LA SENSIBILIDAD DEL CUIDADOR Y SU IMPORTANCIA PARA PROMOVER UN CUIDADO DE CALIDAD EN LA PRIMERA INFANCIA

(N. de la Ed.) Conferencia dictada por la Dra. Olga Alicia Carbonell el 13 de mayo de 2013 (revisada por la autora).  Profesora invitada por el Departamento de Psicología del Desarrollo y Educación de la Facultad de Psicología de la Universidad Católica del Uruguay

Effect of viral storm in patients admitted to intensive care units with severe COVID-19 in Spain: a multicentre, prospective, cohort study

Background: The contribution of the virus to the pathogenesis of severe COVID-19 is still unclear. We aimed to evaluate associations between viral RNA load in plasma and host response, complications, and deaths in critically ill patients with COVID-19. Methods: We did a prospective cohort study across 23 hospitals in Spain. We included patients aged 18 years or older with laboratory-confirmed SARS-CoV-2 infection who were admitted to an intensive care unit between March 16, 2020, and Feb 27, 2021. RNA of the SARS-CoV-2 nucleocapsid region 1 (N1) was quantified in plasma samples collected from patients in the first 48 h following admission, using digital PCR. Patients were grouped on the basis of N1 quantity: VIR-N1-Zero ([removed]2747 N1 copies per mL). The primary outcome was all-cause death within 90 days after admission. We evaluated odds ratios (ORs) for the primary outcome between groups using a logistic regression analysis. Findings: 1068 patients met the inclusion criteria, of whom 117 had insufficient plasma samples and 115 had key information missing. 836 patients were included in the analysis, of whom 403 (48%) were in the VIR-N1-Low group, 283 (34%) were in the VIR-N1-Storm group, and 150 (18%) were in the VIR-N1-Zero group. Overall, patients in the VIR-N1-Storm group had the most severe disease: 266 (94%) of 283 patients received invasive mechanical ventilation (IMV), 116 (41%) developed acute kidney injury, 180 (65%) had secondary infections, and 148 (52%) died within 90 days. Patients in the VIR-N1-Zero group had the least severe disease: 81 (54%) of 150 received IMV, 34 (23%) developed acute kidney injury, 47 (32%) had secondary infections, and 26 (17%) died within 90 days (OR for death 0·30, 95% CI 0·16–0·55; p<0·0001, compared with the VIR-N1-Storm group). 106 (26%) of 403 patients in the VIR-N1-Low group died within 90 days (OR for death 0·39, 95% CI 0·26–0·57; p[removed]11 página

Clonal chromosomal mosaicism and loss of chromosome Y in elderly men increase vulnerability for SARS-CoV-2

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) had an estimated overall case fatality ratio of 1.38% (pre-vaccination), being 53% higher in males and increasing exponentially with age. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, we found 133 cases (1.42%) with detectable clonal mosaicism for chromosome alterations (mCA) and 226 males (5.08%) with acquired loss of chromosome Y (LOY). Individuals with clonal mosaic events (mCA and/or LOY) showed a 54% increase in the risk of COVID-19 lethality. LOY is associated with transcriptomic biomarkers of immune dysfunction, pro-coagulation activity and cardiovascular risk. Interferon-induced genes involved in the initial immune response to SARS-CoV-2 are also down-regulated in LOY. Thus, mCA and LOY underlie at least part of the sex-biased severity and mortality of COVID-19 in aging patients. Given its potential therapeutic and prognostic relevance, evaluation of clonal mosaicism should be implemented as biomarker of COVID-19 severity in elderly people. Among 9578 individuals diagnosed with COVID-19 in the SCOURGE study, individuals with clonal mosaic events (clonal mosaicism for chromosome alterations and/or loss of chromosome Y) showed an increased risk of COVID-19 lethality

La sensibilidad del cuidador y su importancia para promover un cuidado de calidad en la primera infancia

(N. de la Ed.) Conferencia dictada por la Dra. Olga Alicia Carbonell el 13 de mayo de 2013 (revisada por la autora).  Profesora invitada por el Departamento de Psicología del Desarrollo y Educación de la Facultad de Psicología de la Universidad Católica del Uruguay

Marital conflict, maternal care and preschoolers\u27 attachment security in low -income Mexican -American families

