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1.
Medicina (Kaunas) ; 59(7)2023 Jul 19.
Artigo em Inglês | MEDLINE | ID: mdl-37512141

RESUMO

Background: Breastfeeding is a characteristic process of mammals that ensures delivery of an adequate nutritional supply to infants. It is the gold standard food source during an infant's first months of life. Since the onset of the COVID-19 pandemic in 2020, people in quarantine have experienced a wide range of feelings, which may make isolation challenging in terms of maternal health. This study focused on the prevalence of breastfeeding practices and postpartum depression (PPD) among Mexican women during the COVID-19 pandemic. Materials and Methods: This cross-sectional study included 586 postpartum women who completed an online survey 4-8 weeks after delivery from April to December 2020 in Guadalajara, Mexico. The aim was to identify potentially depressed mothers according to the Edinburgh Postnatal Depression Scale (EPDS) and describe their breastfeeding practices. Results: The mean maternal age was 30.4 ± 4.6 years, the mean EPDS score was 9.6 ± 5.0, and the PPD prevalence according EPDS scores was 27.1%. Exclusive breastfeeding (EBF) was reported by 32.3% of mothers in the first 48 h and by 70.3% of mothers 48 h after delivery. EBF was associated with a lower prevalence of PPD during the first 48 h (p = 0.015) and after the first 48 h (p = 0.001) after delivery. Skin-to-skin contact (SSC) was reported by 385 (65.7%) mothers. PPD was less frequent in mothers practicing SSC (20.3%) than it was in those not practicing SSC (40.3%) (p = 0.001). A higher percentage of mothers practiced SSC breastfed (66.9%) and used EBF (150, 79.4%) (p = 0.012 and 0.001, respectively). Conclusions: Results suggest that the pandemic emergency and restrictions imposed on the population significantly affected the well-being of mothers after birth, and that these effects may have posed risks to the mental health and emotional stability of postpartum mothers. Therefore, encouraging BF or EBF and SSC may improve or limit depressive symptoms in postpartum mothers.


Assuntos
COVID-19 , Depressão Pós-Parto , Lactente , Feminino , Humanos , Adulto , Aleitamento Materno/métodos , Depressão Pós-Parto/epidemiologia , Estudos Transversais , Pandemias , COVID-19/epidemiologia , México/epidemiologia , Mães/psicologia
2.
Dermatol Ther ; 35(9): e15703, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35831241

RESUMO

Melasma is a common circumscribed hypermelanosis of sun-exposed areas of the skin. Platelet-Rich Plasma therapy has been evidenced to inhibit melanin synthesis in animals and humans. To determine the effectiveness of platelet-rich plasma as a treatment for melasma. Twenty female patient with melasma were involved in this study. The intervention included three Platelet-Rich Plasma application sessions at 15-day intervals. Patients were evaluated before and after treatment. Variables measured included the facial melanin concentration using the melasma area and severity index score, melasma quality of life scale satisfaction grade, and histologic changes. Mean age was 41 ± 7 years. An initial MELASQOL score of 42 ± 14.8 and final score of 16.6 ± 7.2 (p = 0.008) were reported; the initial and final MASI score were 15.5 ± 8.4 and 9.5 ± 7.2 (p = 0.001), respectively. The dermatoscopy examination revealed a decrease in pigmentation after intervention (p = 0.001). Histopathologic improvement was detected in reductions in cutaneous atrophy (14 [70%] vs. 11 [55%]), solar elastosis (15 [75%] vs.11 [55%]), and inflammatory infiltrate (9 [45%] vs. 6 [30%]), before and after treatment, respectively. The intervention was associated with decreased intensity of the melasma patch and improved skin quality, shown by the MELASQOL and MASI scores.


