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1.
Sci Rep ; 12(1): 5241, 2022 03 28.
Artículo en Inglés | MEDLINE | ID: mdl-35347208

RESUMEN

Serosurveillance helps establish reopening guidelines and determine the immunity levels in different populations to reach herd immunity. Then, there is an urgent need to estimate seroprevalence population wide. In Mexico, information about COVID-19 cases and related deaths is scarce. Also, there is no official serosurveillance, limiting our knowledge of the impact of the SARS-CoV-2 pandemic. Here, we report the prevalence of anti-SARS-CoV-2 antibodies in 522,690 unvaccinated people from July 5th to December 31st, 2020. The overall seroprevalence was 32.8% and highest in adults aged 30-39 years (38.5%) than people under 20 years (33.0%) or older (28.9%). Moreover, in a cohort of 1655 individuals confirmed COVID-19 by PCR, we found that symptomatic people (HR = 2.56) increased seroconversion than presymptomatic. Also, we identified that the most discriminative symptoms for COVID-19 that could predict seroconversion were anosmia and ageusia (HR = 1.70), fever, myalgia/arthralgia, and cough (HR = 1.75). Finally, we found that obese people had lower seroconversion (HR = 0.53) than healthy people, but the opposite happens in diabetic people (HR = 1.39). These findings reveal that around one-third of Mexican outpatients had anti-SARS-CoV-2 antibodies before vaccination. Also, some symptoms improve empirically COVID-19 diagnosis and seroconversion. This information could help fine-tune vaccination schemes and the reopening and back-to-work algorithms.


Asunto(s)
COVID-19 , SARS-CoV-2 , Adulto , COVID-19/epidemiología , Prueba de COVID-19 , Brotes de Enfermedades , Humanos , México/epidemiología , Seroconversión , Estudios Seroepidemiológicos
2.
An. psicol ; 38(3): 448-457, Oct-Dic. 2022. tab, graf
Artículo en Inglés | IBECS | ID: ibc-208816

RESUMEN

Una de las consecuencias de la pandemia es el aumento de la prevalencia de alteraciones mentales como la ansiedad, la depresión y el estrés. En este estudio transversal y observacional se evaluó la prevalencia de estrés, ansiedad y depresión en pacientes hospitalizados por COVID-19 así como la probable asociación con el impacto emocional recibido por familiares de pacientes hospitalizados por COVID-19. Cuarenta y cinco pacientes hospitalizados por COVID-19 con una edad promedio de 54.4 ± 9.6 años y cincuenta y cinco familiares de pacientes hospitalizados con una edad promedio de 43.2 ± 11.8 años respondieron una batería de preguntas y la encuesta DASS-21. Nuestros resultados revelaron una alta prevalencia de depresión, ansiedad y estrés identificados por DASS-21. En este estudio identificamos factores de riesgo asociados a la salud emocional como la edad (< 50 años: depresión RM = 2.99 [1.31, 6.80] p < .05 y ansiedad RM = 2.83 [1.15, 6.93], p < .05), el género (mujeres: ansiedad RM = 4.13 [1.57, 10.89], p < .05 y estrés RM = 5.38 [2.27, 12.8], p < .05) y el grupo de estudio (familiares: depresión RM = 3.83 [1.63, 8.96]; p < .05 , ansiedad RM = 3.60 [1.46, 8.88]; p < .05 y estrés RM = 3.30 [1.41, 7.70]; p < .05). Además, el género femenino y el nivel socioeconómico bajo de los pacientes (β = 3.23; 1.96) y familiares (β = 1.86; 2.31) se asociaron con puntuaciones más altas en ansiedad (p < .05) y estrés (p < .05). Concluimos que la muestra de pacientes con COVID-19 mantiene una alta prevalencia de alteraciones mentales y que algunos factores sociodemográficos se asocian con la magnitud de estos trastornos.(AU)


