COVID-19 en América Latina: Perspectivas Sobre las Acciones Políticas Ante la Emergencia Sanitaria

Sleep medicine is a relatively young field with exponential growth in development and research in the last decades. Parallel to the advances in the United States, Latin America also had its beginnings in sleep medicine housed in neuroscience laboratories. Since the very first Latin American meeting in 1985, and the first sleep society in 1993, sleep research has undergone significant development in subsequent years. From contributions in animal research that allowed understanding of the activity of the brain during sleep to the studies that improved our knowledge of sleep disorders in humans, Latin America has become a scientific hub for expansion of sleep research. In this article, we present a historical account of the development of sleep medicine in Latin America, the current state of education and the achievements in research throughout history, and the latest advances in the trending areas of sleep science and medicine. These findings were presented during World Sleep Society meeting in Vancouver in 2019 and complement the work on sleep societies and training published by Vizcarra-Escobar et al in their article "Sleep societies and sleep training programs in Latin America" (J Clin Sleep Med. 2020;16(6):983-988).

(1) Background: Workplace violence among healthcare providers (HCPs) is a tangible barrier to patient care. The purpose of this study was to gain insight into physicians’ and nurses’ perceptions of workplace violence and their perceptions of communication skills during the COVID-19 health emergency. We also sought to assess and compare the association between types of workplace violence, communication skills, and several sociodemographic factors of physicians and nurses including gender, marital status, site of work, age, and educational level during this era. (2) Methods: We performed a cross-sectional study of a selected hospital in Jordan using the Arabic version of the workplace violence and communication skills scales for September to November 2020. We included a total of 102 physicians and 190 nurses via a self-reported questionnaire. (3) Results: During the COVID-19 health emergency, physicians (48%) experienced workplace violence more than nurses (31.6%). More than two-thirds of the participants did not formally report any type of violence. Multinomial logistic regression analysis showed that marital status, gender, age, site of work, educational levels, and communication skills were associated with different types of violence among the two samples. (4) Conclusions: A high prevalence of workplace violence is noted among HCPs in Jordan compared with before the pandemic, which highlights the importance of promoting public awareness during crises.

In low-income and middle-income countries, such as those in sub-Saharan Africa and Latin America, the COVID-19 pandemic has had substantial implications for women's wellbeing. Policy responses to the COVID-19 pandemic have highlighted the gendered aspect of pandemics; however, addressing the gendered implications of the COVID-19 pandemic comprehensively and effectively requires a planetary health perspective that embraces systems thinking to inequalities. This Viewpoint is based on collective reflections from research done by the authors on COVID-19 responses by international and regional organisations, and national governments, in Latin America and sub-Saharan Africa between June, 2020, and June, 2021. A range of international and regional actors have made important policy recommendations to address the gendered implications of the COVID-19 pandemic on women's health and wellbeing since the start of the pandemic. However, national-level policy responses to the COVID-19 pandemic have been partial and inconsistent with regards to gender in both sub-Saharan Africa and Latin America, largely failing to recognise the multiple drivers of gendered health inequalities. This Viewpoint proposes that addressing the effects of the COVID-19 pandemic on women in low-income and middle-income countries should adopt a systems thinking approach and be informed by the question of who is affected as opposed to who is infected. In adopting the systems thinking approach, responses will be more able to recognise and address the direct gendered effects of the pandemic and those that emerge indirectly through a combination of long-standing structural inequalities and gendered responses to the pandemic.

