ABSTRACT
INTRODUCCIÓN: La infección y resistencia antimicrobiana de Mycoplasma genitalium está infradiagnósticada en nuestra comunidad ya que no es una Enfermedad de Declaración Obligatoria y requiere técnicas de biología molecular, no siempre disponibles. OBJETIVO: Estudiar la epidemiología y prevalencia de M. genitalium y la tasa de resistencia frente a azitromicina en nuestra Área de Salud. MÉTODOS: Estudio retrospectivo, desde abril de 2019 a julio de 2020, realizado en el Área de Salud del Norte de Tenerife, la cual atiende el Hospital Universitario Canarias. Para el diagnóstico de las infecciones de transmisión sexual (ITS) se utilizó la RT-PCR Allplex™ STI Essential Assay (Seegene, South Korea). Las muestras en las que se detectó M. genitalium fueron congeladas a −80°C para posteriormente realizar estudio de resistencia a azitromicina con la RT-PCR Allplex™ MG y AziR Assay (Seegene, South Korea). RESULTADOS: Se identificaron 111/3.849 (prevalencia de 2,8%) pacientes con M. genitalium, de los cuales la mayoría, 59(53,1%) eran hombres con una mediana de 32 años (15-74) y cuyas muestras procedían principalmente de Atención Primaria: 55 (49,5%). Para la detección de resistencia a azitromicina, de los 111 pacientes solo se pudo analizar las muestras de 79, detectándose resistencia in vitro en 15(18,3%): 10 con A2059G, 4 con A2058G y 1 con ambas. La resistencia a azitromicina fue más frecuente en hombres 12 (15,8%). DISCUSIÓN Y CONCLUSIONES: Con este estudio se pone de manifiesto la importancia de la prevalencia de M. genitalium en nuestro entorno, así como su alta tasa de resistencia a azitromicina por lo que se hace necesario vigilar dicha resistencia en nuestro Área de Salud para su adecuado tratamiento.
BACKGROUND: Infection and antimicrobial resistance of Mycoplasma genitalium is under-diagnosed in our community as it is not a Notifiable Infectious Disease and requires for its detection molecular biology techniques, which are not always available. AIM: To study the epidemiology and prevalence of M. genitalium and the rate of resistance to azithromycin in our Health Care Area. METHODS: We conducted a retrospective study from April 2019 to July 2020 in the Northern Health Care Area of Tenerife, which is attended to the Universitary Hospital Complex of the Canary Islands. The RT-PCR Allplex™ STI Essential Assay (Seegene, South Korea) to diagnose Sexually Transmitted Infections (STI) was used. Samples in which M. genitalium was detected were stored at −80°C for subsequent diagnosis of resistance to azithromycin with the RT-PCR Allplex™ MG and AziR Assay (Seegene, South Korea). RESULTS: Of a total of 111/3,849 (2.8% prevalence) patients diagnosed with M. genitalium, 59 (53.1%) were male with a mean age of 30 (19-61) years and mainly from Primary Care 55 (49.5%). Only 79 samples of the 111 patients could be tested to detect azithromycin resistance, of which 15 (18.3%) were resistant in vitro: 10 with A2059G, 4 with A2058G and 1 with both. Azithromycin resistance was more frequent in men 12 (15.8%) and detected mainly in urine samples 6 (60%). Discussion and CONCLUSIONS: This study highlights the prevalence of M. genitalium in our setting as well as the high rate of resistance to azithromycin, making it necessary to detect resistance to azithromycin in M. genitalium for its appropriate treatment in our Health Care Area.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Azithromycin/therapeutic use , Mycoplasma genitalium/drug effects , Mycoplasma Infections/drug therapy , Mycoplasma Infections/epidemiology , Spain/epidemiology , Sexually Transmitted Diseases , Prevalence , Retrospective Studies , Azithromycin/pharmacology , Drug Resistance, Bacterial , Anti-Bacterial Agents/therapeutic use , Anti-Bacterial Agents/pharmacologyABSTRACT
Introducción. El dolor raquídeo es uno de los motivos principales de asistencia sanitaria; suele aparecer durante la etapa escolar, aumenta progresivamente con la edad y se relaciona con ciertos factores de riesgo. El objetivo de esta investigación es analizar la prevalencia de dolor raquídeo en escolares y examinar los factores asociados a su padecimiento. Población y métodos. Estudio transversal mediante un cuestionario realizado en escolares de 9 a 11 años. Se analizó la prevalencia del dolor, la actividad física, los autocuidados del raquis, el uso de la mochila y la utilización de dispositivos electrónicos. Resultados. Se analizaron 329 sujetos. La prevalencia de dolor raquídeo es del 34,3 %, sin diferencias entre sexos. Se considera de baja intensidad, con una media de dolor de 1,99 ± 2,54 sobre 10 según la escala Wong-Baker FACES®, y en más de la mitad de los casos, de corta duración, menos de 12 horas. El 22,2 % de los escolares refieren dolor cervical, mientras que el 14 % y 11,9 % refieren dolor dorsal y lumbar, respectivamente. Además, el 47,9 % refieren dolor en más de una región raquídea. El 73,3 % realiza actividad física fuera del horario escolar, y el 90,6 % de los estudiantes utiliza dispositivos electrónicos. Se observó relación entre la presencia de dolor y hábitos de higiene postural adecuados. Conclusiones. Los escolares refieren dolor raquídeo de baja intensidad y corta duración, con mayor frecuencia en la región cervical. La asociación con factores de riesgo revela que los que refieren dolor presentan mejores hábitos posturales.