One of the consequences of pandemic is the increase in the prevalence of mental alterations such as anxiety, depression and stress. Since here, we aimed to determinate through a transversal and observa-tional studyprevalence of stress, anxiety and depression within hospital-ized patients by COVID-19 as well as their likely association with the emo-tional impact received by relatives with hospitalized patients by COVID-19. Forty-five COVID-19 hospitalized patients with mean age of 54.4 ± 9.6 yearsand fifty-five relatives with mean age of 43.2 ± 11.8 yearsan-swered a questions battery and DASS-21 survey. Our resultsrevealed high prevalence of depression, anxiety and stress assessed by DASS-21 sub-scales. We also identified risk factors associated with the emotional health such as age (<50 years: depression OR=2.99 [1.31, 6.80], p< .05 and anxiety OR=2.83 [1.15,6.93], p< .05), by gender (female: anxiety OR = 4.13 [1.57, 10.89], p< .05 and stress OR = 5.38 [2.27, 12.8], p< .05), by group of study (relatives: depression OR = 3.83 [1.63, 8.96]; p< .05, anxie-ty OR = 3.60 [1.46, 8.88]; p< .05 and stress OR = 3.30 [1.41, 7.70]; p< .05). Additionally, female gender and low socioeconomic status in patients (β= 3.23; 1.96) and relatives (β= 1.86; 2.31) were associated with higher scores in anxiety (p< .05) and stress (p <.05). We concluded that our sample of COVID-19 patients maintain a high prevalence of mental altera-tions and age, gender and socioeconomic status modify the magnitude of these disorders.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Pacientes Internos , Salud Mental , Ansiedad/complicaciones , Ansiedad/tratamiento farmacológico , Trastornos de Ansiedad/diagnóstico , Estrés Psicológico , Depresión , Pandemias , Infecciones por Coronavirus/epidemiología , Factores de Riesgo , México , Psicología , Psicología Clínica , Medicina de la Conducta , Estudios Transversales , Infecciones por Coronavirus/complicaciones
3.
Metas enferm ; 25(7): 7-12, Septiembre 2022. tab, graf
Artículo en Inglés, Español | IBECS | ID: ibc-208077

RESUMEN

Objetivo: identificar la percepción que tienen los estudiantes de Enfermería sobre la adquisición de habilidades clínicas durante la pandemia por COVID-19 y analizar si está asociada con el semestre que están cursando y con haber realizado práctica clínica en escenarios reales. Método: se llevó a cabo un estudio descriptivo transversal con estudiantes de Enfermería de una universidad pública de Zacatecas, México (N= 1.033). Se administró vía electrónica el segundo apartado del cuestionario Clinical Competency Questionnaire traducido al español con un alfa de Cronbach= 0,969. Se analizó la asociación de las habilidades clínicas con el semestre cursado y la experiencia mediante la prueba de Chi cuadrado con una significancia estadística de p≤ 0,05. Resultados: respondieron un total de N= 82 estudiantes. La media de edad fue de 20,7 (DE:1,40), el 87,8% era mujer en su mayoría del séptimo semestre (40,2%). Un 50% se percibió con habilidades clínicas deficientes; un 34,1%, sin habilidades clínicas y un 15,9%, con habilidades clínicas competentes. Los estudiantes de quinto semestre se percibieron con menores habilidades clínicas (p= 0,006), al igual que aquellos que no habían cursado práctica clínica antes de la pandemia (p= 0,005). Conclusiones: a partir de la pandemia, las habilidades en la práctica clínica son percibidas como nulas o deficientes por los estudiantes de Enfermería, por lo que se requiere implementar cambios en la metodología de enseñanza-aprendizaje, transitar a un modelo híbrido e integrador con intervenciones educativas efectivas y que demuestren el desarrollo de los dominios en este tipo de habilidades para cumplir con el perfil de egreso planteado.(AU)


Objective: to understand the perception by Nursing students about the acquisition of clinical skills during the COVID-19 pandemic, and to analyse if this is associated with the semester they are currently taking and with conducting clinical practice in real settings. Method: a cross-sectional descriptive study was conducted with Nursing students from a public university in Zacatecas, Mexico (N= 1,033). The second section of the Clinical Competency Questionnaire in its Spanish translation was administered online, with Cronbach’s alpha= 0.969. The association between the clinical skills and the semester studied and experience was analysed through Chi-squared test withp≤ 0.05 as statistical significance. Results: in total, N= 82 students participated. Their mean age was 20.7 (SD:1.40), 87.8% were female, and the majority were in their seventh semester (40.2%). 50% of them perceived that their clinical skills were poor, 34.1% stated they had no clinical skills, and 15.9% perceived that their clinical skills were proficient. Students in their fifth semester perceived their clinical skills as lower (p= 0.006), as well as those who had not had any clinical practice before the pandemic (p= 0.005). Conclusions: after the pandemic, clinical practice skills are perceived as non-existent or poor by Nursing students; therefore, it is necessary to implement changes in the teaching-learning methodology, to move to a hybrid and inclusive model with effective educational interventions which demonstrate the development of domains in this type of skills, in order to meet the proposed profile of graduation.