Does Africa grow slower than Asia, Latin America and the Middle East? Evidence from a new data-based classification method

Training traditional birth attendants in Guatemala

IntroductionThe selection of a medical specialty has been associated with multiple factors, such as personal preferences, academic exposure, motivational factors and sociodemographic factors, such as gender. The number of women in the medical field has increased in recent years. In Latin America, we have not found any studies that explore this relationship.ObjectiveTo determine whether there is an association between gender and the intention to choose a medical specialty in medical students from 11 countries in Latin America.MethodsSecondary analysis of the Collaborative Working Group for the Research of Human Resources for Health (Red-LIRHUS) data; a multi-country project of students in their first year and fifth year of study, from 63 medical schools in 11 Latin American countries. All students who referred intention to choose a certain medical specialty were considered as participants.ResultsOf the 11073 surveyed students, 9235 indicated the name of a specific specialty. The specialties chosen most often in the fifth year were General Surgery (13.0%), Pediatrics (11.0%), Internal Medicine (10.3%) and Obstetrics/Gynecology (9.0%). For women, the top choices were Pediatrics (15.8%), Obstetrics/Gynecology (11.0%), Cardiology (8.7%), General Surgery (8.6%), and Oncology (6.4%). In the adjusted analysis, the female gender was associated with the choice of Obstetrics/Gynecology (RP: 2.75; IC95%: 2.24–3.39); Pediatric Surgery (RP: 2.19; IC95%: 1.19–4.00), Dermatology (RP: 1.91; IC95%:1.24–2.93), Pediatrics (RP: 1.83; IC95%: 1.56–2.17), and Oncology (RP: 1.37; IC95%: 1.10–1.71).ConclusionsThere is an association between the female gender and the intention to choose Obstetrics/Gynecology, Pediatrics, Pediatric Surgery, Dermatology, and Oncology. We recommend conducting studies that consider other factors that can influence the choice of a medical specialty.

Social capital research in Latin and South American countries has been gravely limited by the absence of valid measures of social capital. This study seeks to create a scale for measuring social capital in the Latin and South American context using exploratory and confirmatory statistical procedures. It also seeks to test the effect of social capital on democratic attitudes in Latin America through structural equation modeling methods. Analysis of four countries in Latin and South America suggests that social capital is positively related to democratic attitudes. Recommendations for future studies are highlighted, and scale properties and outcomes are discussed.

Quality of life in hypertensive patients is one of the priorities committed to health and well-being, given that it depends on how well the person can minimize the risks caused by this disease. Therefore, the objective of this study is to determine the quality of life in hypertensive patients who visit a healthcare facility during the COVID-19 health emergency in northern Lima. This is a quantitative, descriptive, cross-sectional study of a population of 131 hypertensive patients who responded to a questionnaire on sociodemographic aspects and a questionnaire on quality of life in hypertension. The results show that 64.1% (n=84) of hypertensive patients have a good quality of life, 9.2% (n=12) have a fair quality of life, and 26.7% (n=35) have a poor quality of life. In conclusion, strategies for the promotion and prevention of hypertension should be implemented to provide the population with the necessary information about the disease and how to counteract it.

BACKGROUND: The aim of this study was to evaluate the burnout syndrome among nurses who are engaged in the care of patients with Coronavirus disease (COVID-19). A cohort observational- survey study was carried among Italian nurses who work in the Italian Intensive Care Unit (ICU) during the pandemic COVID-19 period.METHODS: The questionnaire was published online on Google form, modules section, from March 25, 2020 to April 26, 2020. The questionnaire contained a first part of demographic data, as: gender, years of experience, if the nurse interviewed at the time of the pandemic COVID-19 event was already working in an ICU or if, due to the urgency of the context, he/she was transferred to an ICU that was set up during this period. Then, the Maslach Burnout Inventory (MBI) questionnaire was administered to evaluate the burnout level among nurses who are in direct contact with critically ill patients with COVID-19.RESULTS: 291 nurses answered the survey. With the MBI threshold values in mind, it can be seen that the clinical condition of burnout can be configured for all three dimensions, both for women and men. As regards the dimension of emotional exhaustion, female nurses are more exposed to the phenomenon than men (P<0.001). However, for the other two dimensions there are no statistically different differences between the two sexes (depersonalization: P=0.809; personal accomplishment: P=0.268).CONCLUSIONS: Burnout levels are high among nurses. Surely the situation since COVID-19 has accentuated the result, regardless of the years of experience or if the nurses have always worked in opposed intensive care units have been transferred due to the health emergency. Also interesting is the aspect of the trend of burnout levels between female nurses who are they are more affected by emotional exhaustion than male nurses.

