Increased behavioral health needs and continued psychosocial stress among children with medical complexity and their families during the COVID-19 pandemic.

OBJECTIVE: Children with medical complexity (CMC) and their caregivers are at increased risk for multiple psychosocial stressors that can impact child and family well-being and health outcomes. During the COVID-19 pandemic, when access to supports diminished, psychosocial screening and integrated behavioral health (IBH) services in the primary care setting were crucial in identifying and addressing the unique needs of this population METHODS: Universal screening to identify psychosocial needs was implemented in a primary care clinic for CMC that includes IBH services. Data on the prevalence of psychosocial screening and IBH services for young children and their caregivers before and during the COVID-19 pandemic were evaluated RESULTS: Psychosocial screening levels remained stable during the pandemic. Psychosocial needs were identified for 36% of screeners prior to the COVID-19 pandemic and 33% during the COVID-19 pandemic. The need for IBH services increased during the COVID-19 time period resulting in a significant increase in IBH services CONCLUSIONS: For CMC and their caregivers, psychosocial needs identified through psychosocial screening remained high during the pandemic, demonstrating the importance of screening for this population. The need for IBH services during the COVID-19 pandemic increased, underscoring the value and demand for these services particularly during an unprecedented time.

Objetivo: Los niños con complejidades médicas (CMC) y quienes les cuidan están bajo un riesgo en aumento sobre múltiples factores sicosociales de estrés que pueden causar impacto en el bienestar y resultados de salud del niño y la familia. Durante la pandemia COVID-19, cuando disminuyó el acceso al apoyo, los servicios de detección sicosocial y la integrada salud del comportamiento (IBH) en escenarios de cuidado primario fueron cruciales para identificar y manejar las necesidades típicas de esta población. Métodos: La detección universal para identificar necesidades sicosociales se implementó en una clínica de cuidado primario para CMC que incluye servicios IBH. Se evaluó la información acerca de la prevalencia de los servicios de la detección sicosocial e IBH para niños pequeños y quienes les cuidaban antes y durante la pandemia COVID-19. Resultados: Los niveles de detección sicosocial se mantuvieron estables durante la pandemia. Se identificaron las necesidades sicosociales para el 36% de los examinados antes de la pandemia del COVID-19 y 33% durante la pandemia COVID-19. La necesidad de servicios IBH aumentó durante el período de tiempo del COVID-19, lo cual resultó en un aumento significativo en servicios IBH. Conclusiones: Para niños CMC y quienes les cuidan, las necesidades sicosociales identificadas a través de la detección sicosocial se mantuvieron altas durante la pandemia, lo que demuestra lo importante de la detección para este grupo de población. La necesidad de servicios IBH durante la pandemia COVID-19 aumentó, subrayando el valor y demanda de estos servicios en particular durante un momento sin precedente.

Objectif: Les Enfants avec une Complexité Médicale (abrégé ici en français ECM) et les personnes qui prennent soin d'eux sont à un risque plus élevé de facteurs de stress psychosociaux multiples qui peuvent impacter le bien-être de l'enfant et de la famille ainsi que la santé. Durant la pandémie du COVID-19, lorsque l'accès aux soutiens a diminué le dépistage psychosocial et les services de santé comportementale intégrée (SCI) dans les contextes de soins primaires se sont avérés cruciaux pour l'identification et la prise en charge des besoins uniques de cette population. Méthodes: Le dépistage universel afin d'identifier les besoins psychosociaux a été mis en place dans une clinique de soin primaire pour les ECM qui comporte des services SCI. Les données sur la prévalence du dépistage psychosocial et les services SCI pour les jeunes enfants et les personnes prenant soin d'eux avant et après la pandémie du COVID-19 ont été évalués. Résultats: Les niveaux de dépistage psychosocial sont restés stables durant la pandémie. Des besoins psychosociaux ont été identifiés pour 36% des dépistés avant la pandémie du COVID-19 et 33% durant la pandémie du COVID-19. Le besoin de services SCI a augmenté durant la période, résultant en une augmentation importante des services SCI. Conclusions: Pour les ECM et les personnes prenant soin d'eux, les besoins psychosociaux identifiés à travers le dépistage psychosocial est resté élevé pendant la pandémie, démontrant l'importance du dépistage pour cette population. Le besoin de services SCI durant la pandémie du COVID-19 a augmenté, ce qui souligne la valeur et le besoin de ces services surtout durant ces temps sans précédents.

[COVID-19 pandemic and mental health: Initial considerations from spanish primary health care]. / Pandemia de la COVID-19 y salud mental: reflexiones iniciales desde la atención primaria de salud española.

An approach is made to the psychological and psychosocial characteristics that the COVID-19 pandemic is acquiring in the countries of our socio-cultural environment. The scarcity of research in this regard and the necessary acceptance of uncertainty to face the situation, both socially, as well as health and psychological, are discussed. Consequently, a series of reflections and recommendations are proposed for the psychological care of the population, health workers and social organization based on: 1) The existence of psychological and psychosocial research into connected fields and 2) In the new neuroscientific perspectives on emotions and their elaboration in crisis situations.

Recommendations of the Spanish Association of Neurogastroenterology and Motility (ASENEM) to restart the activity of gastrintestinal motility laboratories after the state of alarm called due to the Covid-19 pandemic. / Recomendaciones de la Asociación Española de Neurogastroenterología y Motilidad (ASENEM) para el reinicio de la actividad de los laboratorios de motilidad digestiva, tras el confinamiento por el estado de alarma decretado a raíz de la pandemia por COVID-19.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was responsible for the outbreak of the 2019 coronavirus disease (COVID-19), which is now considered as a pandemic. The prevention strategies adopted have included social distancing measures and the modification, reduction or interruption of a large proportion of routine healthcare activity. This has had a significant impact on the care provided in Gastrointestinal Motility Units. Having passed the peak, in terms of mortality and infections, a gradual reduction in transmission figures has been observed in Spain and other European countries. The risk of reactivation, however, remains high, so it is necessary to have a plan in place that allows healthcare centres to safely resume, for their patients and professionals, instrumental examinations linked to the management of motor pathology. Based on the available scientific evidence and the consensus of a panel of experts, the Spanish Association of Neurogastroenterology and Motility (ASENEM) has drawn up a series of practical recommendations, which have been adapted to the risks inherent in each activity. These include individual protection proposals, as well as organisational and structural measures, which are conceived to allow for the gradual resumption of examinations while minimising the possibility of contagion.

