Estigma hacia la demencia: una revisión

La demencia, hoy denominada trastorno neurocognitivo mayor en el DSM-V, es una prioridad para la salud pública debido a su creciente prevalencia y alto impacto individual social. El estigma, es decir, la devaluación y exclusión social que vive un individuo producto de una característica, atributo o comportamiento; es un fenómeno colectivo vinculado a esta condición, el cual impacta en la calidad de vida de las personas con demencia y sus entornos familiares que usualmente brindan apoyo, y ha sido descrito también como una barrera para un diagnóstico oportuno que facilite el acceso a tratamiento y apoyo integral. Se constituye entonces como un problema relevante de considerar en el abordaje integral de la demencia, tanto clínico como a nivel de gestión pública. El propósito de esta revisión teórica es describir y analizar el fenómeno del estigma asociado a la demencia, considerándolo un problema de inminente abordaje en el contexto de América Latina. El estigma hacia la demencia puede clasificarse como: estigma público (personas de la comunidad), estigma estructural (instituciones, profesionales), estigma en las personas con demencia o autoestigma y estigma familiar (cuidadores y entorno de apoyo). En cada uno de estos grupos el fenómeno del estigma presenta características y consecuencias específicas. Este problema tiene directas implicancias en el proceso de toma de decisiones respecto al diagnóstico, tratamiento y a la promoción de la integración social de las personas con demencia, estableciéndose entonces como una problemática que amerita un abordaje ético, social y sanitario

The Association Between Exposure to COVID-19 and Mental Health Outcomes Among Healthcare Workers

Due to the unprecedented impact of the COVID-19 pandemic on health care systems, there has been great interest in the mental wellbeing of healthcare workers. While most studies investigated mental health outcomes among frontline vs. non-frontline healthcare workers, little is known about the impact of various work-related variables. The present study aimed to examine the association between work-related [i.e., having contact with COVID-19 patients, being redeployed due to the pandemic and availability of sufficient personal protective equipment (PPE)] and subjective (i.e., worries about getting infected or infecting others) exposures and self-reported mental health outcomes (i.e., psychological distress, depressive symptoms, and posttraumatic stress symptoms). Between February and May 2021, 994 healthcare workers employed at a variety of healthcare settings in the Netherlands filled out an online survey as part of the COVID-19 HEalth caRe wOrkErS (HEROES) study. Mental health outcomes were measured using the General Health Questionnaire-12, the Patient Health Questionnaire-9, and the Primary Care PTSD Screen for DSM-5. Approximately 13% reported depressive symptoms, 37% experienced psychological distress, and 20% reported posttraumatic stress symptoms. Multilevel linear models consisted of three levels: individual (work-related and subjective exposures), healthcare center (aggregated redeployment and availability of sufficient PPE), and regional (cumulative COVID-19 infection and death rates). Worries about infection were associated with all three mental health outcomes, whereas insufficient PPE was associated with psychological distress and depressive symptoms. There were no differences in outcomes between healthcare centers or provinces with different COVID-19 infection and death rates. Our findings highlight the importance of adequate PPE provision and the subjective experience of the COVID-19 pandemic. These factors should be part of interventions aimed at mitigating adverse mental health outcomes among healthcare workers during the COVID-19 pandemic

Estigma hacia la demencia: una revisión

La demencia, hoy denominada trastorno neurocognitivo mayor en el DSM-V, es una prioridad para la salud pública debido a su creciente prevalencia y alto impacto individual social. El estigma, es decir, la devaluación y exclusión social que vive un individuo producto de una característica, atributo o comportamiento; es un fenómeno colectivo vinculado a esta condición, el cual impacta en la calidad de vida de las personas con demencia y sus entornos familiares que usualmente brindan apoyo, y ha sido descrito también como una barrera para un diagnóstico oportuno que facilite el acceso a tratamiento y apoyo integral. Se constituye entonces como un problema relevante de considerar en el abordaje integral de la demencia, tanto clínico como a nivel de gestión pública. El propósito de esta revisión teórica es describir y analizar el fenómeno del estigma asociado a la demencia, considerándolo un problema de inminente abordaje en el contexto de América Latina. El estigma hacia la demencia puede clasificarse como: estigma público (personas de la comunidad), estigma estructural (instituciones, profesionales), estigma en las personas con demencia o autoestigma y estigma familiar (cuidadores y entorno de apoyo). En cada uno de estos grupos el fenómeno del estigma presenta características y consecuencias específicas. Este problema tiene directas implicancias en el proceso de toma de decisiones respecto al diagnóstico, tratamiento y a la promoción de la integración social de las personas con demencia, estableciéndose entonces como una problemática que amerita un abordaje ético, social y sanitario

Molecular dynamics simulation of the aqueous solvation shell of cellulose and xanthate ester derivatives

