El ultrasonido gástrico en la determinación del estado prandial preoperatorio

Introducción: La aspiración de contenido gástrico representa la principal causa de muerte relacionada con la anestesia. El ultrasonido gástrico parece ser útil para el estudio del contenido gástrico, en especial en situaciones donde no existen o se desconocen las condiciones de ayuno. Objetivo: Describir la utilidad del ultrasonido para la valoración del contenido gástrico preoperatorio. Metodología: Se realizó una búsqueda estructurada en las bases de datos Pubmed, Embase, SciELO y Cochrane Library con los descriptores fasting; anesthesia; anesthesia, general; ultrasonics, ultrasonography, stomach (MeSH) Resultados: Se encontraron alrededor de 29 artículos con información relevante para el desarrollo de la presente revisión. Conclusiones: Aunque el ultrasonido gástrico parece ser una técnica útil para el estudio del contenido gástrico, se desconoce su impacto en la incidencia de aspiración neumónica, por lo que se necesitan más estudios para promover su uso rutinario en la práctica clínica.

Introduction: Gastric content aspiration represents the main cause of death related to anesthesia. Gastric ultrasound seems to be useful for studying gastric content, especially in situations where fasting conditions do not exist or are unknown. Objetive: To describe the utility of ultrasound for the evaluation of gastric content. Methods: A structured search was carried out with the descriptors: fasting; anesthesia; general anesthesia; ultrasounds, ultrasonography, stomach (MeSH), in the databases: Pubmed, Embase, SciELO and Cochrane Library. Results: 29 articles were found with relevant information for the development of this review. Conclusions: Although gastric ultrasound seems to be a useful technique for the study of gastric content, the impact that this may have on the incidence of pneumonic aspiration is unknown, so more studies are needed to promote its routine use in clinical practice.

Alteración de la función pulmonar en vendedores informales de gasolina expuestos a sus vapores en Maicao, Colombia

Objetivo: Determinar los efectos de la exposición a vapores de gasolina sobre la función pulmonar en vendedores informales. Material y métodos: Estudio descriptivo de corte transversal realizado en expendedores informales de gasolina expuestos a sus vapores en el municipio de Maicao, Colombia. Se registraron datos sociodemográficos, se evaluó la función pulmonar por medio de espirometría, oximetría de pulso y, evaluación de la exposición a biomasa. Resultados: Se evaluaron 74 pacientes. El 87,8% eran de sexo masculino, encontrándose principalmente entre los 18 - 40 años (71,6%). El 21,6% (n=16) de la población reportó tener afecciones respiratorias, el 59,4% obtuvo un VEF1 <80% predicho, el 68,9% un FVC <80% predicho y, el 32,4% un VEF1/FVC <70% predicho. De aquellos que tuvieron espirometría anormal (n=45), el 62,2% reportó tener un tiempo de labor ≥ 5 años. Los síntomas reportados con mayor frecuencia fueron disfonía (14,8%), conjuntivitis (14,8%), epigastralgia (10,8%) y cefalea (9,45%). No se encontraron diferencias estadísticamente significativas entre la alteración de la espirometría y antecedentes, saturación de oxígeno medida y presencia de afección respiratoria. Conclusión: Este estudio encontró que un porcentaje representativo de vendedores informales de gasolina expuestos a vapores de combustibles en la frontera colombo-venezolana, presentaron alteración en la función pulmonar comprobado por espirometría anormal y, algunos reportaron sintomatología y afección respiratoria. Estos, son principalmente hombres, adultos jóvenes, con nivel socioeconómico y educacional bajo y, expuestos a diario de forma prolongada y por varios años, a gases derivados del manejo de combustibles fósiles.

