual por curso, ámbito de exposición y periodo de seguimiento, porcentaje de casos según estado de vacunación y correlación entre incidencia acumulada semanal escolar y población general. Resultados: Fueron notificados 1.526 casos, con una incidencia acumulada de 3,17% y escolar de 0,48%; 20,9% estaba vacunado. A lo largo del periodo de seguimiento, destaca el cambio en la incidencia a partir de la semana 49/21, coincidiendo con el inicio de circulación de la variante ómicron en España, con aumento de casos secundarios en todos los niveles educativos, especialmente en bachillerato. Se encuentra una correlación alta entre incidencia provincial/escolar (R2 = 0,59). Conclusiones: La incidencia de COVID-19 en el ámbito escolar se ha visto afectada por la circulación comunitaria de nuevas variantes. Se identificaron dos escenarios de propagación coincidentes con el patrón comunitario. Los resultados apoyan la hipótesis de que los centros educativos reflejan la transmisión comunitaria. El refuerzo de las medidas de prevención y vigilancia a nivel comunitario repercutirá favorablemente en los ámbitos escolares(AU)

Objective: The objective of this study was to know the evolution of the COVID-19 pandemic in the school setting, and the effect of the new variants on it. Design: It is an observational longitudinal descriptive study during the first term of the academic year 21/22. Site: Community health services. Participants: Preschool, elementary, secondary, and high school students. Interventions: none. Main measurements: We calculated cumulative incidence stratified by grade, source of infection and follow-up period, percentage of vaccinated cases and correlation between cumulative incidence in schooled children per week and cumulative incidence in the general population. Results: 1526 cases were reported, and the cumulative incidence was 3,17% and 0,48% in within-school acquired cases. 20,9% were vaccinated. During follow-up, there was an important change in incidence from weeks 49/21 on, at the time Omicron began to appear in Spain, with an increase in secondary cases, mostly high school students. We found a high correlation between general population and schooled children's cumulative incidence (R2 = 0,59). Conclusions: SARS-CoV-2 transmission in school settings has been affected by new circulating variants. Two propagation scenarios were identified, and they were like the community propagation pattern. This supports the hypothesis that school settings reflect the transmission in the community. Reinforcement of preventive measures and surveillance would have a positive effect on school settings.(AU)

Transmisión del SARS-CoV-2 en escolares durante el primer trimestre del curso 2021/2022 en la provincia de Albacete: incidencia e impacto de las nuevas variantes.

OBJECTIVE: The objective of this study was to know the evolution of the COVID-19 pandemic in the school setting, and the effect of the new variants on it. DESIGN: It is an observational longitudinal descriptive study during the first term of the academic year 21/22. SITE: Community health services. PARTICIPANTS: Preschool, elementary, secondary, and high school students. INTERVENTIONS: none. MAIN MEASUREMENTS: We calculated cumulative incidence stratified by grade, source of infection and follow-up period, percentage of vaccinated cases and correlation between cumulative incidence in schooled children per week and cumulative incidence in the general population. RESULTS: 1526 cases were reported, and the cumulative incidence was 3,17% and 0,48% in within-school acquired cases. 20,9% were vaccinated. During follow-up, there was an important change in incidence from weeks 49/21 on, at the time Omicron began to appear in Spain, with an increase in secondary cases, mostly high school students. We found a high correlation between general population and schooled children's cumulative incidence (R2 = 0,59). CONCLUSIONS: SARS-CoV-2 transmission in school settings has been affected by new circulating variants. Two propagation scenarios were identified, and they were like the community propagation pattern. This supports the hypothesis that school settings reflect the transmission in the community. Reinforcement of preventive measures and surveillance would have a positive effect on school settings.

COVID-19 and decreased asylum access: mother work, precarity and preocupación among Central American asylum-seekers in Los Angeles.

