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Resumen Durante el proceso de envejecimiento aparece el dolor como uno de los síntomas más comunes y al que menos se le presta atención, este puede generar un impacto negativo en la calidad de vida de las personas mayores. También, la fatiga se manifiesta frecuentemente, pero no se suele evaluar o exteriorizar en consulta. Por esto, la presente investigación tuvo como propósito estudiar la validez y fiabilidad de las escalas Siluetas de Fatiga, Caras de Dolor Revisada y Catastrofización del Dolor en una muestra de adultos mayores del área metropolitana de Bucaramanga. La muestra estuvo conformada por 131 adultos mayores tanto institucionalizados como no institucionalizados. Los resultados evidenciaron altos valores de fiabilidad en las tres escalas y se revisan las evidencias de validez con el análisis factorial exploratorio. En conclusión, las escalas contribuyen a la medición del dolor en adultos mayores colombianos, brindando a los profesionales de la salud instrumentos confiables. Se sugiere ampliar la muestra con estudios en otras regiones del país.
Abstract Throughout the ageing process, pain arises as one of the most prevalent symptoms which regularly receives the least attention. As a result, pain can negatively impact the quality of life of older people. Fatigue is often present in older adults, yet it is frequently overlooked during consultations. Therefore, the aim of this study was to assess the reliability and validity of the Fatigue Silhouettes, Pain Faces Revised, and Pain Catastrophizing scales in a sample of older adults from the metropolitan area of Bucaramanga. The study included 131 older adults, both institutionalized and non-institutionalized. The results yielded high levels of reliability across all three scales. Moreover, the evidence of validity was assessed through exploratory factor analysis. Overall, these measuring scales provide reliable instruments to healthcare professionals evaluating pain in older adults in Colombia. Future research should expand the sample to other regions of the country.
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The literature on entrepreneurship and technology transfer highlights several factors that impact the creation of university Spin-Offs. However, there is a limited body of research that specifically explores the impact of university-industry collaborations on the performance creation of these spinoffs. This study aims to fill this gap by examining the effects of university-industry collaborations on the creation of Spin-Offs from two perspectives: the number of university collaborations with different companies and the number of previous collaborations between the same university-industry dyad. The research employs joint patents as a source to measure the university-industry collaborations and statistical methods to empirically examine the impact of these collaborations on Spin-Off creation. The study is based on data from 108 universities between the years 2014 and 2017. The findings of this study reveal that both the number of collaborations and specially the presence of previous collaborations between the university and industry have a positive effect on the creation of Spin-Offs. These results suggest that universities and companies should consider these findings when formulating their strategies or policies for technology transfer and innovation management by encouraging university-industry collaborations.
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This study evaluated the effects of different drying methods (freeze drying, vacuum drying, infrared drying, convective drying, and sun drying) on the biological properties of berries from the Chilean murta (Ugni molinae Turcz) shrub. Physical-chemical properties (proximal composition, dietary fiber, sugars) were determined. Total phenolic content through the method of Folin-Ciocalteau, the profile of phenol compounds was determined by HPLC, and antioxidant potential by DPPH and ORAC assays were also evaluated. The topic anti-inflammatory effect was evaluated by mice´s ear edema, and in vitro anti-tumoral activity was tested by MTT assay. The chemical properties of dried berries differed significantly based on the drying method: freeze-dried murta berries showed increased total phenolic content extracted over fresh and dried samples. In addition, this lyophilized extract stood out in its antioxidant potential, in both assays evaluated (DPPH and ORAC), compared to the other drying methods. Notwithstanding, vacuum- and infrared-dried murta also showed a higher ORAC value. Antioxidant potential was significantly associated with phenolic compounds catechin and pyrogallol, which were the most abundant phenolic compounds present in all samples. The anti-inflammatory activity was most effective under freeze-drying and vacuumdrying conditions. Moreover, vacuum drying and infrared drying best preserved the anti-tumoral effect on cancer cells.
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En el presente trabajo de investigación fajado y athaña como estilos de crianza y su relación con el desarrollo psicomotor en bebes de 0 a 1 año de la comunidad de Chulumani Lilata Sud Yungas, se observó de manera no participativa en su entorno natural el desarrollo psicomotor de los bebes de 0 a 1 año de edad y su relación que tiene con el constante fajado y athaña y la influencia de esta práctica o estilo de crianza siendo parte de la cultura y costumbres pasando de generación en generación del fajar a sus niños para que sea fuerte y crezcan rectos sus pies porque ellos están en constante crecimiento.