Assuntos
Melanose , Plasma Rico em Plaquetas , Adulto , Feminino , Humanos , Melaninas/uso terapêutico , Melanose/tratamento farmacológico , Pessoa de Meia-Idade , Qualidade de Vida , Resultado do Tratamento
3.
World J Surg ; 46(2): 356-361, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34731260

RESUMO

BACKGROUND: Postoperative symptoms and pain after laparoscopic cholecystectomy (LC) are common in women. However, there is no evidence of differences in incidence and severity among different age groups. We evaluated whether adverse postoperative symptoms were more common in younger than in older women after LC. METHODS: One hundred and fifty premenopausal (mean age 37.6 ± 3.6 y) and 145 postmenopausal women (59 ± 5.2 y) were included in this retrospective cohort study. Clinical and anthropometric parameters were analyzed. Study endpoints were the incidences of postoperative nausea and vomiting (PONV) and pain, and the additional analgesics and antiemetics needed after surgery. RESULTS: Body mass index was normal in 42.7% of patients in the younger group and 64.8% in the older group (P < 0.001). Reported pain was more frequent and intense in the younger group throughout the study period (P < 0.01). Additional narcotics were required in 18% of premenopausal versus 7.6% of postmenopausal women (P = 0.001), and the doses used to reduce pain were higher for premenopausal women (P = 0.02). PONV was more frequent in the younger group at 1 and 6 h after surgery (P < 0.005). Rescue antiemetics were required in 29 premenopausal and 13 postmenopausal women (P = 0.01). Hospital stay was shorter for the older patients (P = 0.01). Minor morbidity was observed in both groups (0.7% and 2.1%). There was no mortality. CONCLUSIONS: Early PONV and pain after LC were more frequent in premenopausal women, who also required more rescue analgesic and antiemetic medication.


Assuntos
Colecistectomia Laparoscópica , Adulto , Idoso , Colecistectomia Laparoscópica/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/epidemiologia , Dor Pós-Operatória/etiologia , Pós-Menopausa , Náusea e Vômito Pós-Operatórios/epidemiologia , Náusea e Vômito Pós-Operatórios/etiologia , Estudos Prospectivos , Estudos Retrospectivos
4.
BMC Psychiatry ; 22(1): 443, 2022 06 30.
Artigo em Inglês | MEDLINE | ID: mdl-35773635

RESUMO

Depression and anxiety are common after months of social isolation, and they can have a negative impact on anyone's quality of life if they are not treated promptly and appropriately. The aim of this study was to determine if the change to online modality courses and the presence of depression or anxiety symptoms during the COVID-19 pandemic was associated with a difference in the college student's academic achievement. This study was a cross-sectional survey in which we used the Patient Health Questionnaire-9 (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). Also, we examined the students' perceptions of their academic performance using the Academic Self-Concept Scale (ASCS). A total of 610 students responded to the survey. The average score on the Academic Self-Concept Scale was 2.76 ± 0.35, the students presented a risk of 61.5% for possible depressive disorder and 52.1% for possible generalized anxiety disorder. The intensity of depression and anxiety symptoms had a significant effect on Academic Self-Concept Scale scores (p < 0.001 and p < 0.05, respectively). The findings indicate that the COVID-19 pandemic has had a direct effect on students' mental health and academic performance.


Assuntos
Desempenho Acadêmico , COVID-19 , Ansiedade , Transtornos de Ansiedade/epidemiologia , Estudos Transversais , Depressão/psicologia , Humanos , Pandemias , Qualidade de Vida
5.
Eur Surg Res ; 63(3): 145-154, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34818645