In 2020, the public health response to the COVID-19 pandemic and the U.S. government's increased legal restrictions on asylum-seekers acted together to increase social, economic and legal precarity in the lives of Central American asylum-seeking mothers in Los Angeles. In this context, these asylum-seeking mothers discussed their intersectional precarities through the idiom of distress "preocupación", which signalled the concerns, worries, and fears they had in relation to the daily mother work of raising their children. Using ethnographic data collected during the COVID-19 pandemic, I examine how the intersectional precarities Central American asylum-seeking mothers faced necessitated protecting their children from their own preocupación. Through this, I argue that by using the analytic of preocupación it is possible to see exactly how racial and legal barriers to care increase precarity in the lives of asylum-seeking mothers in the U.S., and the detrimental impact that intersectional precarities have on asylum-seekers' mother work today.

Topics, Concerns, and Feelings Commented on Facebook after the First Death by COVID-19 in Mozambique / Temas, preocupaciones y sentimientos comentados en Facebook tras la primera muerte por COVID-19 en Mozambique

In Mozambique, as in other parts of the world, COVID-19 has had consequences in many areas, especially in the health sector. This study aims to analyze the comments made and discussed on Facebook after the first death from the disease, verifying the main topics, concerns, and feelings that users most expressed on that social network. Using the content analysis method, IRaMuTeQ® generated a dendrogram focused on death, diagnostic circumstances, disease prevention, and restrictive government measures. Users also raised concerns about health care professionals, family and community, and feelings of sadness. Although the feelings presented reflect the lan-guage used in comments on a social network, and it is impossible to diagnose from them, this study creates paths for further research in the area. Therefore, for the first time, it demonstrates results from a mental health study with data analyzed from a social network in Mozambique. These results can guide and alert local health entities about health communications, strategies, and attention that should be given to the mental health of individuals during this pandemic and in the long term

En Mozambique, como en otras partes del mundo, el COVID-19 trajo consecuencias en muchas áreas, principalmente en el sector de la salud. Este estudio tiene como objetivo analizar los comentarios realizados y discutidos en Facebook después de la primera muerte por la enfermedad, con el fin de verificar los principales temas, preocupaciones y sentimientos que los usuarios más expresaron en esa red social. Utilizando el método de análisis de contenido, IRaMuTeQ® generó un dendrograma con temas enfocados en las circunstancias de la muerte, las circunstancias del diagnóstico, la prevención de enfermedades, y las medidas restrictivas del gobierno. También hubo preocupaciones con los profesionales de la salud, la familia y la comunidad, además de sentimientos de tristeza. Aunque los sentimientos presentados reflejan el lenguaje utilizado en los comentarios en una red social, y no es posible dar un diagnóstico basado en ellos, este estudio abre caminos para futuras investigaciones en el área. Por lo tanto, por primera vez, se demuestra un estudio de salud mental con datos analizados en una red social en Mozambique, y puede servir como ayuda y alerta a las entidades locales de salud sobre comunicaciones de salud, estrategias y atención que se debe dar a la salud mental de las personas durante esta pandemia y a largo plazo

Preocupación por el consumo de drogas entre hombres gais, bisexuales y otros hombres que tienen sexo con hombres usuarios de chemsex en España / Concern about Drug Use Among Gay, Bisexual, and Other Men Who Have Sex With Men Engaged in Chemsex Sessions in Spain

