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Made available in DSpace on 2022-04-28T19:40:08Z (GMT). No. of bitstreams: 0 Previous issue date: 2021-07-01 Background: The COVID-19 pandemic is having profound mental health consequences for many people. Concerns have been expressed that, at their most extreme, these consequences could manifest as increased suicide rates. We aimed to assess the early effect of the COVID-19 pandemic on suicide rates around the world. Methods: We sourced real-time suicide data from countries or areas within countries through a systematic internet search and recourse to our networks and the published literature. Between Sept 1 and Nov 1, 2020, we searched the official websites of these countries’ ministries of health, police agencies, and government-run statistics agencies or equivalents, using the translated search terms “suicide” and “cause of death”, before broadening the search in an attempt to identify data through other public sources. Data were included from a given country or area if they came from an official government source and were available at a monthly level from at least Jan 1, 2019, to July 31, 2020. Our internet searches were restricted to countries with more than 3 million residents for pragmatic reasons, but we relaxed this rule for countries identified through the literature and our networks. Areas within countries could also be included with populations of less than 3 million. We used an interrupted time-series analysis to model the trend in monthly suicides before COVID-19 (from at least Jan 1, 2019, to March 31, 2020) in each country or area within a country, comparing the expected number of suicides derived from the model with the observed number of suicides in the early months of the pandemic (from April 1 to July 31, 2020, in the primary analysis). Findings: We sourced data from 21 countries (16 high-income and five upper-middle-income countries), including whole-country data in ten countries and data for various areas in 11 countries). Rate ratios (RRs) and 95% CIs based on the observed versus expected numbers of suicides showed no evidence of a significant increase in risk of suicide since the pandemic began in any country or area. There was statistical evidence of a decrease in suicide compared with the expected number in 12 countries or areas: New South Wales, Australia (RR 0·81 [95% CI 0·72–0·91]); Alberta, Canada (0·80 [0·68–0·93]); British Columbia, Canada (0·76 [0·66–0·87]); Chile (0·85 [0·78–0·94]); Leipzig, Germany (0·49 [0·32–0·74]); Japan (0·94 [0·91–0·96]); New Zealand (0·79 [0·68–0·91]); South Korea (0·94 [0·92–0·97]); California, USA (0·90 [0·85–0·95]); Illinois (Cook County), USA (0·79 [0·67–0·93]); Texas (four counties), USA (0·82 [0·68–0·98]); and Ecuador (0·74 [0·67–0·82]). Interpretation: This is the first study to examine suicides occurring in the context of the COVID-19 pandemic in multiple countries. In high-income and upper-middle-income countries, suicide numbers have remained largely unchanged or declined in the early months of the pandemic compared with the expected levels based on the pre-pandemic period. We need to remain vigilant and be poised to respond if the situation changes as the longer-term mental health and economic effects of the pandemic unfold. Funding: None. Centre for Mental Health Melbourne School of Population and Global Health University of Melbourne Swansea University Medical School Translational Health Research Institute Western Sydney University Ministry of Public Health Department of Health Promotion National Confidential Inquiry into Suicide and Safety in Mental Health University of Manchester Centre for Mental Health and Safety and National Institute for Health Research Patient Safety Translational Research Centre University of Manchester School of Public Health National Suicide Research Foundation University College Cork Australian Institute for Suicide Research and Prevention School of Applied Psychology Griffith University Institute for Life Course Health Research Department of Global Health Stellenbosch University Working Group on Prevention of Suicide and Depression at Public Health Council Department of Psychiatry Blekinge Hospital Botucatu Medical School Universidade Estadual Paulista Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz University of Rochester Medical Center Region Friuli Venezia Giulia Central Health Directorate Outpatient and Inpatient Care Service Department of Medicine University of Udine Institute of Health Behaviors and Community Sciences College of Public Health National Taiwan University Thames Valley Local Criminal Justice Board Department of Psychiatry Psychotherapy and Psychosomatics Medical University of Innsbruck Center for Outcomes Research and Evaluation Yale School of Medicine Coroners Court of Victoria Danish Research Institute for Suicide Prevention Department of Mental Health Johns Hopkins School of Public Health Centre for Mental Health Research Australian National University Brigham and Women's Hospital Department of Emergency Medicine School of Population Health University of Auckland Magistrates Court of Tasmania (Coronial Division) Bureau of Vital Records and Statistics Louisiana Office of Public Health Ministry of Public Health Undersecretary of Health Services Research Department, 113 Suicide Prevention