RESUMO

INTRODUCTION: Intra-abdominal adhesions' main etiology is surgical procedures that commonly require reintervention. Oral treatments with sildenafil, zafirlukast, and pirfenidone have yielded decreased severity of fibrotic phenomena secondary to the introduction of foreign material. This study aimed to evaluate the efficacy of oral zafirlukast, sildenafil, or pirfenidone treatment on reducing or preventing intra-abdominal adhesions in an experimental rat model. METHODS: Four groups, each of 10 male Wistar rats weighing 250-300 g, were used. A midline laparotomy was used to excise an area of 1.5 × 1.5 cm and reconstructed with polypropylene mesh fixed to the abdominal wall. After 12 h, oral doses of zafirlukast (1.25 mg/kg, group B), sildenafil (15 mg/kg, group C), or pirfenidone (500 mg/kg, group D) were given every day for 8 days. The control group, A, received no treatment. At day 9, animals were reoperated. The implant was resected after ethically approved euthanasia, and specimens were fixed in 10% formaldehyde for histopathology. RESULTS: Control group A yielded adhesions with greater fibrovascular density and neighboring organ involvement than the other groups (p = 0.001), as well as intense inflammatory infiltrates and numerous granulomas (p = 0.04). Adhesions in group C had less fibrovascular density (p = 0.03) with decreased serosal injuries (p = 0.001) and less organ involvement. Group D had reduced adhesions without organ involvement (p < 0.01) and less inflammatory infiltrates, collagen fibers, and foreign body granulomas than group B or C (p < 0.01). CONCLUSIONS: Oral administration of these agents did not prevent adhesions but ameliorated them. Oral pirfenidone offered the best performance and could be recommended for human use.


Assuntos
Telas Cirúrgicas , Animais , Humanos , Indóis , Masculino , Fenilcarbamatos , Piridonas , Ratos , Ratos Wistar , Citrato de Sildenafila , Sulfonamidas , Telas Cirúrgicas/efeitos adversos , Aderências Teciduais/prevenção & controle
6.
Death Stud ; 46(3): 581-589, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34181508

RESUMO

The world is facing the worst health crisis in modern history. In addition to general concerns about the effects of COVID-19 on health, hospital personnel are developing numerous mental health conditions. This cross-sectional survey study evaluated the prevalence and severity of anxiety caused by the COVID-19 pandemic using the Coronavirus Anxiety Scale (CAS) in 2136 hospital employees. For the employees who presented scores ranging from 1-20 (n = 1090, 51%), the CAS mean score was 4.22 (SD = 3.95). The mean score was higher in women than men. By work category, non-clinical hospital personnel presented the highest CAS scores.


Assuntos
COVID-19 , Ansiedade/epidemiologia , Ansiedade/etiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Pessoal de Saúde/psicologia , Hospitais Urbanos , Humanos , Masculino , Saúde Mental , Pandemias , SARS-CoV-2
7.
BMC Gastroenterol ; 20(1): 79, 2020 Mar 26.
Artigo em Inglês | MEDLINE | ID: mdl-32216787

RESUMO

BACKGROUND: The prevalence of malnutrition remains high in hospitals but no "gold standard" has been established to identify nutritional risks adequately. The Nutrition Risk Screening-2002 (NRS-2002), Subjective Global Assessment (SGA), and Controlling Nutritional Status Index (CONUT) are widely used screening tools, but their efficacy has not yet been compared in Mexican patients. Here, we aimed to compare the efficacy of these tools in identifying nutritional risks within the first 48 h of admission in a group of patients with gastrointestinal diseases. METHODS: This was a cross-sectional study of 196 patients. The results of the screening tools, length of hospital stay, serum albumin and cholesterol concentrations, lymphocyte counts, age, body mass index (BMI), complications, and mortality were analyzed. Kappa (κ) statistics were applied to determine the degree of agreement between tools. The performances of the screening tools in predicting complications and mortality were assessed using binary logistic regression. RESULTS: The NRS-2002, SGA, and CONUT tools identified nutritional risk in 67, 74, and 51% of the patients, respectively. The observed agreements between tools were: NRS2002/SGA, κ = 0.53; CONUT/NRS-2002, κ = 0.42; and SGA/CONUT, κ = 0.36. Within age groups, the best agreement was found in those aged 51-65 years (κ = 0.68). CONUT and length of stay were both predictive for the number of complications. The number of complications and serum cholesterol concentrations were predictive for mortality. CONCLUSIONS: The proportion of patients identified as having nutritional risk was high using all three screening tools. SGA, NRS-2002, and CONUT had similar capacities for screening risk, but the best agreement was observed between NRS-2002 and SGA. Only CONUT predicted complications, but none of these tools performed well in predicting mortality.