[Mental health in epidemics: A perspective from the Spanish Primary Health Care]. / Salud mental en epidemias: una perspectiva desde la Atención Primaria de Salud española.

The pandemic of the disease known as COVID-19 (acronym for coronavirus disease-2019), which was first detected in the Chinese city of Wuhan in December 2019, has led to an international public health emergency. This due to several reasons (threat to the lives of many people, unprecedented health and socioeconomic crisis, cessation of school and work activities, or the need to adopt extraordinary measures, including quarantining entire cities or countries). The PAPPS Mental Health Group has considered it important to observe, reflect and investigate the phenomena that are occurring, and will occur, in what has possibly been one of the most extensive and radical public health interventions in recent history. This work makes an approach to the psychological and psychosocial characteristics that the COVID-19 pandemic is acquiring in the countries of our socio-cultural environment, and proposes a series of reflections and recommendations for the psychological care of the population, health workers, and social organisation.

A comparison of endoscopic procedures performed at a tertiary care hospital before and during the SARS-CoV-2 pandemic.

INTRODUCTION AND AIM: SARS-CoV-2 emerged in 2019 and had a huge impact on the world. The area of endoscopy suffered great changes, causing a reduction in the number of procedures and its indications. The aim of our study was to compare the quantity, indication, and type of procedures in 2019 with those in 2020. METHOD: A retrospective, observational, analytic, and cross-sectional study was conducted, obtaining information from the endoscopy registry. The STROBE checklist was employed. STATISTICAL ANALYSIS: The quantitative variables were analyzed with descriptive statistics (measures of central tendency and dispersion) and the categorical variables with frequencies and percentages. The quantitative variables were compared, using the Student's t test/Mann-Whitney U test, and the categorical variables with contingency tables, using the Fisher's exact test. RESULTS: In 2019, a total of 277 procedures were performed, compared with 139 in 2020. Mean patient age was 98.53 months (61.46 SD) in 2019 and 77.02 months (59.81 SD) in 2020; 352 diagnostic procedures and 136 therapeutic procedures were carried out in 2019, compared with 51 diagnostic procedures and 88 therapeutic procedures in 2020. The number of diagnostic and therapeutic procedures were inverted (72.1%-36.7% and 27.9%-63.3%, respectively) (p<0.0001). Esophageal varices, upper gastrointestinal bleeding (UGIB), and foreign body extraction were the indications, in order of predominance in 2019, compared with foreign body extraction (p<0.05), UGIB, and esophageal varices in 2020. There were no differences regarding colonoscopy. CONCLUSION: There was a clear difference in indication and type of procedure, with an increase in foreign body extraction in preschoolers.

[Food quality in pre-school and school children in Chile during the COVID-19 pandemic]. / Calidad de la alimentación en preescolares y escolares en Chile durante la pandemia de COVID-19.

Introduction: Introduction: the COVID-19 pandemic can affect the quality of food and nutrition of preschoolers and schoolchildren through an increase in food insecurity of families, by measures such as confinement and closure of educational establishments, which affects the daily structure, feeding schedules, and quality of food. Objectives: analyze the overall food quality of preschool and school children in Chile during the COVID-19 pandemic. Methods: five hundred and fifty-one schoolchildren (22.5 % boys and 77.5 % girls) from five Chilean cities distributed in northern, central, and southern macro zones participated in a convenience sampling. The Global Food Quality Index was applied. The data were analyzed in the IBM SPSSV24 statistical program. Differences in proportions were analyzed employing crossed tables. Results: schoolchildren from rural areas presented lower eating quality than their urban peers (p = .005). Schoolchildren who eat with the whole family had better indicators of eating quality than those who ate alone (p = .002). In nine out of 12 dietary components, evaluated females present higher compliance with dietary recommendations. Conclusions: further research is needed on changes in dietary intake and dietary quality of children and their families during the pandemic. This will allow us to analyze the impact of the pandemic on eating behavior and its possible consequences.

Introducción: Introducción: La pandemia por COVID-19 puede afectar en la calidad de la alimentación y la nutrición de preescolares y escolares a través de un incremento de la inseguridad alimentaria de las familias, por medidas como el confinamiento y cierre de establecimientos educacionales, lo que afecta la estructura diaria, horarios de alimentación y calidad de la alimentación. Objetivo: analizar la calidad global de la alimentación de preescolares y escolares en Chile durante la pandemia de COVID-19. Métodos: en un muestreo por conveniencia participaron 551 escolares (22,5 % niños y 77,5 % niñas) de cinco ciudades de Chile distribuidas en macrozonas norte, centro y sur. Se aplicó el índice de calidad global de la alimentación. Los datos fueron analizados en el programa estadístico IBM SPSSV24. Se analizaron diferencias de proporciones a través de tablas cruzadas. Resultados: escolares de zonas rurales presentaron menor calidad de la alimentación que pares de zonas urbanas (p = ,005). Escolares que comen con toda la familia presentan mejores indicadores de calidad de la alimentación que aquellos que lo hacen solos (p = ,002). En nueve de 12 componentes de la alimentación evaluados, las mujeres presentan mayor cumplimiento de recomendaciones alimentarias. Conclusiones: se requieren más investigaciones sobre los cambios de ingesta dietética y calidad de la alimentación de los niños y niñas y sus familias durante la pandemia. Esto permitirá analizar el impacto de la pandemia en la conducta alimentaria y sus posibles consecuencias.

Aprendizaje en las residencias quirúrgicas durante la pandemia de COVID-19 en México.

