Effects of the pandemic crisis on entrepreneurship and sustainable development.

The COVID-19 pandemic has caused an economic crisis in advanced economies greater than the 2008 economic crisis, as the latest Organisation for Economic Co-operation and Development (OECD) forecasts indicate. Entrepreneurship activity is an important factor to be considered to reduce this negative. The objective of this paper is to analyze the factors that favor entrepreneurship in the COVID-19 pandemic situation and explore the relationship between entrepreneurship and sustainable development. Monetary, fiscal, competitiveness, and business expectations are factors to consider. To achieve this objective, we reviewed the specialized literature and proposed an economic model to verify the relationships between the relevant variables. The estimation of this model uses the Partial Least Squares (PLS) method. This study looks at select OECD countries where data on entrepreneurial activity are available and there are calculations by the OECD for the economic projections for 2020.

Gender disparities in access to care for time-sensitive conditions during COVID-19 pandemic in Chile.

BACKGROUND: During the COVID-19 pandemic, reductions in healthcare utilization are reported in different contexts. Nevertheless, studies have not explored specifically gender disparities in access to healthcare in the context of COVID-19. METHODS: To evaluate gender disparities in access to medical in Chile we conducted an interrupted time series analysis using segmented regression. The outcome variable was the number of weekly confirmed cases of a set of oncologic and cardiovascular time-sensitive conditions at a national level. The series contained data from weeks 1 to 39 for 2017 to 2020. The intervention period started at week 12. We selected this period because preventive interventions, such as school closures or teleworking, were implemented at this point. We estimated the level effect using a dummy variable indicating the intervention period and slope effect using a continuous variable from weeks 12 to 39. To test heterogeneity by gender and age group, we conducted a stratified analysis. RESULTS: We observed a sizable reduction in access to care with a slowly recovery for oncologic (level effect 0.323; 95% CI 0.291-0.359; slope effect 1.022; 95% CI 1.016-1.028) and cardiovascular diseases (level effect 0.586; 95% CI 0.564-0.609; slope effect 1.009; 95% CI 1.007-1.011). Greater reduction occurred in women compared to men, particularly marked on myocardial infarction (level effect 0.595; 95% CI 0.566-0.627 versus 0.532; 95% CI 0.502-0.564) and colorectal cancer (level effect 0.295; 95% CI 0.248-0.35 versus 0.19; 95% CI 0.159-0.228). Compared to men, a greater absolute reduction was observed in women for oncologic diseases, excluding sex-specific cancer, (1352; 95% CI 743-1961) and cardiovascular diseases (1268; 95% CI 946-1590). CONCLUSION: We confirmed a large drop in new diagnoses for time-sensitive conditions during the COVID-19 pandemic in Chile. This reduction was greater for women. Our findings should alert policy-makers about the urgent need to integrate a gender perspective into the pandemic response.

Multiple retinal hemorrhages in bilateral congenital venous tortuosity.

We present a case of a previously healthy 52-year-old woman with acute onset of scotomas in both eyes. It was associated with headache and vomiting for the past 1 week after a cold. The best-corrected visual acuity was 20/20 in both eyes. The examination of bilateral fundus revealed a venous tortuosity and mild dilatation in the posterior pole, with pre- and intraretinal hemorrhages. However, vasculatures were normally straight in the mid-peripheral and peripheral retina of both eyes. Hemorrhages showed complete resolution without treatment. There was no change in the appearance and shape of the vasculature. Ophthalmologists should be aware of congenital venous tortuosity as a possible cause of retinal hemorrhages.

[I want to breastfeed my baby: Unvealing the experiences of women who lived process difficulties in their breastfeeding]. / “Yo quiero amamantar a mi hijo”: Develando la experiencia de mujeres que enfrentaron dificultades en su proceso de lactancia.

