Salud Mental en estudiantes universitarios en aislamiento social durante la pandemia COVID-19. Arequipa, Perú

Introducción: La Pandemia COVID-19, ha tenido impactos negativos en la salud física y mental de las personas, así como las medidas adoptadas por los gobiernos, para prevenir el contagio masivo de la población como el confinamiento, el aislamiento social, el trabajo y educación virtual. Dentro de los afectados por estos cambios, se encontrarían los estudiantes universitarios del área de la salud, que además de estudiar en estas condiciones de pandemia, no han podido hacer sus prácticas de los servicios de salud. Esta situación de exposición al aislamiento, podría afectar la salud mental de los jóvenes estudiantes universitarios. Objetivo: determinar los niveles de depresión, ansiedad y estrés en estudiantes universitarios y su relación con variables sociodemográficas y las características del aislamiento social durante la Pandemia COVID-19. Métodos: Se realizó un estudio descriptivo, observacional, de corte transversal y cuantitativo, con una muestra de 818 estudiantes universitarios de facultades de ciencias de la salud, mediante el cuestionario autoadministrado DASS-21. Resultados: Los principales hallazgos fueron: una mayor prevalencia en niveles altos (severos y extremadamente severos) en la ansiedad, alcanzado casi a 4 de cada 10 de los evaluados; por otro lado, en depresión y el estrés, 2 de cada 10 de los evaluados, se encontraron en los niveles mencionados. En relación con las variables sociodemográficas, las relacionadas con el COVID-19 y aislamiento social, se hallaron diferencias estadísticamente significativas con el género (mujeres > varones), el haber tenido COVID-19 (Sí > No) y vivir con familiares como antes de la pandemia (Sí > No) obtuvieron en promedio mayores puntajes en depresión, ansiedad y estrés. Conclusión: Los estudiantes que presentaron mayor depresión, ansiedad y estrés con una diferencia significativa fueron de género femenino, con antecedentes de haber tenido Covid-19, menor contacto con familiares y haber cumplido con aislamiento social total.

Introduction: The COVID-19 Pandemic has had negative impacts on the physical and mental health of people, as well as the measures adopted by governments to prevent the massive contagion of the population, such as confinement, social isolation, virtual work, and virtual education. Among those affected by these changes would be university students in the health area who, in addition to studying in these pandemic conditions, have been unable to do their health service practices. This situation of exposure to isolation could affect the mental health of young university students. Objective: To determine the levels of depression, anxiety, and stress in university students, their relationship with sociodemographic variables, and the characteristics of social isolation during the COVID-19 Pandemic. Methods: A descriptive, observational, cross-sectional, and quantitative study was carried out with a sample of 818 university students from health sciences faculties using the DASS-21 self-administered questionnaire. Results: The main findings were a higher prevalence of high levels (severe and highly severe) in anxiety, reaching almost 4 out of 10 of those evaluated; On the other hand, in depression and stress, 2 out of 10 of those evaluated were found at the mentioned levels. Concerning the sociodemographic variables, those related to COVID-19 and social isolation, statistically significant differences were found with gender (women > men), having had COVID-19 (Yes > No), and living with relatives as before. On average, the pandemic (Yes > No) obtained higher scores in depression, anxiety, and stress. Conclusion: The students who presented greater depression, anxiety, and stress with a significant difference were female, with a history of having had Covid-19, less contact with family members, and having complied with total social isolation

The effects of the COVID-19 pandemic on perceived stress among Romanian young adults: negative affect and avoidant coping as mediators / El impacto de la pandemia COVID-19 en el estrés percibido por jóvenes rumanos: los afectos negativos y las estrategias evasivas como mediadores

Antecedentes y objetivos: Aunque se consideraba que los jóvenes estaban menos expuestos a contraer una forma severa de la infección, los efectos que ellos más resintieron fueron los psicosociales. El presente artículo se propone comprobar el papel mediador de los afectos negativos y de las estrategias evasivas, primero en la relación entre el impacto de la pandemia COVID-19 y el estrés percibido, y luego entre la amenaza percibida y el estrés. Diseño: Se utilizó un diseño transversal. Métodos: Se empleó una muestra de 669 estudiantes de grado (18 - 28 años) durante la cuarta oleada de coronavirus, cuando la variante delta era la dominante. Resultados: Se observaron asociaciones positivas entre el impacto de la pandemia COVID-19 y el estrés percibido (r = .485; p<.001), por un lado, y entre la amenaza percibida y el estrés (r = .283; p< .001), por otro lado. Los datos estadísticos demuestran que los afectos negativos y las estrategias evasivas actúan como mediadores seriales (efecto indirecto = .3349, 95% CI, [.2858; .3852] / (efecto indirecto = .2072, 95% CI, [.1515; .2624]). Consecuentemente, el impacto de la pandemia COVID-19 (β = .137; 95% CI [.0019; .0045]) y la amenaza percibida (β = .069; 95% CI [.0007; .0046]) aumentan el estrés no sólo de manera directa, sino también indirecta, intensificando los afectos negativos. Esto genera una propensión hacia el uso específico de estrategias evasivas de afrontamiento. Conclusiones: El estudio subraya algunos mecanismos explicativos en cuanto a las relaciones entre variables que afectan la salud mental durante la pandemia COVID-19.(AU)

Background and objectives:Although young adults were considered to face a lower risk of severe coronavirus infection, they were at higher risk for adverse psychosocial effects. The aim of this study was to test the me-diating roles of negative affect and avoidant coping, firstly in the relation-ship between COVID-19 impact and perceived stress, and then in the rela-tionship between perceived coronavirus threat and perceived stress. Design:Cross-sectional design. Methods: We conducted the study on a sample of 669 university students (aged between 18-28), during the critical fourth wave, when the delta variant was the dominant strain. Results: The results indicate significant positive associations between the impact of COVID-19 and perceived stress (r = .485; p<.001), and between perceived corona-virus threat and perceived stress (r= .283; p<.001). Our findings demon-strate that negative affect and avoidant coping serially mediate these rela-tionships (total indirect effect = .3349, 95% CI, [.2858; .3852] / (total indi-rect effect = .2072, 95% CI, [.1515; .2624]). Thus, the impact of COVID-19 (β= .137; 95% CI [.0019; .0045]) and perceived coronavirus threat (β= .069; 95% CI [.0007; .0046]) induce an increase in stress not only directly, but also indirectly, through amplified negative affect, which in turn in-creases the specific-oriented use of avoidant coping strategies. Conclusions:Our results highlighted some new explanatory relationships between varia-bles that affect mental health during the COVID-19 pandemic.(AU)

Salud mental: cuando la necesidad queda por fuera de la agenda sanitaria / Mental health: when the need is out of the health agenda

Introducción: Pos-pandemia COVID-19 los centros de salud vieron incrementados el número de consultas en salud mental (SM). Objetivos: -Evidenciar el aumento de la demanda en SM pos-pandemia. Pre y pos-pandemia: -Comparar las características de demanda en SM -Relevar las demandas del área judicial (DAJ) -Evaluar la dispensa de psicofármacos (PF) Material y Métodos: Trabajo descriptivo, retrospectivo, poblacional. Pacientes atendidos en SM del Área Programática del Hospital Penna. Se obtuvieron consultas de psicología (PSI) psiquiatría y psicopedagogía, motivo de consulta, edad, sexo, dispensa de psicofármacos (PF) desde el 1/01 al 31/12/2019 y mismo período 2022. Los datos se analizaron en frecuencia, porcentaje. Resultados: Las consultas pos-pandemia aumentaron un 8%, los pacientes atendidos aumentaron 37.91%. Las consultas PSI pediatría/adolescencia descendieron 6.5% en 2022 predominando niños en 2019 y niñas en 2022. En adultos aumentó 20.10%, predominando mujeres ambos períodos. Si bien consumo, violencia y angustia fueron nombrados en ambos periodos, pobreza apareció en 2022. Las DAJ aumentaron más del 1000%. La dispensa PF aumentó más del 100%. Conclusiones: En pos-pandemia aumentaron las consultas de PSI y los DAJ. El aumento en dispensa PF evidencia el deterioro y la complejidad de la SM pos-pandemia. Estos datos, plantea la necesidad de incorporar nuevos profesionales