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Abstract We present the first case in Colombia of tricuspid endovascular valve in valve for failed bioprosthesis in a 40 years old patient with very high operative risk with great results, proposing kissing balloon annulus cracking technique as a practical solution for the colombian specialists.
Resumen Se presenta el primer caso en Colombia de un reemplazo percutáneo tipo válvula en válvula por falla de bioprótesis tricúspide en un paciente de 40 años con un muy alto riesgo quirúrgico, con excelentes resultados, proponiendo la técnica kissing balloon de fractura anular como una solución práctica para los especialistas colombianos.
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Abstract We present the first case in Colombia of tricuspid endovascular valve in valve for failed bioprosthesis in a 40-year-old patient with very high operative risk with great results, proposing kissing balloon annulus cracking technique as a practical solution for the Colombian specialists.
Resumen Presentamos el primer caso en Colombia de valve in valve tricúspideo para una bioprótesis deteriorada en una paciente de 40 años con muy alto riesgo quirúrgico con muy buenos resultados, y se propone la técnica de kissing balloon para ruptura anular como una solución practica para los especialistas en Colombia.
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In this study the dietary fibre (DF) of fresh and processed murta berries was characterised with respect to bioactive and antioxidant properties. DF content was determined by three different methods (AOAC, dialysis membrane and indigestible fraction methods) comparing their effectiveness. The antioxidant activity of phenolic compounds (PC) in purée, fruit leather and isolated DF of murta berries was evaluated by DPPH and ORAC assays. Total phenolics and flavonoids linked to DF were determined by colorimetric tests, while PC profiles in the respective murta products were identified by HPLC. DF concentration was > 50 g/100 g dm, fluctuating between 52.03 ± 1.32 and 57.18 ± 0.61 g/100 g dm, exhibiting simultaneously high antioxidant activity, with ORAC values of 38,190 ± 661 and 26,425 ± 1399 µmol Trolox equivalent/100 g dm in the isolated DF of fresh murta berries and processed murta fruit leather respectively, which enabled a classification as antioxidant dietary fibre. Total phenolics and flavonoids linked to DF retained a high concentration in the fruit leather, implying a favourable effect of processing. Gallic acid and pyrogallol were found associated to DF, at a level of 34.03 ± 1.17 and 631.07 ± 22.10 mg/100 g dm in the fresh berries respectively, which conferred to murta berries a functional property not yet reported. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-022-05416-1.
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Background: End-stage renal failure of unknown origin (ESRD-UO) is a public health problem in Mexico and many regions of the world. The prevalence of ESRD-UO in Aguascalientes, Mexico, is one of the highest worldwide, particularly in adults between 20 and 40 years of age. Our aim was to screen adolescents for chronic kidney disease (CKD) to identify risk factors and histologically characterize adolescents with persistent albuminuria. Methods: This was a cross-sectional, observational and comparative study of adolescents in whom serum creatinine and the albumin:creatinine ratio (ACR) were determined when screening for CKD. A clinical evaluation and risk factor survey were conducted. Patients with an abnormal ACR (≥30 mg/g) or a low glomerular filtration rate (GFR) (≤75 mL/min/1.73 m2) were re-evaluated and a renal ultrasound (US) was obtained. A kidney biopsy was performed in patients with persistent albuminuria. Results: A total of 513 students were included; 19 had persistent albuminuria and 494 were controls. The prevalence of persistent albuminuria was 3.7% [95% confidence interval (CI) 2.1-5.3]. Only one patient had a decreased GFR. None of the patients with persistent albuminuria had anatomical abnormalities of the urinary tract by renal US. Patients with persistent albuminuria had a decreased total renal volume compared with the control group (150 versus 195 mL/m2; P < 0.01). Eighteen kidney biopsies were performed; 72% had glomerulomegaly and only one patient had mild fibrosis. Podocyte abnormalities were evident on electron microscopy, including partial fusion (100%), microvillous degeneration (80%) and increased organelles (60%). Risk factors for persistent albuminuria were: homestead proximity to maize crops, the use of pesticides at the father's workplace, a family history of CKD and blood pressure abnormalities. The body mass index and breastfeeding were protective factors. Conclusions: The prevalence of persistent albuminuria in adolescents in Aguascalientes is high and histologic compromise is characterized by podocyte injury in the absence of fibrosis. The renal volume of persistent albuminuria patients was decreased, suggesting oligonephronia. Exposure to environmental toxins such as pesticides, even prenatally, may be responsible for this pathological entity. Screening programs in adolescents by determining ACR are necessary in this setting.