Background The global shift in healthcare during the COVID-19 pandemic led to challenges in the care of people living with HIV. Methods We conducted a retrospective study that aimed to delineate sociodemographic, clinical characteristics and outcomes, of people living with HIV diagnosed with ocular syphilis. Results Fifty-three people living with HIV were identified with ocular syphilis. Thirty-eight (71.6%) presented ocular symptoms. Twenty-three (43.3%) underwent lumbar puncture, 5 (9.4%) were positive for neurosyphilis. Forty-seven (88.6%) received treatment, 32 (68%) received standard treatment with aqueous crystalline penicillin G, and 15 (31.9%) were treated with alternative regimens due to the impossibility of hospitalization. Six (11.3%) individuals were lost to follow-up and/or did not receive treatment. Eighteen (56.2%) out of 32 individuals in the aqueous crystalline penicillin G group experienced serological response, 5 (15.6%) experienced treatment failure, and 9 (28.1%) were lost to follow-up. In the alternative therapy group, 12 out of 15 individuals (80%) experienced serological response. One (6.7%) experienced treatment failure, and 2 (13.3%) were lost to follow-up. Conclusions During the COVID-19 health emergency in Mexico, alternative treatments for ocular syphilis demonstrated favorable clinical outcomes amid challenges in accessing hospitalization.

In this paper, a theoretical and operational analysis was carried out on the issue of going concern. First of all, from a theoretical point of view, the subject of going concern has been examined in-depth to explain how the Covid-19 health emergency has impacted the companies' ability to carry out their activities shortly. It also achieves this aim by implementing operational research having as its object forty companies belonging to three macro-sectors: industrial, financial services and non-financial services, whose stocks make up the Italian stock exchange index Ftse Mib (Financial Times Stock Exchange Milan. The FTSE MIB is the benchmark stock index in Italy. It consists of a basket of 40 stocks on the Euronext Milan and Euronext MIV Milan markets identified by capitalisation, trading volume and sector). The theoretical and operational analysis of the concept of going concern was carried out considering, also, the bankruptcy alert indices identified by the Italian National Council of Chartered Accountants and Accounting Experts. These indicators were introduced by Italian legislation with the entry into force of the new Code of Corporate Crisis to identify possible economic and financial instability situations before the state of crisis. The research, as mentioned above, was carried out using the alert indices recognised by the National Council of Chartered Accountants and Accounting Experts. This research emerged that these indices are actually predictive of a company crisis. It also completed the study illustrated in this paper by comparing the results of the bankruptcy's predictive alert indices and Altman's Z-score. It reached the trends identified by the alert indices with the results obtained from Altman's Z-score, and from this comparison, it can see that the final results are similar. The comparison between the alert ratios illustrated by the National Council of Chartered Accountants and Accounting Experts and the results of Altman's Z-score allows us to affirm two observations: undoubtedly, the alert ratios are characterised by a high predictive validity regarding the bankruptcy of companies and, in addition, that these ratios lead to similar results to those that can obtain by applying Altman's Z-score. In this paper, a theoretical and operational analysis was carried out on the issue of going concern. First of all, from a theoretical point of view, the subject of going concern has been examined in-depth to explain how the Covid-19 health emergency has impacted the companies' ability to carry out their activities shortly. It also achieves this aim by implementing operational research having as its object forty companies belonging to three macro-sectors: industrial, financial services and non-financial services, whose stocks make up the Italian stock exchange index Ftse Mib (Financial Times Stock Exchange Milan. The FTSE MIB is the benchmark stock index in Italy. It consists of a basket of 40 stocks on the Euronext Milan and Euronext MIV Milan markets identified by capitalization, trading volume and sector). The theoretical and operational analysis of the concept of going concern was carried out considering, also, the bankruptcy alert indices identified by the Italian National Council of Chartered Accountants and Accounting Experts. These indicators were introduced by Italian legislation with the entry into force of the new Code of Corporate Crisis to identify possible economic and financial instability situations before the state of crisis. The research, as mentioned above, was carried out using the alert indices recognized by the National Council of Chartered Accountants and Accounting Experts. This research emerged that these indices are actually predictive of a company crisis. It also completed the study illustrated in this paper by comparing the results of the bankruptcy's predictive alert indices and Altman's Z-score. It reached the trends identified by the alert indices with the results obtained from Altman's Z-score, and from this comparison, it can see that the final results are similar.