Introduction. Spinal pain is one of the main reasons for seeking care; it usually appears during school age, increases with age, and is related to certain risk factors. The objective of this study is to analyze the prevalence of spinal pain among schoolchildren and examine associated factors. Population and methods. Cross-sectional study with a questionnaire administered to schoolchildren aged 9-11 years. The prevalence of pain, physical activity, spine self-care, backpack use, and electronic device use were analyzed. Results. A total of 329 subjects were analyzed. The prevalence of spinal pain is 34.3 %, with no differences observed between sexes. Pain severity is considered mild, with a mean severity of 1.99 ± 2.54 over 10 according to the Wong-Baker FACES® scale; in more than 50 % of cases, pain had a short duration (less than 12 hours). Cervical pain was referred by 22.2 % of schoolchildren, whereas dorsal and lumbar pain were reported by 14 % and 11.9 %, respectively. In addition, 47.9 % referred pain in more than one region of the spine. Also, 73.3 % of schoolchildren did physical activity outside school hours and 90.6 % used electronic devices. An association was observed between the presence of pain and adequate postural hygiene habits. Conclusions. Schoolchildren referred spinal pain that was mild and short in duration, often in the cervical region. The association with risk factors indicates that children who referred pain have better postural habits.
Subject(s)
Humans , Male , Female , Child , Spine , Low Back Pain , Schools , Spain/epidemiology , Prevalence , Cross-Sectional StudiesABSTRACT
Introducción. La obesidad infantil en España es preocupante y el entorno familiar puede influir en su desarrollo. Los objetivos fueron determinar la prevalencia de exceso de peso en adolescentes, evaluar variables familiares que pudieran condicionarla y determinar la percepción corporal de los padres.Población y métodos. Estudio transversal; se incluyeron alumnos de cinco centros de secundaria del Área V de Murcia. Se registró antropometría de los alumnos y se administró una encuesta a los padres con variables de peso, talla, ejercicio, estudios, tipo de familia y percepción corporal. Se realizó el análisis mediante tablas de contingencia y asociación con d de Somers.Resultados. Participaron 421 alumnos (edad: 12,8 ± 0,6 años); el 21,1 % tenían sobrepeso, y el 19,5 %, obesidad. Existió asociación entre padres e hijos con sobrecarga ponderal (d de Somers con p < 0,05). Si ambos padres eran sedentarios, sus hijos realizaban menos ejercicio. A mayor nivel de estudios parental, menor tasa de sobrepeso infantil (p < 0,05). El sobrepeso-obesidad en los hijos fue mayor en familias separadas o monoparentales. El 32 % de los padres no percibía el exceso de peso de sus hijos ni el 53 % en sí mismos.Conclusiones. La prevalencia de exceso de peso en esta muestra fue del 40,6 %. El estado nutricional de los padres, el nivel de estudios y el tipo de familia se asociaron con la obesidad infantil. Influyó en mayor medida la figura materna. Existió una infraconsideración de la obesidad por parte de los padres.
Introduction. In Spain, childhood obesity is worrying, and its development might be influenced by the family setting. The objectives were to determine the prevalence of excess weight among adolescents, evaluate family variables that could affect it, and determine parents' body perception.Population and methods. Cross-sectional study; students from five secondary schools in health area V of the Region of Murcia were included. Students' anthropometric measurements were recorded and a survey was administered to parents, including variables such as weight, height, exercise, level of education, family structure, and body perception. The analysis was done using contingency tables and the association with Somers' D measures.Results. Four hundred and twenty one students participated (age: 12.8 ± 0.6 years old); 21.1 % were overweight and 19.5 %, obese. There was an association between parent and child excess weight (Somers' D with a p value < 0.05). If both parents had a sedentary lifestyle, their children would exercise less. The higher the level of parental education, the lower the rate of childhood overweight (p < 0.05). Overweight-obesity among children was higher in separated or single-parent families. In total, 32 % of parents misperceived their children's excess weight and 53 %, their own.Conclusions. In this sample, the prevalence of excess weight was 40.6 %. Parents' nutritional status, level of education, and family structure were associated with childhood obesity. Mothers had a greater influence on the development of their children's overweight. Parents underestimated obesity.
Subject(s)
Humans , Male , Female , Adolescent , Nutritional Status , Overweight , Life Style , Parents , Spain/epidemiology , Exercise , Family , Prevalence , Cross-Sectional Studies , Pediatric Obesity/epidemiologyABSTRACT
Background: Pneumonia is a disease with great relevance in public health, as a leading individual cause of infant mortality worldwide. Legionellosis is a respiratory disease with a bacterial origin and two different clinical forms. Aim: To determine pneumonia and legionellosis mortality in Spain. Material and Methods: Time series study of pneumonia and legionellosis in Spain in two periods, from 1997 to 2001 and from 2011 to 2015. Mortality was calculated according to disease and sex, number of deaths and rates per 100,000 inhabitants. Results: Pneumonia mortality in the first period shows a relatively stable and similar tendency according to sex, preferably affecting males. In the second period, pneumonia mortality increased significantly in recent years. Although pneumonia mortality in Spain decreased in both sexes in some age groups (especially 75 years. Deaths due to legionellosis were relevant in 1997, 1998 and 2000 and increased in the last period. Conclusions: A higher mortality due to pneumonia along the years was identified. Strategies to reduce the incidence and improve the diagnosis of pneumonia, especially in children and older people elderly, are encouraged.
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Aged , Pneumonia , Legionellosis/epidemiology , Spain/epidemiology , IncidenceABSTRACT
Resumen Este artículo tiene como objeto analizar la crisis de la atención residencial en España en el contexto de la Covid-19 y su impacto en una elevada mortalidad y el abandono de la población usuaria. Se analizan sus causas inmediatas, mediatas y estructurales. De manera específica se analiza la precariedad en el empleo en las residencias a lo largo de la pasada década como una de las principales causas explicativas de la crisis estructural de las residencias. El enfoque teórico de análisis es el modelo de atención integral y centrada en la persona (AICP) basado en la autonomía de las personas y en la centralidad de sus derechos. La metodología combina el análisis cuantitativo en lo referente al empleo junto con una metodología cualitativa basada en el análisis de documentos y debates. El artículo concluye proponiendo una reforma integral de los cuidados de larga duración que incluya tanto un cambio en la atención residencial bajo la forma de pequeñas unidades de convivencia, como un reforzamiento de la atención en el domicilio y la comunidad en cuanto preferencia creciente la población mayor. La combinación óptima de la atención residencial y domiciliaria es la propuesta básica de este trabajo.
