Eventos de vida estresantes y su efecto en la conducta suicida en mujeres durante la pandemia por Covid-19 en México.

OBJETIVO: Analizar la estructura factorial, la validez convergente y divergente de la Escala Columbia de Severidad Suicida (CSSRS) y el Cuestionario de Eventos de Vida Estresantes (EVE) y medir la asociación entre EVE y conducta suicida (CS) en mujeres mexicanas durante la pandemia por Covid-19. Material y métodos. Se usaron datos de 2 398 mujeres que participaron en un estudio multicéntrico, realizado en México entre mayo y octubre de 2021. La información se recolectó mediante un cuestionario en línea que incluyó la CSSRS y el EVE. Se hizo un análisis factorial confirmatorio para valorar el ajuste de los modelos. RESULTADOS: El modelo final mostró asociación entre los EVE y la CS, y tuvo a la violencia como variable central. Dicho modelo presentó un ajuste adecuado (CFI = 0.950, IFI = 0.950, MFI = 0.975, RMSEA = 0.031, CI RMSEA = 0.026-0.036). CONCLUSIONES: La pandemia por Covid-19 evidenció la necesidad de crear e implementar estrategias que promuevan el cuidado de la salud mental, reduzcan la exposición a la violencia y faciliten los procesos de duelo para prevenir la CS en mujeres mexicanas.

The Columbia-suicide severity rating scale: validity and psychometric properties of an online Spanish-language version in a Mexican population sample.

The aim of this study was to evaluate the validity and psychometric properties in a Mexican sample of a Spanish-language online version of the Columbia-Suicide Severity Rating Scale (C-SSRS). Data were collected between May and October 2021 from 3,645 participants aged 18 years and over, who agreed to complete the questionnaire. Reliability analysis, confirmatory factor analysis (CFA), and psychometric properties were calculated using a two-parameter model. The results showed a reasonable level of reliability with a Cronbach's alpha of 0.814, and evidence of unidimensionality, and construct validity for suicide risk at three risk levels: low, medium, and high. Analysis of the items suggests that they are consistent with the proposed theoretical model. Our results also demonstrate that the parameters are stable and able to efficiently discriminate individuals at high risk of suicide. We propose the use of this version of the C-SSRS in the Spanish-speaking population, since it is a multifactorial assessment of suicide risk and the inclusion of other clinical and risk factor assessments for a more comprehensive evaluation.

Psychological distress, intimate partner violence and substance use in a representative sample from Mexico: A structural equation model.

Introduction: Intimate Partner Violence (IPV) is a public health concern associated with multiple adverse health outcomes, including psychological distress (PD). Objective: To assess the association of IPV and psychological distress, and the mediation of tobacco and alcohol consumption in a national representative sample from Mexico. Material and methods: Data from the Encuesta Nacional de Consumo de Drogas, Tabaco y Alcohol (ENCODAT) were analyzed. The sample included 34,864 people between the ages of 12 and 65 with a partner. Using Structural Equation Modeling (SEM), the association between IPV, use alcohol, tobacco and psychological distress was measured. Results: The population was composed of women (51.9%) and men (48.1%); 15.1% (women = 18.2% and men = 11.9%) reported IPV in the last year. The prevalence of psychological distress in the last year was 3.3%, being 3.8% in women, and 2.7% in men. Results from the SEM in women indicated a direct positive effect of the IPV construct on psychological distress (ß = 0.298, p < 0.01); these findings confirmed that IPV tended to systematically increase psychological distress. Likewise, the presence of IPV increased the consumption of tobacco (ß = 0.077, p < 0.01) and alcohol (ß = 0.072, p < 0.01). The SEM results in men showed that alcohol and tobacco consumption tended to increase in the presence of IPV (ß = 0.121, p < 0.01, and ß = 0.086, p < 0.01, respectively), and in turn, alcohol consumption and tobacco tended to increase psychological distress (ß = 0.024, p < 0.01, and ß = 0.025, p < 0.01, respectively). Conclusion: This study indicated that in women, IPV had a direct effect on psychological distress and on alcohol and tobacco consumption. Meanwhile in men, alcohol and tobacco consumption had a mediating effect between IPV and psychological distress. The empirical findings of this study will contribute toward the design of public health policies for the prevention and attention of IPV, alcohol and tobacco consumption, and consequently address the mental health consequences derived from these problems.

Violence against Women during the COVID-19 Pandemic in Mexico.