OBJECTIVE: To bring up which was the surgical resident's perception about their learning experience during COVID-19 pandemic and if it interfered or not with their classes. METHOD: Cross-sectional observational study through an anonymous survey conducted among surgical residents. The Mexican Association of General Surgery, through its Women in Surgery Committee, created a questionnaire that included 40 questions. RESULTS: 465 participants were included in the survey: 225 women (48.3%), 240 men (51.7%); of 32 entities, only 26 participated. A great part of them said their skills and abilities were affected because elective surgeries were called off. While 303 residents stayed at hybrid hospitals, while a third of them were at 100% Covid facilities. Residents who were on call worked at COVID-19 units. They continued attending class through online platforms and only 134 were able to practice their skills using simulators. 71% of the residents were infected with COVID-19, all were tested to confirm it, and the number of asymptomatic cases was unknown. CONCLUSIONS: COVID-19 pandemic has affected the learning process of surgical residents in Mexico.

OBJETIVO: Citar cuál fue la percepción que tuvieron los médicos residentes quirúrgicos sobre su aprendizaje durante la pandemia de COVID-19 y si continuaron o no con sus clases. MÉTODO: Estudio observacional, de corte transversal, mediante una encuesta anónima de 40 cuestionamientos diseñada por el Comité de Cirujanas de la Asociación Mexicana de Cirugía General, aplicada a los médicos residentes quirúrgicos. El tamaño de la muestra fue a conveniencia. RESULTADOS: Se incluyeron 465 participantes, de los que 225 fueron mujeres (48.3%) y 240 hombres (51.7 %). De 32 entidades, solo participaron 26. La gran mayoría opinaron que sus habilidades y destrezas se vieron afectadas por la suspensión de cirugías electivas. Estuvieron en hospitales híbridos 303 participantes y en hospitales 100% COVID-19 una tercera parte. Las guardias fueron realizadas en áreas COVID-19 y continuaron con sus clases a través de plataformas digitales; solo 134 realizaron prácticas en simuladores. El 71% de los médicos residentes se contagiaron de la enfermedad; el diagnóstico fue corroborado con una prueba y se desconoce el porcentaje de casos asintomáticos. CONCLUSIONES: La pandemia de COVID-19 afectó el aprendizaje de los médicos residentes de especialidades quirúrgicas en México.

The Transformation of Chinese Cultural Images of the Plague through Chinese Characters, Legends and Folkways.

The human experience of survival from a plague is about distinguishing the sick from the healthy as quickly as possible, establishing a barrier to stop the infection, and protecting healthy people. Nevertheless, the various quarantine rules and the acceptance and compliance of the population are a kind of battle between policy implementers and the public. This paper tries to understand how Chinese cultural attitudes (Henderson, 1984) unconsciously influence the Chinese people to be most cooperative with the strict containment and quarantine measures to confront the COVID-19 pandemic. This article begins with the Chinese characters, exemplified by the four characters of disease and plague, to discuss how the pictograph nature and spatial structural way profoundly shaped the cultural mind. Then, through plague-related Chinese legends, stories and folklore, the paper sets out the Chinese cultural attitudes which are also manifested in the analogical associations between disease, plague and seasons, the balance of the five elements of the universe and ghosts, gods and the government bureaucrats in the Kingdom of the Heaven. All of these approaches are well in line with Jung's method of associative amplification as a way to locate the archetypal wisdom that assures survival.

L'expérience humaine de survivre à la peste est de distinguer les malades des personnes saines aussi vite que possible, d'établir une barrière pour stopper l'infection, de protéger les personnes saines. Cependant les diverses règles sur la quarantaine et l'acceptation et la soumission de la population sont une sorte de bataille entre les personnes qui mettent en œuvre les mesures et le public. Cet article tente de comprendre comment les attitudes culturelles Chinoises (Henderson 1984) ont influencé inconsciemment le peuple Chinois, le rendant plus coopératif en ce qui concerne le confinement strict et les mesures de quarantaine pour faire face à la pandémie de COVID-19. Cet article commence avec les caractères Chinois, illustrés par les quatre caractères de la maladie et la peste, pour discuter comment le pictogramme de la nature et la façon de structurer l'espace ont profondément modelé la pensée culturelle. Ensuite, à travers des légendes, des histoires et le folklore Chinois traitant de la peste, l'article cerne les attitudes culturelles Chinoises. Ces attitudes sont également repérables dans les analogies entre la maladie, la peste et les saisons, l'équilibre des cinq éléments de l'univers, les esprits, les dieux et les bureaucrates gouvernementaux dans le Royaume des Cieux. Toutes ces approches sont bien en accord avec la méthode d'amplification associative de Jung en tant que manière de situer la sagesse archétypale qui permet la survie.

La experiencia humana de sobrevivir a una plaga consiste en distinguir lo antes posible a los enfermos de los sanos, establecer una barrera para detener la infección y proteger a las personas sanas. Sin embargo, las diversas normas de cuarentena y la aceptación y el cumplimiento por parte de la población son una especie de batalla entre los responsables políticos y el público. Este artículo trata de entender cómo las actitudes culturales chinas (Henderson 1984) influyen inconscientemente en el pueblo chino para que sea más cooperativo con las estrictas medidas de contención y cuarentena para hacer frente a la pandemia de COVID-19. El presente artículo comienza con los caracteres chinos, ejemplificados por los cuatro caracteres de la enfermedad y la peste, para analizar cómo la naturaleza pictográfica y la forma estructural espacial moldearon profundamente la mente cultural. A continuación, a través de leyendas, cuentos y folclore chinos relacionados con la peste, el artículo expone las actitudes culturales chinas que también se manifiestan en las asociaciones analógicas entre la enfermedad, la peste y las estaciones, el equilibrio de los cinco elementos del universo, y los fantasmas, los dioses y los burócratas del gobierno en el Reino de los Cielos. Todos estos planteamientos se ajustan bien al método de Jung de amplificación asociativa como vía de acceso a la sabiduría arquetípica que asegura la supervivencia.

[Changes in the eating behavior of highly educated adults during the different stages of home confinement by COVID-19 in Iberoamerica]. / Cambios en el comportamiento alimentario de personas adultas con elevado nivel académico durante las diferentes etapas del confinamiento domiciliario por COVID-19 en Iberoamérica.