Abstract The objective of this study is to analyze the residential care crisis in Spain in the context of the COVID-19 pandemic and its impact on high mortality and abandonment of the user population. The direct, indirect and structural causes are analyzed. Specifically, precarious employment in residences over the past decade was analyzed as one of the main explanatory causes of the structural crisis of nursing homes. The theoretical focus of analysis is the comprehensive and person-centered care (CPCC) model based on the autonomy of people and the centrality of their rights. The methodology combines a quantitative analysis of employment and a qualitative analysis of documents and debates. The study concludes by proposing a comprehensive reform of long-term care that includes both a change in residential care in the form of small cohabitation units and reinforcement of care in the home and the community as a growing preference for the elderly population. An optimal combination of residential and home care is the basic proposal of this work.
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Coronavirus Infections/epidemiology , Pandemics , Betacoronavirus , Homes for the Aged/legislation & jurisprudence , Homes for the Aged/organization & administration , Homes for the Aged/statistics & numerical data , Nursing Homes/legislation & jurisprudence , Nursing Homes/organization & administration , Nursing Homes/statistics & numerical data , Spain/epidemiology , Sex Distribution , Coronavirus Infections/mortality , Age Distribution , Patient-Centered Care , Qualitative Research , Employment , Health Services for the Aged/organization & administrationABSTRACT
Objetivo: Descrever as medidas de contenção de tipo lockdown e a incidência da COVID-19 em sete países: África do Sul, Alemanha, Brasil, Espanha, Estados Unidos, Itália e Nova Zelândia. Métodos: Estudo ecológico descritivo, com dados da incidência diária dos casos confirmados de COVID-19 entre 22 de fevereiro e 31 de agosto de 2020, e informações sobre medidas de lockdown implementadas pelo governo de cada país. Resultados: Os países que implementaram lockdown tiveram diminuição da incidência diária de COVID-19 (casos por milhão de habitantes) no período de três semanas, a contar do início da medida: África do Sul (3,7 a 1,7), Alemanha (37,5 a 33,7), Espanha (176,3 a 82,0), Itália (92,0 a 52,1) e Nova Zelândia (7,5 a 1,7). O Brasil e os Estados Unidos, que não implementaram lockdown, não apresentaram uma diminuição considerável. Conclusão: Após a implementação de lockdown, houve uma diminuição considerável do número de casos confirmados.
Objetivo: Describir las medidas de contención tipo lockdown y la incidencia de COVID-19 en los países de Sudáfrica, Alemania, Brasil, España, Estados Unidos, Italia y Nueva Zelanda. Métodos: Estudio ecológico descriptivo con datos de la incidencia diaria de los casos confirmados de COVID-19, del 22 de febrero al 31 de agosto de 2020 e informaciones sobre medidas de contención lockdown implementadas por los gobiernos de cada uno de los países. Resultados: Los países que implementaron lockdown, desde el inicio de su implementación hasta tres semanas después, tuvieron una disminución en la incidencia diaria (casos por millón de habitantes): Sudáfrica (3,7 a 1,7), Alemania (37,5 a 33,7), España (176,3 a 82,0), Italia (92,0 a 52,1) y Nueva Zelanda (7,5 a 1,7). Brasil y Estados Unidos, que no implementaron lockdown, no tuvieron una disminución considerable Conclusión: Luego de la implementación del lockdown, hubo una disminución considerable en el número de casos confirmados.
Objective: To describe lockdown-type containment measures and COVID-19 incidence in South Africa, Germany, Brazil, Spain, United States, Italy and New Zealand. Methods: This is a descriptive ecological study with data on daily incidence of confirmed COVID-19 cases from February 22 to August 31 2020, as well as information on lockdown measures implemented by the governments of each country. Results: Daily COVID-19 incidence (cases per 1 million inhabitants) decreased within three weeks after lockdown started in the countries that implemented it: South Africa (3.7 to 1.7), Germany (37.5 to 33.7) Spain (176.3 to 82.0), Italy (92.0 to 52.1) and New Zealand (7.5 to 1.7). As for Brazil and the United States, which did not implement lockdown, there was no considerable decrease. Conclusion: After lockdown implementation, there was a considerable decrease in the number of confirmed cases.
Subject(s)
Humans , Psychological Distance , Quarantine/methods , Communicable Disease Control/statistics & numerical data , Coronavirus Infections/prevention & control , Coronavirus Infections/epidemiology , South Africa/epidemiology , Spain/epidemiology , United States/epidemiology , Brazil/epidemiology , Incidence , Ecological Studies , Pandemics/prevention & control , Germany/epidemiology , Health Policy/trends , Italy/epidemiology , New Zealand/epidemiologyABSTRACT
Objective@#Previous studies have shown that meteorological factors may increase COVID-19 mortality, likely due to the increased transmission of the virus. However, this could also be related to an increased infection fatality rate (IFR). We investigated the association between meteorological factors (temperature, humidity, solar irradiance, pressure, wind, precipitation, cloud coverage) and IFR across Spanish provinces ( @*Methods@#We estimated IFR as excess deaths (the gap between observed and expected deaths, considering COVID-19-unrelated deaths prevented by lockdown measures) divided by the number of infections (SARS-CoV-2 seropositive individuals plus excess deaths) and conducted Spearman correlations between meteorological factors and IFR across the provinces.@*Results@#We estimated 2,418,250 infections and 43,237 deaths. The IFR was 0.03% in < 50-year-old, 0.22% in 50-59-year-old, 0.9% in 60-69-year-old, 3.3% in 70-79-year-old, 12.6% in 80-89-year-old, and 26.5% in ≥ 90-year-old. We did not find statistically significant relationships between meteorological factors and adjusted IFR. However, we found strong relationships between low temperature and unadjusted IFR, likely due to Spain's colder provinces' aging population.@*Conclusion@#The association between meteorological factors and adjusted COVID-19 IFR is unclear. Neglecting age differences or ignoring COVID-19-unrelated deaths may severely bias COVID-19 epidemiological analyses.