Assuntos
Gastroenteropatias/complicações , Desnutrição/etiologia , Avaliação Nutricional , Medição de Risco , Adulto , Idoso , Colesterol/sangue , Estudos Transversais , Feminino , Humanos , Tempo de Internação , Masculino , México , Pessoa de Meia-Idade , Adulto Jovem
8.
World J Surg ; 44(12): 4070-4076, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32812138

RESUMO

BACKGROUND: Although reports suggest that pain and postoperative nausea and vomiting (PONV) may be more frequent in women, the evidence is inconsistent. The objective of this study was to investigate whether women are more sensitive to pain and PONV after laparoscopic cholecystectomy (LC). METHODS: A total of 370 women and 275 men were included in a retrospective cohort study. All underwent LC under standardized general anesthesia. The variables analyzed included clinical and anthropometric parameters. End points were the incidence of nausea, vomiting, pain, and the requirement for additional pain relievers and antiemetics to control these. RESULTS: The women were younger and had lower body weight than the men (p < 0.001). Body mass index was within the normal range for 50% of women and 30% of men (p < 0.001). Pain was more common in women at 1, 6, 12 and 24 h after surgery (p < 0.02). Narcotics in addition to the doses used to lessen pain intensity (p = 0.01) were required in 60 women and 19 men (p < 0.001). PONV was more frequent in women at 1 and 6 h after surgery (p < 0.01). Rescue antiemetics were required in 35 women and 11 men (p = 0.008). Hospital stay was shorter for men (p < 0.001). Four patients in each group developed postoperative complications (p = 0.14). There was no mortality. CONCLUSIONS: Early postoperative pain, nausea and vomiting after LC were more common in women, who more frequently required analgesic and antiemetic rescue medication.


Assuntos
Colecistectomia Laparoscópica/efeitos adversos , Vesícula Biliar/cirurgia , Dor Pós-Operatória/epidemiologia , Náusea e Vômito Pós-Operatórios/epidemiologia , Administração Intravenosa , Adulto , Analgesia/métodos , Antieméticos/administração & dosagem , Feminino , Humanos , Incidência , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Dor Pós-Operatória/tratamento farmacológico , Complicações Pós-Operatórias/epidemiologia , Estudos Prospectivos , Estudos Retrospectivos , Fatores Sexuais
9.
BMC Health Serv Res ; 20(1): 631, 2020 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-32646516

RESUMO

BACKGROUND: Patients admitted to the intensive care unit (ICU) experience sleep disruption caused by a variety of conditions, such as staff activities, alarms on monitors, and overall noise. In this study, we explored the relationship between noise and other factors associated with poor sleep quality in patients. METHODS: This was a prospective cohort study. We used the Richards-Campbell Sleep Questionnaire to explore sleep quality in a sample of patients admitted to the ICU of a private hospital. We measured the noise levels within each ICU three times a day. After each night during their ICU stay, patients were asked to complete a survey about sleep disturbances. These disturbances were classified as biological (such as anxiety or pain) and environmental factors (such as lighting and ICU noise). RESULTS: We interviewed 71 patients; 62% were men (mean age 54.46 years) and the mean length of stay was 8 days. Biological factors affected 36% and environmental factors affected 20% of the patients. The most common biological factor was anxiety symptoms, which affected 28% of the patients, and the most common environmental factor was noise, which affected 32.4%. The overall mean recorded noise level was 62.45 dB. Based on the patients' responses, the environmental factors had a larger effect on patients' sleep quality than biological factors. Patients who stayed more than 5 days reported less sleep disturbance. Patients younger than 55 years were more affected by environmental and biological factors than were those older than 55 years. CONCLUSIONS: Patient quality of sleep in the ICU is associated with environmental factors such as noise and artificial lighting, as well as biological factors related to anxiety and pain. The noise level in the ICU is twice that recommended by international guides. Given the stronger influence of environmental factors, the use of earplugs or sleeping masks is recommended. The longer the hospital stay, the less these factors seem to affect patients' sleep quality.