This study measured the prevalence of cases of domestic violence against women and some associated factors during the COVID-19 pandemic in Mexico. Data were collected through a remote survey during 2020. The sample included 47,819 women aged 15 years and older. Jointpoint regression and logistic regression models were used. The prevalence of violence was 11.5%, which decreased in July and subsequently increased. The associated factors were being unemployed (OR = 2.01; 95%CI 1.89-2.16); being partially and totally quarantined (OR = 1.58; 95%CI 1.43-1.75 and OR = 1.47; 95%CI 1.32-1.63); being a caregiver of children; being a caregiver of elderly and/or suffering from a chronic illness (OR = 1.27; 95%CI 1.19-1.36; OR = 1.42; 95%CI 1.33-1.53; OR = 1.59; 95%CI 1.47-1.73); losing a family member to COVID-19 (OR = 1.26; 95%CI 1.13-1.41); and binge drinking (OR = 1.94; 95%CI 1.78-2.12). The confinement measures increased gender inequalities, economic problems and workload which further evidenced violence against women.

Measurement invariance of the GAD-5 Generalized Anxiety Disorder Scale in a Mexican general population sample.

The primary objective of this study was to evaluate the measurement of invariance by sex, age, and educational level of an online version of the Generalized Anxiety Disorder Scale in a five-item version (GAD-5). Configural, metric, scalar, and strict invariance were evaluated using data from 79,473 respondents who answered a mental health questionnaire during the COVID-19 pandemic in Mexico. The sex variable was classified as male or female; age was categorized as minors, youth, young adults, adults, and older adults; and educational level was divided into basic, upper secondary, higher, and graduate education. To test for configural invariance, confirmatory factor models were constructed. For metric invariance, equality restrictions were established for the factor loadings between the construct and its items; for scalar invariance, equality restrictions were established between the intercepts; strict variance implied the additional restriction of the residuals. Statistical analysis was performed in R software with the lavaan package. The results show that with respect to sex, age, and educational level, configural and metric measurement invariance was confirmed (ΔCFI < 0.002; ΔRMSEA < 0.015). However, with respect to scalar and strict invariance, the results showed significant differences regarding the fit model (ΔCFI > 0.002; ΔRMSEA > 0.015). We conclude that the GAD-5 presents configural and metric invariance for sex, age, and educational level, and scalar invariance for sex and age groups. However, the scale does not demonstrate strict invariance. We discuss the implications and suggest that this result could be related to the evaluation of sociodemographic variables.

SPARC gene deletion protects against toxic liver injury and is associated to an enhanced proliferative capacity and reduced oxidative stress response.

SPARC, also known as osteonectin and BM-40, is a matricellular protein with a number of biological functions. Hepatic SPARC expression is induced in response to thioacetamide, bile-duct ligation, and acute injuries such as concanavalin A and lipopolysacharide (LPS)/D-galactosamine. We have previously demonstrated that the therapeutic inhibition of SPARC or SPARC gene deletion protected mice against liver injury. We investigated the mechanisms involved in the protective effect of SPARC inhibition in mice. We performed a proteome analysis of livers from SPARC+/+ and SPARC-/- mice chronically treated with thioacetamide. Catalase activity, carbonylation levels, oxidative stress response, and mitochondrial function were studied. Genomic analysis revealed that SPARC-/- mice had an increased expression of cell proliferation genes. Proteins involved in detoxification of reactive oxygen species such as catalase, peroxirredoxine-1, and glutathione-S-transferase P1 and Mu1 were highly expressed as evidenced by proteome analysis; hepatic catalase activity was increased in SPARC-/- mice. Oxidative stress response and carbonylation levels were lower in livers from SPARC-/- mice. Hepatic mitochondria showed lower levels of nitrogen reactive species in the SPARC-/- concanavalin A-treated mice. Mitochondrial morphology was preserved, and its complex activity reduced in SPARC-/- mice. In conclusion, our data suggest that the protection associated with SPARC gene deletion may be partially due to a higher proliferative capacity of hepatocytes and an enhanced oxidative stress defense in SPARC-/- mice after liver injury.

Construcción de una escala para medir relaciones de poder en el aula / Building a scale to measure power relations in the classroom

Se muestran los resultados de un estudio prospectivo, de una cohorte, de validación psicométrica que tuvo como objetivo validar un banco de 20 reactivos que buscaban medir las relaciones de poder en el aula. Estos reactivos se sometieron a juicio de expertos, a análisis de validez factorial y de invarianza de parámetros. Con los mejores reactivos, se armó la Escala de Relaciones de Poder en el Aula (ERPA), aplicada a una muestra de 198 estudiantes en el ámbito nacional. Los resultados indicaron que la ERPA presenta propiedades psicométricas que aseguran la calidad y precisión en sus mediciones. Este estudio permitió discutir las implicaciones teóricas y prácticas en la evaluación y fomento del aprendizaje universitario.