Subject(s)
Adult , Aged , Aged, 80 and over , Humans , Middle Aged , Young Adult , COVID-19/virology , Meteorological Concepts , Pandemics/statistics & numerical data , SARS-CoV-2/physiology , Spain/epidemiology , WeatherABSTRACT
Introdução: A infecção pelo vírus SARS-CoV-2, que provoca a Coronavírus Disease-2019 (COVID-19), desencadeou uma pandemia, que já causou mais de 4,77 milhões de vítimas fatais pelo mundo, até o dia 17 de agosto de 2021. As consequências da doença, entretanto, extrapolam a área da saúde, e ocasionam crises de ordem civil, econômica e política no mundo. Objetivos: avaliar a pandemia por COVID-19, através da análise das tendências na Espanha, e no Brasil, analisar a correlação de fatores políticos, como corrupção, e governança aos indicadores da doença e de vacinação, e promover um levantamento das legislações brasileiras relacionadas a medidas de isolamento. Metodologia: Foram realizados estudos observacionais, com dados agregados de casos novos, hospitalizações, internações em UTI, casos recuperados e mortes para a Espanha e suas comunidades autônomas, e de casos e mortes no Brasil, em seus estados e nas respectivas capitais, para avaliação das tendências, através do método de joinpoint, em busca de avaliar mudanças ao longo do tempo. Em cada país, as informações estão publicamente disponíveis em seus respectivos Ministérios da Saúde, ao passo que os dados populacionais foram obtidos nos Institutos de Estatística dos 2 países. A análise de fatores políticos foi realizada por meio de Análise de Componentes Principais de um banco constituído por linkage de dados mundiais. As variáveis dependentes foram reduzidas a dois componentes (de vacinação e de morbimortalidade) e foi realizada correlação, a regressão linear, e regressão linear múltipla, com significância para p<0,05. Quanto às legislações, foi promovido o levantamento dos principais decretos estaduais brasileiros relacionados ao distanciamento social. Resultados: na Espanha, foi observada, após o estabelecimento de lockdown nacional, uma redução dos indicadores para todas as suas comunidades autônomas no período estudado. A média de dias necessários para mudança no padrão de tendências foi de 18,33 dias para taxas de mortalidade. Comunidades que estavam com menos casos e óbitos no momento do lockdown tiveram suas consequências minimizadas. Para o Brasil, seus estados e capitais, em que não houve padronização das medidas tomadas, a redução demorou aproximadamente 6 meses para início de mudança na curva. As medidas governamentais do início da pandemia mostraram a diversidade de tomada de decisões entre os estados. O país vivenciou desafios relacionados ao acesso ao sistema de saúde (desigual entre os estados), à aceitação da vacinação e à crise econômica, agravada pela polarização da população e pelos problemas já existentes antes da pandemia. Quanto à análise dos fatores políticos, a governança, e o controle da corrupção, associaram-se positivamente à vacinação, ao passo que a morbimortalidade se associou de modo negativo ao controle da corrupção. A avaliação das legislações relacionadas ao distanciamento social demonstrou que todos os estados aplicaram medidas restritivas, de modo descentralizado. Conclusões: a análise da pandemia é complexa e denota haver influência de múltiplos fatores. Por meio dos estudos realizados, percebeu-se a importância de decisões assertivas em prol da minimização das consequências já sofridas pelas populações. A colaboração mundial continua sendo primordial no atual momento, em que a vacinação surge como perspectiva de finalização da pandemia (AU).
Introduction: Infection by the SARS-CoV-2 virus, which causes Coronavirus Disease-2019 (COVID-19), triggered a pandemic, which has already caused more than 4.77 million deaths worldwide, until the August 17, 2021. The consequences of the disease, however, go beyond the health area, and cause civil, economic and political crises in the world. Objectives: Evaluate the COVID-19 pandemic through the analysis of trends in Spain and Brazil, analyze the correlation of political factors such as corruption and governance to disease and vaccination indicators, and promote the search for Brazilian legislation on isolation isolation measures. Methodology: Observational studies were carried out, with aggregated data of new cases, hospitalizations, ICU admissions, recovered cases and deaths for Spain and its autonomous communities, and cases and deaths in Brazil, in its states and in the respective capitals, for evaluation trends, using the joinpoint method, in order to assess changes over time. In each country, the information is publicly available in their respective Ministries of Health, while population data were obtained from the Statistical Institutes of the 2 countries. The analysis of political factors was performed through Principal Component Analysis of a database consisting of linkage of world data. The dependent variables were reduced to two components (vaccination and morbidity and mortality) and correlation, linear regression, and multiple linear regression were performed, with significance to p<0.05. As for legislation, the survey of the main Brazilian state decrees related to social distancing was promoted. Results: in Spain, after the establishment of a national lockdown, a reduction in indicators was observed for all its autonomous communities during the period studied. The average number of days needed to change the pattern of trends was 18.33 days for mortality rates. Communities that had fewer cases and deaths at the time of the lockdown had their consequences minimized. For Brazil, its states and capitals, where there was no standardization of the measures taken, the reduction took approximately 6 months for the beginning of the change in the curve. Government measures at the start of the pandemic showed the diversity of decision-making across states. The country experienced challenges related to access to the health system (unequal between states), acceptance of vaccination and the economic crisis, aggravated by the polarization of the population and the problems that existed before the pandemic. As for the analysis of political factors, governance and corruption control were positively associated with vaccination, while morbidity and mortality were negatively associated with corruption control. The evaluation of legislation related to social distancing showed that all states applied restrictive measures in a decentralized way. Conclusions: the analysis of the pandemic is complex and shows the influence of multiple factors Through the studies conducted, it was perceived the importance of assertive decisions in favor of minimizing the consequences already suffered by the populations. Global collaboration remains paramount at the present time, when vaccination is emerging as a perspective for ending the pandemic (AU).