Assuntos
Ansiedade/epidemiologia , Estado Terminal/terapia , Unidades de Terapia Intensiva , Iluminação/efeitos adversos , Ruído/efeitos adversos , Dor/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Inquéritos e Questionários , Adulto Jovem
10.
Med Educ Online ; 29(1): 2308360, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38281205

RESUMO

INTRODUCTION: Burnout syndrome is a global burden characterized by exhaustion, work detachment, and a sense of ineffectiveness. It affects millions of individuals worldwide, with a particularly high prevalence among medical students. Factors such as demanding education, exposure to suffering, and the COVID-19 pandemic have contributed to elevated stress levels. Addressing this issue is crucial due to its impact on well-being and health-care quality. MATERIALS AND METHODS: This cross-sectional survey study assessed fear of COVID-19 and burnout levels among medical student interns in hospitals in Guadalajara, Jalisco. The study used validated scales and collected data from September 2021 to September 2022. A snowball sampling method was employed and a minimum sample size of 198 participants was calculated. RESULTS: This study included 311 medical students (62.1% female and 37.9% male with a mean age of 23.51 ± 2.21 years). The majority were in their second semester of internship (60.5%) and from public hospitals (89.1%). Most students believed that the COVID-19 pandemic affected the quality of their internship (82.6%). Female students had higher personal burnout scores, while male students had higher work-related burnout scores. The mean score for fear of COVID-19 was 13.71 ± 6.28, with higher scores among women (p = 0.004) and those from public hospitals (p = 0.009). A positive weak correlation was found between COVID-19 scores and burnout subscales. CONCLUSION: Our study emphasizes the significant impact of various factors on burnout levels among medical students and health-care professionals during the COVID-19 pandemic. Prolonged exposure to COVID-19 patients, reduced staffing, and increased workload contributed to burnout, affecting well-being and quality of care. Targeted interventions and resilience-building strategies are needed to mitigate burnout and promote well-being in health-care settings.


Assuntos
Esgotamento Profissional , COVID-19 , Humanos , Masculino , Feminino , Adulto Jovem , Adulto , COVID-19/epidemiologia , Saúde Mental , Estudos Transversais , Pandemias , Hospitais Privados , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/psicologia , Inquéritos e Questionários
11.
Int J Ment Health Addict ; 21(1): 383-394, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34366729

RESUMO

The world is social distancing, and compulsory confinement has caused stress, psychological instability, stigmatization, fear, and discrimination in the general population. In this cross-sectional survey study, we administered the Fear of COVID-19 Scale (FCV-19S) to hospital medical and nonmedical personnel. A total of 1216 participants were surveyed from May 25 to May 29 of 2020. We asked all the staff for their participation in the study, and physical copies of the survey were distributed to the staff willing to participate. All surveys were answered anonymously. We found that the global FCV-19S mean score was 16.4 ± 6.1, with a significant difference between women and men's scores. Medical students presented higher scores than experienced medical personnel. Additionally, the medical and nursing personnel presented a higher level of fear than hospital staff who did not work directly with COVID-19 patients. Our findings suggest that greater knowledge of medicine or infectious diseases could decrease the overall psychological impact of the pandemic disease.

12.
J Rehabil Med ; 55: jrm11641, 2023 Dec 20.
Artigo em Inglês | MEDLINE | ID: mdl-38124428

RESUMO

OBJECTIVE: To evaluate the quality of sexual life in men with spinal cord injury. DESIGN: Cross-sectional analytical study. PATIENTS: Males with a history of spinal cord injury who attended an outpatient rehabilitation service. METHODS: An analytical study examined adult male patients with complete spinal cord injury in rehabilitation. A modified Sexual Life Quality Questionnaire (SLQQ) examined quality of sexual life, with scores below 50 suggesting significant sexual dysfunction and dissatisfaction. The assessment evaluated age, occupation, marital status, comorbidities, and treatment methods. RESULTS: A total of 80 patients were included; 33 (41%) had a thoracic spinal cord injury, and 47 (59%) had a lumbar spinal cord injury. Thirty-seven patients (46%) were dissatisfied with the quality of their sexual life; 29 patients (88%) with thoracic spinal cord injury and 8 patients (17%) with lumbar spinal cord injury were dissatisfied with the quality of their sexual life (p = 0.001). Patients with higher education level experienced less sexual dissatisfaction (p = 0.03). CONCLUSION: Human sexuality involves numerous interconnected elements that impact on general health. Sexual pleasure, self-esteem, and personal relationships are crucial for patients with spinal cord injury to identify rehabilitation needs. These results indicate the importance of supporting sexual well-being in recovery. Further studies of sexual enjoyment and quality of life for patients with spinal cord injury are needed, using larger and more diverse populations.