Introduction: Introduction: the COVID-19 pandemic has forced governments of affected countries to implement preventive measures including quarantine or house confinement. This situation has generally been seen to have affected the dietary patterns of the population. Objective: to evaluate changes in dietary habits and food acquisition during the different stages of home confinement caused by COVID-19 in the highly educated adult population in different Latin American countries. Methods: an observational and cross-sectional study was carried out in which 9,572 people from 58 different countries and with university studies participated. The instrument used for data collection was a survey designed by the International Ibero-American University of Mexico (UNINI-México) to study food habits during home confinement due to COVID-19 as part of the HALCON-COVID-19 study. Results: most of the respondents indicated having maintained their weight during quarantine (57.3 %), although they reported having reduced their physical activity (23.9 %) and eliminated the consumption of ultra-processed foods (53.4 %), alcoholic beverages (43.3 %), chocolates and sweets (41.1 %), while including vegetables (37.7 %), fruits (37 %) and eggs (30.6 %) in their diet. Conclusions: people who usually do not eat healthily have been even more affected in the way they eat during confinement, reducing their physical activity and increasing their body weight, while those with healthier lifestyles have not changed their habits or even maintained their healthy lifestyles during the pandemic.

Introducción: Introducción: la pandemia por COVID-19 ha obligado a los gobiernos de los países afectados a aplicar medidas preventivas que incluyen la cuarentena o el confinamiento domiciliario. Se ha visto que, en general, esta situación ha afectado los patrones alimentarios de la población. Objetivo: evaluar los cambios en los hábitos alimentarios y en la adquisición de los alimentos durante las diferentes etapas del confinamiento domiciliario ocasionado por COVID-19 en la población adulta de alto nivel educativo en diferentes países de Iberoamérica. Métodos: se realizó un estudio observacional y transversal en el que participaron 9.572 personas de 58 países diferentes con estudios universitarios. El instrumento utilizado para la recolección de datos fue una encuesta diseñada por la Universidad Internacional Iberoamericana de México (UNINI-México) para estudiar los hábitos alimentarios durante el confinamiento domiciliario por COVID-19 como parte del estudio HALCON-COVID-19. Resultados: la mayoría de los encuestados indicaron haber mantenido su peso durante la cuarentena (57,3 %), aunque reportaron haber reducido su actividad física (23,9 %)y repecto al consumo de alimentos, reportaron haber disminuido el consumo de alimentos ultraprocesados (53,4 %), de bebidas alcohólicas (43,3 %) y de chocolates y golosinas (41,1 %), mientras que aumentaron en su dieta el consumo de vegetales (37,7 %), frutas (37 %) y huevos (30,6 %). Conclusiones: las personas que no comían de forma saludable previamente, han empeorado la calidad de su dieta durante el periodo de confinamiento además de haber reducido su actividad física, sin embargo, aquellos que tenían un estilo de vida más sano lo han mantenido durante este el periodo.

Socio-economic and psychological impact of COVID-19 pandemic in a Spanish cohort BIOVAL-D-COVID-19 study protocol.

OBJECTIVE: SARS-CoV-2 outbreak has a negative psychological impact among general population. Data comparing mental health status before and during the outbreak is needed. The BIOVAL-D-COVID-19 study assess the socio-economic and psychological impact of the COVID-19 pandemic and lockdown in a representative sample of non-institutionalized Spanish adult population, and estimate the incidence of mental health disorders, including suicidal behaviours, and possible related factors. METHOD: Observational longitudinal study including two online surveys: baseline survey (T0) performed during 2019 and follow-up survey (T1) conducted 12-month later. The latter included nine sections: socio-demographic, health status, mental health, employment conditions and status, material deprivation, use of healthcare services, intimate partner violence and resilience. Four of the nine sections are administered in T0 and T1 assessments. Longitudinal data analyses will estimate adjusted incidence rates of mental health disorders using Poisson regression models. Risk and protective factors will be analysed through multiple logistic regression models.

Moral Panics, Viral Subjects: Black Women's Bodies on the Line during Cuba's 2020 Pandemic Lockdowns.

While Cuba was in a COVID-19-induced lockdown, coleras, women who wait in hours-long colas (lines) to purchase scarce goods to resell, emerged in online state media as "folk devils" responsible for the acute shortages of basic goods. Using an intersection lens, we combine fieldwork in lines and content analysis of online media to examine the creation and policing of the colera threat during the summer of 2020. Coleras were framed as immoral subjects, gendered and racialized, and often depicted as a virus that threatened the nation's health. The colera moral panic attempted to obscure class, race, and gender inequalities and structures that have made certain citizens vulnerable in the aftermath of successive waves of Cuban economic reforms. Understanding this moral panic allows us to appreciate the material scarcities and indignities to which poor Black women have been subjected, and widespread concerns about the state's failure to protect society's most vulnerable.

Durante el encierro inducido por el COVID­19 en Cuba, las coleras, mujeres que esperan horas en colas (filas) para comprar bienes escasos para revenderlos, surgieron en los medios estatales en línea como "diablas populares", responsables de la aguda escasez de bienes básicos. Usando una lente interseccional, combinamos trabajo de campo en líneas y análisis de contenido de medios en línea para examinar la creación y vigilancia de la amenaza colera durante el verano de 2020. Las coleras fueron enmarcadas como sujetas inmorales, generizadas y racializadas, y a menudo representadas como un virus que amenazaba la salud de la nación. El pánico moral sobre la colera intentó oscurecer la clase, la raza y las desigualdades y estructuras de género que han hecho vulnerables a determinados ciudadanos tras las sucesivas oleadas de reformas económicas en Cuba. Entender este pánico moral nos permite apreciar las carencias materiales y las indignidades a las que las mujeres pobres negras han sido sometidas, así como las preocupaciones generalizadas sobre la falta de protección del Estado hacia los más vulnerables de la sociedad.

Craniofacial trauma: Experience in private hospital care during the pandemic provoked by SARS-CoV-2.