Breastfeeding is the most beneficial feeding practice for infants. However, it is not always the first choice for mothers and their encouragement and support from health professionals is variable. OBJECTIVE: To understand the experience of mothers who had difficulties with their breastfeeding process. PATIENTS AND METHOD: A phenomenological study was conducted in a University Health center. Twelve breastfeeding women were included. Data collection technique was in depth interviews, taped recorded with participants’ consent. Phenomenological analysis of data followed Streubert´s method. The rigor of the study was guarded by criteria for qualitative research and the research process. Ethical aspects were sheltered through the informed consent process, confidentiality and methodological rigor. RESULTS: The experience of living difficulties in the breastfeeding process is revealed in five comprehensive categories: recognizing the difficulties with breastfeeding; emotional impact when unable to breastfeed; motivation to overcome the difficulty and ask for help; support for breastfeeding recovery; and transition process from stress and anxiety to peace, gratification and empowerment. CONCLUSION: The understanding of this experience is qualitative evidence that contributes to a comprehensive understanding of the situation of each mother and child, allowing to improve support care interventions in health.

Yo quiero amamantar a mi hijo: develando la experiencia de mujeres que enfrentaron dificultades en su proceso de lactancia / I want to breastfeed my baby: unvealing the experiences of women who lived process difficulties in their breastfeeding

La lactancia materna es el método de elección para alimentar a los niños pequeños por sus múltiples y reportados beneficios. Sin embargo, es una práctica que no siempre es de primera elección para las madres y su estímulo y apoyo por parte de los profesionales de la salud es variable. OBJETIVO: Comprender la experiencia vivida por madres que presentaron dificultades durante su proceso de amamantamiento. PACIENTES Y MÉTODO: Estudio fenomenológico realizado en centro de salud universitario, participantes 12 mujeres. Se utilizó la entrevista en profundidad, grabada con consentimiento de las participantes. Análisis fenomenológico de los datos según método de Streubert. Se cauteló el rigor del estudio a través de criterios de investigación cualitativa y del proceso de investigación. Aspectos éticos resguardados a través de proceso de consentimiento informado, confidencialidad y rigor metodológico. RESULTADOS: La experiencia de vivir dificultades en el proceso de amamantamiento se reveló en cinco categorías comprensivas: reconociendo las dificultades con el amamantamiento; impacto emocional al no poder amamantar; motivación para superar la dificultad y pedir ayuda; apoyo en la recuperación de la lactancia; y proceso de transición desde el estrés y angustia a la tranquilidad, gratificación y empoderamiento. CONCLUSIÓN: La comprensión de esta experiencia constituye evidencia cualitativa que contribuye al conocimiento integral de la situación de cada madre con su hijo, permitiendo mejorar las intervenciones de apoyo en salud.

Breastfeeding is the most beneficial feeding practice for infants. However, it is not always the first choice for mothers and their encouragement and support from health professionals is variable. OBJECTIVE: To understand the experience of mothers who had difficulties with their breastfeeding process. PATIENTS AND METHOD: A phenomenological study was conducted in a University Health center. Twelve breastfeeding women were included. Data collection technique was in depth interviews, taped recorded with participants’ consent. Phenomenological analysis of data followed Streubert´s method. The rigor of the study was guarded by criteria for qualitative research and the research process. Ethical aspects were sheltered through the informed consent process, confidentiality and methodological rigor. RESULTS: The experience of living difficulties in the breastfeeding process is revealed in five comprehensive categories: recognizing the difficulties with breastfeeding; emotional impact when unable to breastfeed; motivation to overcome the difficulty and ask for help; support for breastfeeding recovery; and transition process from stress and anxiety to peace, gratification and empowerment. CONCLUSION: The understanding of this experience is qualitative evidence that contributes to a comprehensive understanding of the situation of each mother and child, allowing to improve support care interventions in health.

Significado de la condición de dependencia severa de una persona mayor chilena / Meaning of severe dependency condition in a Chilean elderly person

El progresivo deterioro biológico y el aumento de problemas de salud derivados del envejecimiento pueden manifestarse de diversas formas, asociándose con una declinación de las capacidades funcionales y autonomía de las personas mayores. El cuidado de estas personas en situación de dependencia está a cargo de las familias, situación bastante estudiada, desde la perspectiva de los cuidadores, sin embargo, es escaso el conocimiento respecto a quien vive el fenómeno. OBJETIVO: develar el significado de la experiencia vivida por una PM chilena en condición de dependencia severa. MÉTODOS: Diseño estudio de caso con enfoque cualitativo fenomenológico. Se realizó una entrevista en profundidad a una PM chilena en situación de dependencia severa. El análisis se realizó aplicando el método propuesto por Streubert & Carpenter. RESULTADOS: la experiencia de esta persona se describe en tres categorías comprensivas: Valoración del apoyo social: Ser cuidado como una experiencia que brinda seguridad, protección y bienestar; Experiencia emocional ante la limitación funcional y Vivir y convivir con la enfermedad. CONCLUSIÓN: las intervenciones a realizar en las PM en condición de dependencia severa deben basarse en los significados que tiene dicha vivencia para ellas. Lo anterior sugiere poner énfasis en las dimensiones halladas en este estudio.