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BACKGROUND: The vitamin D receptor (VDR) is responsible for mediating the effects of vitamin D through regulation of other gene transcriptions. There are several polymorphisms that alter the gene expression or the function of this protein. We aimed to analyze the association between two SNPs of VDR gene and melanoma cancer in Colombian patients. METHODS: We included 120 healthy individual as controls and 120 melanoma cancer patients as cases . Patients in both groups were matched in terms of gender and age. The genotyping of rs731236 and rs2228570 polymorphisms was performed using PCR-RFLP. The SNPStats program was used to carry out the statistical analysis through a logistic regression model. RESULTS: Under dominant model, we found that rs2228570 polymorphism was associated with melanoma cancer risk (C/C vs C/T-T/T, OR: 5.10, 95% CI: 2.85-9.14), whereas rs731236 polymorphism was associated with a protective effect against this cancer (T/T vs T/C, OR: 0.27, 95% CI: 0.14-0.53). CONCLUSION: Our results suggested that both polymorphisms were involved in the development of melanoma cancer, increasing or decreasing this risk.
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Etnicidad/genética , Predisposición Genética a la Enfermedad/genética , Melanoma/genética , Polimorfismo de Nucleótido Simple/genética , Receptores de Calcitriol/genética , Estudios de Casos y Controles , Colombia/etnología , Femenino , Predisposición Genética a la Enfermedad/etnología , Genotipo , Humanos , Masculino , Melanoma/etnología , Persona de Mediana Edad , Polimorfismo de Longitud del Fragmento de RestricciónRESUMEN
During the last decades, the incorporation of beneficial microorganisms in agriculture crop management has become a common practice. Seed coating of these microorganisms still faces technical issues, which limit its implementation in conventional agriculture. An adaption to widely established agricultural practices, e.g. fertigation, could help to overcome these issues. Here, using Bacillus velezensis strain BBC047, we show the influence of the crop phenological stages on the efficiency and success of microbial inoculation under agricultural conditions. In the commercial nursery, strain BBC047 improved growth in a variety of horticulture crops like basil, cabbage, tomato and bell pepper, the latter with the strongest effects in strengthening and accelerating the seedling growth (root and aerial biomass). For a field trial under productive conditions, different application strategies were compared, using bell pepper (Capsicum annuum L.) as crop under fertigation: conventional management (T1), application to the seedling (only nursery, T2), only post-transplant application (field, T3) and a combination of both (T4). In T2 and T4, the post-transplantation survival rate (p < 0.05) improved and the productivity of the plants increased (> 100%). Applications of BBC047 post-transplantation (T3) caused a lower increase in productivity (25%). Fruits from all three application strategies contained significantly more Vitamin C. We conclude that in conventional agriculture, the applications of PGPR inoculants to early crop phenological stages like nurseries are a viable alternative for the efficient use of PGPR inoculants. In comparison, a late introduction of a PGPR reduces its beneficial effect on crop productivity. We highlight that an appropriate timing in the use of PGPR inoculants is crucial for product development and success in sustainable agriculture.
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Objective: To analyze the criteria for diagnosis and treatment decision-making in relation to dental caries in different participants (teachers of dentistry, dental students at dental schools, and dentists practicing at public oral health services) in the city of Medellin (Colombia). Material and Methods: A cross-sectional study was applied in the period September 2015-december 2016 by means of an international validated questionnaire in 340 participants (dental teachers: 69, dental students: 193, dentists: 78). The survey addressed several topics related to detection and restorative threshold, preferences of preparation type, restorative materials used and opinions about diagnosis and treatment for dental caries. A descriptive analysis was carried out and Chi square tests were applied to observe statistically significant differences between the study variables.Results: 340 participants were surveyed among teachers who teach cariology, health care dentists, and undergraduate final-year students. Most participants were women (70%). The age mean was higher for DDSs (46 ± 9 years). On average, practicing dentists and dental teachers had a work experience of 21 ± 9 years. In case of treatment decisions, the majority of the surveyed would use immediate operative restorative treatment for advanced carious lesions (inner one-third of the dentin for approximal and grade 5 for occlusal). In addition, respondents reported different cavities diagnosis for clinical occlusal cases and some significant statistically differences were found for restorative treatment decisions and type of materials according to the type of participant. Conclusion: Criteria for diagnosis and treatment of dental caries differed among the student, dentist and dental teachers with variety in diagnosis and treatment concepts. However, a conservative tendency for restorative treatment decisions was observed. Strategies for incorporating non-restorative and minimal measures in professional practice should be considered in curricula of universities.