Asunto(s)
Humanos , Masculino , Femenino , Estudiantes de Enfermería , Pandemias , Betacoronavirus , Virus del SRAS , Competencia Clínica , Práctica del Docente de Enfermería , Educación a Distancia , Docentes de Enfermería , Aprendizaje , Estudios Transversales , Epidemiología Descriptiva , México , Encuestas y Cuestionarios
5.
PLoS One ; 17(9): e0274322, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36112642

RESUMEN

OBJECTIVE: To explore the moderating effects of sociodemographic and work-related variables on levels of burnout and mental health among medical residents. METHOD: A cross-sectional online survey was administered at the beginning of the second wave of COVID-19 at different public teaching hospitals where medical residents practiced in Mexico City. A total of 201 medical residents of different years completed the survey. RESULTS: Different univariate inferential analyses on the level of burnout and mental health indices showed significant differences between sex, marital status, previous reports of physical illness or psychological conditions, and residency ranking. However, the effect sizes of those differences were of low to medium size. A predictive path analysis revealed that the three stages of burnout (emotional exhaustion, depersonalization, and achievement dissatisfaction) negatively affect psychological wellbeing and positively affect psychological distress. Finally, even though sociodemographic variables showed some significant variation, the effect sizes were small and did not moderate the direct effect of burnout on mental health indices. CONCLUSIONS: Medical residents deling with every day medical situations, will be exposed to stressors that might increase the probability to experience emotional exhaustion. This would negatively affect levels of wellbeing and positively affect distress, despite their sociodemographic characteristics.


Asunto(s)
Agotamiento Profesional , COVID-19 , Internado y Residencia , Agotamiento Profesional/epidemiología , Agotamiento Profesional/psicología , Agotamiento Psicológico , Estudios Transversales , Estado de Salud , Humanos , Salud Mental , México/epidemiología
6.
J Infect Dev Ctries ; 16(8): 1269-1277, 2022 08 30.
Artículo en Inglés | MEDLINE | ID: mdl-36099369

RESUMEN

INTRODUCTION: There is limited information about the coronavirus disease 2019 (COVID-19) disease in Latin-American countries. Our objective was to describe the clinical characteristics and outcomes of COVID-19 patients in Mexico. METHODOLOGY: We conducted a retrospective cohort study with 333 consecutive patients who were admitted to Hospital de Especialidades "Dr. Antonio Fraga Mouret" in Mexico City with COVID-19 between April 1, 2020, and June 30, 2020. Demographic, clinical, laboratory data, treatment details and 30-day outcomes were analyzed. RESULTS: The patients studied included 52% men (172/233) and the median age was 45 years. Up to 75% (250/333) of patients were classified as overweight or obese. There were 185 (56%) inpatients; 85% (158/185) were hospitalized in the general ward, and 15% (27/185) in the Intensive Care Unit (ICU). Laboratory measurements showed significant differences between inpatients and outpatients such as lymphocyte-count (median 0.8 vs 1.2×109/L, p < 0.001), LDH (median 650 vs 294 U/L, p < 0.001), CRP (median 147 vs 5 mg/L, p = 0.007), CK-MB (median, 15 vs 10 U/L, p = 0.008), ferritin (median, 860 vs 392 ng/mL, p = 0.02), and D-dimer (median, 780 vs 600 ng/mL, p = 0.15). These differences were seen between survivor and non-survivor patients as well. The rate of death in mechanically ventilated patients was 94% (67/71). Mortality at 30-day follow-up was 57% (105/185). CONCLUSIONS: We observed that majority of the non-survivors were obese and young. Complications leading to death was observed in majority of the cases.