BACKGROUND: The onset of the SARS-Cov-2 pandemic brought with it important changes in the hospital care for all diseases. According to the international literature, since the beginning of the pandemic there has been an impact in the incidence, etiology, and severity of head trauma, all these changes as a direct consequence of lockdown. OBJECTIVE: In this article we analyzed the characteristics of craniofacial trauma in patients admitted to a private hospital in Mexico City during the SARS-CoV-2 pandemic. METHOD: Medical records from patients admitted in Medica Sur between March 2020 and June 2021. In this study, incidence, etiology, severity of the injuries and the SARS-CoV-2 PCR result performed upon admission were analyzed. RESULTS: Although there is no study in Mexico like ours, the results were similar to those reported by other hospital centers worldwide, presenting a greater number of cases classified as mild craniofacial trauma, in addition to finding that the main age group affected were older adults. CONCLUSIONS: The reported information in our study provides a general view of craniofacial trauma characteristics during SARS-CoV-2 pandemic.

INTRODUCCIÓN: El inicio de la pandemia provocada por SARS-CoV-2 trajo consigo importantes cambios en los cuidados hospitalarios para todas las enfermedades. De acuerdo con la literatura internacional, desde el comienzo, y a consecuencia del aislamiento, ha existido un impacto en la incidencia, la etiología y la gravedad del trauma craneomaxilofacial. OBJETIVO: Estudiar las características del trauma craneofacial en los pacientes ingresados a un hospital privado en la Ciudad de México durante la pandemia por SARS-CoV-2. MÉTODO: Se revisaron los expedientes clínicos de los pacientes ingresados a Médica Sur, entre marzo de 2020 y junio de 2021. Se analizaron la incidencia, la etiología, la gravedad de las lesiones y el resultado de la prueba de reacción en cadena de la polimerasa para SARS-CoV-2 que se realizó durante la atención hospitalaria. RESULTADOS: En México no existe un estudio semejante al nuestro, pero los resultados fueron similares a los reportados por otros centros hospitalarios en el mundo, presentando un mayor número de casos clasificados como traumatismo craneofacial leve, además de encontrar que el principal grupo de edad afectado fueron los adultos mayores. CONCLUSIONES: La información reportada en nuestro estudio brinda un panorama general sobre las características del trauma craneofacial durante la pandemia por SARS-CoV-2.

Back to the future: when children and adolescents return to office sessions following episodes of teletherapy.

Analysts and psychotherapists are beginning to have more thorough and probing discussions about how the COVID-19 pandemic has affected their work. Shifting to online teletherapy has been necessary due to the public health measures put in place to curtail the spread of the virus. Much of the existing literature addresses how using online platforms for teletherapy works for adults. This paper instead looks at its effects on working with children and adolescents. A contrast between Winnicott's notion of holding and Bion's concept of container-contained is reviewed through a summary of a paper by Ogden. This author finds that holding might be more applicable to online work during a pandemic when the collective relationship to time and its usual parameters is severely upended. Containing could be more arduous and challenging online due to the lack of embodied presence to communicate and detect tiny nonverbal cues. A short questionnaire affirms that child analysts and psychotherapists have struggled with dimensions of online work that are particular to the developmental levels of their patients. Further, teletherapy may often not be a good fit for someone with learning differences.

Les analystes et les psychothérapeutes commencent à avoir des discussions plus profondes et plus pointues sur comment la pandémie de COVID-19 a affecté leur travail. Passer à la thérapie en ligne a été nécessaire du fait des mesures de santé publique mises en place pour freiner l'avancée du virus. La majeure partie de la littérature s'intéresse à comment l'utilisation des plateformes en ligne pour la psychothérapie a fonctionné pour les adultes. Par contraste, cet article se penche sur les effets dans le travail avec les enfants et les adolescents. A travers un résumé d'un article d'Ogden, un contraste entre la notion de « holding ¼ de Winnicott et le concept de contenant-contenu de Bion est examiné. L'auteur soutient que la notion de holding serait plus adaptée au travail en ligne durant une pandémie, quand la relation collective au temps et à ses paramètres habituels est gravement perturbée. La contenance (Bion) pourrait s'avérer plus délicate et plus laborieuse en ligne du fait du manque de présence incarnée pour détecter et communiquer les signes non-verbaux. Un court questionnaire confirme que les analystes d'enfants et les psychothérapeutes ont eu du mal avec les aspects du travail en ligne qui se rapportent aux niveaux de développement de leurs patients. De plus, la télé-thérapie peut souvent ne pas être adaptée pour quelqu'un qui présente des différences d'apprentissages.

Analistas y psicoterapeutas están comenzando a tener discusiones más minuciosas y agudas sobre cómo la pandemia por el COVID-19 ha afectado su trabajo. El cambio a la terapia virtual ha sido necesario debido a las medidas de salud pública tomadas para reducir la propagación del virus. Gran parte de la literatura existente da cuenta de como el uso de plataformas para la terapia virtual funciona para los adultos. El presente trabajo en cambio, presta atención a los efectos en el trabajo con niños y adolescentes. Se revisa a través de un trabajo de Ogden, el contraste entre la noción de sostenimiento de Winnicott y el concepto de contenedor-contenido de Bion. Este autor encuentra que el sostenimiento puede aplicarse más al trabajo online durante una pandemia cuando la relación del colectivo con el tiempo y sus parámetros usuales es severamente trastocada. La contención podría ser más ardua y desafiante de manera online debido a la falta de una presencia corporal que comunique y permita detectar pequeñas señales no-verbales. Un breve cuestionario afirma que analistas y psicoterapeutas de niños han luchado con aquellas dimensiones del trabajo online propias del nivel de desarrollo de sus pacientes. Además, la terapia virtual puede a menudo no ser una buena opción para alguien con diferencias en el aprendizaje.

Addictions: current perspectives.

This paper seeks to integrate the perspectives of analytical psychology and neurobiology in order to understand the phenomenon of addiction in contemporary society, taking into account the COVID-19 pandemic. Jung emphasizes the role of the psyche's self-regulation and the development of consciousness in the individuation process. The search for experiences of transcendence is archetypal and can be achieved by the use of some substances or behaviours and can contribute to individuation. However, in contemporary society, many individuals seek to restore internal balance through behaviours that merely soothe discomfort. The difficulty in discerning use, abuse, and dependence, particularly in the case of behavioural addictions, is discussed and neurobiological factors are presented. Empathic relationships play a key role in this process as they can promote the integration of the right and left hemispheres, integrating non-verbal experiences and language, contributing to self-regulation. Jung emphasizes the importance of real encounters in the transformation process. Currently, meetings have become a source of anguish. The author concludes that more than ever it is necessary to invest in the quality of the interactions to prevent and treat addictions.