El chemsex, una actividad recreativa y ocasional para la mayoría de los hombres gais,bisexuales y otros hombres que tienen sexo con hombres (GBHSH) que lo practican, se ha asociado aconsecuencias negativas en distintas esferas de la salud. Sin embargo, apenas existe evidencia sobre lapreocupación por el consumo de drogas entre usuarios de chemsex. Objetivos: Estimar la proporciónde hombres GBHSH usuarios de chemsex preocupados por su consumo de drogas e identificar susprincipales determinantes, así como las drogas asociadas a mayor preocupación. Materiales y métodos:Se realizó un estudio online entre mayo y julio de 2020, en el que se analizaron 779 hombres GBHSHque habían participado en sesiones de chemsex en los últimos 12 meses. Se estimó la prevalencia depreocupación por consumo de drogas y se realizó un análisis multivariante para identificar los factoresasociados mediante regresión de Poisson con varianza robusta. Resultados: La preocupación porconsumo de drogas en los últimos 12 meses (31,6%) se asoció de forma independiente con: tenermenos de 40 años, haber pagado dinero a cambio de sexo, el consumo de las drogas más asociadascon la práctica del chemsex, así como con el consumo regular y la inyección de drogas en cualquiercircunstancia. Metanfetamina y mefedrona fueron las drogas que más preocuparon a los usuariosde chemsex. Conclusión: Se evidencia la necesidad de implementar medidas dirigidas a identificar yfavorecer el acceso de los usuarios de chemsex preocupados por su consumo de drogas a los recursossociosanitarios. Asimismo, es importante incrementar la conciencia acerca de los riesgos asociados alconsumo de drogas en esta población, especialmente entre los usuarios con patrones potencialmenteproblemáticos como el uso regular o inyectado de drogas. (AU)

Chemsex, a recreational and occasional activity for the majority of gay, bisexual, and othermen who have sex with men (GBMSM) who engage in it, has been associated with negative consequences in various health spheres. However, there is scarce evidence regarding concerns about drug useamong chemsex users. Objectives: To estimate the proportion of GBMSM engaged in chemsex who areconcerned about their drug use and identify its main determinants, as well as the drugs associated withgreater concern. Materials and Methods: An online study was conducted between May and July 2020,analyzing 779 GBMSM engaged in chemsex sessions in the last 12 months. The prevalence of concernabout drug use was estimated, and a multivariate analysis was performed to identify associated factorsusing Poisson regression with robust variance. Results: Concern about drug use in the last 12 months(31.6%) was independently associated with being under 40 years old, having paid for sex, the use ofdrugs most associated with chemsex practice, as well as regular drug use and drug injection in any circumstance. Methamphetamine and mephedrone were the drugs that most concerned chemsex users.Conclusion: These results show the need to implement measures aimed at identifying and promotingthe access of chemsex users concerned about their drug use to social and health resources. Likewise, itis important to increase awareness about the risks associated with drug use in this population, especiallyamong users with potentially problematic patterns such as regular or injecting drug use. (AU)

Effect of Fear, Concern, and of Risk Factors for Complicated Covid-19 on Self-Care in People in Pre-elderly and Elderly Stages / Efecto del temor, la preocupación y de los factores de riesgo para COVID-19 complicado sobre el autocuidado en personas en etapa de prevejez y vejez / Efeito do medo, preocupação e fatores de risco para COVID-19 complicado no autocuidado em idosos e idosos

Objective. The work sought to determine the effect of the risk factors, fear, and concern on self-care regarding COVID-19 in people in pre-elderly and elderly stages. Methods. Correlational-predictive study, gathered through convenience sampling. The study applied the scale of fear of COVID-19(Huarcaya et al.), the scale of concern about COVID-19 (Ruíz et al.,), and the scale of self-care during the COVID-19 confinement (Martínez et al.,). Descriptive and inferential statistics were applied as the mediation model based on regression. Results. The study had the participation of 333 people, with the majority being women (73.9%). Correlation was found between self-care with the scores from the scale of fear (r = -0.133, p<0.05) and of concern (r = -0.141, p<0.05) regarding COVID-19. The direct effect of the model was c' = 0.16, [95% BCa CI = -0.28, -0.09]. The standardized value for the indirect effect was estimated as c = -0.14, [95% BCa CI= -0.23,-0.09]), which shows existence of a 14.0% effect of the mediating variable on self-care conducts in the prediction model. Conclusion. A direct effect exists of risk factors for COVID-19 complication on self-care, mediated by concern and fear, besides explaining by 14% the self-care conducts for COVID-19. Recommendation is made to address other emotional variables to consider if these increase the prediction.