This paper presents the results of a prospective study of a cohort of psychometric validation aimed to validate a bank of 20 items that sought to measure the power relations in the classroom. These reactive were subjected to expert judgment, to analysis of factorial validity and invariance of parameters. With the best reagents, Power Relations Scale in the Classroom (PRSC). This scale was applied to a sample of 198 nationally students. The results indicated that the PRSC has psychometric properties that ensure the quality and accuracy in their measurements. This study allowed discussing theoretical and practical implications in the evaluation and promotion of college learning.

Lack of the matricellular protein SPARC (secreted protein, acidic and rich in cysteine) attenuates liver fibrogenesis in mice.

INTRODUCTION: Secreted Protein, Acidic and Rich in Cysteine (SPARC) is a matricellular protein involved in many biological processes and found over-expressed in cirrhotic livers. By mean of a genetic approach we herein provide evidence from different in vivo liver disease models suggesting a profibrogenic role for SPARC. METHODS: Two in vivo models of liver fibrosis, based on TAA administration and bile duct ligation, were developed on SPARC wild-type (SPARC(+/+)) and knock-out (SPARC(-/-)) mice. Hepatic SPARC expression was analyzed by qPCR. Fibrosis was assessed by Sirius Red staining, and the maturation state of collagen fibers was analyzed using polarized light. Necroinflammatory activity was evaluated by applying the Knodell score and liver inflammatory infiltration was characterized by immunohistochemistry. Hepatic stellate cell activation was assessed by α-SMA immunohistochemistry. In addition, pro-fibrogenic genes and inflammatory cytokines were measured by qPCR and/or ELISA. Liver gene expression profile was analyzed in SPARC(-/-) and SPARC(+/+) mice using Affymetrix Mouse Gene ST 1.0 array. RESULTS: SPARC expression was found induced in fibrotic livers of mouse and human. SPARC(-/-) mice showed a reduction in the degree of inflammation, mainly CD4+ cells, and fibrosis. Consistently, collagen deposits and mRNA expression levels were decreased in SPARC(-/-) mice when compared to SPARC(+/+) mice; in addition, MMP-2 expression was increased in SPARC(-/-) mice. A reduction in the number of activated myofibroblasts was observed. Moreover, TGF-ß1 expression levels were down-regulated in the liver as well as in the serum of TAA-treated knock-out animals. Ingenuity Pathway Analysis (IPA) analysis suggested several gene networks which might involve protective mechanisms of SPARC deficiency against liver fibrogenesis and a better established machinery to repair DNA and detoxify from external chemical stimuli. CONCLUSIONS: Overall our data suggest that SPARC plays a significant role in liver fibrogenesis. Interventions to inhibit SPARC expression are suggested as promising approaches for liver fibrosis treatment.

Relaciones estructurales entre estrategias de afrontamiento y síndrome de Burnout en personal de salud: un estudio de validez externa y de constructo / Structural relations between coping strategies and Burnout syndrome on health workers: A study of external and construct validity

El objetivo del estudio fue validar relaciones estructurales y funcionales hipotetizadas entre estrategias de afrontamiento y factores asociados al síndrome de burnout en muestras independientes de trabajadores de la salud, de diferentes hospitales y contextos de atención hospitalaria. Se aplicó el Maslach Burnout Inventory y la escala de Afrontamiento ante Riesgos Extremos adaptados para población mexicana; se analizaron las respuestas de 354 trabajadores de la salud de un hospital de tercer nivel y 300 de un hospital de referencia. Las muestras fueron intencionales, no probabilísticas, por cuotas. Los grupos se conformaron con personal de enfermería, para-médicos, servicios auxiliares y diagnóstico, médicos y médicos residentes. Los resultados confirmaron la estructura factorial de los instrumentos en las dos muestras; mostraron que el uso de estrategias activas de afrontamiento (control, búsqueda de información, soporte social, entre otras) tiene efectos protectores sobre los factores asociados al síndrome (cansancio emocional, despersonalización y realización personal en el trabajo), independientemente de la muestra, del contexto y del tipo de atención hospitalaria. Se discuten los resultados y sus implicaciones en relación con la validez externa y hallazgos en otras investigaciones relacionadas.