Assuntos
Qualidade de Vida , Traumatismos da Medula Espinal , Adulto , Humanos , Masculino , Estudos Transversais , Comportamento Sexual , Sexualidade , Traumatismos da Medula Espinal/reabilitação
13.
JMIR Infodemiology ; 2(1): e29894, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35155994

RESUMO

BACKGROUND: The COVID-19 pandemic has prompted the increasing popularity of several emerging therapies or preventives that lack scientific evidence or go against medical directives. One such therapy involves the consumption of chlorine dioxide, which is commonly used in the cleaning industry and is available commercially as a mineral solution. This substance has been promoted as a preventive or treatment agent for several diseases, including SARS-CoV-2 infection. As interest in chlorine dioxide has grown since the start of the pandemic, health agencies, institutions, and organizations worldwide have tried to discourage and restrict the consumption of this substance. OBJECTIVE: The aim of this study is to analyze search engine trends in Mexico to evaluate changes in public interest in chlorine dioxide since the beginning of the COVID-19 pandemic. METHODS: We retrieved public query data for the Spanish equivalent of the term "chlorine dioxide" from the Google Trends platform. The location was set to Mexico, and the time frame was from March 3, 2019, to February 21, 2021. A descriptive analysis was performed. The Kruskal-Wallis and Dunn tests were used to identify significant changes in search volumes for this term between four consecutive time periods, each of 13 weeks, from March 1, 2020, to February 27, 2021. RESULTS: From the start of the pandemic in Mexico (February 2020), an upward trend was observed in the number of searches compared with that in 2019. Maximum volume trends were recorded during the week of July 19-25, 2020. The search volumes declined between September and November 2020, but another peak was registered in December 2020 through February 2021, which reached a maximum value on January 10. Percentage change from the first to the fourth time periods was +312.85, -71.35, and +228.18, respectively. Pairwise comparisons using the Kruskal-Wallis and Dunn tests showed significant differences between the four periods (P<.001). CONCLUSIONS: Misinformation is a public health risk because it can lower compliance with the recommended measures and encourage the use of therapies that have not been proven safe. The ingestion of chlorine dioxide presents a danger to the population, and several adverse reactions have been reported. Programs should be implemented to direct those interested in this substance to accurate medical information.

14.
Int J Ment Health Addict ; 20(2): 895-906, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-33169075

RESUMO

The presence of COVID-19 has had psychological consequences among health personnel; these include fear, anxiety, and depression. In the current study, we used the Fear of COVID-19 Scale (FCV-19S) to assess the response to fear within health staff in Mexico. This was a cross-sectional survey study in which we administered the Spanish version of the FCV-19S to hospital staff. The FCV-19S is a seven-item questionnaire that assesses the severity of fear caused by COVID-19. A total of 2860 participants-1641 female and 1218 male personnel from three hospitals-were included in the study. The internal reliability of the scale was good, with Cronbach's alpha of .902. A confirmatory factor analysis (CFA) was conducted on the seven items of the FCV-19S, showing good model fit (χ 2 (7) = 29.40, p < .001; CFI = .99; TLI = .99; RMSEA = .03; SRMR = .010; AIC = 71.40). We found a global FCV-19S mean score of 19.3 ± 6.9, with a significant difference in scores between women and men. Our survey shows a significantly higher level of fear in nursing and administrative personnel, which may be explained by the nursing staff being in close contact with infected patients and the administrative staff lacking understanding of the possible implications of the infection, compared with nonclinical hospital personnel. Our results are consistent with those of other researchers. We must remember that fear is a reaction and that we must be courageous enough to trust validated infection prevention practices to provide the highest standard of care, in the safest environment that we can, for as long as we can.