Objetivo. Determinar el efecto de los factores de riesgo, temor y preocupación sobre el autocuidado ante la COVID-19 en personas en etapa de prevejez y vejez. Métodos. Estudio correlacional-predictivo, recolectado mediante un muestreo a conveniencia. Se aplicó la escala de temor ante el COVID-19(Huarcaya et al.), la escala de preocupación ante el COVID-19 (Ruíz et al.) y la escala de autocuidado durante el confinamiento de COVID-19 (Martínez et al.). Se aplicó estadística descriptiva e inferencial como el modelo de mediación basado en regresión. Resultados. Participaron 333 personas, en su mayoría mujeres, 73.9%. Se halló correlación entre el autocuidado con los puntajes de la escala de temor (r=-0.133, p<0.05) y de preocupación (r=-0.141, p<0.05) ante la COVID-19. El efecto directo del modelo fue de c'=0.16, [95% BCa CI =-0.28,-0.09]. Por su parte, el valor estandarizado para el efecto indirecto se estimó en c=-0.14, [95% BCa CI= -0.23,-0.09]), lo que muestra la existencia de un efecto de 14.0% de la variable mediadora sobre las conductas de autocuidado en el modelo predictor. Conclusión. Existe un efecto directo de los factores de riesgo para complicación de la COVID-19 sobre el autocuidado, mediado por la preocupación y el temor, aunado a que explica en un 14% la conducta de autocuidado para la COVID-19. Se recomienda abordar otras variables emocionales para considerar si estas aumentan la predicción.

Objetivo. Determinar o efeito dos fatores de risco, medo e preocupação no autocuidado diante da COVID-19 em pessoas na fase de velhice e velhice. Métodos. Estudo preditivo-correlacional, coletado por amostragem de conveniência. A escala de medo do COVID-19 foi aplicada(Huarcaya et al.), a escala de preocupação COVID-19 (Ruíz et al.) e a escala de autocuidado durante o confinamento COVID-19 (Martínez et al.). Estatísticas descritivas e inferenciais foram aplicadas como modelo de mediação baseado em regressão. Resultados.Participaram 333 pessoas, sendo a maioria mulheres 73,9%. Foi encontrada correlação entre o autocuidado e os escores da escala de medo (r=-0.133, p<0.05) e preocupação (r=-0.141, p<0.05) diante da COVID-19. O efeito direto do modelo foi c'=0.16, [95% BCa CI =-0.28,-0.09]. Por sua vez, o valor padronizado para o efeito indireto foi estimado em c=-0.14, [95% BCa CI= -0.23,-0.09]), o que mostra a existência de um efeito de 14.0% da variável mediadora sobre o self -comportamentos de cuidado no modelo preditor. Conclusão. Há efeito direto dos fatores de risco para complicações da COVID-19 no autocuidado, mediado pela preocupação e medo, além de explicar 14% do comportamento de autocuidado para a COVID-19. Recomenda-se abordar outras variáveis emocionais para considerar se elas aumentam a previsão.

Sub-lineages of the Omicron variant of SARS-CoV-2: characteristic mutations and their relation to epidemiological behavior / Sub-linajes de la variante Ómicron del SARS-CoV-2: mutaciones características y su relación con el comportamiento epidemiológico

Abstract By the end of 2021, the Omicron variant of SARS-CoV-2, the coronavirus responsible for COVID-19, emerges, causing immediate concern, due to the explosive increase in cases in South Africa and a large number of mutations. This study describes the characteristic mutations of the Omicron variant in the Spike protein, and the behavior of the successive epidemic waves associated to the sub-lineages throughout the world. The mutations in the Spike protein described are related to the virus ability to evade the protection elicited by current vaccines, as well as with possible reduced susceptibility to host proteases for priming of the fusion process, and how this might be related to changes in tropism, a replication enhanced in nasal epithelial cells, and reduced in pulmonary tissue; traits probably associated with the apparent reduced severity of Omicron compared to other variants.

