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AIMS: This study explores the mediational role of resilience, experiential avoidance and emotion regulation in the levels of anxiety, depression and posttraumatic stress disorder (PTSD) of healthcare workers during the COVID-19 pandemic. Additionally, we explored the association of such levels with personal and professional variables. DESIGN: Cross-sectional study. METHODS: Healthcare professionals working in Spain (N = 786) were recruited following a snowball approach in November and December 2021. Resilience, emotion regulation, experiential avoidance, depression, anxiety, PTSD and work-related variables were measured. Mean differences and correlations were computed, and a path analysis with latent variables (PALV) model was tested. RESULTS: In total, 18.8% of the sample scored above the cut-off score for depression, 24.6% for anxiety and 36.4% for PTSD. Higher resilience and lower experiential avoidance and expression suppression were correlated with better mental health. The PALV model explained 42%-53% of mental health outcomes. Experiential avoidance showed the greatest explanatory power and mediated the impact that stressors had on mental health. Some work-related variables correlated with greater psychological impact. These factors encompassed being a nurse, feeling that their job remained stressful and had not yet returned to its pre-pandemic state and having interacted with individuals facing economic difficulties due to the pandemic, and those who had lost their lives to COVID-19. CONCLUSION: Healthcare workers showed high levels of psychological impact during the COVID-19 pandemic. Such impact was predicted from some work-stress variables and the reliance on maladaptive strategies such as experiential avoidance and expressive suppression. IMPACT: Training healthcare professionals to use coping strategies incompatible with experiential avoidance may improve their mental health. Additionally, better working conditions are fundamental for reducing the impact of critical situations on healthcare workers' mental health. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
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People can experience posttraumatic growth (PTG) when faced with potentially traumatic events. One of the most widely-used instruments to measure PTG is the Posttraumatic Growth Inventory-Short Form (PTGI-SF). However, it has not been validated for the Spanish population. This study explored the psychometric properties of the PTGI-SF in adults living in Spain during the COVID-19 pandemic. Since it is a global disaster, two items were added to assess communal PTG. The participants were adult inhabitants of Spain during the COVID-19 pandemic (N = 855). They completed the PTGI-SF in July 2020, along with the Impact of Event Scale - Revised to measure symptoms of posttraumatic stress disorder (PTSD). They also rated the degree to which they perceived the COVID-19 crisis as being severe. In November 2020, 592 participants once again completed the PTGI-SF. The factorial validity o was tested by Structural Equations Modeling (SEM). McDonald's ω coefficients were calculated to test internal consistency. The Intra-class Correlation Coefficient (ICC) was obtained to assess test-retest reliability. Sensitivity and criterion-related validity were assessed by exploring the association of the PTGI-SF scores with gender, age, PTSD symptoms, and perceived severity. Results indicated good psychometric properties for an eight-item, four-factor structure of the inventory in terms of structural validity, reliability, sensitivity and criterion-related validity. These factors were: Relating to Others, Personal Strength, Spiritual Change, and Life Value and Opportunities. Communal PTG overlapped with social PTG, and therefore it was not included. Cultural differences need to be addressed when measuring PTG, especially in terms of spiritual growth.
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The SARS-Cov-2 infection disease (COVID-19) pandemic has posed at risk the kidney transplant (KT) population, particularly the elderly recipients. From March 12 until April 4, 2020, we diagnosed COVID-19 in 16 of our 324 KT patients aged ≥65 years old (4.9%). Many of them had had contact with healthcare facilities in the month prior to infection. Median time of symptom onset to admission was 7 days. All presented with fever and all but one with pneumonia. Up to 33% showed renal graft dysfunction. At infection diagnosis, mTOR inhibitors or mycophenolate were withdrawn. Tacrolimus was withdrawn in 70%. The main treatment combination was hydroxychloroquine and azithromycin. A subset of patients was treated with anti-retroviral and tocilizumab. Short-term fatality rate was 50% at a median time since admission of 3 days. Those who died were more frequently obese, frail, and had underlying heart disease. Although a higher respiratory rate was observed at admission in nonsurvivors, symptoms at presentation were similar between both groups. Patients who died were more anemic, lymphopenic, and showed higher D-dimer, C-reactive protein, and IL-6 at their first tests. COVID-19 is frequent among the elderly KT population and associates a very early and high mortality rate.