Introduction: Post- COVID-19 pandemic, health care centers increased the number of mental health (MH) consultations. Objectives: - Evidence the increase in demand for SM post-pandemic. Pre and post-pandemic: -Compare the characteristics of demand in SM -Review the demands of the judicial area (DAJ) -Evaluate the dispensation of psychotropic drugs (PF) Material and Methods: Descriptive, retrospective, population-based study. Patients treated in SM at the Programmatic Area of the Penna Hospital. Consultations from psychology (PSI), psychiatry and psychopedagogy, reason for consultation, age, sex, dispensation of psychotropic drugs (PF) were obtained from 01/01 to 12/31/2019 and the same period 2022. The data was analized in frequency and percentage. Results: Post-pandemic consultations increased by 8%, patients treated increased by 37.91%. Pediatric/adolescent PSI consultations decreased 6.5% in 2022, with boys predominating in 2019 and girls in 2022. In adults it increased 20.10%, with women predominating in both periods. Although consumption, violence and distress were mentioned in both periods, poverty appeared in 2022. The DAJ increased more than 1000%. The PF dispensation increased more than 100%. Conclusions: In the post-pandemic, PSI and DAJ consultations increased. The increase in FP dispensation shows the deterioration and complexity of post-pandemic SM. These data raise the need to incorporate new professionals

Incremento de infecciones respiratorias agudas graves en niños durante la última etapa de la pandemia COVID-19 / Increase in severe acute respiratory infections in children during the last phase of the COVID-19 pandemic

Objetivo. La pandemia COVID-19 ha causado una variación en la circulación de otros patógenos respiratorios. Nuestro objetivo fue analizar la epidemiología de las infecciones respiratorias agudas graves (IRAG) en niños durante 3 años de pandemia COVID-19, en comparación con un período previo de la misma dimensión temporal. Pacientes y métodos. Estudio observacional, realizado en un hospital terciario de España, que analizó la frecuencia y características de pacientes ingresados por IRAG en la Unidad de Cuidados Intensivos Pediátricos (UCIP) durante la pandemia COVID-19 (1 marzo-2020 a 28 de febrero-2023), en relación a un período pre-pandemia (1 marzo-2017 a 29 febrero-2020). Resultados. Se incluyeron 268 pacientes (59,6% varones). La mediana de edad fue 9,6 meses (RIQ 1,7 – 37). En el período pre-pandemia hubo 126 ingresos con una media de 42 admisiones/año. Durante la pandemia se produjeron 142 ingresos, observándose una reducción significativa de admisiones en el primer año (12 ingresos/año), en contraste con 82 ingresos durante el tercer año, que representó un incremento del 95% respecto a la media de admisiones/año en pre-pandemia. Además, en el último año se evidenció un incremento de coinfecciones virales en relación al período prepandemia (54,9% vs 39,7%; p=0,032). No hubo diferencias en días de hospitalización, ni estancia en UCIP. Conclusiones. Durante el último año, coincidiendo con bajas tasas de hospitalización por COVID en España, observamos un notable incremento de ingresos en la UCIP por IRAG por otras causas. Probablemente, el período prolongado de baja exposición a patógenos por las medidas adoptadas durante la pandemia, ha provocado una disminución de la inmunidad poblacional con un repunte de infecciones respiratorias. (AU)

Objective. The COVID-19 pandemic has caused a variation in the circulation of respiratory pathogens. Our aim was to analyze the epidemiology of severe acute respiratory infections (SARI) in children during 3 years of the COVID-19 pandemic, in comparison with a previous period. Patients and Methods. An observational study was conducted in a tertiary hospital in Spain, which analyzed the frequency and characteristics of patients admitted for SARI in the Pediatric Intensive Care Unit (PICU) during the COVID-19 pandemic (1 March 2020 to 28 February 2023), compared to pre-pandemic period (1 March 2017 to 29 February 2020). Results. A total of 268 patients were included (59.6% males). The median age was 9.6 months (IQR 1.7 – 37). In the pre-pandemic period, there were 126 admissions with an average of 42 admissions/year. During the pandemic, there were 142 admissions, observing a significant reduction in admissions in the first year (12 admissions/year), in contrast to 82 admissions during the third year, which represented an increase of 95% compared to the average of admissions/year in pre-pandemic. In addition, in the last year there was evidence of an increase in viral coinfections in relation to pre-pandemic period (54.9% vs 39.7%; p=0.032). There were no differences in length of hospital stay or PICU stay. Conclusions. During the last year, coinciding with low rates of hospitalization for COVID in Spain, we observed a notable increase in admissions to the PICU for SARI. Probably, the prolonged period of low exposure to pathogens due to the measures adopted during the pandemic might have caused a decrease in population immunity with a rise in severe respiratory infections. (AU)

Percepción del efecto de la pandemia en la salud y formación del estudiante de posgrado de pediatría en Uruguay

Introducción: La pandemia impactó en la calidad de vida, salud integral y formación de los estudiantes de posgrados a nivel mundial. Objetivos: Describir la percepción del efecto de la pandemia en la salud integral y formación académica de estudiantes de posgrado de pediatría de Uruguay durante los años 2019- 2021. Metodología: Estudio descriptivo, transversal mediante encuesta a estudiantes de las generaciones 2019, 20 y 21. Se analizaron variables sociodemográficas y percepción del efecto de la pandemia en calidad de vida, salud, formación académica y rendimiento. Resultados: Participaron 93 estudiantes (65% de los habilitados). La mediana de edad fue 30,5 años, de género femenino: 88%. Cursaron la especialidad por residencia: 78,4%, en Montevideo 96%. El 41,3% expresó que cursar el posgrado durante la pandemia repercutió de forma negativa en su calidad de vida. Reportando reducción de actividades sociales: 83,3%, oferta laboral: 33,3%. Manifestaron sentirse agotados: 84%, fatigados: 64,4%. Se le diagnosticó una enfermedad nueva a 12,2% trastorno de ansiedad 5, depresión 4; reportaron consumo de psicofármacos durante la pandemia 13,3% versus 5,5% previo a esta. Consideraron que su formación se afectó negativamente: 57,3% y afectación del rendimiento: 38,2%. Refirieron obstáculos en la participación de actividades virtuales: 94,3%, por superposición con otras actividades: 85,3%, o problemas de concentración: 22,4%. Conclusiones: Los encuestados reportaron efectos de la pandemia en su salud, sobre todo en el área psicoemocional, con repercusión en su calidad de vida. El efecto en la formación fue menor, identificándose puntos a mejorar, sobre todo evitar la superposición de actividades.