Departments of Psychiatry and Epidemiology Columbia University Medical Center/New York State Psychiatric Institute Centre for Suicide Research University of Oxford Louisiana Department of Health Greater Manchester Mental Health NHS Foundation Trust Department of Psychiatry Aga Khan University KU Leuven Center for Contextual Psychiatry Population Health Sciences Bristol Medical School University of Bristol South Asian Clinical Toxicology Research Collaboration Faculty of Medicine University of Peradeniya World Health Organization Country Office for Nepal Karolinska Institutet Bekhterev National Medical Research Center of Psychiatry and Neurology Pavlov First Saint Petersburg State Medical University Unit Suicide Research and Mental Health Promotion Department of Social and Preventive Medicine Center for Public Health Medical University of Vienna Department of Child and Adolescent Psychiatry Medical University of Vienna School of Psychology University of Nottingham Self-Harm Research Group School of Psychology University of Nottingham Mental Health Centre Copenhagen Department of Psychiatry and Psychotherapy Klinikum Klagenfurt am Wörthersee Suicidal Behaviour Research Lab University of Glasgow Preventing Deaths from Poisoning Research Group University of Edinburgh Usher Institute University of Edinburgh Suicide Research and Prevention Center Shanghai Mental Health Center Shanghai Jiao Tong University School of Medicine Departments of Psychiatry and Epidemiology Columbia University Department of Child and Adolescent Psychiatry and Psychotherapy University of Ulm Psychosocial Services in Vienna National Centre for Suicide Research and Prevention Institute of Clinical Medicine University of Oslo Department of Child and Adolescent Psychiatry Psychotherapy and Psychosomatics University Hospital Leipzig Department of Psychiatry and Psychotherapeutic Medicine Landeskrankenhaus Villach Department of Psychiatry Psychosomatic Medicine and Psychotherapy University Hospital Frankfurt Department of Borderline Disorders and Psychotherapy Bekhterev National Medical Research Center of Psychiatry and Neurology Saint Petersburg State University Department of Psychiatry Health Authority Frankfurt am Main Department of Addictive Disorders Psychiatry and Psychotherapy LVR-Klinik Köln Department of Psychiatry Psychosomatic Medicine and Psychotherapy Goethe-University Organizational-Scientific Department Bekhterev National Medical Research Center of Psychiatry and Neurology Department of Psychiatry University of Toronto Department of Psychiatry Sunnybrook Health Sciences Centre Waseda University Faculty of Political Science and Economics Sneha—Suicide Prevention Centre Voluntary Health Services Department of Community Medicine Faculty of Medicine and Allied Sciences Rajarata University of Sri Lanka Department of Psychiatry Sackler School of Medicine Tel Aviv University and Geha Mental Health Center Division of Molecular Imaging and Neuropathology New York State Psychiatric Institute and Department of Psychiatry Columbia University National Institute of Health Research Biomedical Research Centre University Hospitals Bristol and Weston NHS Foundation Trust University of Bristol Department for Psychiatry University Psychiatric Hospital Vrapče School of Medicine University of Zagreb Botucatu Medical School Universidade Estadual Paulista

Background The Ecuadorian earthquake in April 16th was the second strongest and deadliest in 2016 worldwide, with approximately one million people affected. In this paper, we analyzed the psychological impact and the relationship between mental health events and various earthquake-related stressors related to the earthquake, 9 months after the event. Methods We conducted an analytical cross-sectional study, applying an anonymous survey to 316 adolescents (13–19 years old) from Muisne, Ecuador. Suicidal tendency, depression, anxiety and post-traumatic stress (PTSD) were evaluated via the Child PTSD Symptom Scale (CPSS), Spence Children’s Anxiety Scale, Okasha Suicidality Scale, and the Center for Epidemiologic Studies Depression Scale (CES-D) and the adapted seven-questions earthquake-related stressors survey. Results We found a high prevalence of suicidal ideations and behavior, posttraumatic stress, depression and anxiety compared to international studies. Even though adolescents currently living in shelters had higher levels of anxiety, their suicidal tendency was significantly lower than those living in their own or their relatives’ home. Finally, the earthquake-related stressors were not associated with suicidality and mental health events, with the exception of economic damage suffered by the family. Conclusions High levels of depression, post-traumatic stress and anxiety among high-school students were found, especially among those who have suffered serious economic damage. The economic impact in their families and high unemployment rates among their parents seems to be related to lack of hope and favorable perspectives for their future, situation that might lead to lead to emotional disturbances and psychological disorders. Although prolonged homelessness experience in shelters may be a stressful occurrence, might also be related with spiritual growth among adolescents, and may work as a protective factor against suicidal ideations and attempts.