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Betacoronavirus , Infecções por Coronavirus/epidemiologia , Transmissão de Doença Infecciosa/estatística & dados numéricos , Rejeição de Enxerto/prevenção & controle , Transplante de Rim , Pneumonia Viral/epidemiologia , Medição de Risco/métodos , Transplantados/estatística & dados numéricos , Idoso , COVID-19 , Feminino , Seguimentos , Rejeição de Enxerto/epidemiologia , Hospitalização/tendências , Humanos , Incidência , Masculino , Pandemias , Estudos Retrospectivos , Fatores de Risco , SARS-CoV-2 , Espanha/epidemiologia , Fatores de TempoRESUMO
INTRODUCTION: Chronic kidney disease (CKD) increases the risk of mortality during coronavirus disease 2019 (COVID-19) episodes, and some reports have underlined the high incidence and severity of this infection in dialysis patients. Information on COVID-19 in nondialysis CKD patients is not available yet. CASE REPORTS: Here we present 7 patients with grade 4-5 CKD who developed symptomatic COVID-19; they comprise 2.6% of our 267 advanced CKD patients. The estimated GFR was between 12 and 20 mL/min during the month prior to COVID-19. The 3 major symptoms were fever, cough, and dyspnea, and 5 patients showed bilateral pneumonia. Hydroxychloroquine, azithromycin, ceftriaxone, and steroids were the most frequently prescribed drugs. Two patients needed noninvasive mechanical ventilation. All patients showed minimal to moderate kidney function deterioration during admission, with an eGFR decline below 5 mL/min in 6 cases. No patient required acute dialysis. Six patients were discharged alive and remained dialysis free athe t the time of reporting, and one 76-year-old patient died. CONCLUSIONS: COVID-19 affects grade 4-5 CKD patients, but prognosis may be acceptable if prompt supportive measures are applied. These findings should be confirmed in larger cohorts, and further observations will be needed to understand the full spectrum of clinical features and the optimal approach to COVID-19 in patients with advanced CKD.
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Betacoronavirus , Infecções por Coronavirus/diagnóstico por imagem , Pneumonia Viral/diagnóstico por imagem , Insuficiência Renal Crônica/diagnóstico por imagem , Índice de Gravidade de Doença , Idoso , Idoso de 80 Anos ou mais , COVID-19 , Infecções por Coronavirus/complicações , Evolução Fatal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Insuficiência Renal Crônica/complicações , SARS-CoV-2RESUMO
BACKGROUND: To assess whether serum osteoprotegerin (OPG) and/or fetuin-A predict mortality and cardiovascular (CV) morbidity and mortality in hemodialysis patients. METHODS: Multicenter, observational, prospective study that included 220 hemodialysis patients followed up for up to 6 years. Serum OPG and fetuin-A levels were measured at baseline and their possible association with clinical characteristics, CV risk biomarkers, carotid ultrasonographic findings, as well as their association with overall and CV mortality and CV events were assessed. RESULTS: During a mean follow-up of 3.22 ± 1.91 years, there were 74 deaths (33.6%) and 86 new cardiovascular events. In the Kaplan-Meier survival analysis, the highest tertile of OPG levels was associated with higher overall mortality (p = 0.005), as well as a higher, although non-significant, incidence of CV events and CV mortality. In contrast, fetuin-A levels did not predict any of these events. OPG levels were directly associated with age, the Charlson comorbidity index (CCI), prevalent cardiovascular disease, carotid intima-media thickness, adiponectin, troponin-I and brain natriuretic peptide (BNP). OPG showed a negative correlation with left ventricular ejection fraction (LVEF) and phosphate levels. In the multivariate Cox proportional hazard analysis, all-cause mortality was associated with the highest tertile of OPG (HR:1.957, p = 0.018), age (HR:1.031, p = 0.036), smoking history (HR:2.122, p = 0.005), the CCI (HR:1.254, p = 0.004), troponin-I (HR:3.894, p = 0.042), IL-18 (HR:1.061, p < 0.001) and albumin levels (HR:0.886, p < 0.001). In the bootstrapping Cox regression analysis, the best cut-off value of OPG associated with mortality was 17.69 pmol/L (95%CI: 5.1-18.02). CONCLUSIONS: OPG, but not fetuin-A levels, are independently associated with overall mortality, as well as clinical and subclinical atherosclerosis and cardiac function, in prevalent hemodialysis patients.