SUMMARY Objective: To determine the effects of fuel vapor exposure on pulmonary function among informal sellers. Methods: Cross-sectional study carried-out among informal fuel sellers in Maicao, Colombia. Sociodemographic data were gathered as well as pulmonary function by spirometry, pulse oximetry and evaluation of biomass exposure. Results: 74 patients were evaluated; 87.8% were males, 71.6% of them had between 18 to 40 years of age; 21.6% (n=16) reported pulmonary diseases; 59.4% had a predicted FEV1 <80%; 68.9% had a predicted FVC <80% and 32.4% had a predicted FEV1/FVC < 70%. Among those who had abnormal spirometry, (n=45) 62.2% reported to had worked ≥5 years. The most common reported symptoms were dysphonia (14.8%), conjunctivitis (14.8), epigastric pain (10.8) and headache (9.45%). No statistically significant differences were found between spirometry alterations and history of p pulmonary diseases, mean oxygen saturations and presence of a respiratory disease. Conclusions: This study demonstrates that a significant proportion of informal fuel sellers exposed to fuel vapors in the Colombian-Venezuelan border had derangement of the pulmonary function measured by spirometry and that some of them reported symptoms and respiratory disease. Young male adults of low socioeconomic and educational levels with prolonged exposure to fuel vapors are mostly affected.

Using an on-site laboratory for fecal steroid analysis in wild white-faced capuchins.

Hormone laboratories located "on-site" where field studies are being conducted have a number of advantages. On-site laboratories allow hormone analyses to proceed in near-real-time, minimize logistics of sample permits/shipping, contribute to in-country capacity-building, and (our focus here) facilitate cross-site collaboration through shared methods and a shared laboratory. Here we provide proof-of-concept that an on-site hormone laboratory (the Taboga Field Laboratory, located in the Taboga Forest Reserve, Costa Rica) can successfully run endocrine analyses in a remote location. Using fecal samples from wild white-faced capuchins (Cebus imitator) from three Costa Rican forests, we validate the extraction and analysis of four steroid hormones (glucocorticoids, testosterone, estradiol, progesterone) across six assays (DetectX® and ISWE, all from Arbor Assays). Additionally, as the first collaboration across three long-term, wild capuchin field sites (Lomas Barbudal, Santa Rosa, Taboga) involving local Costa Rican collaborators, this laboratory can serve as a future hub for collaborative exchange.

Planificación familiar en mujeres de una institución educativa de la Ciudad de Popayán, Colombia / Contraceptive practices in women of an educational institution in the City of Popayán, Colombia / Contraceptive practices in women of an educational institution in the City of Popayán, Colombia

RESUMEN Introducción . En el mundo, se calcula que al menos 200 millones de mujeres no tienen acceso a servicios de planificación familiar, a pesar de que las condiciones relacionadas con el embarazo, parto y puerperio constituyen un tercio de la morbimortalidad en mujeres en edad reproductiva. Objetivo . Determinar las prácticas de planificación familiar en mujeres de una institución educativa de la ciudad de Popayán, Colombia. Métodos . Se realizó un estudio de corte transversal. Se incluyeron 204 mujeres, a quienes se les aplicó un cuestionario estructurado, de acuerdo a las variables objeto de medición. Resultados . Aproximadamente 90% de las participantes refirió vida sexual activa, 59% tenía pareja esTable y 53% planificaba actualmente, mientras 21% mencionó tener interés en la concepción. El método de planificación más común fue el condón, seguido de los anticonceptivos orales y los métodos hormonales inyecTables. Conclusiones . En la población estudiada, la receptividad respecto a los métodos de planificación familiar fue limitada. En contraste con la literatura disponible, las prácticas de planificación familiar estuvieron influenciadas por las características sociodemográficas de cada población, siendo diferentes en los diversos contextos socioculturales.

ABSTRACT Introduction: At least 200 million women worldwide do not have access to family planning services despite the fact that conditions related to pregnancy, childbirth and the puerperium constitute one third of morbidity and mortality in women of reproductive age. Objective: To determine contraceptive practices in women of an educational institution in the city of Popayán, Colombia. Methods: A crosssectional study was conducted in 204 women, to whom a structured questionnaire was applied according to the variables measured. Results: Approximately 90% of the participants reported active sex life, 59% had a sTable partner and 53% were currently family planning, while 21% mentioned having interest in conceiving. The most common family planning method was the condom, followed by oral contraceptives and injecTable hormones. Conclusions: In the population studied, receptivity to contraceptive methods was limited. In contrast to the available literature, these practices were influenced by the sociodemographic characteristics of each population, being different among sociocultural contexts.