Summary: Introduction: The pandemic impacted the quality of life, comprehensive health and training of postgraduate students worldwide. Objectives: Describe the perception of the effect of the pandemic on the comprehensive health and academic training of postgraduate pediatrics students in Uruguay during the years 2019-2021. Methodology: Descriptive, cross-sectional study using a survey of students from the 2019, 20 and 21 generations. Sociodemographic variables and perception of the effect of the pandemic on quality of life, health, academic training and performance were analyzed. Results: 93 students participated (65% of those qualified). The median age was 30.5 years, female: 88%. They studied the specialty through residency: 78.4%, in Montevideo 96%. 41.3% expressed that pursuing postgraduate studies during the pandemic had a negative impact on their quality of life. Reporting reduction in social activities: 83.3%, job offer: 33.3%. They reported feeling exhausted: 84%, fatigued: 64.4%. 12.2% were diagnosed with a new illness: anxiety disorder 5, depression 4; 13.3% reported consumption of psychotropic drugs during the pandemic versus 5.5% before it. They considered that their training was negatively affected: 57.3% and performance was affected: 38.2%. They reported obstacles in participating in virtual activities: 94.3%, due to overlap with other activities: 85.3%, or concentration problems: 22.4%. Conclusions: Respondents reported effects of the pandemic on their health, especially in the psychoemotional area, with an impact on their quality of life. The effect on training was minor, identifying points for improvement, especially avoiding overlapping activities.

Introdução: A pandemia impactou a qualidade de vida, a saúde integral e a formação de estudantes de pós-graduação em todo o mundo. Objetivos: Descrever a percepção do efeito da pandemia na saúde integral e na formação acadêmica dos estudantes de pós-graduação em pediatria no Uruguai durante os anos 2019-2021. Metodologia: Estudo descritivo, transversal, através de inquérito a estudantes das gerações 2019, 20 e 21. Foram analisadas variáveis ​​sociodemográficas e percepção do efeito da pandemia na qualidade de vida, saúde, formação acadêmica e desempenho. Resultados: participaram 93 alunos (65% dos aprovados). A mediana de idade foi de 30,5 anos, sexo feminino: 88%. Estudaram a especialidade por meio de residência: 78,4%, em Montevidéu 96%. 41,3% expressaram que a realização de estudos de pós-graduação durante a pandemia teve um impacto negativo na sua qualidade de vida. Relatando redução de atividades sociais: 83,3%, oferta de emprego: 33,3%. Relataram sentir-se exaustos: 84%, fatigados: 64,4%. 12,2% foram diagnosticados com alguma doença nova: transtorno de ansiedade 5, depressão 4; 13,3% relataram consumo de psicotrópicos durante a pandemia versus 5,5% antes dela. Consideraram que o seu treino foi afetado negativamente: 57,3% e o desempenho foi afetado: 38,2%. Relataram obstáculos na participação em atividades virtuais: 94,3%, por sobreposição com outras atividades: 85,3%, ou problemas de concentração: 22,4%. Conclusões: Os entrevistados relataram efeitos da pandemia na sua saúde, especialmente na área psicoemocional, com impacto na sua qualidade de vida. O efeito no treinamento foi mínimo, identificando pontos de melhoria, principalmente evitando sobreposição de atividades.

Characteristics of endemic human Coronavirus infections during times of COVID-19 pandemic / Características de las infecciones causadas por Corona virus humanos endémicos durante la pandemia COVID-19

Abstract Introduction : After the implementation of mitigation strategies during the COVID-19 pandemic, the incidence of respiratory viruses, including human coronaviruses (HCoV), experienced a significant decrease. The aim of this study is to characterize the epidemiology and clinical aspects of HCoV infections in ambulatory adults during COVID-19 pandemic times. Methods : descriptive, prospective, longitudinal study performed in a private hospital in La Plata, Buenos Aires, Argentina between November 2020 and October 2022; 458 outpatient adults with upper respiratory tract infections (URTI) were studied undergoing clinical and microbiological follow-up. Results : 44 (9.6%) subjects were positive by multiplex PCR for HCoV. 14 of them for 229E (31.8%), 13 for OC43 (29.5%), 11 for HKU-1 (25.1%) and 6 for NL63 (13.6%). A repeated PCR was positive for the same HCoV in 19 (57%) of 33 patients on day 3-5. No hospitalizations or deaths were reported. Discussion : Endemic HCoV caused a significant pro portion of URTI among outpatient adults during COVID- 19-related restrictions times. An alternating pattern of circulation between alfa-HCoV and beta-HCoV was observed.

Resumen Introducción : Tras la implementación de estrate gias de mitigación durante la pandemia de COVID-19, la incidencia de virus respiratorios, incluyendo los coronavirus humanos (HCoV), disminuyó significati vamente. El objetivo de este estudio es caracterizar la epidemiología y los aspectos clínicos de las infecciones por HCoV en adultos ambulatorios durante la pandemia de COVID-19. Métodos : estudio descriptivo, prospectivo, longitudi nal, realizado en un hospital privado de La Plata, Buenos Aires, Argentina, entre noviembre de 2020 y octubre de 2022. Se estudiaron 458 pacientes adultos ambulatorios con infecciones del tracto respiratorio superior (ITRS) bajo seguimiento clínico y microbiológico. Resultados : 44 (9.6%) sujetos fueron positivos por PCR multiplex para HCoV. Se detectaron 14 229E (31.8%), 13 OC43 (29.5%), 11 HKU-1 (25.1%) y 6 NL63 (13.6%). Una segunda PCR fue positiva para el mismo HCoV en 19 (57 %) de 33 pacientes en los días 3-5. No se reportaron hospitalizaciones ni muertes. Discusión : los HCoV endémicos causaron una pro porción significativa de ITRS entre pacientes adultos ambulatorios durante los tiempos de restricciones rela cionados con COVID-19. Se observó un patrón alternante de circulación entre alfa-HCoV y beta-HCoV.

". . . Mas agora é outro sentido": uma leitura do trauma nas tecituras do trabalho psíquico adolescente / " . . . But now it has different meaning:" a reading of trauma in the textures of adolescent psychic work / " . . . Pero ahora es otro sentido": una lectura del trauma en las tramas del trabajo psíquico adolescente / « . . . Mais maintenant est un autre sens ¼ : une lecture du trauma dans les tessitures du travail psychique adolescent

Resumo Este estudo objetiva discutir possíveis incidências e vicissitudes do traumático, considerando a pandemia covid-19, a partir das narrativas de adolescentes participantes do Projeto Jovem Aprendiz, em uma pesquisa-intervenção de caráter psicanalítico, com 26 adolescentes separados em dois grupos, entrevistados em quatro encontros. As narrativas evidenciaram um encurtamento de experiências, achatamento do tempo psíquico e dificuldade de elaboração, culminando em sentimentos de paralisia e inibição, dificuldade de projetar futuro e perfazer a experiência adolescente. Os encontros foram tomados, pelos adolescentes, enquanto medida potencializadora de fala, pois engendraram uma oferta de escuta, com possibilidades de produção de saídas simbólicas da experiência imobilizante do trauma. Tomamos a escrita do Diário de Anne Frank como inspiração para pensarmos sobre a fala que se forma pela função de escuta e desejo relacionado ao ato analítico. Consideramos fundamental, no trabalho com adolescentes, produzir janelas de abertura e espaços de fala engendrados pelo desejo e oferta de escuta.

Abstract This study aims to discuss possible incidences and vicissitudes of trauma, considering the COVID-19 pandemic, from the narratives of adolescents participating in the Young Apprentice Project, in a psychoanalytical research-intervention, with 26 adolescents separated into two groups, interviewed in four meetings. The narratives highlighted a shortening of experiences, a flattening of psychic time, and difficulties in elaboration, culminating in feelings of paralysis and inhibition, difficulty in projecting the future and making up the adolescent experience. The meetings were taken, by the adolescents, as a speech potentiating measure, since it engendered an offer of listening, with possibilities of producing symbolic outlets from the immobilizing experience of trauma. We took the writing of Anne Frank's Diary as inspiration to think about the speech engendered by the listening function and the desire regarding the analytical act. We consider it essential, while working with adolescents, to produce opening windows and spaces of discussion engendered by the desire and the offer of listening.