Subject(s)
Social Isolation/psychology , Indicators of Morbidity and Mortality , Incidence , Mortality/trends , Vaccination , COVID-19/prevention & control , Spain/epidemiology , Brazil/epidemiology , Linear Models , Surveys and Questionnaires , Decision Making/ethics , Observational Studies as Topic/methodsABSTRACT
RESUMEN La infancia es el sur del virus, como ha visibilizado la pandemia de COVID-19: un mundo donde el cuidado no es un valor escogido desde el deseo, y donde la voz infantil es silenciada en virtud de una injusticia epistémica ancestral. Así, la transformación que las sociedades humanas están experimentando debido a la COVID-19 ha impactado significativamente en los derechos de la infancia, a niveles micro y macro. En España, como país especialmente golpeado por la pandemia, encontramos que tanto la primera infancia (a través especialmente de la violencia obstétrica) como ella misma en todas sus fases, están siendo víctimas de un paradigma adultocéntrico de control e injusticia epistémica basales. En este ensayo se analiza y discute algunas de las consecuencias negativas observadas en este país con relación al cuidado y el confinamiento de menores y sus familias, acaecidas a raíz de la pandemia, considerando que la crisis desencadenada por la COVID-19 puede ser una oportunidad para visibilizar situaciones de injusticia ancestral para con la niñez
ABSTRACT As the COVID-19 pandemic has made visible, childhood is the virus's proverbial south: a world where care is not a value chosen from a place of desire, and where children's voices are silenced at the hands of an ancestral epistemic injustice. Thus, the transformation that human societies are undergoing due to COVID-19 has significantly impacted the rights of children, both at the micro and the macro levels. In Spain - a country that has been particularly hard-hit by the pandemic - we find that both infancy (especially through obstetric violence) and childhood at all its stages fall victim to an adultcentric paradigm based on control and epistemic injustice. This essay analyzes and discusses some of the negative consequences observed in this country related to the care for and the confinement of minors and their families - which has occurred as a result of the pandemic - and considers that the crisis triggered by COVID-19 may be an opportunity to shed light on situations of ancestral injustice towards children.
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Child Welfare , Quarantine , Child Health , Physical Distancing , COVID-19/prevention & control , Human Rights , Spain/epidemiology , Violence , Power, Psychological , Child Rearing , Pandemics , COVID-19/psychology , COVID-19/epidemiology , Health PolicyABSTRACT
Objetivo: to identify and compare burnout levels between Portuguese, Spanish and Brazilian nurses. Method: quantitative, descriptive, correlational, comparative and cross-sectional study conducted using a sample of 1,052 nurses working in hospitals and primary care centers. A sociodemographic questionnaire and the Maslach Burnout Inventory were applied to nurses in Porto, Portugal (n=306), Oviedo, Spain (n=269) and S. Paulo, Brazil (n=477). Data analysis was performed using descriptive, inferential and multivariate analysis. Results: approximately 42% of the nurses showed moderate/high levels of burnout, with no differences found between countries (Portugal and Brazil 42%, Spain 43%). Only depersonalization showed differences between countries, presenting Spain the highest level and Portugal the lowest one. Comparative analysis showed higher burnout levels in young nurses and those working by shifts. Considering job schedules, burnout was associated to shift work in Portugal, while in Spain and Brazil it was associated with fixed schedules. Conclusion: these results suggest that this syndrome among nurses is a global phenomenon. The daily stressors and higher demands of the nursing profession are crucial in the preparation of nurses to deal with complex situations, to avoid burnout, and to reduce the negative impact on nurses' health and on the quality of care they provide.
Objetivo: identificar e comparar os níveis de burnout entre enfermeiros portugueses, espanhóis e brasileiros. Método: estudo quantitativo, descritivo, correlacional, comparativo e transversal, realizado com 1.052 enfermeiros em hospitais e unidades básicas de saúde. Um questionário sociodemográfico e o Maslach Burnout Inventory foram aplicados com enfermeiros de Porto-Portugal (n=306), Oviedo-Espanha (n=269) e São Paulo-Brasil (n=477). Os dados foram analisados por meio de estatística descritiva, inferencial e multivariada. Resultados: aproximadamente 42% dos enfermeiros apresentaram níveis moderados/altos de burnout, não sendo encontradas diferenças entre os países (Portugal e Brasil com 42%, Espanha com 43%). Apenas a dimensão despersonalização apresentou diferenças entre os países, com um nível mais elevado na Espanha e mais baixo em Portugal. A análise comparativa mostrou níveis mais elevados de burnout em enfermeiros jovens e naqueles que trabalhavam em turnos. Em relação às escalas de trabalho, burnout foi associada ao trabalho por turnos em Portugal e aos horários fixos na Espanha e no Brasil. Conclusão: esses resultados sugerem que essa síndrome em enfermeiros é um fenômeno global. Estressores diários e maiores demandas da profissão de enfermagem são elementos cruciais para preparar os enfermeiros para lidar com situações complexas, evitar burnout e reduzir o impacto negativo na sua saúde e na qualidade dos cuidados que prestam.
Objetivo: identificar y comparar los niveles de burnout entre enfermeros portugueses, españoles y brasileños. Método: estudio cuantitativo, descriptivo, correlacional, comparativo y transversal, realizado con 1.052 enfermeros de hospitales y unidades básicas de salud. Se aplicó un cuestionario sociodemográfico y el Maslach Burnout Inventory a enfermeras de Porto, Portugal (n=306), Oviedo, España (n=269) y São Paulo, Brasil (n=477). Los datos se analizaron mediante estadística descriptiva, inferencial y multivariada. Resultados: aproximadamente el 42% de los enfermeros presentaban niveles moderados/altos de burnout y no se encontraron diferencias entre países (Portugal y Brasil 42%, España 43%). Solo la dimensión de despersonalización mostró diferencias entre países, con un nivel mayor en España y menor en Portugal. El análisis comparativo mostró mayores niveles de burnout en enfermeros jóvenes y en los que trabajaban por turnos. En cuanto a los horarios de trabajo, el burnout se asoció con el trabajo por turnos en Portugal y con horario fijo en España y Brasil. Conclusión: estos resultados sugieren que el síndrome de burnout en enfermeros es un fenómeno global. Los estresores cotidianos y las mayores exigencias de la profesión de Enfermería son elementos cruciales para preparar a los enfermeros para enfrentar situaciones complejas, evitar el burnout y reducir el impacto negativo en la salud de los enfermeros y la calidad de la atención que brindan.