Resumen A finales de 2021 surge la variante Omicron del SARS-CoV-2, el coronavirus responsable de la COVID-19, causando preocupación inmediata, debido al aumento explosivo de casos en Suráfrica, y a su gran cantidad de mutaciones. Este estudio describe las mutaciones características de la variante Ómicron en la proteína de la Espiga (S) y el comportamiento de las sucesivas olas epidémicas asociadas a la circulación de sus sub-linajes en todo el mundo. Las mutaciones en la proteína S descritas están relacionadas con su capacidad para evadir la protección provocada por las vacunas actuales, así como su posible susceptibilidad reducida a las proteasas del hospedero para la preparación del proceso de fusión. Se infiere cómo esto podría estar relacionado con su cambio en el tropismo, con una replicación mayor en las células epiteliales nasales y menor en el tejido pulmonar, rasgos probablemente asociados a su aparente menor gravedad en comparación con otras variantes.

O estágio da concernência e a elaboração do complexo de Édipo: revisitando Winnicott e o caso Piggle / The stage of concern and the elaboration of the Oedipus complex: revisiting Winnicott and the Piggle case / La etapa de preocupación y la elaboración del complejo de Edipo: revisando Winnicott y el caso Piggle

O nosso texto toma como ideia central o referencial winnicottiano, salientando a importância de um bom atravessamento do estágio da concernência (stage of concern) ­ etapa que, a nosso ver, é indispensável para constituir os pilares de um psiquismo relativamente saudável, capaz de enfrentar as mazelas oriundas do conflito edipiano. Para tanto, iniciaremos o trabalho com uma breve descrição do estágio da concernência, seguida das questões relativas à ambivalência característica do Édipo propriamente dito. Por fim, tecemos algumas considerações que objetivam relacionar uma análise do caso Piggle (The Piggle), uma menina de dois anos e meio, cujo tratamento, realizado por D. W. Winnicott, ocorreu em dezesseis encontros, constituindo uma espécie de análise, de acordo com a demanda, tratando, sobretudo, questões ligadas à intensidade de sentimentos ambivalentes não elaborados pela paciente, que anteciparam o seu ingresso no complexo de Édipo antes que ela passasse, fundamentalmente, pelo estágio da concernência.

Our text makes as its central idea the Winnicott's approach, emphasizing the importance of a good crossing of the stage of concern - a stage that, in our view, is essential to constitute the pillars of a relatively healthy psyche, capable of coping with ailments arising from the oedipal conflict. Therefore, we will begin our work with a brief description of the stage of concern, followed by questions relating to the characteristic ambivalence of Oedipus himself. Finally, we make some considerations that aim to connect with an analysis of the Piggle case (The Piggle), a two and a half year old girl, whose treatment, carried out by D.W. Winnicott, occurred during sixteen meetings, constituting a kind of analysis according to demand, dealing with, above all, issues related to the intensity of ambivalent feelings not elaborated by the patient, which anticipated her entry into the Oedipus complex before she went, fundamentally, through the stage of concern.

Nuestro texto toma como idea central el marco winnicottiano, enfatizando la importancia de un buen cruce de la etapa de la preocupación, etapa que, a nuestro juicio, es fundamental para constituir los pilares de una psique rela-tivamente sana, capaz de hacer frente a las dolencias que surgen. del conflicto edípico. Por lo tanto, comenzaremos el trabajo con una breve descripción de la etapa de preocupación, seguida de preguntas relacionadas con la ambiva-lencia característica del propio Edipo. Finalmente, hacemos algunas consi-deraciones que pretenden relacionar un análisis del caso Piggle (The Piggle), una niña de dos años y medio, cuyo tratamiento, realizado por DW Winnicott, ocurrió en dieciséis encuentros, constituyendo una especie de análisis según demanda, abordando, sobre todo, cuestiones relacionadas con la intensidad de sentimientos ambivalentes no elaborados por la paciente, que anticipaban su entrada en el complejo de Edipo antes de pasar, fundamentalmente, por la etapa de la preocupación.