How the thermal environment shapes the structure of termite mounds.

A computational model has been developed to predict the role of environment in the forms and functions of termite mounds. The proposed model considers the most relevant forces involved in the heat transfer process of termite mounds, while also reflecting their gas-exchange function. The method adopts a system configuration procedure to determine thermally optimized mound structures. The model successfully predicts the main architectural characteristics of typical Macrotermes michaelseni mounds for the environmental conditions they live in. The results indicate that the mound superstructure and internal condition strongly depend on the combined effect of environmental forces. It is noted that mounds being exposed to higher solar irradiances develop intricate lateral channels, inside, and taller and more pronounced spire tilt towards the Sun, outside. It is also found that the mounds' spire tilt angle depends on the geographical location, following the local average solar zenith angle for strong irradiances. Although wind does not influence the overall over-ground mound shape, it significantly affects the mound internal condition. The results of this study resonate with what is seen in nature. The proposed approach provides a broader view of the factors that are effective in the form and function of a naturally made structure.

High density of white-faced capuchins (Cebus capucinus) and habitat quality in the Taboga Forest of Costa Rica.

Across the globe, primates are threatened by human activities. This is especially true for species found in tropical dry forests, which remain largely unprotected. Our ability to predict primate abundance in the face of human activity depends on different species' sensitivities as well as on the characteristics of the forest itself. We studied plant and primate distribution and abundance in the Taboga Forest, a 516-ha tropical dry forest surrounded by agricultural fields in northwestern Costa Rica. We found that the density of white-faced capuchins (Cebus capucinus) at Taboga is 2-6 times higher than reported for other long-term white-faced capuchin sites. Using plant transects, we also found relatively high species richness, diversity, and equitability compared with other tropical dry forests. Edge transects (i.e., within 100 m from the forest boundary) differed from interior transects in two ways: (a) tree species associated with dry forest succession were well-established in the edge and (b) canopy cover in the edge was maintained year-round, while the interior forest was deciduous. Sighting rates for capuchins were higher near water sources but did not vary between the edge and interior forest. For comparison, we also found the same to be true for the only other primate in the Taboga Forest, mantled howler monkeys (Alouatta palliata). Year-round access to water might explain why some primate species can flourish even alongside anthropogenic disturbance. Forest fragments like Taboga may support high densities of some species because they provide a mosaic of habitats and key resources that buffer adverse ecological conditions.

Factores de precariedad laboral y su relación con la salud de trabajadores en Bolivia

[RESUMEN]. Objetivo. Investigar la asociación de los factores de precariedad laboral con el uso de servicios de salud, consumo de tabaco y de alcohol entre trabajadores asalariados y con contrato en Bolivia. Métodos. Estudio transversal con una muestra de trabajadores de entre 14 y 65 años, 1 203 mujeres y de 1 780 hombres, con datos de la Encuesta de Hogares 2015 de Bolivia. Las variables dependientes fueron el uso de servicios de salud, el consumo de tabaco y el consumo de alcohol. Las variables independientes fueron el salario, el tipo de contrato, las horas de trabajo y el ejercicio de derechos laborales. Se calcularon prevalencias y la asociación de los factores de precariedad laboral con las variables dependientes mediante modelos de regresiones binomiales multivariadas ajustadas por variables sociodemográficas. Los análisis fueron estratificados por sexo. Resultados. Los modelos ajustados mostraron asociaciones significativas entre tener un contrato temporal y un menor uso de servicios de salud (USS) en hombres (razón de probabilidades [OR por sus siglas en inglés]: 0,70; intervalo de confianza de 95% [IC95%]: 0,56-0,87) y mujeres (OR: 0,62; IC95%: 0,46–0,82). El bajo ejercicio de derechos estuvo también asociado a un menor USS (OR: 0,61; IC95%: 0,45–0,83) en hombres. Las horas de trabajo prolongadas se asociaron al mayor consumo de alcohol en mujeres (OR: 1,75; IC95%: 1,34–2,29). El salario bajo estuvo asociado al menor consumo de tabaco tanto en hombres (OR: 0,75; IC95%: 0,57–0,99) como en mujeres (OR; 0,57; IC95%: 0,33–0,99). Sin embargo, ser trabajador manual se asoció al consumo de tabaco (OR: 1,36; IC95%: 1,09–1,70) entre los hombres. Conclusiones. Tener un contrato temporal y pertenecer al quintil I (inferior) de ingresos se asocia a la menor utilización de servicios de salud y menor probabilidad de fumar en personas de uno y otro sexo. El horario prolongado de trabajo se asocia a mayor consumo de alcohol entre las mujeres. El bajo ejercicio de derechos estuvo asociado a un menor USS en hombres.