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Aterosclerose/sangue , Doenças Cardiovasculares/sangue , Falência Renal Crônica/sangue , Osteoprotegerina/sangue , Diálise Renal , Idoso , Aterosclerose/mortalidade , Biomarcadores/sangue , Doenças Cardiovasculares/mortalidade , Feminino , Seguimentos , Humanos , Falência Renal Crônica/mortalidade , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Mortalidade/tendências , Estudos Prospectivos , Diálise Renal/mortalidadeRESUMO
INTRODUCTION: The influence of socioeconomic and cultural barriers in the choice of renal replacement therapy (RRT) techniques in advanced chronic kidney disease (ACKD) has been scarcely explored, which can generate problems of inequity, frequently unnoticed in health care. The aim of this study is to identify the "non-medical" barriers that influence the choice of RRT in an advanced chronic kidney disease (ACKD) consultation in Spain. MATERIAL AND METHODS: Retrospective analysis including the total number of patients seen in the ACKD consultation in a tertiary hospital from 2009 to 2020. Inclusion in the ACKD consultation began with an eligibility test and a decision-making process, conducted by a specifically trained nurse. The variables considered for the study were: age, sex, etiology of CKD, level of dependence for basic activities of daily living (Barthel Scale) and instrumental activities of daily living (Lawton and Brody Scale), Spanish versus foreign nationality, socioeconomic level and language barrier. The socioeconomic level was extrapolated according to home and health district by primary care center to which the patients belonged. RESULTS: A total of 673 persons were seen in the ACKD consultation during the study period, of whom 400 (59.4%) opted for hemodialysis (HD), 156 (23.1%) for peritoneal dialysis (PD), 4 (0.5%) for early living donor renal transplantation (LDRT) and 113 (16.7%) chose conservative care (CC). The choice of PD as the chosen RRT technique (vs. HD) was associated with people with a high socioeconomic level (38.7% vs. 22.5%) (pâ¯=â¯0.002), Spanish nationality (91% vs. 77.7%) (pâ¯<â¯0.001), to a lower language barrier (0.6% vs 10.5%) (pâ¯<â¯0.001), and to a higher score on the Barthel scale (97.4 vs 92.9) and on the Lawton and Brody scale (7 vs 6.1) (pâ¯<â¯0.001). Neither age nor sex showed significant differences in the choice of both techniques. Patients who opted for CC were significantly older (81.1 vs 67.7 years; pâ¯<â¯0.001), more dependent (pâ¯<â¯0.001), with a higher proportion of women (49.6% vs 35.2%; pâ¯=â¯0.006) and a higher proportion of Spaniards (94.7% vs 81%, pâ¯=â¯0.001) in relation to the choice of other techniques (PD and HD). Socioeconomic level did not influence the choice of CC. CONCLUSION: Despite a regulated decision-making process, there are factors such as socioeconomic status, migration, language barrier and dependency of the population that influence the type of RRT chosen. To address these aspects that may cause inequity, an intersectoral and multilevel intervention is required with interdisciplinary teams that include, among others, social workers, to provide a more holistic and person-centered assessment.