Asunto(s)
COVID-19 , COVID-19/epidemiología , Femenino , Humanos , Masculino , México/epidemiología , Persona de Mediana Edad , Obesidad/epidemiología , Pandemias , Derivación y Consulta , Estudios Retrospectivos
7.
PLoS One ; 17(9): e0273923, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36084073

RESUMEN

BACKGROUND: Influenza cause a clinical and economic burden for health systems and society. It is necessary to know the cost of the disease in order to perform cost-effectiveness assessments of preventive or treatment interventions. OBJECTIVE: Assess the costs of the care of children with influenza in a third level hospital in Mexico. METHODS: Longitudinal retrospective study based on the review of clinical files of children hospitalized with influenza. The use of resources used during their hospitalization in the emergency room, general ward, or PICU was logged, and the amount of supplies were multiplied by their corresponding prices to calculate the direct medical expenses. Descriptive statistics were used, and a GLM was adjusted in order to assess the effect of the clinical characteristics of the patients on the cost. Goodness of fit tests were performed. RESULTS: 132 files were reviewed, out of which 95% were of subjects who had comorbidities. Subjects admitted at the PICU generates the highest cost (mean $29,608.62 USD), when analyzing the total cost summarizing the three clinical areas (Emergency room, general ward and PICU) by age group, the highest cost was for patients over age 10 (mean $49,674.53 USD). Comorbidities increase the cost of hospitalization by $10,000.00 USD. CONCLUSIONS: Influenza causes a significant financial burden on the health system. Children with comorbidities increase the costs and children over 10 years uses a significant amount of resources and they are not a priority in immunization program. It is necessary to perform studies on the use of resources in the first and second attention levels, which represent the highest incidence of the disease.


Asunto(s)
Gripe Humana , Neumonía , Niño , Costo de Enfermedad , Hospitalización , Hospitales Públicos , Humanos , Gripe Humana/prevención & control , México/epidemiología , Estudios Retrospectivos
8.
TechTrends ; : 1-3, 2022 Sep 14.
Artículo en Inglés | MEDLINE | ID: mdl-36120499

RESUMEN

During the Covid-19 pandemic, the world turned to online tools as a means of ensuring continued access to education, highlighting possibilities for innovation, particularly in contexts like Mexico, where the use of edtech was not previously prevalent. When educational institutions reopened their physical campuses, many schools and universities considered a hybrid, flexible (HyFlex) approach as a way of catering for different needs. While research findings on students' perspectives tend to be positive, the implementation of HyFlex courses has shown some challenges. Issues reported by teachers relate to poor technical infrastructure, work overload and lack of guidance. The initial excitement for the HyFlex approach has subdued. However, an openness to innovation is still there, ready to be exploited.

9.
Med Anthropol Q ; 2022 Sep 19.
Artículo en Inglés | MEDLINE | ID: mdl-36121921

RESUMEN

Based on longitudinal research conducted with 21 Mexican immigrants between 2018 and 2021, this article examines the challenges the COVID-19 pandemic posed to undocumented immigrants in the United States attempting to provide care for aging parents in Mexico. As the United States excluded undocumented immigrants from pandemic support, the pandemic undermined their ability to provide health care for their parents even as the Mexican public health care system crumbled. Meanwhile, as the pandemic hastened their parents' demise, it thwarted immigrants' ability to time returns to see their parents before they died. While scholars have amply documented how spatial disparities exacerbated the impact of the pandemic among marginalized groups, few have examined the temporal disruptions caused by the pandemic. This article suggests that the pandemic provoked particular distress by desynchronizing the temporalities of family life across borders and preventing immigrants' abilities to coordinate care for their parents in time. [COVID-19, transnational families, eldercare, death, time].

10.
Artículo en Inglés | MEDLINE | ID: mdl-36078730

RESUMEN

Worldwide lockdowns caused by the COVID-19 pandemic had one thing in common between different countries: they highly affected family life in different ways. However, the way they affected women with young children has not been well studied. With the purpose of evaluating the experience of lockdown in Mexico in mothers with and without a paid job carried out at home, 220 Mexican women between 24 and 55 years of age, with one or more children under 15 years of age and who lived with their partner, answered online questionnaires. The results show that, although most of the domestic tasks were carried out by the mothers, the partners of those who had a paid job significantly collaborated more with them. Information and communication technologies (ICTs) were frequently used in both groups, but mothers working from home used them to a greater extent. For these mothers, work overload and confinement were among the main problems caused by the lockdown measures, while the economic situation was the main issue for the group with no paid jobs. Both groups considered family coexistence and the lack of the need to hurry as the advantages of lockdown. To face it, the participants mainly carried out coexistence and entertainment activities. To explain these differences between mothers with and without teleworking, new studies will need to be carried out.