[ABSTRACT]. Objective. To examine the association between factors involved in job insecurity and: health service use, tobacco use, and alcohol use among salaried workers and contract workers in Bolivia. Methods. A cross-sectional study was performed with a sample of workers composed of 1203 women and 1780 men between the ages of 14 and 65 years using data from Bolivia’s 2015 Household Survey. The dependent variables were health service use, tobacco use, and alcohol use; the independent variables were wages, type of contract, work hours, and exercise of workers’ rights. Prevalence rates were calculated and the association between factors involved in job insecurity and the dependent variables was assessed using multivariate binomial regression models with adjustment for sociodemographic variables. The analyses were stratified by sex. Results. The adjusted models showed a significant association between working under a temporary contract and lower use of health services among men (odds ratio [OR]: 0.70; 95% confidence interval [95% CI]: 0.56–0.87) and women (OR: 0.62; 95% CI: 0.46–0.82). Poor exercise of workers’ rights was also associated with lower use of health services (OR: 0.61; IC 95%: 0.45-0.83) among men. Long work hours showed an association with greater use of alcohol among women (OR: 1.75; 95% CI: 1.34–2.29). Low wages were associated with lower tobacco use among men (OR: 0.75; 95% CI: 0.57–0.99) and women (OR; 0.57; 95% CI: 0.33–0.99). However, being a manual worker was associated with tobacco use (OR: 1.36; 95% CI: 1.09-1.70) among men. Conclusions. Having a temporary contract and belonging to income quintile I (the poorest) are both associated with lower use of health services and lower probability of smoking in individuals of either sex. Long work hours are associated with greater alcohol use among women. Poor exercise of workers’ rights is associated with lower use of health services among men.

[RESUMO]. Objetivo. Investigar a associação entre fatores relativos a condições precárias de trabalho e a utilização de serviços de saúde, tabagismo e uso de álcool em trabalhadores assalariados e contratados na Bolívia. Métodos. Estudo transversal realizado em uma amostra de trabalhadores, 1.203 do sexo feminino e 1.780 do sexo masculino, com idade de 14 a 65 anos, a partir de dados obtidos da Pesquisa Nacional por Amostra de Domicílios de 2015 na Bolívia. As variáveis dependentes foram utilização dos serviços de saúde, tabagismo e uso de álcool. As variáveis independentes foram salário, tipo do contrato de trabalho, horas da jornada de trabalho e exercício dos direitos trabalhistas. Foram calculadas prevalências e a associação dos fatores relativos às condições de trabalho com as variáveis dependentes com o uso de modelos de regressão binomial multivariada ajustados segundo variáveis sociodemográficas. As análises foram estratificadas por sexo. Resultados. Os modelos ajustados demonstraram uma associação significativa entre ter um contrato de trabalho temporário e menor utilização dos serviços de saúde entre os trabalhadores do sexo masculino (razão de chances [OR] 0,70; intervalo de confiança de 95% [IC95%] 0,56–0,87) e do sexo feminino (OR 0,62; IC95% 0,46–0,82). O pouco exercício dos direitos também foi associado a menor utilização dos serviços de saúde (OR 0,61; IC95% 0,45–0,83) no sexo masculino. Longas jornadas de trabalho foram associadas a um maior uso de álcool no sexo feminino (OR 1,75; IC95% 1,34–2,29). O salário baixo foi associado a uma proporção menor de tabagismo tanto no sexo masculino (OR 0,75; IC95% 0,57–0,99) como no sexo feminino (OR 0,57; IC95% 0,33–0,99). Porém, ser trabalhador braçal foi associado ao tabagismo (OR 1,36; IC95% 1,09–1,70) no sexo masculino. Conclusões. Ter contrato de trabalho temporário e pertencer ao quintil I (inferior) de renda estão associados a menor utilização dos serviços de saúde e menor probabilidade de ser tabagista em trabalhadores de ambos os sexos. Longas jornadas de trabalho estão associadas a um maior uso de álcool no sexo feminino. O pouco exercício dos direitos trabalhistas foi associado a menor utilização dos serviços de saúde no sexo masculino.