15.
Intensive Crit Care Nurs ; 68: 103138, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-34750044

RESUMO

OBJECTIVE: Comparison of nurse involvement in end of life decision making in European countries participating in ETHICUS I- 1999 and ETHICUS II- 2015. METHODOLOGY: This was a prospective observational study of 22 European ICUs included in the ETHICUS-II and I. Data were collected as per the ETHICUS-I and ETHICUS-II protocols. Four questions within the ETHICUS protocols related to nurse involvement in end of life decision making were analyzed. This is a comparison of changes in nurse involvement in end of life decisions from 1999 to 2015. SETTING: International e-based questionnaire completed by an intensive care clinician when an end of life decision was performed on any patient. SUBJECTS: Intensive care physicians and nurses, no interventions were performed. MEASUREMENTS: A 20 question survey was used to describe the decision making process, on what basis was the decision made, who was involved in the decision making process, and what precise decisions were made. RESULTS: A total of 4592 cases from 22 centres are included. While there was more agreement between nurses and physicians in ETHICUS-I compared to ETHICUS-I, fewer discussions with nurses occurred in ETHICUS-II. The frequency of end of life decisions that were discussed with nurses decreased in all three regions between ETHICUS-I and ETHICUS-II. CONCLUSION: Based on the results of the current study, nurses should be further encouraged to increase their involvement in end of life decision-making, especially those in southern Europe.


Assuntos
Assistência Terminal , Cuidados Críticos , Morte , Tomada de Decisões , Humanos , Unidades de Terapia Intensiva
16.
Artigo em Inglês | MEDLINE | ID: mdl-36497537

RESUMO

Confinement and a lack of social interaction are associated with depressive symptoms, low self-esteem, and suicidal thoughts. We report the results of a cross-sectional survey of 1414 junior high school students. The aim was to evaluate the prevalence of depression, anxiety, and stress in Guadalajara, Mexico, during the COVID-19 pandemic. Mean scores on the validated Spanish version of the Depression, Anxiety, and Stress Scale (DASS-21) were found to be 6.15 ± 5.6 for depression, 5.8 ± 5.2 for anxiety, and 8.08 ± 5.3 for stress. Female students scored higher in all three conditions (p < 0.001). Students who had relatives infected with COVID-19 showed significantly more anxiety than those who did not (p < 0.004). Although certain demographic groups are at higher risk of manifesting depression, anxiety, and stress, the student population has also been affected by the global impact of the pandemic.


Assuntos
COVID-19 , Pandemias , Feminino , Humanos , Estudos Transversais , COVID-19/epidemiologia , SARS-CoV-2 , Saúde Mental , Depressão/epidemiologia , Estresse Psicológico/epidemiologia , Ansiedade/epidemiologia , Prevalência
17.
Artigo em Inglês | MEDLINE | ID: mdl-36497715

RESUMO

This is an observational cross-sectional study designed to ascertain the prevalence and severity of dysexecutive symptoms in high school students during the COVID-19 pandemic. The validated Spanish version of the Dysexecutive Questionnaire (DEX) was used. A total of 2396 participants aged 14-22 years were included. Our sample yielded a mean DEX scale score of 28.14 ± 17.42. By the DEX classification, 889 (37.1%) students achieved optimal scores, 384 (16%) reported mild dysexecutive symptoms, 316 (13.2%) reported moderate dysexecutive symptoms, and 807 (33.7%) reported strong dysexecutive symptoms. We found a significant difference between those with and those without employed mothers, with the former scoring higher (p = 0.004), the same as those with both parents employed (p = 0.004). Adolescents face emotional susceptibility and changes in their family, social, and educational environment related to isolation, resulting in altered emotional responses and social interaction.