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Diálise Renal , Insuficiência Renal Crônica , Determinantes Sociais da Saúde , Humanos , Estudos Retrospectivos , Feminino , Masculino , Idoso , Insuficiência Renal Crônica/terapia , Pessoa de Meia-Idade , Espanha , Comportamento de Escolha , Idoso de 80 Anos ou mais , Transplante de Rim , Diálise Peritoneal , Equipe de Assistência ao PacienteRESUMO
Background: The paper presents the rationale and methods of the planned systematic review to understand the effects of nature-based interventions on individuals' environmental behaviors. There is ample evidence that experiences in nature not only enhance human well-being but also help promote people's pro-environmentalism. Nevertheless, synthesized evidence regarding the effects of nature-based interventions on individuals' environmental behaviors is lacking. Methods: This protocol follows the Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) guidelines. The planned literature search will be conducted by using APA PsycInfo, APA PsyArticles, PubMed, ERIC, Education Source, GreenFILE, OpenDissertations, Scopus, and WEB of Science. In the protocol, we present search strategies for each specific database. Data items that we will seek to obtain from the selected publications are described in detail and cover general information about included studies, information about studies' methodology and participants, outcomes of the studies, and nature-based and comparative interventions. The outcomes will be behavioral, including aggregated and specific types of environmental behaviors, as well as reported and observed behaviors. Furthermore, the protocol provides a description of the prospective assessment of the risk of bias in both randomized and non-randomized studies. If studies appear sufficiently homogeneous, we will conduct a meta-analysis using the inverse-variance method. Details of the data synthesis are likewise provided in the paper. Results: Dissemination of the results of the planned review will be carried out via a peer-reviewed open-access journal publication. Implications: Given the great need to address current environmental issues, understanding what encourages people to act pro-environmentally is critical. It is expected that the findings of the planned review will provide valuable insights for researchers, educators, and policymakers who are involved in understanding and promoting human environmental behaviors.
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This chapter first summarizes how the consequences of global climate change (GCC) can harm young people's well-being through physical health impacts and awareness of GCC. We then outline how youth may cope with GCC by denying the problem, distancing themselves from it, or taking individual actions. However, the coping strategy shown to have the best mental well-being outcomes relates to collective actions and agency. Next, an examination of school-based GCC interventions reveals that engaging, participatory approaches may be more effective in promoting positive outcomes for youth and climate action. Our main contribution is a discussion of how the evidence-based design of learning environments presents an undeveloped but potentially effective way to enhance interventions for the development of constructive GCC coping strategies among youth. Utilizing environmental affordances and design as scaffolding can guide the design of learning environments that give youth opportunities for active cognitive, emotional, and physical engagement with climate change education. Natural environments may be particularly effective in supporting active engagement and pathways to constructive coping. More research is needed to understand what design features underly these pathways to improved well-being and GCC coping strategies that may have positive implications for youth climate action.
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Mudança Climática , Aprendizagem , Adolescente , Humanos , Adaptação Psicológica , Escolaridade , Instituições AcadêmicasRESUMO
Background: The Posttraumatic Growth Inventory (PTGI) and its Short Form (PTGI-SF) are two instruments highly used in research on posttraumatic growth. They include a religious growth item that has been demonstrated to be problematic in cultures that are not very religious. Previous research has addressed this issue in other countries, but no attention has been paid to this critical problem in Spanish samples.Objective: Our aim is to address the psychometric issues presented by the religious growth item in Spain.Method: To do so, we reviewed several studies conducted with various populations in Spain.Results: The scores of the religious growth item in Spain present very low means and standard deviations, as well as high skewness and kurtosis, all of which point to a floor effect. The item scores show low item-test correlations, and it has failed to load on a specific dimension in factor analyses, thus casting doubts about its validity.Conclusions: The inventory does not seem to work properly in its current form in Spain. The inappropriateness of the item measuring religious growth in Spain may be due to cultural reasons. We recommend using the PTGI expanded version (PTGI-X) instead of the PTGI and exploring the possible substitution of the religious growth item in the PTGI-SF for an alternative item. In both cases, ascertaining the psychometric properties of the scores in Spain will be necessary.