Factores asociados a preocupación y miedo durante la COVID-19 en practicantes preprofesionales de salud

RESUMEN Introducción: Los practicantes preprofesionales de la salud también fueron afectados mentalmente por la COVID-19. Objetivos: Determinar los factores asociados a tener más preocupación y miedo durante la COVID-19 en practicantes preprofesionales de la salud peruanos. Métodos: Estudio transversal con métodos analíticos; participaron 285 estudiantes de diferentes carreras de la salud del sur del Perú; les fueron aplicados 2 test validados localmente, a los resultados se les cruzó con diversas variables socio-educativas. Resultados: Las principales preocupaciones fueron: no podían evitar preocuparse a pesar de las medidas tomadas, incertidumbre por ser una enfermedad impredecible, que su centro laboral tiene muchos riesgos y la percepción de que su capacidad laboral fuera afectada por ser contagiado. Los principales miedos fueron: percepción de que el corazón se aceleraba o que las manos le suden. Quienes se encontraban en algún establecimiento I-3 (sin internamiento) tenían menos preocupación que los de otros (RPa: 0,56; IC 95 %: 0,43-0,72; valor p< 0,001), ajustado por el sexo y la carrera de estudios. A mayor edad había más miedo (RPa: 1,76; IC 95 %: 1,46-2,11; valor p< 0,001), ajustado por 4 variables. Conclusiones: Los practicantes evidenciaron preocupación en relación a lo impredecible que es la enfermedad, riesgos laborales y el poder ser contagiado; además, miedo que causó una aceleración cardiaca muy fuerte y sudor en las manos. Asociado a la preocupación estuvo el nivel del establecimiento de la salud en donde laboraban y asociado al miedo, la edad de los encuestados.

ABSTRACT Introduction: Preprofessional health care practitioners were also mentally affected by COVID-19. Objectives: To determine the factors associated with having more worry and fear during COVID-19 in Peruvian pre-professional health care practitioners. Methods: Cross-sectional study with analytical methods, with the participation of 285 students from different health careers in southern Peru, to whom 2 locally validated tests were applied and crossed with different socio-educational variables. Results: The main concerns were that they could not help worrying despite the measures taken, the uncertainty of being an unpredictable disease, the fact that their workplace has many risks and the perception that their ability to work would be affected by being infected. The main fears were the perception that their heart was racing or that their hands were sweating. Those who were in an I-3 facility (without hospitalization) were less worried than those in other facilities (RPa: 0.56; 95 % CI: 0.43-0.72; p-value< 0.001), adjusted for sex and educational career. In addition, the older the age, the more fear (RPa: 1.76; 95 % CI: 1.46-2.11; p-value< 0.001), adjusted for 4 variables. Conclusions: The practitioners showed concern in relation to the unpredictability of the disease, occupational hazards and the fact that they could be infected; in addition, fear that caused a very strong cardiac acceleration and sweating in the hands. Associated with the concern was the level of the health facility where they worked. Associated with fear was the age of the respondents.

Posttraumatic stress symptoms and interpersonal processes in burn survivors and their partners.