The progressive biological deterioration and increased health problems resulting from aging can manifest itself in various forms and are generally associated with a decline in functional capacity and autonomy of the elderly. Care for dependent eldery people is in charge of families, well-studied situation from the perspective of caregivers; however, there is little knowledge from the point of view of who bears the phenomenon. OBJECTIVE: To reveal the meaning of the experience of a chilean aged person in a condition of severe dependence. METHODS: Design phenomenological case study with qualitative approach. The method used was the interview in depth. The analysis was conducted using the method proposed by Streubert & Carpenter. RESULTS: the experience of this person is described in three comprehensive categories: 1. Social support: Be careful as an experience that provides security, safety and welfare; 2. Emotional experience to the functional limitation and 3. Live with the disease. CONCLUSION: perform interventions in older people living in severe dependence should be based on the meanings that have this experience for them. This suggests emphasizing the dimensions found in this study.

La diferencia entre tiempo programado y efectivo en hemodiafiltración en línea: ¿cada minuto cuenta en la eficacia dialítica? / The difference between programmed time and effective time in online haemodiafiltration: does every minute count in dialytic efficiency?

Introducción. El factor tiempo es determinante en la eficacia de la diálisis, recomendando las European Best Practices Guides of Dialysys Adequaccy una duración semanal no inferior a 720 minutos. Los modernos monitores de diálisis interrumpen el procedimiento por auto chequeos que incrementan la seguridad. Esos minutos de diferencia no han sido tenidos en cuenta en otros resultados obtenidos, algún autor ya hace referencia a la necesidad de contemplarlos. Los objetivos del presente estudio fueron determinar la diferencia real entre el tiempo programado y el tiempo efectivo de diálisis, y una vez comprobado incrementar la duración de la sesión para hacer que el tiempo efectivo sea realmente el deseado en cada paciente, y nunca inferior a 240 minutos por sesión. Finalmente comprobamos si existen diferencias en la eficacia dialítica, midiendo el Kt y el volumen total de reinfusión. Pacientes y métodos Diseñamos un estudio prospectivo sobre población prevalente en hemodiafiltración on-line. Reclutamos 152 pacientes en hemodiafiltración on-line. Durante 6 sesiones consecutivas (912 sesiones) la diálisis se efectuó con un tiempo programado ≥ 240 minutos. En un segundo periodo 6 sesiones consecutivas (912 sesiones), la sesión de diálisis se alargó hasta un tiempo efectivo igual al previo programado. La variable principal en estudio fue el tiempo, siendo variables secundarias el flujo sanguíneo, Kt, y volumen total de reinfusión. En el segundo periodo se recogieron posibles complicaciones intradialíticas en el tiempo añadido. Resultados Se analizan 152 pacientes, 66% hombres, de 65,7 ± 14,9 (26-88) años de edad, con una permanencia en diálisis de 56,5 ± 59,5 meses, en un total de 1824 sesiones de hemodiafiltración on-line. No se aprecian diferencias significativas en Qb (428,74±39,73 vs 429,86±38,54 ml/min). El tiempo medio de la sesión aumenta significativamente (p<0,001) en 7 minutos (de 233,58±3,29 hasta 240,67±2,71 minutos). El Kt aumenta significativamente (p<0,001) un 3,2% (desde 60,06±5,86 hasta 61,99±5,80 litros), disminuyendo el % de sesiones en las que no se alcanza el Kt deseado por superficie corporal (de 5,7% a 3,1%). El volumen total de reinfusión se incrementa significativamente (p<0,001) un 1,5% (de 24,10±2,72 a 24,46±2,77 litros), con un % similar de sesiones donde no se alcanzan los 20 litros objetivo (4,6% versus 4,3%). No se observan complicaciones intradialíticas en el periodo de tiempo incrementado ni episodios de coagulación...(AU)