The religious growth item in the PTGI and the PTGI-SF show serious psychometric validity issues in Spain. The PTGI Expanded version (PTGI-X) should be used instead of the PTGI in Spain. For the PTGI-SF, the religious item needs to be substituted.
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Crescimento Psicológico Pós-Traumático , Humanos , Psicometria , Emoções , Análise Fatorial , EspanhaRESUMO
The COVID-19 crisis has generated a severe and negative psychological impact worldwide. Despite this, it is also possible to experience post-traumatic growth (PTG). This study aimed to longitudinally explore the prevalence of PTG in the Spanish population and test a predictive model for PTG from resilience, post-traumatic stress symptoms (PTSS), and participation in social activities. Data were collected longitudinally in March, July, and November 2020 via an online survey. About 20% of the sample showed moderate-high levels of PTG, with no significant differences over time. The predictive model explained 19% of the variance in PTG, showing that the inverse relation between resilience and PTG was mediated by PTSS. Additionally, participation in social activities acted as a predictor of PTG. Women, young people, those who had lost their job and people who had experienced COVID-19 symptoms or the loss of a loved one presented higher PTG. Thus, people have experienced positive changes (PTG), but these did not protect them from adverse symptomatology (PTSS).
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This cross-sectional study aims to explore the prevalence of protein-energy wasting (PEW) in dialysis patients in Catalonia, Spain, using a new and practical online tool which enables rapid calculation and comparison with other nutritional scores. METHODS: A web tool (Nutrendial) was created to introduce different variables and automatically calculate PEW, Malnutrition inflammation Score (MIS) and Subjective Global Assessment (SGA) in 1389 patients (88% in haemodialysis (HD)), 12% in peritoneal dialysis (PD) from different regions of Catalonia. RESULTS: A prevalence of 23.3% (26% HD, 10.2% PD) of PEW was found, with a mean MIS score of 6 and SGA score of C in 7% of the patients. ROC analysis showed MIS as the best nutritional score to diagnose PEW (AUC 0.85). Albumin delivered lower diagnostic precision (AUC 0.77) and sensitivity (66%). A cut off point of 7 (86% sensitivity and 75% specificity) for MIS and 3.7 mg/dL for albumin were found to predict the appearance of PEW in this population. SGA B or C showed an 87% sensitivity and 55% specificity to diagnose PEW. Very low nutritional intervention (14%) was recorded with this tool in patients with PEW. CONCLUSIONS: This new online tool facilitated the calculation of PEW, enabling different professionals-including nephrologists, dieticians and nurses-to efficiently obtain insights into the nutritional status of the Catalonian dialysis population and implement the required nutritional interventions. MIS is the score with more sensitivity to diagnose PEW.