Asunto(s)
COVID-19 , Adolescente , COVID-19/epidemiología , Niño , Preescolar , Control de Enfermedades Transmisibles , Femenino , Humanos , México/epidemiología , Madres , Pandemias
11.
Int J Epidemiol ; 2022 Sep 29.
Artículo en Inglés | MEDLINE | ID: mdl-36174226

RESUMEN

BACKGROUND: In 2020, Mexico experienced one of the highest rates of excess mortality globally. However, the extent of non-COVID deaths on excess mortality, its regional distribution and the association between socio-demographic inequalities have not been characterized. METHODS: We conducted a retrospective municipal and individual-level study using 1 069 174 death certificates to analyse COVID-19 and non-COVID-19 deaths classified by ICD-10 codes. Excess mortality was estimated as the increase in cause-specific mortality in 2020 compared with the average of 2015-2019, disaggregated by primary cause of death, death setting (in-hospital and out-of-hospital) and geographical location. Correlates of individual and municipal non-COVID-19 mortality were assessed using mixed effects logistic regression and negative binomial regression models, respectively. RESULTS: We identified a 51% higher mortality rate (276.11 deaths per 100 000 inhabitants) compared with the 2015-2019 average period, largely attributable to COVID-19. Non-COVID-19 causes comprised one-fifth of excess deaths, with acute myocardial infarction and type 2 diabetes as the two leading non-COVID-19 causes of excess mortality. COVID-19 deaths occurred primarily in-hospital, whereas excess non-COVID-19 deaths occurred in out-of-hospital settings. Municipal-level predictors of non-COVID-19 excess mortality included levels of social security coverage, higher rates of COVID-19 hospitalization and social marginalization. At the individual level, lower educational attainment, blue-collar employment and lack of medical care assistance prior to death were associated with non-COVID-19 deaths. CONCLUSION: Non-COVID-19 causes of death, largely chronic cardiometabolic conditions, comprised up to one-fifth of excess deaths in Mexico during 2020. Non-COVID-19 excess deaths occurred disproportionately out-of-hospital and were associated with both individual- and municipal-level socio-demographic inequalities.

12.
PLoS One ; 17(9): e0275216, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36173956

RESUMEN

In this paper we model the spreading of the SARS-CoV-2 in Mexico by introducing a new stochastic approximation constructed from first principles, where the number of new infected individuals caused by a single infectious individual per unit time (a day), is a random variable of a time-dependent Poisson distribution. The model, structured on the basis of a Latent-Infectious-(Recovered or Deceased) (LI(RD)) compartmental approximation together with a modulation of the mean number of new infections (the Poisson parameters), provides a good tool to study theoretical and real scenarios.

13.
Front Public Health ; 10: 1010256, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36176536

RESUMEN

Mexico, one of the countries severely affected by COVID-19, accumulated more than 5. 1 all-cause excess deaths/1,000 inhabitants and 2.5 COVID-19 confirmed deaths/1,000 inhabitants, in 2 years. In this scenario of high SARS-CoV-2 circulation, we analyzed the effectiveness of the country's vaccination strategy that used 7 different vaccines from around the world, and focused on vaccinating the oldest population first. We analyzed the national dataset published by Mexican health authorities, as a retrospective cohort, separating cases, hospitalizations, deaths and excess deaths by wave and age group. We explored if the vaccination strategy was effective to limit severe COVID-19 during the active outbreaks caused by Delta and Omicron variants. Vaccination of the eldest third of the population reduced COVID-19 hospitalizations, deaths and excess deaths by 46-55% in the third wave driven by Delta SARS-CoV-2. These adverse outcomes dropped 74-85% by the fourth wave driven by Omicron, when all adults had access to vaccines. Vaccine access for the pregnant resulted in 85-90% decrease in COVID-19 fatalities in pregnant individuals and 80% decrease in infants 0 years old by the Omicron wave. In contrast, in the rest of the pediatric population that did not access vaccination before the period analyzed, COVID-19 hospitalizations increased >40% during the Delta and Omicron waves. Our analysis suggests that the vaccination strategy in Mexico has been successful to limit population mortality and decrease severe COVID-19, but children in Mexico still need access to SARS-CoV-2 vaccines to limit severe COVID-19, in particular those 1-4 years old.