Background:Nurses are susceptible to several mental problems, such as fear, stress, and depression due to the COVID-19 pandemic, which affects their emotional well-being. However, resilience plays an important role in mitigating the effects of COVID-19.Objective:This study was to examine the mediating role of resilience in the relation between fear, stress, and depression of nurses during COVID-19 health emergencies.Methods:A cross-sectional—predictive study was carried out. The variables analyzed were fear, resilience, stress, and depression. A total of 286 nurses from 2 hospitals in the cities of Juliaca and Puno, Peru. Data analyses were performed using structural equation modeling (SEM).Results:Analyses showed that the variables were significantly related (P < .01). In addition, a confirmatory analysis of the hypothesized model using structural equation modeling shows that fear and stress are predictors of depression, and that resilience plays a role in mediating the effect of fear on stress (X2 = 534.69, gl = 372, P = .000; TLI = .902, CFI = .910, RMSEA = .039 [95% CI = 0.032-0.046], and SRMR = .065).Conclusion:Nurses tend to develop fear, stress, and depression. Resilience reduces the impact of these psychological variables. Hospital management should provide psychological support and training for nurses in coping strategies.

article: ST-segment elevation myocardial infarction care during the COVID-19 health emergency: the organization of one Hub center in Milan, Italy - Italian Journal of Emergency Medicine 2020 December;9(3):139-41 - Minerva Medica - Journals