Subject(s)
Humans , Male , Female , Portugal/epidemiology , Quality of Health Care , Spain/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Surveys and Questionnaires , Burnout, Psychological , Job Satisfaction , Nurses , Nurses, MaleABSTRACT
Este texto apresenta um panorama internacional das medidas econômicas adotadas para reduzir os graves efeitos econômicos da pandemia de Sars-COV-2 em três países: Estados Unidos, Reino Unido e Espanha. A análise toma como base primordialmente documentos governamentais que normatizaram as medidas de política econômica. São analisados os diversos canais por meio dos quais a crise sanitária afeta a economia. Por um lado, estão os fatores de oferta: oferta de trabalho, produtividade do trabalho e funcionamento das cadeias produtivas. Por outro lado, encontram-se os fatores de demanda: consumo das famílias, investimento privado e comércio exterior. O terceiro canal diz respeito aos fatores financeiros que incidem sobre as variáveis de demanda e, principalmente, sobre o grau de liquidez das empresas financeiras e não financeiras. As medidas adotadas nos três países apresentam como características comuns a mobilização de grande volume de recursos fiscais e financeiros, a adoção de uma grande diversidade de instrumentos de política econômica e o uso de arranjos institucionais sofisticados em termos de regras de focalização e de mecanismos de operacionalização das medidas adotadas.
This text presents an international overview of the economic measures adopted to reduce the serious economic effects of the Sars-COV-2 pandemic in three countries: the USA, the United Kingdom and Spain. The analysis is based primarily on government documents that regulated economic policy measures. The various channels through which the health crisis affects the economy are analyzed. On one hand, there are the supply factors: labor supply, labor productivity and the functioning of production chains. On the other hand, there are demand factors: household consumption, private investment and foreign trade. The third channel concerns the financial factors on demand variables and, mainly, on the degree of liquidity of financial and non-financial companies. The measures adopted in the three countries have as common characteristics the mobilization of large volumes of fiscal and financial resources, the adoption of a wide range of economic policy instruments and the use of sophisticated institutional arrangements in terms of targeting rules and mechanisms for operationalizing the measures adopted.
Subject(s)
Public Policy , Coronavirus , Pandemics , Spain/epidemiology , United States/epidemiology , United Kingdom/epidemiologyABSTRACT
Objetivo: analisar casos acumulados da COVID-19 em Brasil, Espanha, Itália, China e EUA. Métodos: estudo ecológico, com uso de dados secundários. Realizou-se série temporal de casos cumulativos de COVID-19 por 28 dias, após o 100º caso confirmado de cada país (baseado nas estatísticas do Worldometer 2020). Modelos de tendência linear, exponencial, potencial e logaritmo foram testados, sendo escolhido o melhor coeficiente de determinação (R²). No Brasil, a linha de tendência foi segmentada em 1º-14º dia e 15º-28º dia. Resultados: no 100º dia, os EUA possuíam maior número de casos e o Brasil, o menor. Houve linha de tendência em sua maioria exponencial, com maior velocidade de crescimento nos EUA. No Brasil, houve tendência de crescimento mais lento no segundo período. Conclusão: as linhas de tendência calculadas demonstraram pior prognóstico para os EUA. No Brasil, o crescimento do número cumulativo de casos foi mais lento na no segundo período do estudo.
Objective: to examine cumulative cases of COVID-19 in Brazil, Spain, Italy, China, and USA. Method: in this ecological study, secondary data were used to produce time series of cumulative cases of COVID-19 over 28 days after the 100th case confirmed in each country (from Worldometer 2020 statistics). Linear, exponential, potential and logarithmic trend models were tested, and the best coefficient of determination (R²) was chosen. In Brazil, the trend line was segmented into days 1-14 and 15-28. Results: on day 100, the USA had the highest number of cases and Brazil, the lowest. The trend lines were mostly exponential, with highest growth rate in the USA. In Brazil, the growth trend was slower in the second period. Conclusion: the calculated trend lines showed a worse prognosis for the USA. In Brazil, the cumulative number of cases grew more slowly in the second period of the study.
Objetivo: examinar casos acumulados de COVID-19 en Brasil, España, Italia, China y Estados Unidos. Método: en este estudio ecológico, se utilizaron datos secundarios para producir series de tiempo de casos acumulados de COVID-19 durante 28 días después del 100o caso confirmado en cada país (de las estadísticas del Worldometer 2020). Se probaron modelos de tendencia lineal, exponencial, potencial y logarítmica y se eligió el mejor coeficiente de determinación (R²). En Brasil, la línea de tendencia se segmentó en los días 1-14 y 15-28. Resultados: el día 100, EE.UU. tuvo el mayor número de casos y Brasil, el menor. Las líneas de tendencia fueron en su mayoría exponenciales, con la tasa de crecimiento más alta en los EE. UU. En Brasil, la tendencia de crecimiento fue más lenta en el segundo período. Conclusión: las líneas de tendencia calculadas mostraron un peor pronóstico para EE. UU. En Brasil, el número acumulado de casos creció más lentamente en el segundo período del estudio.
Subject(s)
Humans , Coronavirus Infections/epidemiology , Betacoronavirus , Spain/epidemiology , United States/epidemiology , Brazil/epidemiology , China/epidemiology , Time Series Studies , Ecological Studies , Italy/epidemiologyABSTRACT
Resumen: Objetivo: Medir el efecto del cambio en mortalidad por sida en la esperanza de vida de la población española en 1985-2017. Material y métodos: Se analizaron 56 863 defunciones por sida. Se calcularon tasas estandarizadas de mortalidad y se aplicó regresión de Poisson y descomposición de esperanzas de vida. Resultados: En 1985-1995, la mortalidad por sida contribuyó a disminuir la esperanza de vida 0.64 años en hombres y 0.17 en mujeres. En 1996-2017, la hizo crecer 0.60 en hombres y 0.17 en mujeres. Conclusión: La introducción en 1996 de los tratamientos antirretrovirales de gran actividad y la prevención fueron decisivas para disminuir la mortalidad por sida y cronificar la epidemia.