Energy Efficient GNSS Signal Acquisition Using Singular Value Decomposition (SVD).

A significant challenge in global navigation satellite system (GNSS) signal processing is a requirement for a very high sampling rate. The recently-emerging compressed sensing (CS) theory makes processing GNSS signals at a low sampling rate possible if the signal has a sparse representation in a certain space. Based on CS and SVD theories, an algorithm for sampling GNSS signals at a rate much lower than the Nyquist rate and reconstructing the compressed signal is proposed in this research, which is validated after the output from that process still performs signal detection using the standard fast Fourier transform (FFT) parallel frequency space search acquisition. The sparse representation of the GNSS signal is the most important precondition for CS, by constructing a rectangular Toeplitz matrix (TZ) of the transmitted signal, calculating the left singular vectors using SVD from the TZ, to achieve sparse signal representation. Next, obtaining the M-dimensional observation vectors based on the left singular vectors of the SVD, which are equivalent to the sampler operator in standard compressive sensing theory, the signal can be sampled below the Nyquist rate, and can still be reconstructed via ℓ 1 minimization with accuracy using convex optimization. As an added value, there is a GNSS signal acquisition enhancement effect by retaining the useful signal and filtering out noise by projecting the signal into the most significant proper orthogonal modes (PODs) which are the optimal distributions of signal power. The algorithm is validated with real recorded signals, and the results show that the proposed method is effective for sampling, reconstructing intermediate frequency (IF) GNSS signals in the time discrete domain.

[Factors involved in job insecurity and their relationship with the health of salaried workers and contract workers in BoliviaRelação entre condições precárias de trabalho e a saúde dos trabalhadores assalariados e contratados na Bolívia]. / Factores de precariedad laboral y su relación con la salud de trabajadores en Bolivia.

OBJECTIVE: To examine the association between factors involved in job insecurity and: health service use, tobacco use, and alcohol use among salaried workers and contract workers in Bolivia. METHODS: A cross-sectional study was performed with a sample of workers composed of 1203 women and 1780 men between the ages of 14 and 65 years using data from Bolivia's 2015 Household Survey. The dependent variables were health service use, tobacco use, and alcohol use; the independent variables were wages, type of contract, work hours, and exercise of workers' rights. Prevalence rates were calculated and the association between factors involved in job insecurity and the dependent variables was assessed using multivariate binomial regression models with adjustment for sociodemographic variables. The analyses were stratified by sex. RESULTS: The adjusted models showed a significant association between working under a temporary contract and lower use of health services among men (odds ratio [OR]: 0.70; 95% confidence interval [95% CI]: 0.56-0.87) and women (OR: 0.62; 95% CI: 0.46-0.82). Poor exercise of workers' rights was also associated with lower use of health services (OR: 0.61; IC 95%: 0.45-0.83) among men. Long work hours showed an association with greater use of alcohol among women (OR: 1.75; 95% CI: 1.34-2.29). Low wages were associated with lower tobacco use among men (OR: 0.75; 95% CI: 0.57-0.99) and women (OR; 0.57; 95% CI: 0.33-0.99). However, being a manual worker was associated with tobacco use (OR: 1.36; 95% CI: 1.09-1.70) among men. CONCLUSIONS: Having a temporary contract and belonging to income quintile I (the poorest) are both associated with lower use of health services and lower probability of smoking in individuals of either sex. Long work hours are associated with greater alcohol use among women. Poor exercise of workers' rights is associated with lower use of health services among men.

