Sindemia, anomia social y complejidad de la emergencia del COVID-19 / Syndemic, social anomie and complexity of the COVID-19 emergency

La pandemia de COVID-19, declarada en el 2020 por la Organización Mundial de la Salud (OMS), se ha constituido en una de las crisis de mayor impacto para la salud y sus determinantes sociales. Las sindemias se presentan cuando la inequidad sanitaria de la biopolítica predominante manifiesta su control sobre la vida. Para hacer frente a esta sindemia, es necesario comprender, mejorar y tomar en cuenta las determinantes sociales de la salud, con el propósito de propiciar las condiciones del bienestar de la población y reducir las inequidades. La presencia de entornos no saludables, la estigmatización de los enfermos o de los prestadores de servicios de salud, manifestada en actos de agresión y violencia, revelan la anomia social; el momento en que el estado pierde su capacidad de regulación normativa, y que tiene como resultado la resistencia individual y colectiva que repercute en la labor preventiva.El reconocimiento de la sindemia por parte de los actores políticos, sociales y del ciudadano común debe asentarse en un escenario más igualitario y reconsiderar las conductas anómicas. Es necesario empoderar a la población, fomentar la ciudadanía, así como el uso de la evidencia científica, reconfigurar los sistemas de atención a la salud e integrar a la población en las decisiones asumidas e instrumentadas por el estado.La atención de la sindemia y la anomia social, producidas por la pandemia e intensificadas por factores socioeconómicos, requiere la solidaridad ciudadana y la reformulación de la biopolítica de estado

The COVID-19 pandemic, declared in 2020 by the World Health Organization (WHO), has become one of the crises with the greatest impact on health and its social determinants. Syndemics appear when the health inequity of the prevailing biopolitics displays its power over life. In order to face this syndemic, it is necessary to understand, improve and consider the social determinants of health, with the purpose of restoring the well-being conditions of the population and thus reducing social inequities. The presence of unhealthy environments, the stigmatization of the sick or of health service providers manifested through acts of aggression and violence, reveal social anomie; a moment when the state loses its capacity for normative regulation, which can result in forms of individual and collective resistance that have an impact on preventive work.The recognition of the syndemic by the political and social actors and the common citizen must move towards a more egalitarian scenario and reassess anomic behaviors. It is necessary to empower the population, promote citizenship, as well as the use of scientific evidence, reconfigure health care systems and, above all, fully integrate the population into the decisions taken and implemented by the state.Actions against the syndemic and the social anomie resulting from the pandemic and exacerbated by economic-social factors, requires citizen convergence and the reformulation of state biopolitics.

El cuidado de la salud mental y ubicuidad / Mental healthcare and ubiquity

La ubicuidad en salud plantea una serie de estrategias para hacer llegar los servicios de salud donde y cuando sea necesario. La modalidad uHealth surgida en Corea (2006) tiene la finalidad de mejorar la calidad de vida al brindar servicios, productos e información de salud. La atención de la salud en la ubicuidad incluye: eHealth, mHealth, uHeath y pHealth. En la atención a la salud mental se requiere un enfoque preventivo alterno al hospitalario que actualmente prevalece y resulta más favorable en su cobertura aprovechando los vínculos generados con los usuarios. De esta forma, promover la salud mental a través de eHealth para prevenir trastornos mentales, brindar atención, mejorar la recuperación, promover los derechos humanos y reducir la mortalidad, morbilidad y discapacidad de personas con trastornos mentales. Conclusiones: La práctica de enfermería a través de dispositivos digitales promueve nuevas relaciones consigo mismo y con el mundo, es una oportunidad de ampliar las posibilidades de encuentro. La mHealth considera la práctica del cuidado como un acto responsable y racional, de capacidad de las tecnologías digitales para registrar múltiples aspectos corporales y comportamentales, de emergencia de una economía digital y un capital viviente explotable.

The ubiquity in health raises a series of strategies to get health services where and when necessary. The uHealth modality emerged in Korea (2006) in this way has the purpose of improving the quality of life by providing health services, products and information.Health care in ubiquity includes: eHealth, mHealth, uHeath, and pHealth. In mental health care, an alternative preventive approach to the hospital approach is required that currently prevails and that is more favorable in its coverage, taking advantage of the links generated with users. In this way, promoting mental health through eHealth to prevent mental disorders, provide care, improve recovery, promote human rights and reduce mortality, morbidity and disability of people with mental disorders. Conclusions:Nursing practice through digital devices promotes new relationships with oneself and with the world and is an opportunity to expand the possibilities of encounter. MHealth considers the practice of care as a responsible and rational act, of the capacity of digital technologies to register multiple bodily and behavioral aspects, the emergence of a digital economy and an exploitable living capital.

El cuidado de la fibromialgia en la mujer y la importancia de la práctica deportiva / Caring for Fibromyalgia in women and the importance of sport

Introducción: la fibromialgia suele agravarse conel esfuerzo físico, la fatiga, la humedad ambiental,cambios climáticos e incluso por algunos factoreslaborales que tiene que ver con la postura durante eltrabajo.Objetivo: conocer si la práctica deportiva es unaestrategia viable para disminuir las manifestacionesclínicas de la fibromialgia.Metodología: se realizó una revisión sistemática,tomando como palabras claves fibromialgia, deporte,cuidado y mujer, en los últimos diez añosResultados: existen evidencias del efecto positivode la práctica deportiva, del ejercicio aeróbico en lasmanifestaciones de la fibromialgia, además de ser unefecto positivo en el estado de ánimo relacionado conla incidencia de fibromialgia.Conclusiones: la práctica deportiva es unaestrategia viable para disminuir las manifestacionesclínicas de la fibromialgia.