15.
Nutrients ; 14(17)2022 Aug 31.
Artículo en Inglés | MEDLINE | ID: mdl-36079845

RESUMEN

In this study, we explore how to use household expenditures and income surveys (HEIS) to provide replicable and comparable measures of nutrients availability at the population level. Our method formalizes the common practice in the literature and consists of three steps: identification of relevant food categories, pairing of food contents food groups in HEIS data, and calculation of the typical amount of nutrients by food group. We illustrate the usage of the method with Mexican data and provide a publicly available data set to readily convert food purchases into six nutrients: calories, proteins, vitamins A and C, iron, and zinc. We perform a descriptive analysis of the evolution of nutrients intake among Mexican households between 2008 and 2020, considering differences by income level. Our results reflect the effect of the COVID-19 pandemic on nutrient availability in Mexican households, mainly driven by a substantial reduction in the expenditure in food consumed away from home, although for most nutrients the trend was stable over most of the period.


Asunto(s)
COVID-19 , Gastos en Salud , COVID-19/epidemiología , Humanos , México , Pandemias , Vitaminas
16.
Rev Med Inst Mex Seguro Soc ; 60(5): 533-539, 2022 Aug 31.
Artículo en Español | MEDLINE | ID: mdl-36048744

RESUMEN

Background: The coronavirus disease 2019 (COVID-19) was declared a pandemic on March 11, 2020. The health personnel were the first line of action, so detecting the presence of burnout and work engagement allows us to have an overview of the perspective on the work environment of these workers. Objective: To identify the presence of high levels of work engagement and burnout in COVID-19 response teams (RT) during the COVID-19 pandemic in a secondary care level. Material and methods: Cross-sectional, descriptive, and observational, discretionary study. Data from 156 workers belonging to the COVID-19 RT were collected. It was administered a survey-type instrument, which collected sociodemographic data, as well as the UWES-9 and the MBI-HSS scales. Data analysis was performed with measures of central tendency and inferential statistics. Results: High levels of work engagement were identified in 55.1% of the COVID-19 RT members, while the high levels of burnout were 3.2%. Conclusions: The prevalence of work engagement was higher than burnout, but this did not imply protection against exhaustion.


Introducción: la enfermedad por coronavirus (COVID-19) fue declarada pandemia el 11 de marzo de 2020. El personal de salud fue la primera línea de acción, por lo que detectar la presencia de desgaste profesional y compromiso laboral nos permite tener un panorama de la perspectiva que se tiene del entorno laboral de estos trabajadores. Objetivo: identificar la presencia de altos niveles de compromiso laboral y desgaste profesional en equipos de respuesta COVID-19 (ERC), durante la pandemia por COVID-19 en un segundo nivel de atención médica. Material y métodos: el tipo de estudio fue transversal, descriptivo y observacional, discrecional. Se recabaron datos de 156 trabajadores pertenecientes a los ERC. Se aplicó un instrumento, el cual recogió datos sociodemográficos, así como las escalas UWES-9 y MBI-HSS. Se realizó el análisis de datos con medidas de tendencia central y estadística inferencial. Resultados: se identificaron niveles altos de compromiso laboral en un 55.1% de los integrantes de los ERC, mientras que los niveles de alto desgaste profesional fueron de 3.2%. Conclusiones: la prevalencia de alto compromiso laboral fue superior a la de alto desgaste profesional, pero no implicó protección contra el agotamiento.


