Salud ocupacional y el síndrome de Burnout

The world of work has undergone a socio-cultural transformation in recent decades. Thus, the new demands of work and the mismatch between the requirements of the job in organizations and the performance possibilities of each subject have given rise to so-called psychosocial risks, including burnout syndrome (emotional exhaustion, depersonalization or dehumanization and lack of personal fulfillment at work), whose prevalence has been increasing and has become a social and public health problem that entails an economic and social cost. Due to the fact that Ecuador does not have a large number of studies carried out in this regard and the important role played by the fishing sector within the country's economy, there is a need to address this problem. In this sense, the objective of the present investigation is to know the prevalence of psychosocial burnout risks in the collaborators or workers. Keywords: Burnout Syndrome, Fishing companies, Emotional health.El mundo laboral experimenta una transformación en las últimas décadas en lo sociocultural. Así, las nuevas exigencias del trabajo y el desajuste entre los requisitos del puesto de trabajo en las organizaciones y las posibilidades de rendimiento de cada sujeto han originado riesgos denominados psicosociales, entre ellos el síndrome de burnout (agotamiento emocional, despersonalización o deshumanización y falta de realización personal en el trabajo), cuya prevalencia se ha ido incrementando y que ha venido a constituirse en un problema social y de salud pública que conlleva, un costo económico y social. Debido a que Ecuador no existe gran cantidad de estudios realizados al respecto y el importante papel que desempeña el sector pesquero dentro de la economía del país, se ve la necesidad de abordar esta problemática. En ese sentido, el objetivo de la presenta investigación es conocer la prevalencia de riesgos psicosocial burnout en los colaboradores o trabajadores de la salud. Palabras claves: Síndrome de Burnout, Empresas pesqueras, Salud emocional. Abstract The world of work has undergone a socio-cultural transformation in recent decades. Thus, the new demands of work and the mismatch between the requirements of the job in organizations and the performance possibilities of each subject have given rise to so-called psychosocial risks, including burnout syndrome (emotional exhaustion, depersonalization or dehumanization and lack of personal fulfillment at work), whose prevalence has been increasing and has become a social and public health problem that entails an economic and social cost. Due to the fact that Ecuador does not have a large number of studies carried out in this regard and the important role played by the fishing sector within the country's economy, there is a need to address this problem. In this sense, the objective of the present investigation is to know the prevalence of psychosocial burnout risks in the collaborators or workers. Keywords: Burnout Syndrome, Fishing companies, Emotional health. Información del manuscrito:Fecha de recepción: 19 de mayo de 2022.Fecha de aceptación: 04 de julio de 2022.Fecha de publicación: 11 de julio de 2022

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Percepción de la atención integral recibida en los pacientes atendidos por los Médicos Familiares graduados en la PUCE Manabí devengando en el centro de Salud Manta Tipo C en el periodo de enero del 2017 a junio del 2019

Esta investigación tiene como objetivo evaluar la percepción de la atención recibida en los pacientes atendidos por los médicos familiares graduados de la PUCE sede Manabí, devengando en el centro de salud Manta tipo C en el periodo de enero del 2017 a junio del 2019, a través de un método investigativo cualitativo-descriptivo con análisis de contenidos de discurso, en donde empleamos como muestra grupos focal y entrevistas a profundidad, para lo cual emplearemos como instrumentos un temario semiestructurado, obteniendo su información mediante la grabación de su discurso para posterior análisis del contenido de las frases por categorías. Se determinó que la población fu abordada bajo un contexto integral, donde el componente biopsicosocial es la estrategia más importante que resalta en el médico familiar devengando en el Centro de Salud tipo C de Manta, sin embargo, también es importante denotar que si bien es una especialidad que se abre caminos en nuestra población, aún falta conocer más profundamente las competencias del médico familiar