The aim of this study was to validate hypothesized structural and functional relationships between coping strategies and factors associated with burnout syndrome in independent samples of health workers from different hospitals and hospital care settings. We applied the Maslach Burnout Inventory and the scale of Coping with Extreme Risks adapted to the Mexican population, we analyzed the responses of354 health workers in a tertiary hospital and 300 from a reference hospital. The samples were intentional, non-probability, quota. The group was formed by nurses, paramedics, diagnostics services, physicians and resident physicians. Results confirmed the factor structure of the instruments in the two samples and showed that the use of active coping strategies (control, information seeking, social support, among others) has protective effects on the factors associated with the syndrome (emotional exhaustion, depersonalization and personal fulfillment at work), regardless of the sample, context and type of hospital care. We discuss the results and their implications in relation to external validity and findings in other related research.

Prevalencia delssíndrome de burnout y estrategis de afrontamiento durante una epidemia de influenz aah1n1 / Prevaence of burrnout syndrome and coping strategies uring an epidemmiology because of ah1n1 influenza

El objetivo de este estudio fue evaluar el síndrome de Burnout en una muestra de 477 trabajadores de la salud durante una epidemia por influenza AH1N1 en la Ciudad de México, e identificar si el uso de estrategias de afrontamiento tenía efectos protectores al Burnout. Se realizó un estudio descriptivo transversal con una muestra no probabilística por cuotas, utilizando como instrumentos el Maslach Burnout Inventory versión Human Services y la Escala de Afrontamiento Frente a Riesgo Extremos. Se hizo una distribución de frecuencia y de normalidad para analizar las diferencias, un análisis de varianza en Burnout y regresión lineal múltiple para estrategias de afrontamiento. A partir del análisis, se encontró que el 24% presentó el síndrome de Burnout en grado moderado (cansancio emocional y despersonalización, con presencia de realización personal); asimismo, fueron empleadas estrategias activas y pasivas. Se constató que el uso de estrategias de afrontamiento fue selectivo y las estrategias activas tuvieron una función moderadora al Burnout, protectora a la escala de cansancio emocional, que aumentó cuando presentaban realización personal. El estudio propone el desarrollo de investigaciones cuantitativas y cualitativas, así como el uso de modelos mixtos de intervención: centradas en las personas.

The aim of this study was to assess the Burnout syndrome in health workers during a contingency in Mexico City because of epidemiology AH1N1 influenza, and identify if the use of coping strategies had protective effects for the Burnout. We had a sample of 477 health workers and was performed a transversal descriptive study with a nonrandom quote sample. The instruments used were Maslach Burnout Inventory Human Services version and scale measuring coping face to extreme risks. It was performed a frequency and normality distribution to analyze the differences, and also an analysis of variance in Burnout, and multiple lineal regression for coping strategies. We found that 24% had Burnout (in emotional exhaustion and a moderate degree depersonalization, with the presence of personal accomplishment). They were also employed active and passive strategies. We found that the use of coping strategies was selective, active strategies had a moderating role to Burnout and protective to the scale of emotional exhaustion, which seems to increase when there is personal realization. We propose the development of quantitative and qualitative research and the use of mixed models of intervention: focusing on people.

[Burnout syndrome among medical residents during the influenza A H1N1 sanitary contigency in Mexico]. / Síndrome de burnout en médicos mexicanos en entrenamiento durante una contingencia sanitaria por virus de influenza A H1N1.

OBJECTIVE: To measure the degree of stress among medical residents at a Third Level Hospital in Mexico City during the sanitary contingency caused by the AH1N1 influenza virus. METHODS: A transversal descriptive study with a non-probabilistic sample of 99 medical residents with different fields of specialization related to respiratory medicine. Researchers applied the Maslach Burnout Inventory questionnaire to evaluate three dimensions: emotional fatigue, depersonalization, and personal fulfillment. The survey was self-administered and anonymous, and the study was conducted during the first AH1N1 influenza virus outbreak (April 23 to May 10, 2009). During that period, the hospital underwent a process of reorganization that included cancelling vacation periods for all medical residents and adjusting duty rosters. RESULTS: The highest proportion of medical residents with burnout syndrome was those in their second year of specialization in the area of pneumology. Results also showed that medical residents under 30 years of age had a higher probability of presenting burnout syndrome. No significant differences were found regarding the residents' place of origin.

Extravasación de orina espontánea por cálculo ureteral obstructivo: informe de dos casos y revisión de la literatura / Spontaneous urine tissular leak caused by ureteral calculus: report of two cases and literature review

Se presentan dos casos de extravasación espontánea de orina por rotura de la vía, secundaria a obstrucción ureteral distal por cálculo. El diagnóstico se estableció con urografía intravenosa, ultrasonografía y tomografía axil computadorizada. En ambos enfermos, la extracción del cálculo resolvió la extravasación. Se revisan etiopatogenia, cuadro clínico y diagnóstico diferencial. Está indicado el tratamiento de su etiología y la recuperación morfofuncional completa suele ser regla.