Asunto(s)
Agotamiento Profesional , COVID-19 , Agotamiento Profesional/epidemiología , Agotamiento Profesional/etiología , Agotamiento Psicológico , COVID-19/epidemiología , Estudios Transversales , Humanos , México/epidemiología , Pandemias , Atención Secundaria de Salud , Encuestas y Cuestionarios , Compromiso Laboral
17.
J Antimicrob Chemother ; 77(Supplement_1): i43-i50, 2022 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-36065728

RESUMEN

BACKGROUND: Antimicrobial resistance (AMR) is one of the biggest threats to global public health. Selection of resistant bacteria is driven by inappropriate use of antibiotics, amongst other factors. COVID-19 may have exacerbated AMR due to unnecessary antibiotic prescribing. Country-level knowledge is needed to understand options for action. OBJECTIVES: To review AMR in Mexico and initiatives addressing it. Identifying any areas where more information is required will provide a call to action to minimize any further rises in AMR and to improve patient outcomes. METHODS: National AMR initiatives in Mexico, antibiotic use and prescribing, and availability of susceptibility data, particularly the key community-acquired respiratory tract infection (CA-RTI) pathogens Streptococcus pneumoniae and Haemophilus influenzae, were identified. National and international antibiotic prescribing guidelines commonly used in Mexico for specific CA-RTIs (community-acquired pneumonia, acute otitis media and acute bacterial rhinosinusitis) were also reviewed, along with local antibiotic availability. Insights from a local clinician were sought to contextualize this information. CONCLUSIONS: The Mexican national AMR strategy was published in 2018. This comprised similar objectives to the Global Action Plan from the World Health Assembly (2015) and was compulsory, requiring full compliance from members of the National Health System. Historically, antibiotic consumption in Mexico has been high, however, between 2000 and 2015, consumption fell, in sharp contrast to the majority of countries. Mexico lacks a national surveillance network for AMR, however there are several ongoing global surveillance studies providing local antibiotic susceptibility data. International and local antibiotic prescribing guidelines for CA-RTIs are used. A more standardized inclusive approach in developing local guidelines, using up-to-date local surveillance data of isolates from community-acquired infections, could make guideline use more locally relevant. This would pave the way for a higher level of appropriate antibiotic prescribing and improved adherence. This would, in turn, potentially limit AMR development in Mexico and improve patient outcomes.


Asunto(s)
COVID-19 , Infecciones Comunitarias Adquiridas , Neumonía , Infecciones del Sistema Respiratorio , Enfermedad Aguda , Antibacterianos/uso terapéutico , Infecciones Comunitarias Adquiridas/tratamiento farmacológico , Infecciones Comunitarias Adquiridas/epidemiología , Accesibilidad a los Servicios de Salud , Humanos , México/epidemiología , Neumonía/tratamiento farmacológico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Infecciones del Sistema Respiratorio/epidemiología
18.
BMJ Paediatr Open ; 6(1)2022 07.
Artículo en Inglés | MEDLINE | ID: mdl-36053635

RESUMEN

OBJECTIVE: This study aimed to determine parents' and school-aged children's mental well-being after experiencing confinement and prolonged school closures during the COVID-19 pandemic. DESIGN: Using a cross-sectional design, an online survey was applied to parents of school-aged children inquiring about their mental well-being and COVID-19 pandemic changes in their home and working lives. To assess the presence of depression, anxiety and stress in parents, the participants responded to the Depression, Anxiety and Stress Scale - 21 scale. To assess psychosocial dysfunction and sleep disturbances in children, participants responded to the Pediatric Symptom Checklist and the Children Sleep Habits Questionnaire. RESULTS: A total of 209 parents answered the questionnaire, most of them were female (87.1%) with a mean age of 40 years. The prevalence of anxiety, stress and parental depression symptoms were 35.9%, 28.2% and 25.4%, respectively. Children's mean age was 8.9 years, the prevalence of children's psychosocial dysfunction was 12%, while their sleep disturbance symptoms were 59.8%. 10.5% of children were suffering both outcomes. We found a bidirectional relationship between parents' and children's mental health outcomes. Parental depression symptoms were associated with experiencing COVID-19 infection within the household, having children with pre-existing medical diagnoses, children's psychosocial dysfunction and sleep disturbances. Children's psychosocial dysfunction was associated with parental depression and changes in their school routine. Children's sleep disturbances were associated with parental anxiety, younger age, increased use of electronic devices, night-time awakenings and shorter sleep time. CONCLUSION: Our results support the impact of long confinement and school closure due to the COVID-19 pandemic in Mexican children and parents' mental well-being. We advocate for specific mental health interventions tailored to respond to parents and children at risk of mental well-being distress.