Objetivo: Analizar los criterios para la toma de decisiones diagnósticas y terapéuticas en relación a la caries dental en diferentes participantes (docentes, estudiantes de odontología de las facultades de odontología y odontólogos de los servicios públicos de salud bucal) de la ciudad de Medellín (Colombia). Material y Métodos: Se aplicó un estudio transversal en el período septiembre 2015 - diciembre 2016 mediante cuestionario internacional validado en 340 participantes (profesores de odontología: 69, estudiantes de odontología: 193, odontólogos: 78). La encuesta abordó varios temas relacionados con la detección y el umbral de restauración, las preferencias del tipo de preparación, los materiales de restauración utilizados y las opiniones sobre el diagnóstico y el tratamiento de la caries dental. Se realizó un análisis descriptivo y se aplicaron pruebas de Chi cuadrado para observar diferencias estadísticamente significativas entre las variables de estudio. Resultados: Se encuestó a 340 participantes entre profesores que imparten clases de cariología, odontólogos y estudiantes de último año de pregrado. La mayoría de los participantes eran mujeres (70%). La edad media fue mayor para los odontólogos (46 ± 9 años). En promedio, los odontólogos y los profesores de odontología tenían una experiencia laboral de 21 ± 9 años. En caso de decisiones de tratamiento, la mayoría de los encuestados utilizaría tratamiento restaurador quirúrgico inmediato para lesiones cariosas avanzadas (tercio interno de la dentina para proximal y grado 5 para oclusal). Además, los encuestados informaron diferentes diagnósticos de caries para los casos clínicos oclusales y se encontraron algunas diferencias estadísticamente significativas para las decisiones de tratamiento restaurativo y el tipo de materiales según el tipo de participante. Conclusion: Los criterios para el diagnóstico y tratamiento de la caries dental fueron diferentes entre los estudiantes, odontólogos y profesores de odontología con variedad en los conceptos de diagnóstico y tratamiento. Sin embargo, se observó una tendencia conservadora para las decisiones de tratamiento restaurativo. Las estrategias para incorporar medidas mínimas y no restaurativas en la práctica profesional deben ser consideradas en los planes de estudio de las universidades.
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Humanos , Masculino , Femenino , Caries Dental/diagnóstico , Caries Dental/terapia , Toma de Decisiones Clínicas , Estudiantes de Odontología , Estudios Transversales , Encuestas y Cuestionarios , Atención Odontológica , Guías de Práctica Clínica como Asunto , Colombia , OdontólogosRESUMEN
Nowadays berries are globally recognized to be among the healthiest foods because they contain diverse and abundant bioactive compounds. Among these are phenolic acids, flavonoids, and anthocyanins, which are known to have beneficial health effects. South America, particularly southern Chile, is covered by a diversity of insufficiently studied and underexploited native berry species. In this review we summarize all the available literature on the phenolic composition, antioxidant activity, bioaccessibility, and biological activity of five native South American berries: calafate, maqui, murta, arrayán, and chequén. The potential of these native berries for promoting human health and as source of bioactive substances is remarkable. Bioactive compounds, mainly anthocyanins, and in less abundance flavonoids and phenolic acids, show strong antioxidant effects. Some of these constituents are bioaccessible and bioavailable, and exert anticancer, antimicrobial, and anti-inflammatory activities as well as inhibitory effects against enzymes involved in metabolic syndromes. Given the potential of native South American berries to promote health, more work is still needed to understand fully the potential beneficial effects of the consumption of these berries on human health. © 2020 Society of Chemical Industry.