Objetivo. Recabar y ofrecer información a quienes toman decisiones en los programas de salud en general, y de salud mental en particular, sobre las características epidemiológicas del suicidio de jóvenes y adolescentes ecuatorianos. Método. Se realizó un estudio ecológico transversal con datos de los registros de mortalidad por suicidio de los jóvenes y adolescentes de Ecuador de 2001 a 2014. El análisis se desagregó por región natural, sexo, edad, grupo étnico y por el método usado para cometer el suicidio. Se estimaron tasas de mortalidad por suicidio (por 100 000 habitantes) y los riesgos relativos (RR) de suicidio por sexo y regiones. Resultados. Entre 2001 y 2014 se registraron 4 855 suicidios en adolescentes y jóvenes. El riesgo más alto se estimó en los varones de 15 a 24 años y en los adolescentes residentes en la Amazonía, seguidos por los de la Sierra. La etnia con más casos de suicidio fueron los mestizos, aunque 40% de los jóvenes que se suicidan en la Amazonía son indígenas. El método más frecuente fue el ahorcamiento seguido por el envenenamiento con pesticidas. Conclusiones. El suicidio de adolescentes y jóvenes es un problema de salud pública importante en Ecuador. Como en él influyen diversos factores psicológicos, sociales y culturales, se observan grandes variaciones según la región, los grupos de edad y las etnias. La restricción del acceso a pesticidas y a otros productos químicos, los programas de prevención universales y en centros educativos en las áreas con las tasas más altas, y las intervenciones específicas dirigidas a grupos vulnerables podrían ayudar a reducir los suicidios de jóvenes en Ecuador.

The consumption and addiction to drugs and alcohol by Ecuadorian teenagers is a constant problem in today's education. There is a difficult or absent response by educators in schools, thus, a certain silence or taboo is denoted as an answer of the educational institution and families. In this context, the "Desvincúla-T" inclusion project, originated at the Department of Psychology of the Pontifical Catholic University of Ecuador, based in Santo Domingo, with its philosophers, psychologists, educators and Students, oriented to motivate the search of meaning in the life of students. It has the main objective of preventing the harmful consumption of drugs and alcohol in high school students from schools of Santo Domingo de los Tsachilas, through a logoterapeutic approach. "Desvincúla-T" develops workshops by educators, psychologists and students of the university with the intention of holding days of personal reflection and inclusive experience with students at risk, as well as being able to value their emotions, feelings and perception of their reality., El consumo y la adicción a las drogas y el alcohol en adolescentes ecuatorianos es una problemática constante en la actualidad educativa, y de difícil o ausente respuesta por los educadores en los colegios, un cierto silencio o tabú es la respuesta de la institución educativa y de las familias. En este contexto presidido por la complejidad nace el proyecto de inclusión “Desvincúla-T”, originado desde el Departamento de Sicoética de la Pontificia Universidad Católica del Ecuador con sede en Santo Domingo, contando en su planificación y desarrollo con filósofos, sicólogos, educadores y estudiantes, con el objetivo principal de prevenir el consumo perjudicial de drogas y alcohol en estudiantes de secundaria en colegios de Santo Domingo de los Tsáchilas, a través de un enfoque logoterapéutico, orientado a motivar la búsqueda del sentido en la vida de los estudiantes. Desvincúla-T se traduce en la realización de talleres por educadores, sicólogos y estudiantes de la universidad con la intención de realizar jornadas de reflexión personal y vivencial inclusiva con estudiantes que presentan factores de riesgo, así como poder valorar sus emociones, sentimientos y percepción de su realidad.

Fundamento. Analizar las tendencias temporales de las tasas de suicidio en ninos, adolescentes y adultos jovenes ecuatorianos, segun sexo, y describir la evo-lucion de las razones hombre/mujer entre 1990 y 2017. Metodo. Se emplearon los datos de poblacion y de-funciones generales del Instituto Nacional de Estadisticas y Censos de Ecuador para calcular las tasas de suicidio para cada grupo de edad (10-14, 15-19, 20-24 anos) y sexo por ano. Para estimar las tendencias temporales y los cambios porcentuales anuales (CPA) por edad y sexo se utilizo el Joinpoint Regression Program 4.6.0.2. Resultados. En Ecuador hubo un promedio de 313 suicidios anuales entre 1990 y 2017, con un incremento del 480% en ninos, del 322% en ninas, del 111% en adolescentes varones y del 57% en adultos jovenes, mientras que en las mujeres adolescentes y adultas jovenes se redujo un 19 y un 37%. Las tasas de suicidio aumentaron anualmente en ninos (CPA=5,10%), ninas (2,57%), adolescentes (3,07%) y adultos jovenes (10,42%) mientras que, tras un maximo alrededor de 2006, disminuyeron para las adolescentes (0,81%, no significativo) y mujeres jovenes (1,16%). Aunque hasta comienzos de siglo las mujeres adolescentes y jovenes tuvieron mayores tasas de suicidio, actualmente son mas altas para los hombres en todos los grupos de edad (entre 1,5:1 y 4,3:1 en 2017). Conclusiones. El suicidio en poblacion menor de 25 anos en Ecuador es un problema destacado de salud publica, y se ha incrementado entre 1990 y 2017, especialmente, entre ninos, ninas, y adolescentes y jovenes de sexo masculino. La estrategia intersectorial propuesta en 2018 para reducir el suicido queda pendiente de evaluacion e inferencia.