Asunto(s)
COVID-19 , Trastornos del Sueño-Vigilia , Adulto , COVID-19/epidemiología , Niño , Estudios Transversales , Femenino , Humanos , Masculino , Salud Mental , México/epidemiología , Pandemias , Padres/psicología , Trastornos del Sueño-Vigilia/epidemiología , Encuestas y Cuestionarios
19.
Environ Dev Sustain ; : 1-29, 2022 Sep 17.
Artículo en Inglés | MEDLINE | ID: mdl-36158991

RESUMEN

Assessing the security of the water-energy-food nexus is a topic of great importance, which allows determining the situation of each resource to implement actions for sustainable management of these resources in today's society. For this reason, a systematic procedure is proposed to evaluate the synergies of the water-energy-food nexus in a large region that is divided into subregions that allow considering their interactions. The new procedure considers the availability, accessibility and regional interdependence of resources while annexing economic and social aspects. A composite index called the WEF Global Index is developed, which involves the WEF nexus index and has nine indicators that evaluate the availability, accessibility and regional interdependence of each resource in the water-energy-food nexus. This new index considers the Gross Domestic Product per capita and the involved population. As a case study, the 32 states of Mexico were considered to assess the effects of the COVID-19 pandemic on the economy and the security of the water-energy-food nexus at the state level. For this, the composite index was evaluated in the years 2019 and 2020. The results show that from 2019 to 2020, the value of the global index increased in 13 states, in 21 states the security index of the WEF nexus increased, and in 9 states the GDP per capita index increased. On the other hand, the results indicate that in 11 states there was no improvement in the nexus security index due to the increase in water demand, which considerably affected the water availability indicator. Supplementary Information: The online version contains supplementary material available at 10.1007/s10668-022-02671-2.

20.
Front Public Health ; 10: 931306, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36148330

RESUMEN

Background: SARS-CoV-2 prevalence is elevated among people who inject drugs (PWID). In Tijuana, Mexico, COVID-19 vaccines became available to the general population in June 2021, but uptake among PWID was <10%. We studied COVID-19 vaccine uptake among PWID in Tijuana following implementation of a pop-up vaccination clinic. Methods: Beginning in October, 2020, PWID in Tijuana aged ≥18 years were enrolled into a longitudinal cohort study. At baseline and semi-annually, participants underwent interviewer-administered interviews on health behaviors and COVID-19 exposures through April 5, 2022. From June 21-September 20, 2021, staff referred PWID to a temporary COVID-19 vaccine pop-up clinic that was coincidentally established near the study office. Participants attending the clinic completed a short interview on barriers to vaccination and were offered facilitated access to free Janssen® COVID-19 vaccine. All participants were reimbursed $5 for this interview, regardless of whether or not they chose to be vaccinated. Poisson regression was used to evaluate the effect of the pop-up clinic on COVID-19 vaccination uptake, controlling forpotential confounders. Results: Of 344 participants, 136 (39.5%) reported having received at least one COVID-19 vaccine dose during the 10 months follow-up period, of whom 113 (83.1%) received vaccine at the pop-up clinic and 23 (16.9%) elsewhere. One third of those receiving COVID-19 vaccine during the pop-up clinic were previously vaccine hesitant. Attending the pop-up clinic was independently associated with higher rates of COVID-19 vaccination Adjusted Rate Ratio (AdjRR: 9.15; 95% CI: 5.68-14.74). Conclusions: We observed a significant increase in COVID-19 vaccine uptake associated with attending a temporary pop-up vaccine clinic in Tijuana suggesting that efforts to improve vaccination in this vulnerable population should include convenient locations and staff who have experience working with substance using populations. Since COVID-19 vaccination rates remain sub-optimal, sustained interventions to increase uptake are needed.


Asunto(s)
COVID-19 , Consumidores de Drogas , Abuso de Sustancias por Vía Intravenosa , Adolescente , Adulto , COVID-19/epidemiología , COVID-19/prevención & control , Vacunas contra la COVID-19 , Humanos , Estudios Longitudinales , México/epidemiología , SARS-CoV-2 , Abuso de Sustancias por Vía Intravenosa/complicaciones , Abuso de Sustancias por Vía Intravenosa/epidemiología
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