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Caquexia , Desnutrição Proteico-Calórica , Diálise Renal , Albuminas , Estudos Transversais , Humanos , Inflamação/diagnóstico , Falência Renal Crônica/terapia , Estado Nutricional , Prevalência , Desnutrição Proteico-Calórica/diagnóstico , Desnutrição Proteico-Calórica/epidemiologia , Desnutrição Proteico-Calórica/etiologia , Diálise Renal/efeitos adversosRESUMO
BACKGROUND: In COVID-19 patients, low serum vitamin D (VD) levels have been associated with severe acute respiratory failure and poor prognosis. In regular hemodialysis (HD) patients, there is VD deficiency and markedly reduced calcitriol levels, which may predispose them to worse outcomes of COVID-19 infection. Some hemodialysis patients receive treatment with drugs for secondary hyperparathyroidism, which have well known pleiotropic effects beyond mineral metabolism. The aim of this study was to evaluate the impact of VD status and the administration of active vitamin D medications, used to treat secondary hyperparathyroidism, on survival in a cohort of COVID-19 positive HD patients. METHODS: A cross-sectional retrospective observational study was conducted from 12 March to 21 May 2020 in 288 HD patients with positive PCR for SARS-CoV2. Patients were from 52 different centers in Spain. RESULTS: The percent of HD patients with COVID-19 was 6.1% (288 out of 4743). Mortality rate was 28.4% (81/285). Three patients were lost to follow-up. Serum 25(OH)D (calcidiol) level was 17.1 [10.6-27.5] ng/mL and was not significantly associated to mortality (OR 0.99 (0.97-1.01), p = 0.4). Patients receiving active vitamin D medications (16/94 (17%) vs. 65/191(34%), p = 0.003), including calcimimetics (4/49 (8.2%) vs. 77/236 (32.6%), p = 0.001), paricalcitol or calcimimetics (19/117 (16.2%) vs. 62/168 (36.9%); p < 0.001), and also those on both paricalcitol and calcimimetics, to treat secondary hyperparathyroidism (SHPTH) (1/26 (3.8%) vs. 80/259 (30.9%), p < 0.001) showed a lower mortality rate than patients receiving no treatment with either drug. Multivariate Cox regression analysis confirmed this increased survival. CONCLUSIONS: Our findings suggest that the use of paricalcitol, calcimimetics or the combination of both, seem to be associated with the improvement of survival in HD patients with COVID-19. No correlation was found between serum VD levels and prognosis or outcomes in HD patients with COVID-19. Prospective studies and clinical trials are needed to support these findings.
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COVID-19/mortalidade , Calcitriol/administração & dosagem , Ergocalciferóis/administração & dosagem , Diálise Renal/mortalidade , Idoso , Idoso de 80 Anos ou mais , COVID-19/sangue , Calcifediol/sangue , Cálcio/sangue , Estudos Transversais , Feminino , Humanos , Hiperparatireoidismo Secundário/sangue , Hiperparatireoidismo Secundário/tratamento farmacológico , Masculino , Estudos Retrospectivos , SARS-CoV-2/isolamento & purificação , Análise de Sobrevida , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/mortalidade , Deficiência de Vitamina D/virologiaRESUMO
By the end of March 2020, Spain was one of the countries most affected by the COVID-19 pandemic. This commentary provides an initial picture of the psychological impact of the COVID-19 outbreak during its initial stage in Spain. Data of 3055 participants aged 18-88 years old were collected over a week (March 17th-24th 2020) using an online forms platform. Participants provided information regarding sociodemographic data and completed the Spanish version of the Impact of Event Scale-Revised, which assesses psychological distress caused by a traumatic life event in terms of three symptomatic responses (avoidance, intrusion, and hyperarousal). Results revealed that 36.6% of participants showed psychological distress due to the COVID-19 pandemic. Avoidance was the most prevalent symptom in the total sample and for all genders studied. The psychological impact was consistently higher for young people, and for women compared to men. Our data confirm the great psychological toll that the COVID-19 crisis took on the Spanish general population during the first week of confinement. Women and young people seem particularly vulnerable to the negative psychological impact of the pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Adaptação Psicológica , Sintomas Comportamentais/psicologia , Infecções por Coronavirus , Controle de Infecções , Pandemias , Pneumonia Viral , Angústia Psicológica , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Sintomas Comportamentais/etiologia , Sintomas Comportamentais/terapia , COVID-19 , Intervenção em Crise , Humanos , Pessoa de Meia-Idade , Espanha , Adulto JovemRESUMO