Background: A burn event can elicit symptoms of posttraumatic stress disorder (PTSD) in survivors and their partners and may impact the way these couple members interact with each other. They may try to protect each other from further emotional distress by avoiding talking about the burn event, but they may also show concern towards each other.Objective: The aim of this study was to investigate bidirectional relationships between survivor's and partner's PTSD symptoms and two interpersonal processes: partner-oriented 'self-regulation', which is avoidance-oriented, and 'expressed concern', which is approach-oriented.Method: In this longitudinal multi-centre study, 119 burn survivors and their partners participated. Measures of PTSD symptoms, self-regulation, and expressed concern were administered in the acute phase following the burns, and follow-ups took place up to 18 months postburn. Intra- and interpersonal effects were examined in a random intercept cross-lagged panel model. Exploratory effects of burn severity were also investigated.Results: Within individuals, survivor's expressed concern predicted later higher levels of survivor's PTSD symptoms. In their partners, self-regulation and PTSD symptoms reinforced each other in the early phase postburn. Between the two couple members, partner's expressed concern predicted later lower levels of survivor's PTSD symptoms. Exploratory regression analyses showed that burn severity moderated the effect of survivor's self-regulation on survivor's PTSD symptoms, indicating that self-regulation was continuously related to higher levels of PTSD symptoms over time within more severely burned survivors, but not in less severely burned survivors.Conclusion: PTSD symptoms and self-regulation reinforced each other in partners and possibly also in more severely burned survivors. Partner's expressed concern was related to lower levels of survivor's PTSD symptoms, whereas survivor's expressed concern was related to higher levels of survivor's PTSD symptoms. These findings emphasize the importance of screening for and monitoring PTSD symptoms in burn survivors and their partner and of encouraging couple's self-disclosure.

PTSD symptoms in burn survivors and their partners are related to both avoidance- and approach-oriented interpersonal processes.In partners, higher levels of self-regulation were bidirectionally related to higher levels of posttraumatic stress symptoms.Concern expressed by partners may mitigate posttraumatic stress symptoms in burn survivors.

Parental worry about children: Scale development and validation among Chinese parents of preschool children.

Chinese parents tend to exhibit a high level of worry about their children during the preschool years, which may adversely influence children's mental health. Few studies have investigated the content and intensity of parental worry about children among Chinese parents of preschool children. This study developed and validated the Parental Worry About Children Scale (PWCS) for Chinese parents of preschool children. A pool of 70 items was created after an open-ended questionnaire survey of 1069 Chinese parents of preschool children and an Internet-content analysis, followed by an assessment for content validity by eight experts. Exploratory factor analysis was then conducted with 680 Chinese parents of preschool children, resulting in the formal PWCS consisting of 40 items in four dimensions: physical well-being, psychological well-being, learning/living abilities, and future/uncertain risks. With a sample of 1548 Chinese parents of preschool children, the PWCS demonstrated good structural validity, internal consistency reliability, measure invariance across mothers and fathers, and criterion-related validity. The PWCS may help elucidate the characteristics and antecedents of parental worry about children and the mechanisms underlying its influence on children's mental health in the Chinese context. In clinical practice, this new instrument may facilitate the emergence of effective intervention strategies for alleviating parental worry about children and its negative impact on children's mental health.

Los padres chinos tienden a demostrar un alto nivel de preocupación por sus hijos durante los años de preescolar, lo cual puede influir negativamente en la salud de mental de los niños. En pocos estudios se ha investigado el contenido y la intensidad de la preocupación de los padres por los niños entre los padres chinos de niños en edad preescolar. En este estudio se desarrolló y se validó la Escala de preocupación de los padres por los hijos (Parental Worry About Children Scale, PWCS) para padres chinos de niños en edad preescolar. Se creó un grupo de 70 ítems después de una encuesta abierta de 1069 padres chinos de niños en edad preescolar y un análisis de contenido de internet, seguido de una evaluación de validez del contenido realizada por ocho especialistas. Luego se llevó a cabo un análisis factorial exploratorio con 680 padres chinos de niños en edad preescolar, cuyo resultado fue la PWCS formal que consta de 40 ítems en cuatro dimensiones: bienestar físico, bienestar psicológico, habilidades de aprendizaje/para la vida y riesgos futuros/inciertos. Con una muestra de 1548 padres chinos de niños en edad preescolar, la PWCS demostró una buena validez estructural, fiabilidad de la coherencia interna, invariancia de las medidas entre las madres y los padres, y validez relacionada con el criterio. La PWCS puede contribuir a dilucidar las características y los antecedentes de la preocupación de los padres por los niños y los mecanismos que subyacen a su influencia en la salud mental de los niños en el contexto chino. En la práctica clínica, este nuevo instrumento puede facilitar el surgimiento de estrategias eficaces de intervención para aliviar la preocupación de los padres por los niños y su efecto negativo en la salud mental de los niños.