Abstract: Objective: To measure the effect of the change in mortality by AIDS in life expectancy at birth of Spanish population in 1985-2017. Materials and methods: We analyzed 56 863 deaths by AIDS. We calculated age-standardized death rates, and we applied Poisson regression and decomposition of life expectancies. Results: From 1985 to 1995, mortality by AIDS contributed to reduce life expectancy at birth of 0.64 years for men, and 0.17 for women; in 1996-2017, increase it by 0.60 years, men, and 0.17, women. Conclusion: The introduction of highly active antiretroviral therapy in 1996 and prevention were decisive to reduce mortality by AIDS and to become chronic the epidemic.
Subject(s)
Female , Humans , Male , Life Expectancy , Acquired Immunodeficiency Syndrome/mortality , Spain/epidemiology , Cause of DeathABSTRACT
Objective: Depression has been associated with hepatitis C, as well as with its treatment with proinflammatory cytokines (i.e., interferon). The new direct-acting antiviral agents (DAAs) have minimal adverse effects and high potency, with a direct inhibitory effect on non-structural viral proteins. We studied the incidence and associated factors of depression in a real-life prospective cohort of chronic hepatitis C patients treated with the new DAAs. Methods: The sample was recruited from a cohort of 91 patients with hepatitis C, of both sexes, with advanced level of fibrosis and no HIV coinfection, consecutively enrolled during a 6-month period for DAA treatment; those euthymic at baseline (n=54) were selected. All were evaluated through the depression module of the Patient Health Questionnaire (PHQ-9-DSM-IV), at three time points: baseline, 4 weeks, and end-of-treatment. Results: The cumulative incidence (95%CI) of major depression and any depressive disorder during DAA treatment was 13% (6.4-24.4) and 46.3% (33.7-59.4), respectively. No differences were observed between those patients with and without cirrhosis or ribavirin treatment (p > 0.05). Risk factors for incident major depression during DAA treatment included family depression (relative risk 9.1 [1.62-51.1]), substance use disorder (11.0 [1.7-73.5]), and baseline PHQ-9 score (2.1 [1.1-3.1]). Conclusions: The findings of this study highlight the importance of screening for new depression among patients receiving new DAAs, and identify potential associated risk factors.
Subject(s)
Humans , Male , Female , Adult , Aged , Antiviral Agents/therapeutic use , Hepatitis C/psychology , Hepatitis C/drug therapy , Depressive Disorder/epidemiology , Psychiatric Status Rating Scales , Ribavirin/therapeutic use , Spain/epidemiology , Time Factors , Logistic Models , Incidence , Prospective Studies , Risk Factors , Treatment Outcome , Hepatitis C/epidemiology , Middle AgedABSTRACT
Ante el escaso número de estudios en este ámbito, el objetivo es analizar el contenido visual en la prensa durante la crisis sanitaria del Ébola en España que ocasionó gran alarma en la sociedad en 2014. En una muestra nacional de diarios, se identifica contenido visual en el 92% (n=160) de artículos sobre el Ébola y en el 87,5% (n=14) de portadas. La fotografía es el recurso más usado (69,2%), seguido de gráficos (9,2%) e infografías (8,8%), mientras que 'conflicto' es el encuadre más frecuente (42%). Se detecta un aumento rápido del contenido visual en los primeros dos días de la crisis que disminuye paulatinamente a partir del quinto día (p<.001). Este estudio puede abrir nuevas vías de investigación para profundizar en la investigación del contenido visual, especialmente durante la crisis sanitaria dada la gran importancia que adquiere la comunicación.(AU)
Considering the scarce number of studies in this sphere, the objective is to analyze the visual content published by the press during the health crisis of Ebola in Spain, which caused great alarm in that society in 2014. In a sample of Spanish newspapers, visual content was identified in 92% (n=160) of the articles about Ebola and in 87.5% (n=14) of front pages. Photography was the most used resource (69.2%), followed by graphs (9.2%) and infographics (8.8%), while 'conflict' was the most frequent framing (42%). A rapid increase in the use of visual content was detected in the first two days of the crisis, followed by a gradual decrease from the fifth day onwards (p <0.001). This study can open new research paths for further investigation of visual content, especially during a health crisis, due to the great importance communication acquires in this situation.(AU)
Considerando o número escasso de estudos neste âmbito, o objetivo é analisar o conteúdo visual na imprensa durante a crise sanitária do Ebola na Espanha, que causou um grande alarme na sociedade em 2014. Em uma amostra de diários nacionais, identifica-se conteúdo visual em 92% (n = 160) dos artigos sobre o Ébola e em 87,5% (n = 14) das capas. A fotografia é o recurso mais utilizado (69,2%), seguido por gráficos (9,2%) e inforgráficos (8,8%), enquanto 'conflito' é o enquadramento mais frequente (42%). Detecta-se um rápido aumento no conteúdo visual nos dois primeiros dias da crise, que diminui gradativamente a partir do quinto dia (p <0,001). Este estudo pode abrir novas vias de pesquisas que aprofundem na investigação do conteúdo visual, especialmente durante uma crise sanitaria devido à grande importância que a comunicação adquire.(AU)
Subject(s)
Hemorrhagic Fever, Ebola , Photograph , Mass Media , Spain/epidemiologyABSTRACT
Abstract Dogs play a potential role as reservoirs for zoonotic parasites, being especially problematic uncontrolled dog populations such as stray and farm dogs with access to populated areas. In order to investigate the prevalence of canine intestinal parasites in at-risk dog populations, we tested a total of 233 faecal samples shed by stray and dairy farm dogs from northern Spain. Telemann method was used to detect the presence of eggs and (oo)cysts of common dog intestinal parasites and Cryptosporidium was detected by PCR. One hundred and forty eight out of 233 samples (63.5%) were positive for at least one intestinal parasite, being Ancylostomidae (35.6%; 83/233) and Trichuris (35.2%; 82/233) the parasites most frequently identified. Cryptosporidium DNA was not detected in any of the faecal samples analysed. The overall prevalence was significantly higher in stray dogs than in farm dogs (72.5% vs 58.8%). Specifically, stray dogs had a significantly higher prevalence of Ancylostomatidae, Toxocara, Toxascaris and Taenidae. These dog populations are an important source of environmental contamination with intestinal parasite forms, which could be of significance to animal and human health.