Resumen Este estudio tiene como objetivo discutir las posibles incidencias y vicisitudes de lo traumático durante la pandemia de la covid-19 a partir de las narrativas de adolescentes participantes del Proyecto Joven Aprendiz; para ello, se realizó una investigación-intervención psicoanalítica, con la aplicación de entrevistas a 26 adolescentes separados en dos grupos durante cuatro encuentros. Los relatos evidenciaron un acortamiento de las vivencias, aplanamiento del tiempo psíquico y dificultad en la elaboración, culminando en sentimientos de parálisis e inhibición, dificultad para proyectar el futuro y completar la experiencia adolescente. Los encuentros fueron considerados por los adolescentes como una medida potenciadora del habla, puesto que permiten la escucha, con posibilidades de producir salidas simbólicas de la experiencia inmovilizadora del trauma. Se tomó como inspiración el Diario de Anne Frank para pensar el discurso que se crea desde la función de escucha y el deseo relacionado con el acto analítico. Es fundamental, en el trabajo con adolescentes, generar espacios de apertura y de discurso basados en el deseo y la oferta de escucha.

Résumé Cette étude a pour objectif de discuter de possibles incidences et vicissitudes du traumatique, en considérant la pandémie de covid-19, à partir des narrations d'adolescents participants au Projet Jeune Apprenti, dans une recherche-intervention de caractère psychanalytique, avec 26 adolescents répartis en deux groupes, interviewées dans quatre rencontres. Les narrations ont mis en évidence un raccourcissement d'expériences, un aplatissement du temps psychique et une difficulté d'élaboration, culminant en sentiments de paralysie et d'inhibition, en une difficulté de projeter l'avenir et de parfaire l'expérience adolescente. Les rencontres ont été prises, par les adolescents, en tant que mesure potentialisatrice de parole, car elles ont engendré une offre d'écoute, avec des possibilités de production d'issues symboliques de l'expérience immobilisante du trauma. Nous avons pris l'écriture du Journal d'Anne Frank comme inspiration pour penser sur la parole engendrée par la fonction d'écoute et de désir relationné à l'acte analytique. Nous considérons comme fondamental, dans le travail avec des adolescents, de produire des fenêtres d'ouvertures et des espaces de parole engendrés par le désir et l'offre d'écoute.

Beneficios de la atención telefónica durante la pandemia covid19 en la adherencia terapéutica en pacientes con alcoholismo y otras adicciones / Advantages of telephone assistance on adherence to treatment in patients with alcohol and other addictions during the Covid19 pandemic

La pandemia por covid19 ha generado muchas publicaciones acerca de su influencia en el tratamiento y evolución de personas con un trastorno por uso de sustancias, con resultados contradictorios, a veces basadas en datos y otras en inferencias indirectas de otros datos. En este trabajo se estudia la adherencia y tasas de abstinencia de pacientes que inician tratamiento en una Unidad de Conductas Adictivas durante la pandemia, respecto a otros que acudieron el año previo y comparando los que hicieron visita presencial o telefónica. Los resultados indicaron mejor adherencia al mes de seguimiento en los pacientes del periodo covid19 y en los que fueron atendidos telefónicamente. A los 3 y 12 meses se mantuvo una mejor adherencia, aunque no significativa estadísticamente. Respecto a la abstinencia, el pequeño tamaño de la muestra dificultó obtener diferencias significativas. Se concluye que la pandemia, aunque ha significado una disminución del número de inicios de tratamientos por consumo de sustancias, también ha repercutido en una mayor adherencia a corto y medio plazo. La atención telefónica puede jugar un papel importante y positivo en este aspecto, complementario a otros recursos e intervenciones. (AU)

The Covid19 pandemic has led to many publications about its influence on the treatment and evolution of individuals with a substance use disorder, leading to contradictory results. In this study, the adherence and abstinence rates of patients who started treatment in an Addictive Behavior Unit during the pandemic are analyzed, compared with others who attended the previous year and comparing those who were attended in person or by phone. The results indicate that during the Covid19 period, patients had greater adherence to treatment after one month of follow up and when attended to by phone. At 3 and 12 months, greater adherence was maintained, although it was not statistically significant. Regarding abstinence, the small sample size made it difficult to obtain significant differences. The conclusion is that, despite a quantitative decrease in the number of patients beginning drug treatment, in qualitative terms the pandemic led to greater adherence in the short and medium term. Telephone attention can play an important and positive role at this point, complementary to other resources and interventions. (AU)

Ergonomia en actividades académicas desde casa

Introducción: A consecuencia de la emergencia sanitaria por el virus SARS-CoV2, las actividades académicas migraron de forma repentina a un entorno de trabajo remoto; esto provocó que los hogares de todo el mundo se convirtieran en el asentamiento urgente de las estaciones de trabajo académico. La ergonomia como disciplina científica cobra relevancia al ser un aliado subsanador para mitigar los riesgos asociados con la aparición de lesiones musculoesqueléticas. De acuerdo con la memoria estadística del Instituto Mexicano de Seguridad Social, IMSS1, en el primer año de pandemia de COVID-19 se registraron 30 860 atenciones por lesiones en la región de manos y muñecas, 9696 en la zona de cabeza y cuello, 6251 dorsopatías y 1673 atenciones por astenopia a jóvenes de entre 18 a 29 años que desarrollaban actividades escolares. Objetivo: En este sentido, se aborda la presente investigación para conocer la composición de los espacios de trabajo académico en casa y analizar si existen factores o elementos que incidan en el riesgo de lesiones musculoesqueléticas en los estudiantes del nivel superior. Metodología: A través de un modelo de ecuaciones estructurales que cuenta con el constructo latente de las posibles lesiones (PL) en manos, espalda, piernas, cabeza, vista, oído, agotamiento físico y la respiración, las variables observables se atribuyen a los espacios utilizados para las actividades académicas en casa, muebles y equipos, Condiciones y Medio Ambiente (CyMAT). Resultados y discusión: Se encontró que un mal diseño de la estación de trabajo académico en casa, aunado a la utilización inadecuada de los muebles y equipos, aumenta la posibilidad de presentar síntomas asociados con las LMEs y, por tanto, daños en la salud del estudiante. Conclusión: La mediación de las estaciones de trabajo a través de la implementación de elementos ergonómicos mejora de forma sustancial la calidad de trabajo académico en casa, y hace evidente la importancia de la ergonomía como disciplina científica.

Introduction: As a result of the health emergency of the SARS-CoV2 virus, academic activities suddenly migrated to a remote work environment, causing homes around the world to become the urgent settlement of academic workstations. Ergonomics as a scientific discipline becomes relevant as it is a healing ally to mitigate the risks associated with the appearance of musculoskeletal injuries. According to the statistical report of the Mexican Institute of Social Security, IMSS1, in the first year of the COVID 19 pandemic, 30,860 care for injuries in the hands and wrists region, 9,696 in the head and neck area, 6,251 dorsopathies and 1,673 care for asthenopia were registered to young people between 18 and 29 years old who develop school activities. Objective: In this sense, this research is addressed to know the composition of academic workspaces at home and analyze if some factors or elements affect the risk of musculoskeletal injuries in students of the higher level. Methodology: Through a structural equations model that has the latent construct of possible injuries (PL) in the hands, back, legs, head, eyesight, hearing, physical exhaustion, and breathing; the observable variables are attributed to the spaces used for academic activities at home, furniture and equipment, conditions and environment (CyMAT) Results and discussion: It is explored that a bad design of the academic workstation at home coupled with the inappropriate use of furniture and equipment increases the possibility of presenting symptoms associated with SCI and therefore, damage to the student's health. Conclusion: The mediation of workstations through the implementation of ergonomic elements substantially improves the quality of academic work at home, making evident the importance of ergonomics as a scientific discipline