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Antioxidantes/química , Frutas/química , Extractos Vegetales/química , Animales , Antiinfecciosos/química , Antiinfecciosos/farmacología , Antiinflamatorios/química , Antiinflamatorios/farmacología , Antineoplásicos Fitogénicos/química , Antineoplásicos Fitogénicos/farmacología , Antioxidantes/farmacología , Humanos , Extractos Vegetales/farmacología , América del SurRESUMEN
AIM: To explore the emotional impact and experiences of geriatric nurses working in nursing homes and caring for patients with coronavirus 2019 disease (COVID-19). DESIGN: This is a qualitative study with phenomenological method and data were gathered through in-depth interview. METHODS: The experiences and expectations that nurses are facing during their care duties were explored via video conference, using a semi-structured interview guide. We have followed the Consolidated criteria for reporting qualitative research COREQ. RESULTS: Interviews (N=24) were conducted with nurses from four countries (Spain, Italy, Peru, and Mexico) during April 2020. Three main categories were extracted: fear of the pandemic situation, the sense of duty and professional commitment, and emotional exhaustion. CONCLUSIONS: Regardless of the country and situation, in the face of the pandemic, dramatic situations have been experienced in nursing homes worldwide, with nursing staff feeling exhausted and overwhelmed, and reflection is urged on a global level to consider the most appropriate model of care in nursing homes.
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COVID-19/epidemiología , COVID-19/enfermería , COVID-19/psicología , Enfermería Geriátrica , Atención de Enfermería/psicología , Casas de Salud , Personal de Enfermería en Hospital/psicología , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Italia/epidemiología , Masculino , México/epidemiología , Persona de Mediana Edad , Pandemias , Perú/epidemiología , Investigación Cualitativa , SARS-CoV-2 , España/epidemiologíaRESUMEN
BACKGROUND: Weight stigma is a societal phenomenon that is very prevalent in healthcare, precipitating poor patient-provider relationships, discontinuity of care, and delayed cancer screening. Little research, though, has investigated weight stigma in prenatal and postpartum healthcare. To address this gap, this study examined the prevalence and frequency of weight-stigmatizing experiences in prenatal and postpartum healthcare. METHODS: 501 pregnant and postpartum women responded to an online survey where they reported whether they had experienced weight stigma in prenatal or postpartum healthcare and, if so, how frequently. Participants also responded to questions about how providers had treated them regarding their weight and their reactions to these experiences. A subset of participants (n = 80) also provided examples of their experiences, and these were subjected to a thematic analysis and coded for overarching themes. RESULTS: Nearly 1 in 5 women (n = 92) reported experiencing weight stigma in healthcare settings. Percentages differed by BMI, with 28.4% of participants with pre-pregnancy obesity endorsing healthcare providers as a source of weight stigma. Experiences occurred between "less than once a month" and "a few times a month." Obstetricians were the most commonly-reported source (33.8%), followed by nurses (11.3%). Participants reported feeling judged, shamed, and guilty because of their weight during healthcare visits. Additionally, 37 participants (7.7%) reported having changed providers because of treatment regarding their weight. Many also reported that they expected to feel or had felt uncomfortable seeking help with breastfeeding from a healthcare professional. Finally, thematic analysis of the open-ended examples identified four key themes: (1) negative attitudes and unkind or disrespectful treatment from providers; (2) evaluative comments about their weight; (3) healthcare providers focusing on their high-risk status and potential negative consequences (often when birth outcomes were ultimately healthy); and (4) inappropriate or demeaning comments. CONCLUSIONS: Weight stigma may be a common experience in pregnancy and postpartum healthcare. Providers need additional training to avoid stigmatizing their patients and inadvertently undermining patient-provider relationships, quality of care, and health outcomes.