The purpose of this study was to investigate and clarify the associations among global marital conflict and three of its specific domains (inter-parental childrearing disagreements, verbal, and physical aggression from husband towards wife), quality of maternal care, and preschoolers\u27 child-mother attachment security in a low-income, first generation, and non-clinical Mexican-American sample of 44 families with their preschool child. Marital conflict information was gathered from maternal and paternal reports. Maternal care and attachment security were collected from home and park observations of child and mother behavior. Furthermore, quality of maternal care was explored as a potential mediator between marital conflict and child attachment security. Results showed none significant associations between marital conflict and its three dimensions reported by mother and child-mother attachment security. Nor were there significant relationships between global marital conflict, and father childrearing disagreement reported by father and child-mother attachment security. Findings demonstrated a marginally significant association between mother\u27s global marital conflict, and quality of maternal care. This study provides evidence of a significant and concurrent association between maternal care and child attachment security during early childhood. The finding gives empirical support to the theoretical assumption that maternal care keeps having a key role in the organization and maintenance of the secure base behavior beyond infancy. In addition, the association between maternal care and preschool children attachment security, in the Mexican-American sample, supports the hypothesis of the link between maternal care and attachment security in other ethnic and socio-economic groups other than white-American and/or middle class populations. Results do not support the mediator role of quality of maternal care between mothers\u27 marital conflict and child attachment security. Finally, the study shows the relevance of being methodologically aware of cultural differences regarding methods of data collection. Limitations of the study, research future directions, and social implications for practice and policy are discussed

Impact assessment of the Safe Environment Intervention Module for prevention of domestic accidents during early childhood

El impacto de la intervención Módulo Ambientes Seguros contra los accidentes domésticos que sufren niños durante la primera infancia fue evaluado a través de visitas domiciliarias en las cuales se valoró el nivel de riesgo de accidentes domésticos y la calidad del contexto inmediato de desarrollo temprano de los niños, antes y después de la intervención, en dos grupos. Se conformó un grupo intervención de 29 cuidadoras y un grupo control de 18 participantes que fueron seleccionadas según su disponibilidad para ser visitadas en sus hogares y para participar en la intervención. Los resultados mostraron que la intervención mejoró la calidad del contexto inmediato del desarrollo temprano de los niños en su dimensión interacción, y disminuyó la conducta de dejar solos a los niños en casa. Al finalizar, las participantes manifestaron un alto grado de satisfacción con la intervención Módulo Ambientes Seguros.The Safe Environment Intervention Module for the prevention of domestic accidents in early childhood was assessed using home visits to test its effects on the level of risk of domestic accidents, as well as the quality of the immediate context of early child development. The intervention was developed in four sessions in which 29 caregivers participated. They self-reported their satisfaction at the end of the intervention. A control group with 18 caregivers was formed according to their availability. The results showed that the intervention improves the quality of the immediate context of early child development in their interactive dimensions, and reduces the behaviour of leaving children alone at home. Participants were highly satisfied with the Safe Environment Intervention Module

Calidad de cuidado materno: Una comparación entre bebés prematuros en cuidado madre canguro y bebés a término en cuidado regular

The purpose of this study was to examine the potential impact of an intervention program (Kangaroo Mother Care, KMC) on maternal sensitivity in a sample of high-risk adolescent mothers. Two mother-infant groups were compared: adolescent mothers with their preterm baby in kangaroo care and adolescent mothers with their full-term baby in regular care. Naturalistic observations at the home environment were conducted to assess maternal quality of care. No significant differences were found between both groups of dyads. Results are in line with the notion that KMC seems to play a protective role for adolescent mothers and their premature babies, given the additional risk factor of prematurity when compared to the full term group. These preliminary findings are stimulating and support further inquiry into the effects of KMC on maternal sensitivity particularly in high-risk populationsEl propósito de esta investigación fue estudiar los efectos de la intervención del Cuidado Madre Canguro (CMC) en la sensibilidad materna en una muestra de madres adolescentes con alto riesgo psicosocial. Se compararon dos grupos de díadas: madres adolescentes con bebés prematuros en cuidado madre canguro y madres adolescentes con bebés a término en cuidado regular. Se realizaron observaciones en el medio familiar para evaluar la calidad del cuidado materno. Los análisis indican que no existen diferencias significativas entre los dos grupos de madres adolescentes respecto a la calidad de cuidado materno. Este hallazgo permite suponer un efecto protector por parte del CMC en las díadas madres adolescente-bebé prematuros, ya que esta condición del bebé es un factor de riesgo adicional a las condiciones del grupo a término en cuidado regular. Estos resultados preliminares plantean la necesidad de continuar explorando los efectos de la intervención canguro en la sensibilidad materna especialmente en poblaciones vulnerable