Atividades de extensão em enfermagem: Medidas excecionais em tempos de pandemia por COVID-19 / Extension activities in nursing: Exceptional measures during the COVID-19 pandemic / Actividades de extensión en enfermería: medidas excepcionales en tiempos de pandemia por COVID-19

Resumo Enquadramento: A Escola Superior de Enfermagem de Coimbra, ciente do valor das unidades de extensão na articulação do tripé Ensino-Investigação-Extensão tem na sua estrutura a Unidade de Prestação de Serviços à Comunidade e Coordenação das Atividades de Extensão na Comunidade (UPSCCAEC). Objetivo: Descrever o trabalho desenvolvido pela UPSCCAEC em 2019 e 2020, destacando a sua capacidade adaptativa mediante a pandemia pela COVID-19. Principais tópicos em análise: Utilizaram-se como fonte de dados os relatórios de atividades realizadas no contexto da UPSCCAEC nos anos civis de 2019 e 2020, e realizou-se a comparação com achados nos dois anos, os quais foram discutidos à luz do referencial teórico disponível, considerando a pandemia COVID-19 e o impacte a nível das Instituições do Ensino Superior (IES) em seus processos formativos, de investigação e extensão. Conclusão: A atividade da UPSCCAEC nos referidos anos contribuiu para a afirmação da instituição, do desenvolvimento académico, e constituiu recurso de excelência na resposta aos atuais desafios da sociedade, particularmente num período caracterizado por enorme turbulência resultante da pandemia COVID-19.

Abstract Background: The Nursing School of Coimbra knows the importance of extension units in the articulation between teaching, research, and extension. For this reason, the School has a Service Provision and Community Extension Activities Coordination Unit (UPSCCAEC). Objective: To describe the work developed by the UPSCCAEC in 2019 and 2020, highlighting its adaptive capacity in the face of the COVID-19 pandemic. Main topics under analysis: The reports of activities carried out within the scope of the UPSCCAEC in 2019 and 2020 were used as a data source. A comparison was made with findings in the two years, discussed based on the available theoretical framework and considering the COVID-19 pandemic and its impact on Higher Education Institutions' training, research, and extension processes. Conclusion: The UPSCCAEC's activity in those years contributed to the institution's excellence and academic development and successful response to the current societal challenges in a time of great instability due to the COVID-19 pandemic.

Resumen Marco contextual: La Escuela Superior de Enfermería de Coímbra, consciente del valor de las unidades de extensión en la articulación del trípode Enseñanza-Investigación-Extensión, cuenta en su estructura con la Unidad de Prestación de Servicios a la Comunidad y Coordinación de Actividades de Extensión Comunitaria (UPSCCAEC). Objetivo: Describir el trabajo desarrollado por la UPSCCAEC en 2019 y 2020, y destacar su capacidad de adaptación frente a la pandemia por COVID-19. Principales temas en análisis: La fuente de datos utilizada fueron los informes de las actividades realizadas en el marco de la UPSCCAEC en los años civiles de 2019 y 2020, y se realizó una comparación con los hallazgos en ambos años, los cuales se discutieron considerando el marco teórico disponible, la pandemia del COVID-19 y el impacto en las Instituciones de Educación Superior (IES), en sus procesos de formación, investigación y extensión. Conclusión: La actividad de la UPSCCAEC en estos años contribuyó a la afirmación de la institución, al desarrollo académico y constituyó un recurso de excelencia para responder a los desafíos actuales de la sociedad, particularmente en un período caracterizado por enormes turbulencias derivadas de la pandemia del COVID-19.

Estilo de vida, hábitos de higiene oral y autopercepción del estado anímico en estudiantes de Odontología de la Comunidad de Madrid durante la pandemia de la COVID-19: ¿pudo la pandemia tener algún efecto favorable? / Lifestyle, oral hygiene habits and self-perception of mood in Dental students of the Community of Madrid during the COVID-19 pandemic: could the pandemic have any favorable effect?

Fundamentos: La pandemia de la COVID-19 y sus medidas de control parecen haber alterado la dinámica vital de la población. Fue justificable, por tanto, tratar de precisar el impacto sobre el estilo de vida, la higiene bucodental y el estado anímico, en grupos específicos, como estudiantes universitarios de Odontología de Madrid, que nos eran accesibles.Métodos: Se realizó un estudio observacional transversal anónimo y voluntario en la primera quincena de diciembre de 2021, mediante cuestionario online ad hoc, en estudiantes de Odontología de universidades de la Comunidad Autónoma de Madrid (CAM). Se realizó análisis descriptivo de las variables y se valoraron las asociaciones y significación con Chi-cuadrado y T-student. Resultados: Se recibieron setenta y dos encuestas. El 82% eran mujeres y el 18% varones, con 23±3 años de media. El 94% tenía buenos hábitos de higiene oral, que mejoraron con la pandemia. Su dieta habitual era variada y completa. Las mujeres consumían menos carne (p=0,014) y más fruta (p=0,066), hábitos que mantenían, y mejoraron los varones con incremento en frutas (p<0,002), verduras y legumbres (p<0,003) en la pandemia. El consumo de tabaco (23,4%) y alcohol (54%) disminuyó en confinamiento y subió en postconfinamiento. Un 36% aumentó, especialmente en postconfinamiento, su actividad física, antes baja. Conclusiones: Los estudiantes de la muestra tienen buenos hábitos de higiene oral y alimentación que mantienen e incluso mejoran con la pandemia, incluido un incremento del ejercicio físico en una fracción importante de la muestra. El confinamiento afecta al estado anímico y las relaciones sociales, llegando a alterar el sueño de las mujeres, con aumento de despertares nocturnos, sobre todo, en postconfinamiento.(AU)

Background: The COVID-19 pandemic and its control measures seem to have altered the vital dynamics of the population. It was justifiable, therefore, to try to specify the impact on lifestyle, oral hygiene and mood, in specific groups, such as dental university students in Madrid, who were accessible to us. Methods: An anonymous and voluntary cross-sectional observational study was carried out in the first fortnight of December 2021, through an ad hoc online questionnaire, in dentistry students from the Autonomous Community of Madrid. Descriptive analysis of the variables was performed and the associations and significance were assessed using Chi-square and T-student. Results: There were received seventy-two surveys. 82% were women and 18% men, with 23±3 years of mean age. 94% had good oral hygiene habits that improved with the pandemic. Their usual diet was varied and complete. Women consumed less meat (p=0.014) and more fruit (p=0.066), habits that they maintained, and men have improved with an increase in fruits (p<0.002), vegetables and legumes (p<0.003) in the pandemic. Tobacco (23,4%) and alcohol (54%) consumption decreased in confinement and increase in post-confinement. 36% increased their physical activity, initially low, especially in post-confinement. Conclusions: The students in the sample have good oral hygiene and eating habits, which they keep and even improve with the pandemic, including an increase in physical exercise in a significant fraction of the sample. The confinement affect the mood and social relationships, even altering the sleep of women, with an increase in night awakenings, especially in post-confinement.(AU)

Análise de situações de trabalho na fiscalização sanitária de medicamentos da agência reguladora federal / Analysis of work scenarios in the sanitary enforcement of medicines from the federal regulatory agency

Resumo Este estudo analisa as situações de trabalho vividas pelos profissionais na fiscalização sanitária de medicamentos da Agência Nacional de Vigilância Sanitária, durante a pandemia de COVID-19. Estudo de caso único, de natureza qualitativa, com abordagem ergológica. Os dados foram produzidos entre 2020 e 2021, por meio de 18 entrevistas e observação participante em três reuniões de trabalho online. As práticas discursivas foram sistematizadas em mapas ergodialógicos, resultando em três categorias: os trabalhos vividos na fiscalização dos medicamentos; as variabilidades do contexto organizacional e as renormalizações frente à pandemia. As fragilidades dos sistemas de informação, o marco regulatório desatualizado, o modelo de atuação, a fragmentação do trabalho, dentre outros, ocasionaram entraves à realização da atividade pelo profissional. A conformação de novo modo de fazer fiscalização envolve a combinação de intervenções direcionadas à prevenção, detecção e resposta ao consumo de medicamentos nocivos à saúde. A transformação necessária ultrapassa a função restrita de controle e punição e se consolida como um novo modelo de atuação proativo e dinâmico, baseado na gestão do risco sanitário e na implantação das Boas Práticas de Fiscalização.