Cet article chercher à intégrer les perspectives de la psychologie analytique et de la neurobiologie afin de comprendre le phénomène de l'addiction dans la société contemporaine, en tenant compte de la pandémie de COVID-19. Jung a souligné le rôle autorégulateur de la psyché et le développement de la conscience dans le processus d'individuation. La recherche d'expériences de transcendance est archétypale et peut être atteinte par l'utilisation de certaines substances ou certains comportements et elle peut contribuer à l'individuation. Néanmoins dans la société contemporaine, beaucoup de personnes cherchent à restaurer l'équilibre intérieur par des comportements qui visent simplement à apaiser l'inconfort. La difficulté à différencier entre l'utilisation, l'abus, et la dépendance, particulièrement en ce qui concerne les addictions comportementales - est étudiée et les facteurs neurobiologiques sont exposés. Les relations empathiques jouent un rôle clé dans ce processus parce qu'elles peuvent promouvoir l'intégration des hémisphères droit et gauche, intégrant les expériences non-verbales et le langage, contribuant à l'autorégulation. Jung souligne l'importance des rencontres réelles dans le processus de transformation. En ce moment les réunions sont devenues une source d'angoisse. L'auteur conclut qu'il est plus que jamais nécessaire d'investir dans la qualité des interactions afin de prévenir et de soigner les addictions.

El presente trabajo busca integrar perspectivas de psicología analítica y neurobiología en vistas a la comprensión del fenómeno de la adicción en la sociedad contemporánea, tomando en cuenta la pandemia del COVID-19. Jung enfatiza el rol auto-regulador de la psique y el desarrollo de la consciencia en el proceso de individuación. La búsqueda de experiencias de trascendencia es arquetípica y puede ser alcanzada a través del uso de ciertas sustancias o conductas y puede contribuir al proceso de individuación. Sin embargo, en la sociedad contemporánea, muchos individuos buscan restaurar el balance interno a través de conductas que meramente alivian el malestar. Se discute acerca de la dificultad para discernir uso, abuso y dependencia, particularmente en el caso de conductas adictivas y se presentan los factores neurobiológicos. Las relaciones empáticas juegan un rol fundamental en este proceso en la medida que promueven la integración de los hemisferios derecho e izquierdo, integrando experiencias no-verbales y lenguaje, contribuyendo a la auto-regulación. Jung enfatiza la importancia de encuentros reales en el proceso de transformación. Actualmente, los encuentros se han convertido en una fuente de angustia. La autora concluye que más que nunca se vuelve necesario invertir en la calidad de las interacciones para prevenir y tratar las adicciones.

Este artigo busca integrar as perspectivas da psicologia analítica e da neurobiologia para entender o fenômeno dos vícios na sociedade contemporânea, levando em consideração a pandemia de COVID-19. Jung enfatiza o papel da autorregulação da psique e o desenvolvimento da consciência no processo de individuação. A busca por experiências de transcendência é arquetípica e pode ser alcançada pelo uso de algumas substâncias ou comportamentos e pode contribuir para a individuação. No entanto, na sociedade contemporânea, muitos indivíduos buscam restaurar o equilíbrio interno por meio de comportamentos que apenas acalmam o desconforto. A dificuldade em discernir o uso, abuso e dependência, particularmente no caso de vícios comportamentais, é discutida e fatores neurobiológicos são apresentados. As relações empáticas desempenham um papel fundamental nesse processo, pois podem promover a integração dos hemisférios direito e esquerdo, integrando experiências não verbais e linguagem, contribuindo para a autorregulação. Jung enfatiza a importância de encontros reais no processo de transformação. Atualmente, os encontros se tornaram uma fonte de angústia. O autor conclui que mais do que nunca é necessário investir na qualidade das interações para prevenir e tratar vícios.

Cardiac rehabilitation in the COVID-19 time. Programs. Results.

INTRODUCCIÓN: La pandemia de enfermedad por coronavirus 2019 (COVID-19) ha incidido de forma negativa en los programas de rehabilitación cardiaca (PRC) españoles. OBJETIVO: Este trabajo tiene como objetivo fundamental el analizar la posibilidad de mantenerlos abiertos y como secundario valorar si se mantienen los beneficios demostrados a nivel físico y psicológico. MÉTODOS: Analizamos los resultados de nuestro PRC en el año 2020 (119 pacientes) y los comparamos con los del año 2019 (121 pacientes), libre de COVID-19. Se comparan distintas variables generales, y los resultados obtenidos en capacidad física, a nivel psicológico, así como las complicaciones y abandonos. RESULTADOS: No existen diferencias significativas entre ambos grupos en la edad (61.6 vs. 61.5), sexo (mujeres: 12.6 vs. 14.8%), diagnóstico de cardiopatía isquémica (106 vs. 99) y fracción de eyección de ventrículo izquierdo (55.9 vs. 55.8%). La ansiedad media-alta fue superior al inicio (p = 0.02) y final (p = 0.002) del programa en el año 2019, así como las puntuaciones del patrón de conducta tipo A (p = 0.041 vs. 0.034). El porcentaje de depresión fue similar. Más del 95% de los pacientes del año 2020 referían miedo al contagio. La capacidad funcional aumentó, pero menos en el año 2020 (p = 0.001). La duración del programa fue superior en el año 2020 (p = 0.001). Los abandonos (15 vs. 11 pacientes) no mostraron diferencias significativas. CONCLUSIONES: Los PRC en época COVID-19 son posibles y siguen mostrando beneficios. La duración del programa fue mayor por periodos de falta de asistencia. La menor capacidad física puede estar relacionada con el uso de la mascarilla. INTRODUCTION: COVID-19 pandemic has had a negative impact on Spanish Cardiac Rehabilitation Programmes (CRP). OBJECTIVES: The main objective of this study is to analyze the possibility of keeping these units open and, secondly, to assess whether demonstrated physical and psychological benefits are preserved. METHODS: We analyzed results of our CRP in 2020 (119 patients) and compared them with those of 2019 (121 patients), year free of Covid. We compare different general variables, and results obtained in physical capacity, psychological level, as well as complications and dropouts. RESULTS: There were no significant differences between two groups in age (61.6 vs. 61.5), sex (women: 12.6% vs. 14.8%), diagnosis of ischemic heart disease (106 vs. 99) and left ventricular ejection fraction (55.9% vs. 55.8%). Mean-high anxiety was higher at baseline (p = 0.02) and endline (p = 0.002) of program in 2019, as well as type A behavior pattern scores (p=0.041 and 0.034). Percentage of depression was similar. More than 95% of patients in 2020 reported fear of infection. Functional capacity increased, but less in 2020 (p = 0.001). Programme duration was longer in 2020 (p=0.001). Dropouts (15 vs. 11 patients) showed no significant differences. CONCLUSIONS: CR programmes in COVID-19 era are possible and continue to show benefits. The duration of programme was longer due to periods of non-attendance. Lower physical capacity may be related to mask use.