OBJETIVO: Investigar a associação entre fatores relativos a condições precárias de trabalho e a utilização de serviços de saúde, tabagismo e uso de álcool em trabalhadores assalariados e contratados na Bolívia. MÉTODOS: Estudo transversal realizado em uma amostra de trabalhadores, 1.203 do sexo feminino e 1.780 do sexo masculino, com idade de 14 a 65 anos, a partir de dados obtidos da Pesquisa Nacional por Amostra de Domicílios de 2015 na Bolívia. As variáveis dependentes foram utilização dos serviços de saúde, tabagismo e uso de álcool. As variáveis independentes foram salário, tipo do contrato de trabalho, horas da jornada de trabalho e exercício dos direitos trabalhistas. Foram calculadas prevalências e a associação dos fatores relativos às condições de trabalho com as variáveis dependentes com o uso de modelos de regressão binomial multivariada ajustados segundo variáveis sociodemográficas. As análises foram estratificadas por sexo. RESULTADOS: Os modelos ajustados demonstraram uma associação significativa entre ter um contrato de trabalho temporário e menor utilização dos serviços de saúde entre os trabalhadores do sexo masculino (razão de chances [OR] 0,70; intervalo de confiança de 95% [IC95%] 0,56­0,87) e do sexo feminino (OR 0,62; IC95% 0,46­0,82). O pouco exercício dos direitos também foi associado a menor utilização dos serviços de saúde (OR 0,61; IC95% 0,45­0,83) no sexo masculino. Longas jornadas de trabalho foram associadas a um maior uso de álcool no sexo feminino (OR 1,75; IC95% 1,34­2,29). O salário baixo foi associado a uma proporção menor de tabagismo tanto no sexo masculino (OR 0,75; IC95% 0,57­0,99) como no sexo feminino (OR 0,57; IC95% 0,33­0,99). Porém, ser trabalhador braçal foi associado ao tabagismo (OR 1,36; IC95% 1,09­1,70) no sexo masculino. CONCLUSÕES: Ter contrato de trabalho temporário e pertencer ao quintil I (inferior) de renda estão associados a menor utilização dos serviços de saúde e menor probabilidade de ser tabagista em trabalhadores de ambos os sexos. Longas jornadas de trabalho estão associadas a um maior uso de álcool no sexo feminino. O pouco exercício dos direitos trabalhistas foi associado a menor utilização dos serviços de saúde no sexo masculino.

Factores de precariedad laboral y su relación con la salud de trabajadores en Bolivia / Factors involved in job insecurity and their relationship with the health of salaried workers and contract workers in Bolivia / Relação entre condições precárias de trabalho e a saúde dos trabalhadores assalariados e contratados na Bolívia

RESUMEN Objetivo Investigar la asociación de los factores de precariedad laboral con el uso de servicios de salud, consumo de tabaco y de alcohol entre trabajadores asalariados y con contrato en Bolivia. Métodos Estudio transversal con una muestra de trabajadores de entre 14 y 65 años, 1 203 mujeres y de 1 780 hombres, con datos de la Encuesta de Hogares 2015 de Bolivia. Las variables dependientes fueron el uso de servicios de salud, el consumo de tabaco y el consumo de alcohol. Las variables independientes fueron el salario, el tipo de contrato, las horas de trabajo y el ejercicio de derechos laborales. Se calcularon prevalencias y la asociación de los factores de precariedad laboral con las variables dependientes mediante modelos de regresiones binomiales multivariadas ajustadas por variables sociodemográficas. Los análisis fueron estratificados por sexo. Resultados Los modelos ajustados mostraron asociaciones significativas entre tener un contrato temporal y un menor uso de servicios de salud (USS) en hombres (razón de probabilidades [OR por sus siglas en inglés]: 0,70; intervalo de confianza de 95% [IC95%]: 0,56-0,87) y mujeres (OR: 0,62; IC95%: 0,46-0,82). El bajo ejercicio de derechos estuvo también asociado a un menor USS (OR: 0,61; IC95%: 0,45-0,83) en hombres. Las horas de trabajo prolongadas se asociaron al mayor consumo de alcohol en mujeres (OR: 1,75; IC95%: 1,34-2,29). El salario bajo estuvo asociado al menor consumo de tabaco tanto en hombres (OR: 0,75; IC95%: 0,57-0,99) como en mujeres (OR; 0,57; IC95%: 0,33-0,99). Sin embargo, ser trabajador manual se asoció al consumo de tabaco (OR: 1,36; IC95%: 1,09-1,70) entre los hombres. Conclusiones Tener un contrato temporal y pertenecer al quintil I (inferior) de ingresos se asocia a la menor utilización de servicios de salud y menor probabilidad de fumar en personas de uno y otro sexo. El horario prolongado de trabajo se asocia a mayor consumo de alcohol entre las mujeres. El bajo ejercicio de derechos estuvo asociado a un menor USS en hombres.

