Análisis de salud mental en el personal de la unidad de cuidados intensivos del Hospital Simón Bolívar en la ciudad de Bogotá (Colombia) en el marco de la pandemia covid -19, 2020.

Este estudio de investigación se centra en precisar las causas que generan la sobrecarga laboral en el personal que maneja las UCI de hospitales y clínicas de la capital, identificando los efectos del estrés y otras patologías que se generan y se estimulan por la actividad laboral desbordada a causa de la pandemia. La utilidad de esta investigación aporta información destacada de los síntomas y efectos que producen el estrés en niveles altos, surgiendo otras enfermedades físicas asociadas al ritmo de trabajo acelerado y extenso que vive todos los días estos centros médicos de la capital. El compromiso es inmenso a la hora de salvar vidas, pero al mismo tiempo es arriesgado, por la exposición de estos factores y el peligro de perder la salud física, mental, laboral y familiar del trabajador. El estudio pretende identificar, analizar y mitigar, los factores que generan el estrés y demás afectaciones a este personal y por medio de actividades, reforzar la buena salud mental de los trabajadores del sector salud. La emergencia sanitaria ocasionada por el Covid-19, nos llevó a reflexionar el trabajo agotador que ejerce el personal de la UCI, en los diferentes procesos que a su vez contienen variedad de actividades, donde deben enfrentar este devastador virus con escaso personal y equipos de ventilación pulmonar insuficiente, ejerciendo la tarea con miedos, tensiones, agotamiento físico y mental. El estudio de investigación visibilizará los efectos que tienen los agentes estresores en el personal de salud, en relación a la emergencia sanitaria de la pandemia Covid-19, igualmente, se plantea recomendaciones para afrontar o menguar los efectos colaterales del estrés y demás enfermedades arraigadas a esta, con el fin de mejorar la salud mental del personal de la UCI. Por otro lado, sin entrar a departir conceptos matemáticos, partimos de la premisa que la productividad, los costos y la calidad, son una triada de conceptos que se pueden analizar como un todo prácticamente inherente, por cuanto el cambio en uno de ellos, impactara en los demás. La productividad va muy ligada al factor psicosocial del operario, nuestra preocupación está en que muchos de los trabajadores de la UCI al tener estas afectaciones mentales disminuyen su desempeño (se presenta producción de errores, pausa, repetición en los procesos, para modificarlo y mejorarlo) lo cual va correlacionado a degradar su calidad de servicio, el cual sabemos en el ámbito medico es de suma delicadez tratándose del manejo de un producto con tan alta importancia, como es la vida de las personas. Ahora, en la UCI las enfermedades mentales se reflejan mayormente en el presentismo, donde el personal a pesar de experimentar sintomatología, sigue cumpliendo las funciones en su puesto de trabajo, así lo realicen a baja productividad, lo cual también impacta de forma directa los costos de la organización, pues hay estudios que determinan que el impacto en la productividad del presentismo es hasta 3 veces el del absentismo (medido en días perdidos). Partiendo de lo anterior, revelamos de nuevo la gran importancia de realizar nuestra investigación, pues al entrar a determinar y mejorar los factores mentales de los operarios de la UCI, mejoraremos desde una perspectiva cualitativa la productividad de los mismos, enriqueciendo la calidad de vida del trabajador, la calidad del servicio que brinda, el bienestar del paciente, la imagen del Hospital y probablemente, los costos financieros de las instituciones de salud que establezcan estas mismas medidas, beneficiándose en dos aspectos: En los costos directos respecto a los recursos que dejan de gastar en la recuperación del trabajador y por otro lado los costos indirectos con relación a los recursos que se dejaran de ganar al tener al trabajador enfermo.Tabla de contenido Introducción 5 1. Titulo 7 2. Planteamiento del problema 7 2.1 Descripción del problema 8 2.2 Pregunta de investigación 10 3. Objetivos 10 3.1. Objetivo general 10 3.2. Objetivos específicos 11 4. Justificación del trabajo 11 5. Marcos Referenciales 13 5.1 Estado del arte 13 5.2 Marco Teórico 25 5.3 Marco Legal 38 6. Marco Metodológico 43 6.1 Paradigma 43 6.2 Tipo de estudio 43 6.3 Metodología 44 6.4 Población 45 6.5 Muestra 45 6.6 Instrumentos de la Investigación 46 6.7 Fases del estudio 46 6.7.1 Fase 1. 47 6.7.2. Fase 2. 47 6.7.3. Fase 3. 47 6.8 Cronograma 48 6.9 Presupuesto 48 7. Resultados 49 9. Conclusiones 70 10. Recomendaciones 71 Bibliografía 73 Anexos 77EspecializaciónEspecialización en Gerencia de la Seguridad y Salud en el trabaj