Gonzalo Riadi, Fernando González-Nilo. Centro de Bioinformática y Simulación Molecular, Universidad de Talca, Casilla 721, Talca, Chile.MD simulations of a pentasaccharide having D-glucopyranoside residues connected by (14)- glycosidic linkages, as a model of cellulose solvated in water, were carried out comparing the solvation of the hydroxyl group at C2 of the central ring of the pentamer and that of a single glucopyranose ring. MD simulations of 10 nsec were carried under NPT and periodic boundary conditions at 298 K and 1 atm. Explicit solvent (TIP3) and the force field CHARMM27 (modified for xanthate ester derivatives) were used in the molecular dynamics simulations. RDF calculations with respect to O2 of the central ring of the pentamer showed a well structured first solvation shell followed by secondary shells. When comparing the simulations of the pentamer to a single glucopyranose ring, it was observed that the solvation of O2 was lower for one repetitive unit, indicating that the pentamer had a stronger H-bond structure of water around O2 due to the cooperative effect of the neighboring residues. When the O2 of the central ring of the pentamer was substituted by a p-nitrobenzylxanthate moiety (pentXNB) there was a strong decrease in the hydration of the substituted O2 but the carbon and the sulfur of the thiocarbonyl group were clearly hydrated compared to the sulfur bridge. The global minimum energy conformation showed the p-nitrobenzyl group folded over the neighboring glucose ring. However, the simulations showed that the XNB group oscillates over the pentamer in periods of ca. 3000 psec

The Association Between Exposure to COVID-19 and Mental Health Outcomes Among Healthcare Workers

Due to the unprecedented impact of the COVID-19 pandemic on health care systems, there has been great interest in the mental wellbeing of healthcare workers. While most studies investigated mental health outcomes among frontline vs. non-frontline healthcare workers, little is known about the impact of various work-related variables. The present study aimed to examine the association between work-related [i.e., having contact with COVID-19 patients, being redeployed due to the pandemic and availability of sufficient personal protective equipment (PPE)] and subjective (i.e., worries about getting infected or infecting others) exposures and self-reported mental health outcomes (i.e., psychological distress, depressive symptoms, and posttraumatic stress symptoms). Between February and May 2021, 994 healthcare workers employed at a variety of healthcare settings in the Netherlands filled out an online survey as part of the COVID-19 HEalth caRe wOrkErS (HEROES) study. Mental health outcomes were measured using the General Health Questionnaire-12, the Patient Health Questionnaire-9, and the Primary Care PTSD Screen for DSM-5. Approximately 13% reported depressive symptoms, 37% experienced psychological distress, and 20% reported posttraumatic stress symptoms. Multilevel linear models consisted of three levels: individual (work-related and subjective exposures), healthcare center (aggregated redeployment and availability of sufficient PPE), and regional (cumulative COVID-19 infection and death rates). Worries about infection were associated with all three mental health outcomes, whereas insufficient PPE was associated with psychological distress and depressive symptoms. There were no differences in outcomes between healthcare centers or provinces with different COVID-19 infection and death rates. Our findings highlight the importance of adequate PPE provision and the subjective experience of the COVID-19 pandemic. These factors should be part of interventions aimed at mitigating adverse mental health outcomes among healthcare workers during the COVID-19 pandemic

Dissecting phosphatidylinositol 4,5-bisphosphate activation and thermosensation in TRP channels

Gonzalez Nilo, Danilo and Gonzalez, Wendy. Centro de Bioinformatica y Simulacion Molecular, Universidad de Talca, Talca, Chile.Phosphatidylinositol 4,5-bisphosphate (PIP2) is able to regulate the activity of many ion channels, transporters and enzymes. In particular, the activation of several TRP channels has been shown to be PIP2-dependent. For the case of TRPM8, this activation is supposed to be possible through a direct the interaction between PIP2 and key positively charged residues present in the TRP Domain. Because of the high sequence similarity among Transient Receptor Potential (TRP) channels on their TRP Domain, that region has been proposed as a common PIP2 binding site. In this work, we have exchanged different segments of the C-terminal region between TRPM8 and TRPV1 trying to understand the role of PIP2 during temperature activation of the channel. A chimera dubbed TRPM8(CTV1686-752) is activated by PIP2 and is able to confer the phenotype of heat activation. PIP2 sensitivity disappears when charges R701 and K710 were neutralized. When the exchanged fragment reached a length of 11 amino acid TRPM8(CTV1741-752), temperature dependence disappears. Together, our findings suggest the existence of different activation domains for temperature, PIP2 and voltage. Here, we also provide a simple interpretation for Channel-PIP2 interaction using a refined full-atom molecular model of TRPV1, and PIP2 docking analysis. (Supported by Fondecyt Grants Nº 3060003 (GO), 1040254 (FG) and 103-0830 (RL)

Stigma towards mental illness and substance use issues in primary health care: Challenges and opportunities for Latin America

Stigma towards mental illness and addictive disorders is a global problem and one of the main obstacles in tackling this issue remains the effective integration of mental health services into primary health care (PHC). In Latin America, information has significantly increased on the existence of stigma; however, little is known about effective interventions to prevent stigma and promote recovery-oriented practices in PHC. The aim of this study is to understand the existing evidence regarding mental health stigma in PHC with a special focus on the Latin American region. A scoping review of the literature related to mental health stigma in PHC was conducted. Two hundred and seventeen articles were evaluated; 74 met inclusion criteria and 14 additional articles were selected from references of search results. Results were subdivided into five different perspectives: users, family members and significant others, health professionals, contextual factors, and potential effective interventions. Only nine studies were based in Latin America, and only one described an intervention to reduce stigma in mental health services, not specifically in PHC. We found an urgent need to develop interventions to understand and reduce stigma in PHC settings, especially in Latin America