Aim To determine the difference between programmed time and effective dialysis time, and once it has been found, to increase the duration of the session so that the effective time is actually as desired for each patient, and never less than 240 minutes per session. Finally, we determined whether there are differences in dialytic efficiency, by measuring Kt and total reinfusion volume. Patients and methods We designed a prospective study on the prevalent population in online haemodiafiltration. We recruited 152 patients undergoing online haemodiafiltration. For 6 consecutive sessions (912 sessions), the dialysis was carried out with a programmed time ≥ 240 minutes. In a second period of 6 consecutive sessions (912 sessions), the dialysis session was extended to an effective time equal to the previously programmed time. The principal variable in the study was time, with blood flow, Kt and total reinfusion volume as secondary variables. In the second period, any intradialytic complications in the added time were noted. Results A total of 152 patients were analysed, 66% of whom were man, 65.7 ± 14.9 (26-88) years old, with 56.5 ± 59.5 months on dialysis, in a total of 1824 online haemodiafiltration sessions. No significant differences in Qb were observed (428.74±39.73 v. 429.86±38.54 ml/min). The average duration of the session increased significantly (p<0.001) by 7 minutes (from 233.58±3.29 to 240.67±2.71 minutes). Kt increased significantly (p<0.001) by 3.2% (from 60.06±5.86 to 61.99±5.80 litres), with a reduction in the % of sessions in which the desired Kt per body surface area is not reached (from 5.7% to 3.1%). The total reinfusion volume increased significantly (p<0.001) by 1.5% (from 24.10±2.72 to 24.46±2.77 litres), with a similar % of sessions in which the target of 20 litres was not reached (4.6% compared to 4.3%). No intradialytic complications or coagulation episodes were observed in the increased time period. D...(AU)

Infusión automatizada manual en la hemodiafiltración on-line postdilucional: hacia la optimización del volumen de reinfusión / Manual automated infusion in post-dilution on-line haemodiafiltration: towards optimizing the reinfusion volume

Las técnicas de hemodiafiltración (HDF) con altos volúmenes convectivos, constituyen una interesante forma de depuración por su aproximación a la del riñón nativo. De entre ellas, la HDF on-line postdilucional es el modo de infusión más eficaz para la eliminación de moléculas de diferentes pesos moleculares. Recientes avances en la tecnología permiten la prescripción automática del flujo de infusión (Qi), resultando al menos tan eficaz como el manual. El objetivo del presente estudio es evaluar si es posible incrementar la eficacia de la infusión automatizada en la HDF on-line postdilucional, incrementando manualmente el Qi inicial, mediante la medición del volumen convectivo final y del Kt. Por otro lado, se evalúan las cargas de enfermería medidas por el número de intervenciones relacionadas con la técnica. En todos los pacientes (n 96) se realizan 3 sesiones de diálisis (ST 5008 Fresenius Medical Care) con reinfusión automática, y seguidamente, otras 3 sesiones con reinfusión automatizada manual incrementando el Qi en 10 ml/min al medido automaticamente. De los resultados obtenidos, se aprecian diferencias significativas (p<0,001) en el volumen de reinfusión, siendo un 6% mayor en la forma automatizada manual (23,01 ± 2,22 litros) que en la automatizada (21,7 ± 2,62 litros). El 75% de los pacientes alcanzan 20 litros o más con la autosustitución, frente al 87,5% con la sustitución automatizada manual (p<0,001). No existen diferencias en cuanto al Qb, Qd, tiempo efectivo de diálisis y Kt. El número de intervenciones por alarmas relacionadas con la técnica del personal de enfermería es superior (p=0,001) (AU)

Haemodiafiltration (HDF) techniques with high convective volumes are an interesting form of filtering due to their approximation to the native kidney. Among them, post-dilution on-line HDF is the most efficacious form of infusion for eliminating molecules with different molecular weights. Recent advances in technology permit the automatic prescription of the infusion flow (Qi), proving at least as efficacious as manual infusion. The aim of this study is to assess whether it is possible to increase the efficacy of automated infusion in post-dilution on-line HDF by manually increasing the initial Qi by measuring the final convective volume and Kt. The nursing workloads are also assessed, measured by the number of interventions related to the technique. In all patients (n 96) 3 dialysis sessions are carried out (ST 5008 Fresenius Medical Care) with automatic reinfusion, followed by another 3 sessions with manual automated reinfusion increasing the Qi by 10 ml/min to the automatically measured dose. The results obtained show significant differences (p<0.001) in the reinfusion volume, which is 6% higher in manual automated form (23.01 ± 2.22 litres) than in automated (21.7 ± 2.62 litres). 75% of patients reached 20 litres or more with self-replacement, compared to 87.5% with manual automated replacement (p<0.001). There are no differences in Qb, Qd, effective dialysis time and Kt. The number of interventions due to alarms related to the technique or nursing staff is higher (p=0.001) (AU)