La apropiación de la biomúsica por el cuidador primario de niños con el síndrome de Williams / The Acquiring biomusic by the main healthcare provider of children diagnosed with De Williams syndrome

Enseñar y motivar al cuidador primario de niños con diagnóstico de Síndrome de Williams, a conocer su cuerpo y a cuidarlo fue nuestro principal objetivo, ya que adolecen de herramientas para afrontar el desgaste y estrés. Nuestro abordaje se sustentó en la investigación-acción emprendida por grupos o comunidades con la finalidad de cambiar su situación de vida. La acción se orientó hacia la habilitación de los padres, en la conducción de la biomúsica. En el estudio se diseñaron instrumentos de autoevaluación de la expresión corporal. Los resultados muestran efectos inmediatos de la musicoterapia sobre la expresión corporal manifiestos en la disminución de la resistencia muscular y de las cifras tensionales, así como diversos indicadores de una percepción corporal congruente con la salud.

To teach and to motivate to the primary caregiver of children with diagnosis of Syndrome of Williams, to know its body and to take care of it was our main objective, since they suffer from tools to confront the wearing down and stress. Our boarding sustained in the investigation-action undertaken by groups or communities with the intention of changing its situation of life. The action was oriented towards the rating of the parents, in the conduction of the bio-music. In the study instruments of self-evaluation of the corporal expression were designed. The results show immediately effects of the music therapy under the corporal expression manifest in the diminution of the muscular resistance and of the cipher of blood pressure, just as diverse manifestation sing corporal perception congruent with the health.

Ultrastructural changes in pancreatic beta cells treated with NGF and dbcAMP.

Nerve growth factor (NGF) induces morphological and physiological changes in cultured pancreatic beta-cells, including the extension of neurite-like processes. This latter effect is potentiated by dibutyryl cAMP (dbcAMP). beta-cells cultured under these conditions maintain their immunoreactivity to insulin and gamma-amino-butyric acid (GABA). NGF, dbcAMP, and high glucose concentrations also increase the expression of the GABA-synthesizing enzyme glutamic acid decarboxylase-65 in cultured beta-cells. The aim of this work was to study the effect of NGF alone or in combination with dbcAMP on pancreatic beta-cell ultrastructural morphology, after 10 days in culture. We used light microscopy, scanning electron microscopy, and transmission electron microscopy to analyze the modifications in cell surface and neurite-like projections. Morphometric analysis showed that NGF and/or dbcAMP treatment substantially increased the insulin and GABA content in granules and rough endoplasmic reticulum. Given that pancreatic beta-cells express NGF receptors and that NGF is synthesized and secreted by beta-cells, these results further suggest that NGF could have trophic actions on pancreatic hormone synthesis and/or storage.

Evoked potentials elicited by natural stimuli in the brain of unanesthetized crayfish.

Experiments were conducted to test some characteristics of vision by crayfish underwater and in air, and determine possible motion reactions elicited in response to naturalistic or quasi-ethological visual stimuli. Chronically implanted electrodes on the brain were used to record visually evoked potentials in response to moving bars at different speeds or to fish of different sizes. Electroretinograms were also recorded to detect when an object or a shadow appeared in the crayfish visual field. Ongoing brain activity is mild under basal conditions, but increases in RMS by approximately 6% in response to bar passage and 12 to 53% in response to fish motionless or swimming in front of the crayfish. When crayfish are free to move, fish swimming in front of them elicit intense brain activity, together with displacement toward them and an attempt to grab them. Visual evoked potentials are elicited by moving objects as small as 1 degree at a distance of 30 cm in air as well as underwater. None of the stimuli used induced evident behavioral responses under our conditions. We conclude that vision-action activities can be divided into (a) vision of irrelevant objects with short lasting electrical activity and no motion in response to it; (b) vision of mildly interesting objects with long-lasting electrical effects, but no motion in response to it; and (c) vision of relevant objects with appropriate motion reaction.

Steroids modulate the excitability of crayfish (Procambarus digueti) photoreceptors: long- and short-term actions.

Short- and long-term actions of the steroids corticosterone, progesterone, and ecdysterone were analyzed upon excitability of crayfish retinular cells. The three hormones showed short-term actions, particularly during photoreceptor dark adaptation; effects were found to be dependent on the hour of the day. Corticosterone and progesterone had similar effects, i.e., resembled dark-adapted conditions; ecdysterone actions were opposite and resembled light adaptation. Long-term effects were opposed to short-term effects in all cases. Possible mechanisms underlying these effects are discussed.

Role of corticosterone on the development of passive electrical properties of cultured chick embryo neurons.

We worked with neuronal cells of chick embryo cultures. The cells were obtained from 7 days-old embryos and cultured for 12 days. The experimental group was submitted to a single dose of corticosterone during the first 48 hours of culture. We measured the membrane resting potential at different external potassium concentrations, as well as the passive electrical properties of the membrane, resistance, time constant and capacitance. We found that the control cells develop progressively their potassium permeability and the electrical properties of the membrane until reaching values in this parameters that were similar to those found in adult cells. Corticosterone application induced a significant enhancement in these parameters in 3 and 6 days-old cultures as compared with the control cultures. These results suggest that glucocorticoids accelerate the differentiation process of the neurons in culture when applied at very early stages of development. We discuss the possible mechanisms involved in this action.