Assuntos
COVID-19 , Pandemias , Adolescente , Humanos , Estudos Transversais , COVID-19/epidemiologia , Inquéritos e Questionários , Prevalência
18.
Artigo em Inglês | MEDLINE | ID: mdl-36498227

RESUMO

Social isolation and school closure may predispose adolescents to higher prevalence rates of depression, anxiety, and stress. In this cross-sectional observational study, the validated Spanish version of the Depression, Anxiety, and Stress Scale was administered to 3112 students aged 14-22 years old. We also collected data on participant gender, age group, school shift (morning or afternoon), school year, family type, whether they or any first-degree relative had been infected with COVID-19, whether any family member had died of COVID-19, and whether either of their parents worked. Mean scores were 8.34 ± 6.33 for depression, 7.75 ± 5.89 for anxiety, and 10.26 ± 5.84 for stress. Female students presented significantly higher scores on all three measures compared with male students. Students who had been infected with COVID-19, who had an infected family member, or who had a family member who died of COVID-19 also presented higher scores on all three measures. Identifying the symptoms and warning signs of depression and anxiety disorders is critical, particularly in vulnerable populations like adolescents.


Assuntos
COVID-19 , Adolescente , Humanos , Masculino , Feminino , Adulto Jovem , Adulto , COVID-19/epidemiologia , Pandemias , SARS-CoV-2 , Estudos Transversais , Depressão/epidemiologia , Depressão/diagnóstico , Saúde Mental , Ansiedade/epidemiologia , Ansiedade/diagnóstico , Transtornos de Ansiedade/epidemiologia , Estresse Psicológico/epidemiologia
19.
Artigo em Inglês | MEDLINE | ID: mdl-36613036

RESUMO

OBJECTIVES: This observational cross-sectional study examined changes in substance use during the coronavirus disease 2019 (COVID-19) pandemic in the Mexican population and evaluated whether depression or anxiety was associated with these new consumption patterns. METHODS: An online survey was distributed to the general population. Participants were questioned about their demographics, situation during the COVID-19 pandemic, and substance consumption patterns. The Patient Health Questionnaire-9 for depression and the Coronavirus Anxiety Scale were used. RESULTS: A total of 866 individuals completed the survey. The mean scores for the Patient Health Questionnaire-9 and Coronavirus Anxiety Scale were 8.89 ± 6.20 and 3.48 ± 3.22, respectively. The preferred substances were alcohol (19%), tobacco (16.5%), and marijuana (5.6%). Consumption of alcohol (p = 0.042) significantly increased during the pandemic and it was higher in women than in men (p = 0.040). CONCLUSIONS: Substance use patterns were affected by the pandemic, with an increase in the number of users and consumption rate, as well as the reported psychiatric symptoms.


Assuntos
COVID-19 , Angústia Psicológica , Transtornos Relacionados ao Uso de Substâncias , Masculino , Humanos , Adulto , Feminino , COVID-19/epidemiologia , Pandemias , Estudos Transversais , SARS-CoV-2 , Depressão/epidemiologia , Ansiedade/psicologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Estresse Psicológico/epidemiologia
20.
Front Public Health ; 10: 932010, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36304240

RESUMO

Introduction: Understanding how Mexicans behave during the pandemic could present a complete picture of the phenomenon in our country and provide better management of it. Objective: This study aimed to analyze the Mexican population's behavior and preventive measures. Methods: This was a cross-sectional study in which a total of 4,004 participants from the general population responded to the survey. Results: Almost 99% of the participants mentioned knowing the symptoms of COVID-19. Although 77.5% of participants considered that they followed proper social distancing measures, 60% of them mentioned that they knew at least six individuals who did not follow social distancing measures. Furthermore, 96.2% of participants reported using preventive measures at least 50% of the time. Only 51.3% used a certified mask. Conclusion: The COVID-19 pandemic outcomes in Mexico are the result of multiple negative factors, such as high rates of comorbidities, high number of people living together at home, many people breaking social isolation, and most of the population using non-certified preventive measures that may not be effective enough.


Assuntos
COVID-19 , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Pandemias/prevenção & controle , Estudos Transversais , SARS-CoV-2 , México/epidemiologia
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