[Non-pharmacological interventions for the treatment of erectile dysfunction in adult men: systematic review]. / Intervenciones no farmacológicas para el tratamiento de la disfunción eréctil en varones adultos: revisión sistemática.

OBJECTIVE: To review current evidence on the non-pharmacological (non-invasive) treatment of erectile dysfunction (ED). METHOD: We performed a systematic review of research articles that included adult men diagnosed with ED who had undergone some type of non-pharmacological and non-surgical intervention for this disorder. Free-access, complete texts with an available summary published between 2000 and 2006 were sought. Studies not published in English were excluded. RESULTS: A total for 124 articles were found, and after critical analysis only 8 matched the inclusion criteria (of the 8 articles, 2 were classified as showing quality criterion 1-B and none met the criterion for 1-A). Four types of non-pharmacological, non-surgical therapy were found, which could reverse or improve ED in patients with organic, psychological or mixed impairment and could be applied by nurses. Among these therapies were lifestyle changes (losing weight, pelvic musculature strengthening, psychotherapy and/or psychoeducation and the use of Internet and/or other multimedia devices. CONCLUSIONS: Alternative therapies are available for men with ED. These therapies help to improve or reverse ED and guarantee satisfactory and lasting Results. Nevertheless, we stress that our aim is not to compete with invasive and non-invasive therapies but rather to provide a greater number of treatment alternatives. The low quality of studies could be attributed to the lack of economic resources and the fact that ED is still an emerging subject in current medicine.

Terpsicoretranceterapia (T.T.T.) en el control del stress, experiencia en la Universidad de Valparaíso / Terpsychoretrancetherapy (T.T.T.) in the stress control, an experience at the University of Valparaiso

Se presenta un estudio clínico de aplicación de una novedosa técnica no convencional de terapia breve, la terpsicoretranceterapia (T.T.T.) en el control del stress y las enfermedades asociadas, desarrollada durante un curso de control de stress, como parte del programa de extensión del bienestar del personal de la Universidad de Valparaíso. T.T.T. es una terapia grupal que utiliza trances hipnóticos cinéticos que ocurren sin intervención directa del terapeuta durante el desarrollo del proceso, y que se caracteriza por intensas catarsis emocionales y por la mobilización de recursos inconscientes para solucionar los problemas del paciente. Los resultados obtenidos son extraordinariamente buenos y alientan a continuar con la investigación y la práctica de T.T.T., no solamente en el control y tratamiento del stress, sino en varios campos de la conducta humana

Cien casos de eritrosedimentación muy elevada en pediatría / 100 cases of very high erythrocyte sedimentation in pediatrics

Se revisaron 100 casos de VHS muy elevada (>80 mm en la 1a hora) que se reunieron en un período de 23 meses, Se analiza la incidencia, un 3,30 por ciento de los egresos durante ese período; la causa resultando un 71 por ciento de origen infeccioso, un 13 por ciento de causa renal o enfermedad del colágeno, 8 por ciento de enfermedad neoplásica o hematológica y 5 por ciento de causas misceláneas. Se analizaron las características de cada grupo causal y cuando la causa era de origen infeccioso se trató de pacientes de menor edad, un Hb normal o disminuído y recuento de leucocitos, polimorfonucleares y baciliformes elevados. Cuando la causa fue renal o enfermedad colágeno se trató de pacientes de mayor edad con Hb normal o disminuída, con recuento de leucocitos y polimorfonucleares elevados; pero sin desviación izquierda. Cuando la causa fue una enfermedad neoplásica o hematológica fueron pacientes de edad escolar, con Hb disminuída, recuento de leucocitos y polimorfonucleares normales y no hubo desviación izquierda. Sólo existió mortalidad, 3 casos, en el grupo de enfermos neoplásicos o hematológicos y en general el pronóstico es favorable comparado con adultos