Anthony Bebbington and Jeffrey Bury (eds.) (2013) Subterranean Struggles: New Dynamics of Mining, Oil and Gas in Latin America, University of Texas Press ( Austin, TX), xiii + 361 pp. $40.00 hbk. Subterranean Struggles, edited by Anthony Bebbington and Jeffrey Bury is the culmination of many years of collaboration between researchers and activists on the issue of mine-community conflicts. It is no exaggeration to say that Bebbington, Bury, and other collaborators such as Denise Humphrey Bebbington, Leonith Hinojosa and Martin Scurrah have defined this field – extending the analysis of the ‘resource curse’ to highly localised socio-environmental struggles in communities near the point-source of extraction. For those familiar with their first collaboration in this series, ‘Mining and Social Movements’ in World Development (2008), and subsequent works including Social Conflict, Economic Development and Extractive Industry (Routledge 2012), this is familiar territory, but finally synthesised in this book into an overarching argument about the nature and consequences of extractive industry. Bebbington and Bury provide the theoretical coherence for the collection taken as a whole, which is characterised by a wide variety of context-rich accounts of social mobilisation around mining, oil and gas projects in the Andes (principally Bolivia, Ecuador and Peru). The title, Subterranean Struggles is a play on words that underlines the transformative but often hidden consequences of expansion of the extractive frontier to the subsuelo (subsoil), in terms of its direct impact on people's lives and livelihoods, their identities, social struggles for rights and territory, and institutional innovation across scales of analysis. In the broadest terms, this oeuvre is a plea for the relevance of a political ecology framework to the social struggles related to the subsoil, as a way of rendering visible the effects of resource-led development. In narrower terms, Bebbington and Bury bring together the themes that have characterised much of their writing: how extraction has transformed peasant livelihoods; how local social struggle has contributed to institutional innovation across different scales and actors; and how the state uses extraction to further its interests, is also drawn into social conflict as a regulator, arbitrator, and is even manipulated by other actors to attain legal or territorial objectives. The other contributors cover a diverse set of cases and topics, including the relationship between resource extraction, nationalism and identity (Perreault; Warnaars); activist strategies to defend alternative livelihoods (Bury and Norris; Moore and Velásquez; Postigo, Montoya and Young); the consequences for state-building and institutional innovation (Bebbington and Scurrah); and the regionalisation of extractivism (Hindery). Within the organising theoretical framework of political ecology, there is considerable diversity in the methodologies pursued by this diverse group of contributors. Bebbington and Bury recognise as much, describing their approach to the case studies as guided by a ‘similar protocol’ (p. 244), but evolving over the course of the project. They are also explicit about the challenges of engaging in grounded research in conflict zones, writing that ‘simply being able to operate in the midst of such conflict depends on the insights and legitimacy bestowed by long periods of fieldwork’ (p. 15). What goes unsaid here is that the challenge of working in a politically polarised environment makes rigorous impartiality difficult if not impossible. While Bebbington and Bury are careful to present a balanced and analytical rigorous framework for the analysis, some of the chapters are clearly the product of politically engaged activist scholars (as is most of the published case-study literature on firm-community conflict). In this respect, it is worth noting that the book as a whole is characterised by the relative absence of corporate or governmental voices, which results in downplaying the possibility that resource extraction could constitute a development opportunity for these countries. Subterranean Struggles is an important book for the study of extractive industry in Latin America, constituting as it does, the culmination of the most important collaborative project on this topic to date. Bebbington and Bury were pioneers in bringing this objectively important phenomenon to academic attention, which has literally been reshaping the socio-environmental, political and institutional environment of many Latin American countries. However, we must admit that much of the case study work on mine-community conflict over the last decade has attracted limited attention from the mainstream journals, in part, due to the descriptive empiricism of case studies and a failure to frame the problem of the new extractivism in a theoretical language that renders it visible and important to political scientists, sociologists and economists outside the activist community. Bebbington and Bury take an important step forward in this theoretical unveiling of the problem by contextualising these struggles in a political ecology framework imported from geography, and by examining the impact of extractive industry on societies, politics and institutions across scales. Researchers from other disciplines need now to build on this foundation.

Although nursing today is an intellectual profession to all intents and purposes, thesocial and professional image gap has not yet been bridged. Also, in the rest of the world, the social image of the nurse suffers from some stereotypes, not only perpetuated by a wrong knowledge on the part of the population but also fostered by the mass media (commentary, cinema, television series). To investigate the perception of students at the University of Piemonte Orientale about the nursing profession. A survey was conducted using an online questionnaire sent during the period of the health emergency linked to COVID-19 (from 18 August to 15 September 2020). 662 questionnaires were analysed. It was investigated how students describe nurses and whether that description would have been the same even before the COVID-19 health emergency. Furthermore, it was assessed which gender they consider most suited for the profession and whether the mass media has influenced their view of nurses. The students described the nurse with adjectives such as "expert / capable", "courteous / polite" and "welcoming / listening oriented" and stated that they would use the same terms even before the health emergency. The majority of the sample then believed that there is no more suitable gender to fill the role of nurse and that TV series or news reports have positively influenced their perception. However, only a small percentage of the sample would have considered the idea of becoming a nurse. A positive view of nurses emerged to overcome gender stereotype and a greater confidence in their technical-professional abilities. The data also highlight that the positive view of the nursing profession is not a consequence of the "publicity" provided by the media during COVID-19 emergency, which represented nurses as "heroes" of the National Health System.