Cardiopulmonary resuscitation during the COVID-19 pandemic in Spain.

OBJECTIVES: The disease COVID-19 produces serious complications that can lead to cardiorespiratory arrest. Quality cardiopulmonary resuscitation (CPR) can improve patient prognosis. The objective of this study is to evaluate the performance of the specialty of Anesthesiology in the management of CPR during the pandemic. METHODS: A survey was carried out with Google Forms consisting of 19 questions. The access link to the questionnaire was sent by email by the Spanish Society of Anesthesia (SEDAR) to all its members. RESULTS: 225 responses were obtained. The regions with the highest participation were: Madrid, Catalonia, Valencia and Andalusia. 68.6%% of the participants work in public hospitals. 32% of the participants habitually work in intensive care units (ICU), however, 62.1% have attended critical COVID-19 in the ICU and 72.6% have anesthetized them in the operating room. 26,3% have attended some cardiac arrest, 16,8% of the participants admitted to lead the manoeuvres, 16,8% detailed that it had been another department, and 66,2% was part of the team, but did not lead the assistance. Most of the CPR was performed in supine, only 5% was done in prone position. 54.6% of participants had not taken any course of Advance Life Support (ALS) in the last 2 years. 97.7% of respondents think that Anesthesia should lead the in-hospital CPR. CONCLUSION: The specialty of Anesthesiology has actively participated in the care of the critically ill patient and in the management of CPR during the COVID-19 pandemic. However, training and/or updating in ALS is required.

Clinical experiences during the COVID-19 pandemic.

Most of the clinical experiences discussed in this article arose from monthly Zoom meetings at Rome's Italian Centre of Analytical Psychology (CIPA). We set up a discussion group in April 2020, one month after lockdown began in Italy, and these monthly online meetings continue to this day. All senior analysts and analysts-in-training at Rome's CIPA, whose backgrounds range from child and adolescent psychotherapy to adult psychotherapy and analysis, to sandplay therapy and medicine and psychiatry, have been participating in these meetings. The group discussions focus on the present time and its impact on us, as well as on our relationships with patients. By further developing these reflections during the lockdown in Italy (9 March - 3 May 2020), it is fair to ask whether a sense of unreality, depersonalization, or derealization has occurred, either in the therapist or patient, and if so, whether it is possible that therapists miss the human contact more than clients. We will mainly refer to clinical and personal experiences as our most precious guidelines.

La plupart des expériences cliniques discutées dans cet article proviennent de rencontres mensuelles par Zoom à la CIPA, le Centre de Psychologie Analytique Italien, à Rome. Nous avons mis en place en avril 2020 un groupe de discussion, un mois après que le confinement ait commencé en Italie. Ces réunions mensuelles, en ligne, se poursuivent jusqu'à ce jour. Les analystes confirmés et les analystes en formation à la CIPA participent à ces rencontres. Leurs contextes sont variés: de la psychothérapie d'enfants et d'adolescents à la psychothérapie d'adultes et à l'analyse, et également la thérapie par le jeu de sable, la médecine et la psychiatrie. Les discussions se concentrent sur le temps présent et son impact sur nous, et sur nos relations avec nos patients. En poussant plus loin les réflexions durant le confinement en Italie (du 9 mars au 3 mai 2020), il est pertinent de se demander s'il s'est produit un sentiment d'irréalité, de dépersonnalisation ou déréalisation, chez le thérapeute ou chez le patient. Et si c'est le cas, est-il envisageable que le contact humain manque aux thérapeutes plus qu'aux clients? Notre consigne la plus précieuse sera de nous appuyer principalement sur des expériences cliniques et personnelles.

La mayor parte de la experiencia clínica descripta en este artículo emergió de los encuentros mensuales vía Zoom del Centro de Psicología Analítica de Roma (CIPA). Creamos un grupo de discusión en Abril 2020, un mes después del comienzo del confinamiento, y estos encuentros mensuales virtuales continúan hasta estos días. Todos los analistas con antigüedad, y analistas en formación en la CIPA de Roma, cuyos antecedentes van desde psicoterapia con niños y adolescentes hasta psicoterapia y análisis de adultos, terapia de juego de arena, medicina y psiquiatría, han participado de estos encuentros. La discusión del grupo se focalizó en el tiempo presente y su impacto en todos nosotros, así como en nuestras relaciones con los pacientes. Al continuar desarrollando estas reflexiones surgidas durante el confinamiento en Italia (9 de Marzo - 3 de Mayo 2020), es válido preguntar si ha tenido lugar un sentido de no realidad, despersonalización o desrealización, en el terapeuta o en el paciente, y de ser así, si es posible que los terapeutas hayan extrañado el contacto humano más que los pacientes. Haremos referencia principalmente a experiencias personales y clínicas como nuestras guías más preciosas.