Variante Ómicron SARS-CoV-2: una nueva variante de preocupación / Ómicron SARS-CoV-2 variant: anew variant of concern

Ha surgido una nueva variante de preocupación de SARS-CoV-2, cuyos efectos en la evolución de la pandemia parecen inciertos. Sin embargo, ha comenzado a surgir evidencia con respecto al comportamiento viral en cuanto a su transmisibilidad, unión a receptor de la célula hospedadora y escape del sistema inmune. Presentamos una revisión actualizada de los datos existentes en la literatura respecto a los aspectos microbiológicos y epidemiológicos que pueden ayudarnos a comprender las futuras investigaciones en esta variante.(AU)

A new variant of concern for SARS-CoV-2 has emerged, the effects of which on the evolution of the pandemic appear uncertain. However, evidence has begun to emerge regarding viral behavior in terms of its transmissibility, receptor binding on the host cell, and escape from the immune system. We present an updated review of the existing data in the literature regarding the microbiological and epidemiological aspects that can help us understand future research on this variant.(AU)

Biological characteristics of SARS-CoV-2 variants of epidemiological interest and their impact on vaccine efficacy and effectiveness. / Características biológicas de las variantes de SARS-CoV-2 de interés epidemiológico y su impacto sobre la eficacia y la efectividad vacunal

Since December 2020, the detection of emerging viral variants of SARS-CoV-2 has attracted the attention of the scientific community and governments at the national and international levels. Some versions of the virus characterized by genetic/evolutionary, epidemiological and/or phenotypic changes have been classified by the WHO as alerts for further monitoring, variants of interest (VOI), or variants of concern (VOC). At the international level, the current situation of variants reflects the sustained advance of the VOC Delta, driving new waves in much of the globe. On the other hand, South America, which exhibits an exceptional landscape of variants dominated by the regionally emerged Gamma (VOC) and Lambda (VOI) begins to face Delta's entry into a dynamic equilibrium of tension between viral evolution, immunity of the population associated with the second wave, and the asymmetry of vaccination campaigns and regional health policies. In this review, we present an update of the latest advances regarding the study of these variants, their potential impact on the epidemiological dynamics and vaccine effectiveness, with a special focus on the Latin American situation of the COVID-19 pandemic, in the second half of 2021.

Desde el mes de diciembre de 2020, la detección de variantes virales emergentes del SARS-CoV-2 ha llamado la atención de la comunidad científica y de los gobiernos a nivel nacional e internacional. Algunas versiones del virus caracterizadas por cambios genéticos, epidemiológicos y/o fenotípicos han sido clasificados por la OMS como variantes para monitoreo adicional, variantes de interés (VOI) o variantes de preocupación (VOC). A nivel internacional la situación actual de variantes refleja el avance sostenido de la VOC Delta, impulsando nuevas olas de infecciones en gran parte del mundo. Por otro lado, América del Sur exhibe un paisaje particular de linajes circulantes, dominado por las variantes de emergencia regional Gamma (VOC) y Lambda (VOI). Esta región empieza a afrontar el ingreso de Delta en un equilibrio dinámico de tensión entre la evolución viral, la inmunidad adquirida de la población asociada a la segunda ola, y la asimetría en las campañas de vacunación y en las políticas sanitarias regionales. En esta revisión presentamos una actualización de los últimos avances relativos al estudio de las variantes virales emergentes del SARS-CoV-2, su potencial impacto en la dinámica epidemiológica y en la efectividad vacunal, con especial foco en la situación regional latinoamericana de pandemia de la COVID-19 en el segundo semestre de 2021.