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Actitud del Personal de Salud , Obesidad , Atención Prenatal , Estigma Social , Adulto , Peso Corporal , Brasil , Femenino , Humanos , Atención Posnatal , Embarazo , Adulto JovenRESUMEN
RESUMEN Objetivos. Determinar y correlacionar la densidad mineral ósea (DMO) y los marcadores bioquímicos del metabolismo óseo de adultos de 30 a 40 años de Lima, Perú, en el año 2018. Métodos. Estudio descriptivo, transversal, realizado a 84 mujeres y 53 varones, de 30 a 40 años de edad, residentes en Lima, Perú, sin manifestaciones ni tratamiento de enfermedades metabólicas óseas primarias ni secundarias. Se registró información del estado actual, antecedentes personales fisiológicos, patológicos, familiares y examen clínico. Se midió la DMO por absorciometría dual de rayos X en columna, cadera y antebrazo; en sangre, parathormona, osteocalcina, 25-hidroxi-vitamina-D, hormona luteinizante, estradiol en las mujeres, testosterona en los varones, calcio sérico, fósforo sérico, fosfatasa alcalina, proteínas totales y fracciones, creatinina; en orina N-telopéptido de enlaces de colágeno tipo I, calcio y fósforo, por métodos convencionales. Resultados. La DMO se efectuó a 62 mujeres y 40 varones; 2 mujeres y 1 varón tuvieron osteoporosis, y 3 mujeres y 2 varones osteopenia, retirados para la evaluación estadística; 58 mujeres y 35 varones tuvieron una DMO normal. Los varones tuvieron mayor DMO y concentraciones mayores de calcio, fosfatasa alcalina y creatinina; 14 mujeres y 2 varones tuvieron cifras bajas de 25-OH-vitaminaD. Hubo correlación positiva entre DMO y el IMC. Conclusiones. La DMO normal de personas de 30 a 40 años de Lima fue lineal y hubo una relación positiva con el IMC; hubo osteoporosis en 2 mujeres y 1 varón, osteopenia en 3 mujeres y 2 varones, cifras bajas de 25-hidroxi-vitamina-D en 16 personas.
ABSTRACT Objectives. To determine and correlate the bone mineral density (BMD) and the biochemical markers of bone metabolism in adults 30 to 40 years old from Lima, Perú, in year 2018. Methods. A total of 84 women and 53 men, 30 to 40 years old from Lima, Perú, were submmited to a descriptive, transversal study. They did not have symptoms nor treatment for bone metabolic diseases. Information about their present health state, personal and familiar physiological and pathological history and physical examinatión were registered. BMD was measured by dual energy-X-ray absorptiometry in spine, hip and forearm. Parathormone, osteocalcine, 25-hidroxi-vitamine-D, luteinizing hormone, estradiol in women, testosterone in men, calcium, phosphorus, alkaline fosfatase, total and fractionated proteins, creatinine were measured in blood; in urine N-telopéptide, calcium and phosphorus by conventional methods. Results. BMD was measured in 62 women and 40 males; 2 women and 1 man had osteoporosis and 3 women and 2 men osteopenia, who were taken out of statistical evaluation; 58 women and 35 men showed a normal BMD. Male subjects had a greater BMD, higher calcium, alkaline fosfatase and creatine blood concentrations than the female ones; 14 women y 2 men had low 25-OH-vitaminaD concentrations. A positive correlation between the BMD and BMI was found. Conclusions. The normal BMD of persons 30 to 40 years old showed a linear figure and there was a positive correlate with the BMI; premature osteoporosis in 2 women and 1 men as well as osteopenia in 3 women y 2 men was found, low concentrations of 25-hidroxi-vitamine-D was detected in 16 persons.
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Se presentan resultados parciales del proyecto de investigación doctoral "Narrativas de niños y niñas sobre el trastorno de hiperactividad". Se exploran las experiencias subjetivas alrededor del tratamiento farmacológico del TDAH en un grupo de padres y educadores de un grupo de niños y niñas con dicho diagnóstico en la ciudad de Bogotá, Colombia. La información fue recolectada a través de entrevistas en profundidad y fue organizada y analizada a partir de seis categorías emergentes: Conocimientos acerca del medicamento, ideas acerca de la efectividad del medicamento, efectos secundarios identificados, función social del medicamento, roles asumidos frente al TDAH y valoración del medicamento. Los resultados muestran que los relatos de los participantes se organizan de acuerdo con su rol y contexto, respondiendo a procesos sociales de medicalización de la vida educativa.
We present partial results of the research project entitled "Narratives of boys and girls about Hyperactivity Disorder". The subjective experiences around the pharmacological treatment of ADHD in a group of parents and educators of boys and girls with the diagnosis in Bogotá, Colombia are explored. the information was collected through in-depth interviews and was organized and analysed from six emerging categories: Knowledge about the medication, ideas about the effectiveness of the medication, identified side effects, social function of the medication, assumed roles against ADHD, and evaluation about the medication. The results show that the participant's narratives are organized according to their role and context, responding to social processes of medicalization of educational context.