Background: At times, the question for meaning comes to nothing and a crisis of meaning ensues. This state is very painful, but difficult to account. Both those who suffer from it and care professionals find themselves at a loss for words. Aims: This study introduces an operationalization of a crisis of meaning. It aims to distinguish the concept from depression, and to investigate whether a crisis of meaning can explain suicidality beyond the known protective and risk factors self-esteem, family functioning, life-event load, and depression. Method: Final-year school pupils in Ecuador (N = 300) completed questionnaires assessing the above variables. Data were analyzed using chi-square, hierarchic multiple regression, serial mediation, and moderator analyses. Results: Crisis of meaning was distinguished from depression. It explained a significant amount of variance in suicidality beyond the mentioned protective and risk factors. For males, crisis of meaning was the only significant risk factor, and the strongest predictor overall. The acute risk factors depression and crisis of meaning mediated the effects of the baseline factors self-esteem, family functioning, and life-event load on suicidality. Limitations: The study was cross-sectional; assessed factors predicted variance in suicidal thoughts, plans, and past suicide attempts, while their relevance cannot be generalized to actual future suicide attempts. Conclusion: A crisis of meaning is an important factor to take into account in further research on the prevention and treatment of people at risk of suicide.

La presencia de docentes extranjeros en las instituciones educativas ecuatorianos forma parte de su actualidad. Personas que han abandonado sus paises de origen por circunstancias como conflictos sociales, economicos, o laborales. Inmigrantes que vienen a ejercer entre las distintas profesiones la docencia, siendo participes de la elaboracion de un ambicioso proyecto politico y social que es el sumak Kawsay, y que tiene como eje fundamental el reconocimiento de la persona y sus categorias personales. Asi su dignidad es la base elemental de la educacion intercultural como propuesta de relacion con el entorno, tanto nacional como supranacional. Este trabajo tiene por objeto fomentar el debate sobre la relevancia de promover una cultura politica educativa que permita cuestionar y coadyuvar al desarrollo de esta utopia latinoamericana que supone el buen vivir por cuanto alternativa de refiere. De este modo, a traves de la hermeneutica normativa se parte de la investigacion de la realidad educativa constitucional para situar la contradiccion politica y juridica que supone la incursion por via reglamentaria del articulo 33.2 del Reglamento a la Ley de Extranjeria del Ecuador, la discriminacion del docente inmigrante y el lastre para la educacion intercultural que supone el revestimiento juridico del ego nacionalista. Palabras clave : Legislacion educativa. Politica educativa. Programas interculturales. Educacion migrante. Educacion inclusiva. Illegal immigrant teachers in Ecuador: the challenge of right to education Abstract The presence of foreign teachers in the Ecuadorian educational institutions is part of this country current moment. People who have left their birthplaces by different circumstances, for example social, economic, security or labor conflicts. Immigrants who come to work in teaching among different professions, and who are also participants in the development of an ambitious political and social project called sumak Kawsay; which has as its main idea the recognition of the person and his or her personal categories. In this sense, the dignity of the person is the elemental basis of intercultural education as a proposal of relationship with the surrounding context, both national and supranational. The purpose of this work is to encourage the debate about the importance of promoting an educational policy culture that allows the questioning and contribution to the development of Latin American utopia that assumes “el buen vivir” as an alternative. Thus, through the hermeneutic rules, the investigation starts with the constitutional educational reality to place political and legal contradiction that supposes the incursion by regulation of Article 33.2 of Regulations to the Immigration Law of Ecuador, the discrimination of the immigrant teacher and the obstacle for intercultural education that presumes a legal lining of nationalist ego. Keywords: Educational Legislation . Educational Policy . Intercultural Programs . Migrant Education . Inclusive Education .