Abstract This study analyzes the work situations experienced by professionals in the sanitary fiscalization of medicines at the Brazilian Health Regulatory Agency, during the COVID-19 pandemic. This is a single-case study, qualitative in nature, with an ergological approach. The data were collected from 2020 to 2021. During this period, 18 interviews and 3 online work meetings were conducted. The discursive practices were systematized in ergodialogical maps, resulting in three categories: the works experienced in the sanitary enforcement of medicines; the variabilities of the organizational context and the renormalizations facing the pandemic. The fragilities of the information systems, the outdated regulatory framework, the performance model, the fragmentation of the work, among others, have caused barriers to the professional's activity. The conformation of a new way of performing the sanitary fiscalization of medicines involves the combination of interventions aimed at prevention, detection, and response to the consumption of medicines that are harmful to health. The necessary transformation goes beyond the restricted function of control and punishment and consolidates itself as a new proactive and dynamic action model, based on health risk management and the implementation of Good Fiscalization Practices.

Prospecção das condições de trabalho do Samu-192 fluvial em cenários de crise a partir da resiliência no enfrentamento à Covid-19 no Alto Solimões / Investigation of the working conditions of the river-based SAMU-192 in crisis scenarios based on resilience in the face of COVID-19 in Alto Solimões

RESUMO Esta pesquisa teve como objetivo prospectar as condições de trabalho das equipes de socorro do Serviço de Atendimento Móvel de Urgência (Samu-192) fluvial das áreas ribeirinhas e costeiras da região do Alto-Solimões, a partir da análise sistêmica das atividades no serviço de embarcações popularmente chamadas de 'ambulanchas' durante os picos da Covid-19 no estado do Amazonas, quando o sistema de saúde funcionou sob o estresse provocado pela pandemia. Os dados foram obtidos a partir de um desenho transversal exploratório, baseado em dados qualitativos coletados por meio de entrevistas e observação do funcionamento normal do sistema antes da pandemia. A partir daí modelos de dois cenários foram elaborados mostrando o funcionamento do serviço de ambulanchas ao lidar com a pandemia de Covid-19 e o impacto nas condições de trabalho das equipes de socorro interprofissionais de socorro. Entrevistas remotas com trabalhadores das ambulanchas após a pandemia indicaram que a prospecção das condições de trabalho a partir das instâncias dos modelos corresponderam ao funcionamento real do sistema durante a pandemia de Covid-19.

ABSTRACT This research aimed to prospect the working conditions of the rescue teams of the Mobile Emergency Care Service (SAMU-192) at the fluvial areas of the Alto Solimoes region, trough the systemic analysis of the activities of the water ambulances service popularly called 'ambulanchas' during the peaks of COVID-19 in the state of Amazonas, when the health system functioned under stress caused by the pandemic. Data were obtained from an exploratory cross-sectional design, based on qualitative data collected through interviews and observation of the normal functioning of the system before the pandemic. From there, models of two scenarios were developed showing the functioning of the water ambulances service when coping with the COVID-19 pandemic and the impact on the working conditions of the interprofessional rescue teams. Remote interviews with workers after the pandemic indicated that the prospection of working conditions from the instances of the models corresponded to the real functioning of the system during the COVID-19 pandemic.

Evaluación del formato remoto en tiempos de pandemia / Evaluation of a remote format in times of pandemic

En el contexto de la pandemia de COVID 19 durante el año 2020 y hasta la fecha se diseñó un formato de evaluación para nuestros alumnos de pre y posgrado bajo el alero de los exámenes clínicos objetivos estructurados (ECOE) en un formato remoto. Se revisó la literatura al respecto y se diseñó un instrumento que diera cuenta en forma oportuna y estandarizada del desempeño de nuestros alumnos y residentes. Estas experiencias están siendo evaluadas en estudios con metodología mixta. Sin embargo, decidimos compartir esta experiencia, por su impacto en el desarrollo docente de las ciencias de la salud.

In the context of the COVID-19 pandemic during 2020 and to date, an evaluation format has been designed for our undergraduate and graduate students under the design of the objective structured clinical examinations (OSCE) in a remote format. The literature was reviewed, and an instrument was designed to account for the performance of our students and residents in a timely and standardized manner. These experiences are being evaluated in studies with mixed methodology. However, we wanted to convey this experience due to its impact on the educational development of health sciences.

Aprendizaje en las residencias quirúrgicas durante la pandemia de COVID-19 en México.

OBJECTIVE: To bring up which was the surgical resident's perception about their learning experience during COVID-19 pandemic and if it interfered or not with their classes. METHOD: Cross-sectional observational study through an anonymous survey conducted among surgical residents. The Mexican Association of General Surgery, through its Women in Surgery Committee, created a questionnaire that included 40 questions. RESULTS: 465 participants were included in the survey: 225 women (48.3%), 240 men (51.7%); of 32 entities, only 26 participated. A great part of them said their skills and abilities were affected because elective surgeries were called off. While 303 residents stayed at hybrid hospitals, while a third of them were at 100% Covid facilities. Residents who were on call worked at COVID-19 units. They continued attending class through online platforms and only 134 were able to practice their skills using simulators. 71% of the residents were infected with COVID-19, all were tested to confirm it, and the number of asymptomatic cases was unknown. CONCLUSIONS: COVID-19 pandemic has affected the learning process of surgical residents in Mexico.

OBJETIVO: Citar cuál fue la percepción que tuvieron los médicos residentes quirúrgicos sobre su aprendizaje durante la pandemia de COVID-19 y si continuaron o no con sus clases. MÉTODO: Estudio observacional, de corte transversal, mediante una encuesta anónima de 40 cuestionamientos diseñada por el Comité de Cirujanas de la Asociación Mexicana de Cirugía General, aplicada a los médicos residentes quirúrgicos. El tamaño de la muestra fue a conveniencia. RESULTADOS: Se incluyeron 465 participantes, de los que 225 fueron mujeres (48.3%) y 240 hombres (51.7 %). De 32 entidades, solo participaron 26. La gran mayoría opinaron que sus habilidades y destrezas se vieron afectadas por la suspensión de cirugías electivas. Estuvieron en hospitales híbridos 303 participantes y en hospitales 100% COVID-19 una tercera parte. Las guardias fueron realizadas en áreas COVID-19 y continuaron con sus clases a través de plataformas digitales; solo 134 realizaron prácticas en simuladores. El 71% de los médicos residentes se contagiaron de la enfermedad; el diagnóstico fue corroborado con una prueba y se desconoce el porcentaje de casos asintomáticos. CONCLUSIONES: La pandemia de COVID-19 afectó el aprendizaje de los médicos residentes de especialidades quirúrgicas en México.