Hospital Radiopharmacy in Argentina during the COVID-19 pandemic. Criteria and rationale for the organization of work. / Radiofarmacia Hospitalaria en Argentina durante la pandemia de COVID-19. Criterios y fundamentos para la organización del trabajo.

This publication presents criteria and bases for the work organization in the safe practice of Hospital Radiopharmacy, in order to minimize the risk of viral transmission during the COVID-19 pandemic, in a reference facility of the National Energy Commission Atomic of Argentina, while continuing to perform essential services for the health system. For this purpose, documents from the National Energy Commission Atomic, IAEA, WHO and other scientific publications were consulted as reference. These recommendations are under constant review and are permanently updated. Within this framework, the present model of work organization for this essential activity is proposed, including general and specific recommendations and its epidemiological and immunological basis.

Salud mental: cuando la necesidad queda por fuera de la agenda sanitaria / Mental health: when the need is out of the health agenda

Introducción: Pos-pandemia COVID-19 los centros de salud vieron incrementados el número de consultas en salud mental (SM). Objetivos: -Evidenciar el aumento de la demanda en SM pos-pandemia. Pre y pos-pandemia: -Comparar las características de demanda en SM -Relevar las demandas del área judicial (DAJ) -Evaluar la dispensa de psicofármacos (PF) Material y Métodos: Trabajo descriptivo, retrospectivo, poblacional. Pacientes atendidos en SM del Área Programática del Hospital Penna. Se obtuvieron consultas de psicología (PSI) psiquiatría y psicopedagogía, motivo de consulta, edad, sexo, dispensa de psicofármacos (PF) desde el 1/01 al 31/12/2019 y mismo período 2022. Los datos se analizaron en frecuencia, porcentaje. Resultados: Las consultas pos-pandemia aumentaron un 8%, los pacientes atendidos aumentaron 37.91%. Las consultas PSI pediatría/adolescencia descendieron 6.5% en 2022 predominando niños en 2019 y niñas en 2022. En adultos aumentó 20.10%, predominando mujeres ambos períodos. Si bien consumo, violencia y angustia fueron nombrados en ambos periodos, pobreza apareció en 2022. Las DAJ aumentaron más del 1000%. La dispensa PF aumentó más del 100%. Conclusiones: En pos-pandemia aumentaron las consultas de PSI y los DAJ. El aumento en dispensa PF evidencia el deterioro y la complejidad de la SM pos-pandemia. Estos datos, plantea la necesidad de incorporar nuevos profesionales

Introduction: Post- COVID-19 pandemic, health care centers increased the number of mental health (MH) consultations. Objectives: - Evidence the increase in demand for SM post-pandemic. Pre and post-pandemic: -Compare the characteristics of demand in SM -Review the demands of the judicial area (DAJ) -Evaluate the dispensation of psychotropic drugs (PF) Material and Methods: Descriptive, retrospective, population-based study. Patients treated in SM at the Programmatic Area of the Penna Hospital. Consultations from psychology (PSI), psychiatry and psychopedagogy, reason for consultation, age, sex, dispensation of psychotropic drugs (PF) were obtained from 01/01 to 12/31/2019 and the same period 2022. The data was analized in frequency and percentage. Results: Post-pandemic consultations increased by 8%, patients treated increased by 37.91%. Pediatric/adolescent PSI consultations decreased 6.5% in 2022, with boys predominating in 2019 and girls in 2022. In adults it increased 20.10%, with women predominating in both periods. Although consumption, violence and distress were mentioned in both periods, poverty appeared in 2022. The DAJ increased more than 1000%. The PF dispensation increased more than 100%. Conclusions: In the post-pandemic, PSI and DAJ consultations increased. The increase in FP dispensation shows the deterioration and complexity of post-pandemic SM. These data raise the need to incorporate new professionals

Clínicas Populares de Saúde a partir da perspectiva de empresários e de representantes da classe médica / Popular Health Clinics from the perspective of entrepreneurs and representatives of the medical profession

Resumo Este artigo pretende compreender a perspectiva de empresários de Clínicas Populares de Saúde (CPS) e representantes da classe médica sobre serviços ofertados pelo setor; impactos decorrentes da pandemia covid-19; e futuro do mercado de trabalho médico. Trata-se de pesquisa qualitativa, da área de saúde coletiva, com enfoque nas representações sociais. Foram realizadas entrevistas semiestruturadas, entre março e julho de 2021, com quatro empresários locais e três representantes de classe médica de uma cidade da região Nordeste do Brasil. As CPS ofertam serviços assistenciais restritos a consultas e exames e com estratégias de lógica financeirizada; se apresentam como "alternativa" ao SUS, uma suposta "lacuna" entre planos de saúde privados e serviços públicos, e como "novo" trabalho médico. As empresas ofertam consultas com especialistas a preços "populares" e sem fila de espera. A assistência prestada é restrita e os profissionais não têm garantia de direitos trabalhistas. Para os entrevistados, o acesso à saúde representa acessibilidade geográfica e temporal de serviço a preço reduzido. O direito universal à saúde e princípios do SUS são confrontados com a defesa da autonomia dos clientes e dos profissionais visando suas necessidades: saúde e trabalho.

Abstract The objective is to understand the perspective of entrepreneurs from Popular Health Clinics (PHC) and representatives of the medical profession on services offered by the sector; impacts resulting from the COVID-19 pandemic; and future of the medical job market. This is a qualitative research, in the area of collective health, focused on social representations. Semi-structured interviews were carried out, from March to July 2021, with four local entrepreneurs and three representatives of the medical profession from a municipality in the Northeast region of Brazil. PHC offer assistance services restricted to consultations and exams and with financialized logic strategies. The PHC are presented as an "alternative" to the SUS, a supposed "gap" between private health plans and public services, and as a "new" medical work. Companies offer consultations with specialists at "popular" prices and without a waiting list. The assistance provided is restricted and professionals have no guarantee of labor rights. For those interviewed, access to healthcare represents geographic and temporal accessibility of services at a reduced price. The universal right to health and SUS principles are confronted with the defense of the autonomy of clients and professionals targeting their needs: health and work.