ABSTRACT Objective To examine the association between factors involved in job insecurity and: health service use, tobacco use, and alcohol use among salaried workers and contract workers in Bolivia. Methods A cross-sectional study was performed with a sample of workers composed of 1203 women and 1780 men between the ages of 14 and 65 years using data from Bolivia's 2015 Household Survey. The dependent variables were health service use, tobacco use, and alcohol use; the independent variables were wages, type of contract, work hours, and exercise of workers' rights. Prevalence rates were calculated and the association between factors involved in job insecurity and the dependent variables was assessed using multivariate binomial regression models with adjustment for sociodemographic variables. The analyses were stratified by sex. Results The adjusted models showed a significant association between working under a temporary contract and lower use of health services among men (odds ratio [OR]: 0.70; 95% confidence interval [95% CI]: 0.56-0.87) and women (OR: 0.62; 95% CI: 0.46-0.82). Poor exercise of workers' rights was also associated with lower use of health services (OR: 0.61; IC 95%: 0.45-0.83) among men. Long work hours showed an association with greater use of alcohol among women (OR: 1.75; 95% CI: 1.34-2.29). Low wages were associated with lower tobacco use among men (OR: 0.75; 95% CI: 0.57-0.99) and women (OR; 0.57; 95% CI: 0.33-0.99). However, being a manual worker was associated with tobacco use (OR: 1.36; 95% CI: 1.09-1.70) among men. Conclusions Having a temporary contract and belonging to income quintile I (the poorest) are both associated with lower use of health services and lower probability of smoking in individuals of either sex. Long work hours are associated with greater alcohol use among women. Poor exercise of workers' rights is associated with lower use of health services among men.

RESUMO Objetivo Investigar a associação entre fatores relativos a condições precárias de trabalho e a utilização de serviços de saúde, tabagismo e uso de álcool em trabalhadores assalariados e contratados na Bolívia. Métodos Estudo transversal realizado em uma amostra de trabalhadores, 1.203 do sexo feminino e 1.780 do sexo masculino, com idade de 14 a 65 anos, a partir de dados obtidos da Pesquisa Nacional por Amostra de Domicílios de 2015 na Bolívia. As variáveis dependentes foram utilização dos serviços de saúde, tabagismo e uso de álcool. As variáveis independentes foram salário, tipo do contrato de trabalho, horas da jornada de trabalho e exercício dos direitos trabalhistas. Foram calculadas prevalências e a associação dos fatores relativos às condições de trabalho com as variáveis dependentes com o uso de modelos de regressão binomial multivariada ajustados segundo variáveis sociodemográficas. As análises foram estratificadas por sexo. Resultados Os modelos ajustados demonstraram uma associação significativa entre ter um contrato de trabalho temporário e menor utilização dos serviços de saúde entre os trabalhadores do sexo masculino (razão de chances [OR] 0,70; intervalo de confiança de 95% [IC95%] 0,56-0,87) e do sexo feminino (OR 0,62; IC95% 0,46-0,82). O pouco exercício dos direitos também foi associado a menor utilização dos serviços de saúde (OR 0,61; IC95% 0,45-0,83) no sexo masculino. Longas jornadas de trabalho foram associadas a um maior uso de álcool no sexo feminino (OR 1,75; IC95% 1,34-2,29). O salário baixo foi associado a uma proporção menor de tabagismo tanto no sexo masculino (OR 0,75; IC95% 0,57-0,99) como no sexo feminino (OR 0,57; IC95% 0,33-0,99). Porém, ser trabalhador braçal foi associado ao tabagismo (OR 1,36; IC95% 1,09-1,70) no sexo masculino. Conclusões Ter contrato de trabalho temporário e pertencer ao quintil I (inferior) de renda estão associados a menor utilização dos serviços de saúde e menor probabilidade de ser tabagista em trabalhadores de ambos os sexos. Longas jornadas de trabalho estão associadas a um maior uso de álcool no sexo feminino. O pouco exercício dos direitos trabalhistas foi associado a menor utilização dos serviços de saúde no sexo masculino.