Resumo Os cães desempenham um importante papel como reservatório de parasitos zoonóticos, sendo especialmente problemáticas as populações descontroladas, como a de cães errantes e de fazenda, com acesso às áreas povoadas. Para investigar a prevalência de parasitos intestinais em populações caninas de risco, foram analisadas 233 amostras fecais provenientes de cães de fazendas leiteiras e errantes do norte da Espanha. O método Telemann foi utilizado para detectar ovos, cistos e oocistos dos parasitos caninos mais comuns e para a detecção de Cryptosporidium foi utilizada a técnica da PCR. Cento e quarenta e oito de 233 amostras analisadas (63,5%) foram positivas para pelo menos um parasito intestinal, sendo Ancyostomatidae (35,6%; 83/233) e Trichuris sp. (35,2%; 82/233) os parasitos identificados com maior frequência. O DNA de Cryptosporidium sp. não foi detectado em nenhuma das amostras fecais analisadas. A prevalência geral foi significativamente maior em cães errantes do que em cães de fazenda (72,5% vs 58,8%). Especificamente, os cães errantes tiveram prevalência maior para Ancylostomatidae, Toxocara, Toxascaris e Taenidae. Essas populações de cães são importantes fontes de contaminação ambiental, pois eliminam formas de vida desses parasitos, que podem ter impacto na saúde animal e humana.
Subject(s)
Animals , Dogs , Dog Diseases/parasitology , Dog Diseases/epidemiology , Farms/statistics & numerical data , Intestinal Diseases, Parasitic/veterinary , Spain/epidemiology , Prevalence , Cryptosporidiosis/epidemiology , Cryptosporidium , Feces/parasitology , Intestinal Diseases, Parasitic/parasitology , Intestinal Diseases, Parasitic/epidemiologySubject(s)
Humans , Health Personnel/statistics & numerical data , Pandemics , Professionalism , SARS-CoV-2 , COVID-19/epidemiology , Spain/epidemiology , Health Care Surveys/statistics & numerical data , Personal Protective Equipment/supply & distribution , COVID-19/mortality , Occupational Diseases/mortality , Occupational Diseases/epidemiologyABSTRACT
En marzo de 2020, el virus SARS-CoV-2 procedente de China ha llegado a España y desde el 14 de marzo se ha declarado el estado de alarma en todo el Estado español, llevando al confinamiento a toda la población. La presente investigación se contextualiza en la Comunidad Autónoma Vasca (situada al norte de España). Se han analizado los niveles de estrés, ansiedad y depresión a la llegada del virus y se han estudiado los niveles de sintomatología psicológica según edad, cronicidad y confinamiento. Se ha recogido una muestra de 976 personas y la medición de las variables ansiedad, estrés y depresión se ha hecho mediante la escala DASS (Escala de Depresión, Ansiedad y Estrés). Los resultados demuestran que, aunque los niveles de sintomatología han sido bajos en general al principio de la alarma, la población más joven y con enfermedades crónicas ha referido sintomatología más alta que el resto de población. También se ha detectado un mayor nivel de sintomatología a partir del confinamiento, donde las personas tienen prohibido salir de sus casas. Se prevé que la sintomatología aumentará según vaya transcurriendo el confinamiento. Se defienden intervenciones psicológicas de prevención y tratamiento para bajar el impacto psicológico que pueda crear esta pandemia.
Em março de 2020, o vírus SARS-CoV-2, procedente da China, chegou à Espanha e desde 14 de março está declarado estado de emergência em todo o país, forçando toda a população ao confinamento. O presente estudo foi conduzido no País Basco (norte da Espanha). Foram analisados os níveis de estresse, ansiedade e depressão desde a introdução do vírus e os níveis de sintomas psicológicos segundo idade, comorbidades e confinamento. A amostra foi composta de 976 indivíduos e a medição das variáveis ansiedade, estresse e depressão foi realizada a partir do intrumento DASS (Escala de Depressão, Ansiedade e Estresse). Os resultados mostram que, ainda que os níveis de sintomas tenham sido baixos no início do confinamento, os indivíduos mais jovens e com comorbidades referiram mais sintomas que o restante da população. Também se detectou maior nível de sintomas desde o confinamento, quando a população foi proibida de sair de suas casas. Se prevê aumento dos sintomas conforme o confimaneto continuar. Intervenções psicológicas de prevenção e tratamento são necessárias para diminuir o impacto psicológico causado pela pandemia.
The SARS-CoV-2 virus reached Spain in March 2020, and a nationwide state of alert was declared on March 14th, leading to the confinement of the entire population. The current study was conducted in the Basque Autonomous Community in northern Spain. The authors analyzed stress, anxiety, and depression with the arrival of the virus and the levels of symptoms according to age, comorbidity, and confinement. Levels of anxiety, stress, and depression were measured in a sample of 976 adults, using the DASS scale (Depression Anxiety, and Stress Scale). Although levels of symptoms were generally low at the start of the alert, younger individuals with chronic diseases reported more symptoms than the rest of the population. The study also detected higher levels of symptoms after the stay-at-home order was issued. Such symptoms are predicted to increase as the confinement continues. The authors propose psychological interventions for prevention and treatment in order to mitigate the pandemic's psychological impacts.