Estratégias facilitadoras na construção da resiliência moral dos enfermeiros no contexto da pandemia Covid-19: scoping review / Facilitating strategies for building nurses' moral resilience in the context of the Covid-19 pandemic: a scoping review

A Resiliência Moral, enquanto conceito, tem ganho destaque como forma de transformar o profundo desespero e impotência associada a situações moralmente angustiantes. A emergência e a rápida disseminação provocada pelo SARS- Cov-2 colocou desafios inesperados às entidades de saúde nos mais diversos níveis de atuação nos serviços de medicina intensiva. Objetivos: O presente estudo teve como objetivo geral identificar estratégias facilitadoras na construção da resiliência moral pelos enfermeiros que cuidaram de doentes infetados pelo SARS-CoV-2 e com necessidade de cuidados intensivos. Definiram se como objetivos específicos: Distinguir o conceito de angústia moral e resiliência moral; Identificar sintomas moralmente prejudiciais e fatores que cooperam na construção da resiliência moral, nos enfermeiros que prestaram cuidados a doentes com COVID-19, nos cuidados intensivos; Reconhecer estratégias de resiliência moral utilizadas pelos enfermeiros nos cuidados aos doentes com COVID-19. Métodos: Foi desenvolvida uma Scoping Review, nas bases de dados EBSCO e Web of Science, segundo metodologia da Joanna Briggs Institute - Participants; Concept and Context - e utilizadas diretrizes estabelecidas pelo modelo PRISMA-Extension for Scoping Reviews, para analisar a extensão e a natureza da produção científica disponível, bem como clarificar os conceitos da pesquisa. Foram incluídos os artigos publicados a partir de 2018, em inglês, espanhol e português, sobre resiliência moral em enfermeiros que prestaram cuidados intensivos a doentes COVID-19, em época de pandemia. Resultados: Foram identificados 24 estudos potencialmente relevantes, após exclusão de duplicados. Todos os registos foram exportados e agrupados num software para investigação e gestão de referências (EndNodeX8.2). Após leitura integral do texto, 20 artigos foram excluídos por não cumprirem os critérios de inclusão. Assim sendo, apenas foram incluídos quatro estudos nesta revisão. Conclusão: Os estudos mostraram que os enfermeiros moralmente resilientes estão profundamente familiarizados com os seus pontos fortes, limitações e núcleo moral e, habitualmente, são discretos. Entre os enfermeiros, a resiliência moral pode ser cultivada através de estratégias que enfoquem a esperança, compromisso e a autoeficácia. Os enfermeiros que cuidaram de doentes positivos para SARS-CoV-2, relatam ter experienciado mais angústia moral do que aqueles que não foram expostos a esta tipologia de doentes. Devem ser tomadas medidas e estratégias para promover a resiliência moral nos enfermeiros com vista a melhorar o seu bem-estar e a qualidade dos cuidados de enfermagem.

Moral Resilience, as a concept, has gained prominence as a way to transform the deep despair and impotence associated with morally distressing situations. The emergence and rapid spread caused by SARS-Cov-2 posed unexpected challenges to health entities at the most diverse levels of performance in intensive care services. Aim: This study aimed to: identify facilitating strategies in building moral resilience by nurses who cared for patients infected with SARS-CoV-2 and in need of intensive care. Specific objectives were defined: Distinguish the concept of moral distress and moral resilience; Identify morally harmful symptoms and factors that cooperate in building moral resilience, in nurses who provide care to patients with Covid-19, in intensive care; Recognize moral resilience strategies used by nurses in the care of patients with Covid-19. Methods: A Scoping Review was developed, in the EBSCO and Web of Science database, according to the methodology of the Joanna Briggs Institute - Participants; Concept and Context - and used the guidelines established by the PRISMA-ScR model (PRISMA Extension for Scoping Reviews) to analyze the extent and nature of the available scientific production, as well as to clarify the concepts that underlie moral resilience in nurses. Articles published from 2018 onwards, in English, Spanish and Portuguese, on moral resilience in nurses who provided intensive care to Covid-19 patients during a pandemic were included in the research. Results: We identified 24 potentially relevant studies after exclusion of duplicates. All records were exported and grouped in software for investigation and management of references (EndNodeX8.2). After reading the entire text, 20 articles were excluded for not meeting the inclusion criteria. Therefore, only four studies were included in this review. Conclusion: Studies have shown that morally resilient nurses are deeply familiar with their strengths, limitations, and moral core, and are usually discreet. Among nurses, moral resilience can be cultivated through strategies that focus on hope, commitment and self-efficacy. Nurses who cared for patients positive for SARS-CoV-2 report experiencing more moral distress than those who were not exposed to this type of patient. Measures and strategies must be taken to promote moral resilience in nurses in order to improve your well-being and the quality of nursing care.

Abordagem à pessoa nos Serviço de Urgência e Unidade de Cuidados Intensivos após a pandemia COVID-19: scoping review / Approach to the person in emergency and intensive care after the pandemic covid-19: scoping review

Objetivo: Perceber quais as alterações que ocorreram na abordagem à pessoa em situação crítica no Serviço de Urgência e Unidade de Cuidados Intensivos após início da pandemia COVID-19. Método: A estratégia de pesquisa para a scopingreview foi realizada nas bases de dados Medline via PubMed, EBSCO Host, BioMed Central, ScienceDirect, BVS e Scielo através da utilização de descritores MeSH e DeCS, artigos com fulltext gratuito, publicados em língua portuguesa, inglesa e espanhola, com datas de publicação entre 2019 e 2021, implementados critérios de inclusão e exclusão.Resultados: Foram identificados 4 estudos elegíveis para análise, publicados em 2020, nenhum dos estudos em Português. Conclusão: As principais alterações estão relacionadas com a utilização de equipamento de proteção individual, colocando o enfoque na segurança dos profissionais de saúde.(AU)

Aim: To understand the changes that occurred in the approach to critically ill patients in the Emergency Department and Intensive Care Unit after the beginning of the COVID-19 pandemic. Method: The search strategy for the scoping review was conducted in Medline databases via PubMed, EBSCO Host, BioMed Central, ScienceDirect, BVS and Scielo by using MeSH and DeCS descriptors, articles with free full text, published in Portuguese, English and Spanish language, with publication dates between 2019 and 2021, implemented inclusion and exclusion criteria.Results: Four eligible studies were identified for analysis, published in 2020, and none of the studies was in Portuguese. Conclusion: The main changes are related to the use of personal protective equipment, focusing on the safety of health professionals.(AU)

Objetivo: Conocer qué cambios se han producido en el abordaje a los pacientes críticos en el Servicio de Urgencia y enUnidades de Cuidados Intensivos tras el inicio de la pandemia COVID-19.Método: La estrategia de búsqueda para la revisión se realizó en las bases de datos Medline e PubMed, EBSCO Host, BioMed Central, ScienceDirect, BVS y Scielo con el uso de descriptores MeSH y DeCS, artículos con libre acceso a texto completo, publicados en portugués, inglés y español, entre el 2019 y 2021, usando criterios de inclusión y exclusión.Resultados: Identificamos 4 estudios elegibles para el análisis, todos publicados en 2020, e ninguno en portugués.Conclusión: Los principales cambios están relacionados con el uso de equipamientos de protección personal, conel enfoque en la seguridad de los profesionales de salud.(AU)

[Food quality in pre-school and school children in Chile during the COVID-19 pandemic]. / Calidad de la alimentación en preescolares y escolares en Chile durante la pandemia de COVID-19.