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Humanos , Padres , Trastorno por Déficit de Atención con Hiperactividad , Investigación , Terapéutica , Conocimiento , Diagnóstico , MedicalizaciónRESUMEN
Los pacientes que ingresan a las Unidades de Cuidados Intensivos (UCI) no siempre evolucionan hacia la recuperación, lo que implica que el personal de la UCI tenga una visión holística para favorecer una "buena muerte" centrada en el acompañamiento familiar y la mitigación del sufrimiento. Objetivo: comprender el sentido otorgado por los profesionales de la salud de la UCI respecto a los cuidados del paciente al final de la vida y el apoyo a sus familiares. Metodología: estudio cualitativo descriptivo en dos UCI de Bogotá. La información se obtuvo con la técnica de grupos focales y se analizó siguiendo la propuesta de Taylor y Bogdan, adaptada por Amezcua y Hueso. Resultados: emergieron cuatro categorías: sentidos y significados del equipo interdisciplinario respecto a la muerte, comunicación al final de vida en la UCI, percepciones sobre muerte digna en la UCI y dilemas éticos respecto al manejo terapéutico al final de vida. Conclusiones: Para la atención del paciente crítico al final de la vida se debe garantizar comodidad, ausencia de dolor, acompañamiento familiar, bienestar espiritual, respeto por la voluntad del paciente y una buena comunicación que facilite la inclusión de los familiares en la toma de decisiones. Para mitigar la sobrecarga y el sufrimiento del personal de salud generado por la muerte y la toma de decisiones al final de vida, se sugiere formación y diseño de protocolos multidisciplinarios.
Patients admitted to the intensive care units (ICUs) do not always progress toward recovery. This implies that the ICU staff has a holistic vision centered in family reassurance and mitigation of suffering to favor a "good death". Objective: to understand the sense given to ICU healthcare professionals regarding end-of-life care to patients while providing emotional support to their relatives. Methodology: a qualitative descriptive study was conducted in two ICUs in Bogotá. Data capturing was based on focus group sessions and the Taylor and Bogdan methods adapted by Amezcua and Hueso were used for data analysis. Results: the following four analysis categories were identified: senses and meanings of the interdisciplinary team regarding death; communication at the end of life in the ICU; perceptions about dignity in dying in the ICU; and ethical dilemmas regarding therapeutic management at the end of life. Conclusions: critically ill patient care at the end of life includes ensuring comfort, absence of pain and family reassurance, spiritual well-being, respect for the will of patients and good communication facilitating involvement of relatives in end-of-life care decision making. We suggest training heath care staff and designing multidisciplinary protocols as a means to mitigate the overburden and suffering generated by death and end-of-life decision making.
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Humanos , Unidades de Cuidados Intensivos , Cuidados Paliativos , Pacientes , Familia , Enfermería , MuerteRESUMEN
Strongyloides stercoralis affects 30-100 million people worldwide. The burden is underestimated because of the paucity of studies, limited geographical areas surveyed, and poor quality of diagnostic tests. This study aimed at determining the epidemiology of strongyloidiasis using sensitive microscopy testing in rural populations living at different altitudes in Cusco, Peru. Data were collected from subjects aged > 3 years living in Quellouno (elevation 2,600 ft) and Limatambo (elevation 8,379 ft) districts. Subjects provided one fresh stool sample and answer a standardized questionnaire. Fresh stool was tested on site using the Baermann's test and agar plate culture. Formalin-preserved stool was tested by rapid sedimentation. Eighty percent (585/715) of eligible subjects consented to participate; after excluding subjects with missing data, 65% (462/715) were included. Fifty-five percentage were female; the median age was 33 years (interquartile range 13-52), and 72% had government health insurance. Half had intestinal parasites, and Strongyloides was the most common (24.5%) followed by Giardia (15.5%), Blastocystis (14.9%), and hookworm (11.5%). The agar plate culture detected more cases of Strongyloides than Baermann's or sedimentation tests. Strongyloides infection was more common at low altitude (26.4%) than at high altitude (18.6%), but the difference was not statistically significant (P = 0.08). Older age, walking barefoot, bathing in rivers/streams, and using municipal sewage were associated with strongyloidiasis. Strongyloides was the most prevalent parasite in the areas studied and was associated with demographic, socioeconomic, and sanitary factors.