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamentos de Cundinamarca Y Tolima.

La imagen y la narrativa como herramientas para el abordaje psicosocial en escenarios de violencia. Departamentos de Cundinamarca Y Tolima.El diplomado acompañamiento psicosocial en escenarios de violencia orientado por docentes con gran experiencia en el tema, brinda a los estudiantes que se forman en Psicología y futuros profesionales en la rama, las herramientas necesarias para abordar este tipo de problemáticas que comprenden las diferentes dinámicas de la violencia ocasionadas por el conflicto armado que ha enfrentado Colombia. Las diferentes actividades programadas en el diplomado y las unidades planteadas para su desarrollo, exploración y conocimiento del tema, permitió ver desde otra óptica, la difícil situación de las víctimas, las diferentes situaciones traumáticas que vivenciaron y el complejo camino que recorrieron para ser reconocidas como víctimas para que el Estado no le vulnere sus derechos y emerger de la invisibilidad de los agentes estatales y de la comunidad en general. En este punto conviene revisar un paso muy importante que sacudió al país y fue el acuerdo de paz que se dio entre la guerrilla de las Farc y el Gobierno Nacional hace unos años atrás, que dejó a la vista las condición humana entre las más destacadas el incalculable deseo de poder, de figurar de pasar por encima incluso de quienes más padecieron los vejámenes de una guerra cruenta que aún deja sin sabores que solo el tiempo y la justicia así no sea la terrenal permitirán darle valor a todas esas voces que se apagaron pero que por medio de las narraciones siguen vivas y todo ese cúmulo de emociones de las víctimas del conflicto, han dejado una gran enseñanza como futuro Psicólogos con la oportunidad de poder ayudar a más personas en sus mismas condiciones como seres humanos que disponen su formación y don de servicio para ayudar al prójimo a afrontar y superar momentos traumáticos y potencializar el fortalecimiento de la resiliencia . Por otra parte, la actividad colaborativa estuvo enmarcada en profundizar el caso de la señora “Ligia”, para el equipo de trabajo originó gran admiración por su capacidad de resiliencia y ejemplo de supervivencia frente a situaciones adversas, fue necesario fusionar la imagen y la narrativa como herramientas para la superación de situaciones que sin duda marcan la vida de una persona puestas al servicio del otro, convirtiéndose en cimientos y ejemplos de vida. “En la foto voz”, se observada desde otra óptica, a través de la imagen y las narraciones, la fusión de la realidad y la subjetividad desde un abordaje del conflicto armado, reconstruyendo momentos que fueron de gran relevancia y que marcaron a las personas inmersas en esta arraigada realidad, surgiendo emociones negativas derivados del conflicto y que es trasformada en apoyo a su propia identidad. Palabras claves: Violencia, Conflicto armado, Víctima, Relato, Narración, Resiliencia, Voz.The graduate psychosocial accompaniment in scenarios of violence oriented by teachers with extensive experience in the subject, provides students who are trained in psychology and future professionals in the field, the necessary tools to address this type of problems that comprise the different dynamics of the violence caused by the armed conflict that Colombia has faced. The different activities programmed in the diploma course and the units proposed for its development, exploration and knowledge of the subject, allowed to see from another perspective, the difficult situation of the victims, the different traumatic situations they experienced and the complex path they traveled to be recognized as victims so that the State does not violate their rights and emerge from the invisibility of state agents and the community in general. At this point it is important to review a very important step that shook the country and it was the peace agreement that was made between the FARC guerrilla and the National Government a few years ago, which exposed the human condition among the most prominent ones. Incalculable desire for power, to appear to pass over even those who suffered most from the vexations of a bloody war that still leaves without flavors that only time and justice, even if it is not earthly, will allow to give value to all those voices that went out but that through the narrations are alive and all that accumulation of emotions of the victims of the conflict, have left a great teaching as future Psychologists with the opportunity to be able to help more people in their same conditions as human beings who have their training and gift of service to help the neighbor to face and overcome traumatic moments and potentiate the strengthening of resilience. On the other hand, the collaborative activity was framed in deepening the case of Mrs. "Ligia", for the work team originated great admiration for its capacity of resilience and example of survival in front of adverse situations, it was necessary to merge the image and the narrative as tools for overcoming situations that undoubtedly mark the life of one person put at the service of the other, becoming foundations and examples of life. "In the photo voice", it was observed from another perspective, through the image and the narrations, the fusion of reality and subjectivity from an approach of the armed conflict, reconstructing moments that were of great relevance and that marked the people immersed in this ingrained reality, arising negative emotions derived from the conflict and that is transformed in support of its own identity. Keywords: Violence, Armed Conflict, Victim, Story, Narration, Resilience, Voice