Fatores que influenciam na resposta à terapia de pressão negativa (TPN) nas feridas de pacientes do Hospital Universitario de Neiva / Factores que influyen en respuesta a terapia de presion negativa (TPN) en heridas de pacientes del Hospital Universitario de Neiva / Factors which influence the response to the negative pressure therapy (NPT) in wounds of patients of the Neiva University Hospital

Objective: identifying the factors which influence the response to the negative pressure therapy for wounds. Method: there were carried out between March and May 2013 a prospective longitudinal study at the University Hospital of Neiva with a sample of 9 patients, non-probabilistic by convenience. Results: there was clear predominance of males (88,9%) aged < 41 years old or less (77,7%). Before the treatment the patients manifested via numerical scale a pain level between 5 and 6 (44,4%), weight loss (88,9%), the average duration of treatment was 4.4 weeks, reduced wound size (88,9 %), social isolation during hospitalization (88,8%), reuse of canisters during refills (88,9%). Conclusion: nursing care for patients with wounds difficult to manage with a negative pressure therapy should be holistic; to generating a healthy environment by solving problems integrating the biopsychosocial needs affected and to minimizing the level of dependence.

Objetivo: identificar os fatores que influenciam na resposta a terapia de pressão negativa nas feridas. Método: foi realizado entre março - maio 2013 um estudo longitudinal prospectivo no HUHMP de Neiva, com mostra de 9 pacientes, não probabilística por conveniência. Resultados: predomínio do gênero masculino (88,9%) e idade <41 anos (77,7%). Expressaram nível de dor pela escala numérica, antes do tratamento, de intensidade entre 5 e 6 (44,45), diminuição de peso (88,9%), duração média da terapia de 4.4 semanas,diminuição do tamanho da ferida (88,9%), isolamento social durante a hospitalização (88,8%), reutilização do canister durante recâmbios (88,9%). Conclusão: a atenção de enfermagem ao paciente com feridas do difícil tratamento com Terapia de Pressão Negativa deve ser holística, que gere um ambiente saudável mediante a resolução de problemas integrando as necessidades biopsicossociais afetadas e diminui o nível de dependência.

Objetivo: identificar los factores que influyen en la respuesta a la TPN en heridas. Método: se realizó entre Marzo-Mayo 2013 un estudio longitudinal prospectivo en el HUHMP de Neiva, con muestra de 9 pacientes, no probabilística por conveniencia. Resultados: predominio del sexo masculino (88,9%) y edad <41 años (77,7%). Manifestaron nivel de dolor mediante escala numérica, antes del tratamiento de intensidad entre 5 y 6(44,4%), disminución de peso (88,9%), duración de terapía en promedio de 4.4 semanas, disminución tamaño de herida (88,9%), aislamiento social durante hospitalización (88,8%), reutilización de canister durante recambios (88,9%). Conclusión: la atención de Enfermería al paciente con heridas de difícil manejo conTPN, debe ser holística, que genere un ambiente saludable mediante la resolución de problemas al integrarlas necesidades biopsicosociales afectadas y minimice el nivel de dependencia.