The outbreak of COVID-19 in Spain started at the end of February. By 9th April 2020 Spain was the second country in confirmed cases and in deaths. On March 14, 2020, the Spanish Government declared the state of alarm to limit viral transmission. During such state, citizens must stay confined at home with few justified exceptions. This whole situation drastically changed the life of the population, which can cause a wide range of psychosocial impacts. This study explored the psychological impact of the COVID-19 pandemic in the general adult population (N = 3055) during the first stages of the outbreak in Spain, as well as their anxiety, stress and depression levels. We also examined the extent to which the following variables were associated to participants' mental health: (1) demographics; (2) degree of concern about the pandemic; (3) environmental conditions during the home confinement, (4) changes in daily life as a consequence of the pandemic; (5) contact with the COVID-19 disease; (6) actual and perceived severity of the crisis; (7) information about the COVID-19, (8) perceived health status and (9) leisure activities conducted within the last 24 h. Our results show that Spanish consider the current COVID-19 health crisis as fairly severe, and the majority felt that the COVID-19 crisis had greatly impacted on their daily life, including changes in their daily routines and cancelation of important activities. About 36% of the participants reported moderate to severe psychological impact, 25% showed mild to severe levels of anxiety, 41% reported depressive symptoms, and 41% felt stressed. Women, young, and those who that lost their job during the health crisis showed the strongest negative psychological symptoms. What worried Spaniards the most was the likelihood of suffering an economic crisis derived from the pandemic. We found factors associated with better mental health, such as being satisfied with the information received about the health crisis, conducting leisure activities, and the perception of being in good health. These findings can be used to design psychological interventions to help coping with COVID-19 pandemic, both in Spain and other countries.
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Living in rural areas has been described a driver for behaving in a pro-environmental way, mainly due to the more frequent contact with nature that people from rural areas have. However, the processes that link living in a rural area and behaving in a more ecological manner have not been systematically studied. Moreover, most studies have focused on adults living in developed countries. Given the importance that the actions conducted by people in developing countries have for the future of the environment, as well as the relevance of children's pro-environmentalism for nature conservation, we present a brief research report examining the relationship between Mexican children's place of residence and self-reported pro-environmental behavior (PEB). Participants were 200 children from Mexican rural areas (<1,000 inhabitants) and 200 from a Mexican urban city (>150,000 inhabitants). Children were between 9 and 12 years old. Children's connection to nature was considered as a mediator in the relationship between children's place of residence and PEB. Our findings revealed that rural children hold a stronger sense of connection to nature and behave in a more pro-environmental way than urban children. In addition, place of residence was directly and positively linked to their PEBs, and this relationship was mediated by children's connection to nature. The relationship between connection to nature and PEB was stronger for girls than for boys. The model explained 45% of the variance of children's self-reported PEBs.
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The COVID-19 epidemic represents a special risk for kidney patients due to their comorbidities and advanced age, and the need for hemodialysis treatment in group rooms. It also represents a risk for professionals responsible for their attention. This manuscript contains a proposal for action to prevent infection of professionals in the Nephrology Services, one of the most valuable assets at the present time.
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Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pessoal de Saúde , Nefrologia , Doenças Profissionais/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Diálise Renal , COVID-19 , Infecções por Coronavirus/transmissão , Infecção Hospitalar/prevenção & controle , Humanos , Transmissão de Doença Infecciosa do Paciente para o Profissional/prevenção & controle , Transmissão de Doença Infecciosa do Profissional para o Paciente/prevenção & controle , Exposição Ocupacional , Estresse Ocupacional/prevenção & controle , Equipamento de Proteção Individual , Pneumonia Viral/transmissão , SARS-CoV-2 , Isolamento SocialRESUMO
The current outbreak of SARS-CoV-2 represents a special risk for renal patients due to their comorbidities and advanced age. The usual performance of hemodialysis treatments in collective rooms increases the risk. The specific information at this time in this regard is very limited. This manuscript includes a proposal for action to prevent infection in the Nephrology Services, and in particular in Hemodialysis Units, with the objective of early identification of patients who meet the definition of a suspected case of infection by SARS-CoV-2 and propose circuits and mechanisms to carry out hemodialysis treatments. They are recommendations in continuous review and can be modified if the epidemiological situation, the diagnostic and therapeutic options so require.