A DNA Microarray-Based Assay to Detect Dual Infection with Two Dengue Virus Serotypes

Here; we have described and tested a microarray based-method for the screening of dengue virus (DENV) serotypes. This DNA microarray assay is specific and sensitive and can detect dual infections with two dengue virus serotypes and single-serotype infections. Other methodologies may underestimate samples containing more than one serotype. This technology can be used to discriminate between the four DENV serotypes. Single-stranded DNA targets were covalently attached to glass slides and hybridised with specific labelled probes. DENV isolates and dengue samples were used to evaluate microarray performance. Our results demonstrate that the probes hybridized specifically to DENV serotypes; with no detection of unspecific signals. This finding provides evidence that specific probes can effectively identify single and double infections in DENV samples

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

The PREDICTS database: a global database of how local terrestrial biodiversity responds to human impacts

Biodiversity continues to decline in the face of increasing anthropogenic pressures such as habitat destruction, exploitation, pollution and introduction of alien species. Existing global databases of species’ threat status or population time series are dominated by charismatic species. The collation of datasets with broad taxonomic and biogeographic extents, and that support computation of a range of biodiversity indicators, is necessary to enable better understanding of historical declines and to project – and avert – future declines. We describe and assess a new database of more than 1.6 million samples from 78 countries representing over 28,000 species, collated from existing spatial comparisons of local-scale biodiversity exposed to different intensities and types of anthropogenic pressures, from terrestrial sites around the world. The database contains measurements taken in 208 (of 814) ecoregions, 13 (of 14) biomes, 25 (of 35) biodiversity hotspots and 16 (of 17) megadiverse countries. The database contains more than 1% of the total number of all species described, and more than 1% of the described species within many taxonomic groups – including flowering plants, gymnosperms, birds, mammals, reptiles, amphibians, beetles, lepidopterans and hymenopterans. The dataset, which is still being added to, is therefore already considerably larger and more representative than those used by previous quantitative models of biodiversity trends and responses. The database is being assembled as part of the PREDICTS project (Projecting Responses of Ecological Diversity In Changing Terrestrial Systems – www.predicts.org.uk). We make site-level summary data available alongside this article. The full database will be publicly available in 2015

Nurses' perceptions of aids and obstacles to the provision of optimal end of life care in ICU

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