Introduction: Introduction: the COVID-19 pandemic can affect the quality of food and nutrition of preschoolers and schoolchildren through an increase in food insecurity of families, by measures such as confinement and closure of educational establishments, which affects the daily structure, feeding schedules, and quality of food. Objectives: analyze the overall food quality of preschool and school children in Chile during the COVID-19 pandemic. Methods: five hundred and fifty-one schoolchildren (22.5 % boys and 77.5 % girls) from five Chilean cities distributed in northern, central, and southern macro zones participated in a convenience sampling. The Global Food Quality Index was applied. The data were analyzed in the IBM SPSSV24 statistical program. Differences in proportions were analyzed employing crossed tables. Results: schoolchildren from rural areas presented lower eating quality than their urban peers (p = .005). Schoolchildren who eat with the whole family had better indicators of eating quality than those who ate alone (p = .002). In nine out of 12 dietary components, evaluated females present higher compliance with dietary recommendations. Conclusions: further research is needed on changes in dietary intake and dietary quality of children and their families during the pandemic. This will allow us to analyze the impact of the pandemic on eating behavior and its possible consequences.

Introducción: Introducción: La pandemia por COVID-19 puede afectar en la calidad de la alimentación y la nutrición de preescolares y escolares a través de un incremento de la inseguridad alimentaria de las familias, por medidas como el confinamiento y cierre de establecimientos educacionales, lo que afecta la estructura diaria, horarios de alimentación y calidad de la alimentación. Objetivo: analizar la calidad global de la alimentación de preescolares y escolares en Chile durante la pandemia de COVID-19. Métodos: en un muestreo por conveniencia participaron 551 escolares (22,5 % niños y 77,5 % niñas) de cinco ciudades de Chile distribuidas en macrozonas norte, centro y sur. Se aplicó el índice de calidad global de la alimentación. Los datos fueron analizados en el programa estadístico IBM SPSSV24. Se analizaron diferencias de proporciones a través de tablas cruzadas. Resultados: escolares de zonas rurales presentaron menor calidad de la alimentación que pares de zonas urbanas (p = ,005). Escolares que comen con toda la familia presentan mejores indicadores de calidad de la alimentación que aquellos que lo hacen solos (p = ,002). En nueve de 12 componentes de la alimentación evaluados, las mujeres presentan mayor cumplimiento de recomendaciones alimentarias. Conclusiones: se requieren más investigaciones sobre los cambios de ingesta dietética y calidad de la alimentación de los niños y niñas y sus familias durante la pandemia. Esto permitirá analizar el impacto de la pandemia en la conducta alimentaria y sus posibles consecuencias.

Afectaciones de la salud mental relacionadas con la COVID-19 / Mental Health Conditions Related to COVID-19

Introducción: La pandemia de COVID-19 ha creado una situación de crisis que requiere un enfrentamiento a los efectos directos del virus y otros problemas de salud relacionados por el temor al contagio, y a las medidas de confinamiento que repercuten en la salud mental. Objetivo: Describir afectaciones de la salud mental relacionadas con la COVID-19. Métodos: Se efectuó una revisión bibliográfica documental, mediante búsquedas electrónicas en las bases de datos científicas MEDLINE, Pubmed, EBsCO y Scielo. Se utilizaron como palabras clave: pandemia COVID-19; salud mental y COVID; cuarentena; impacto psicológico de la COVID-19 y su equivalente en inglés. Se consideraron comunicaciones oficiales de organismos internacionales, regionales y nacionales. Como resultado de la búsqueda se analizaron 44 artículos científicos que cumplieron los criterios de inclusión. El período de estudio estuvo comprendido entre septiembre del 2020 y febrero del 2021, en La Habana, Cuba. Conclusiones: La pandemia COVID-19 ha provocado un impacto negativo en la salud mental. Los síntomas más frecuentes desde el punto de vista de la salud mental han sido: depresión, ansiedad irritabilidad, insomnio, ira, agotamiento emocional y pánico. Se observó trastorno de estrés postraumático. El análisis y conocimiento de los resultados expuestos en esta revisión pueden ser útiles para la valoración de medidas que contribuyan a mitigar los trastornos emocionales en la población y prestarles atención especial a las afectaciones en la salud mental en grupos vulnerables, particularmente al personal de salud(AU)

Introduction: The COVID-19 pandemic has created a crisis situation that requires coping with the direct effects of the virus and other related health problems due to fear of contagion, and confinement measures that impact mental health. Objective: To describe mental health effects related to COVID-19. Methods: A documentary literature review was carried out by means of electronic searches in the scientific databases MEDLINE, PubMed, Ebsco and SciELO. Key words used were: COVID-19 pandemic; mental health and COVID; quarantine; psychological impact of COVID-19 and its English equivalent. Official communications from international, regional and national agencies were considered. As a result of the search, 44 scientific articles that met the inclusion criteria were analyzed. The study period was between September 2020 and February 2021, in Havana, Cuba. Conclusions: The COVID-19 pandemic has had a negative impact on mental health. The most frequent symptoms from the mental health point of view have been: depression, anxiety, irritability, insomnia, anger, emotional exhaustion and panic. Post-traumatic stress disorder was observed. The analysis and knowledge of the results presented in this review may be useful for the assessment of measures that contribute to mitigate emotional disorders in the population and pay special attention to mental health effects in vulnerable groups, particularly health personnel(AU)

Burnout em enfermeiros nos cuidados ao doente crítico em contexto pós pandemia Covid ­ 19 - estudo em medicina intensiva / Burnout in nurses caring for critically ill patients in a post-pandemic context Covid - 19 - study in intensive care medicine

A Síndrome de Burnout (SB), tornou-se expressiva, na pandemia de Covid-19, com consequências na vida pessoal e profissional dos enfermeiros. O objetivo, deste trabalho, é reconhecer a perceção de comportamentos da Síndrome de Burnout (SB), por enfermeiros em Medicina Intensiva (MI), pós pandemia Covid-19; estudar as relações entres as variáveis independentes e o nível da SB. Como metodologia, foi desenvolvido um estudo de abordagem quantitativa, transversal e analítico, a partir dos resultados da aplicação Copenhagen Burnout Inventory (CBI), numa amostra de 61 enfermeiros, maioritariamente do sexo feminino (70.5%) e idades entre 18 e 45 anos. A análise dos resultados, reconheceu comportamentos da SB, segundo a perceção dos enfermeiros em MI: 42.6% da amostra percecionou SB elevado. Verificaram-se relações estatisticamente significativas entres as variáveis independentes e o nível da SB percecionado: 73.8% perceciona comportamentos da SB relativos ao trabalho, 60.7% percecionam SB a nível pessoal e 19.7% da amostra perceciona SB relativo à interação com o doente. Concluímos, que o nível elevado da SB percecionado pelos enfermeiros em contexto laboral e pessoal e, até na interação com o doente, fundamentam a proposta que aqui se coloca: a experiência de intensidade e proximidade pessoal com o doente, merece neste momento uma atenção especial em termos de formação e, sobretudo, atendimento específico para despiste de evolução da SB e quaisquer sinaléticas pré depressivas.

Burnout Syndrome (BS) has become significant during the Covid-19 pandemic, with consequences for the personal and professional lives of nurses. The objective of this study is to recognize nurses' perceptions of Burnout Syndrome (BS) behaviors in Intensive Medicine (IM) post Covid-19 pandemic and to study the relationships between the independent variables and the level of BS. As a methodology, a quantitative, cross-sectional, and analytical study was developed based on the results of the application of the Copenhagen Burnout Inventory (CBI) in a sample of 61 nurses, mostly female (70.5%) and aged between 18 and 45 years. The analysis of the results recognized BS behaviors, according to the perception of nurses in IM: 42.6% of the sample perceived high levels of BS. Statistically significant relationships were found between the independent variables and the perceived level of BS: 73.8% perceived work-related BS behaviors, 60.7% perceived BS at a personal level, and 19.7% of the sample perceived BS related to interactions with patients. It is concluded that the high level of BS perceived by nurses in their work and personal contexts and even in their interactions with patients, justifies the proposal made here: the experience of intensity and personal closeness with the patient deserves special attention in terms of training and, above all, specific care to detect the evolution of BS and any pre- depressive signals.