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Betacoronavirus , Infecções por Coronavirus/prevenção & controle , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Diálise Renal/métodos , Fatores Etários , COVID-19 , Comorbidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Desinfecção/métodos , Unidades Hospitalares de Hemodiálise , Humanos , Educação de Pacientes como Assunto , Equipamento de Proteção Individual/normas , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Diálise Renal/normas , Fatores de Risco , SARS-CoV-2 , Avaliação de SintomasRESUMO
The COVID-19 pandemic has led to frequent referrals to the emergency department on suspicion of this infection in maintenance hemodialysis (MHD) and kidney transplant (KT) patients. We aimed to describe their clinical features comparing confirmed and suspected non-confirmed COVID-19 cases during the Spanish epidemic peak. Confirmed COVID-19 ((+)COVID-19) corresponds to patient with positive RT-PCR SARS-CoV-2 assay. Non-confirmed COVID-19 ((-)COVID-19) corresponds to patients with negative RT-PCR. COVID-19 was suspected in 61 patients (40/803 KT (4.9%), 21/220 MHD (9.5%)). Prevalence of (+)COVID-19 was 3.2% in KT and 3.6% in MHD patients. Thirty-four (26 KT and 8 MHD) were (+)COVID-19 and 27 (14 KT and 13 MHD) (-)COVID-19. In comparison with (-)COVID-19 patients, (+)COVID-19 showed higher frequency of typical viral symptoms (cough, dyspnea, asthenia and myalgias), pneumonia (88.2% vs. 14.3%) and LDH and CRP while lower phosphate levels, need of hospital admission (100% vs. 63%), use of non-invasive mechanical ventilation (36% vs. 11%) and mortality (38% vs. 0%) (p < 0.001). Time from symptoms onset to admission was longer in patients who finally died than in survivors (8.5 vs. 3.8, p = 0.007). In KT and MHD patients, (+)COVID-19 shows more clinical severity than suspected non-confirmed cases. Prompt RT-PCR is mandatory to confirm COVID-19 diagnosis.
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There is empirical evidence suggesting a positive link between direct experiences in nature and people's environmental attitudes (EA) and behaviors (EB). This has led researchers to encourage more frequent contact with nature, especially during childhood, as a way of increasing pro-environmentalism (i.e., pro-EA and pro-EB). However, the association between experiences in nature and EA/EB is complex, and specific guidelines for people's everyday contact with nature cannot be provided. This article offers an overview of the research conducted until know about the relation between experiences in nature and pro-environmentalism, and opens up new inquiries for future research. We begin with an introduction to people's current tendency toward an alienation from the natural world and set out the objectives of the article. It is followed by three main sections. The first one reports on what experiences in nature refer to, how and where they occur. The second section describes the different approaches used to investigate and interpret the experiences in nature-EA and EB relation. The last section provides suggestions for future research. We close by making some final remarks about the importance of (re)stablishing a greater interaction with nature for people's pro-EA and EB.
RESUMO
This cross-sectional study aims to improve our understanding of the psychological pathways behind the commonly reported link between experiences in nature and pro-environmentalism. Particularly, we explore whether nature experiences lead to self-reported pro-environmental behaviors (PEBs) and whether this relation is mediated by connectedness to nature. Additionally, we examine the possible lasting effect of childhood experiences with nature on adults' PEB. Most studies reporting on the link between contact with nature and pro-environmentalism have been conducted in developed countries, limiting the generalization of the results. To address this gap in the literature, the current study was conducted in a developing country (Brazil) with a sample of 224 young adults. According to our findings, greater contact with nature during childhood is associated with greater contact with nature as an adult, which, in turn, is positively associated with connectedness to nature and PEB. The stimulation of pleasant experiences while in direct contact with nature during childhood seems to trigger interactions with nature in adulthood and consequently, adults embrace pro-environmental actions.