Percepción del adulto mayor en atención a enfermedades crónicas recibida en Centro de Salud “Pedro Altamirano”, enfocado en el Modelo de Salud Familiar Comunitario, Managua, III Trimestre 2015

“El envejecimiento es un proceso ineludible y gradual que se manifiesta, principalmente, en cambios morfológicos y fisiológicos como consecuencia de la acción del tiempo sobre los organismos vivos”. León, Zunzunegui, Muñoz & Soria (1991, p. 105) En Nicaragua “El Gobierno creó una Ley de protección y beneficios del adulto mayor”, (Gaceta, 2010), que tiene por objeto establecer el régimen jurídico e institucional de protección y garantías para las personas adultas mayores, grupo poblacional que cada vez viene creciendo más y con menos oportunidades laborales, lo que les dificulta llegar a tener condiciones adecuadas para sobrevivir, de seguir esta situación afectará la salud de estos pacientes. Aún con sus limitaciones el Centro de Salud “Pedro Altamirano” está haciendo esfuerzos para lograr satisfacer estas necesidades, implementando acciones para elevar la calidad y calidez en la atención

Percepción del adulto mayor sobre la atención a enfermedades crónicas no transmisibles recibidas en el centro de Salud "Pedro Altamirano", Managua, III Trimestre 2015

La calidad de los servicios de salud en el adulto mayor es concebida como la atención oportuna, personalizada, humanizada, continua y eficiente, otorgada de forma holística e integral; con el propósito de lograr la satisfacción de los usuarios. La investigación se propuso evaluar la percepción del usuario Adulto Mayor sobre la calidad de la atención de salud proporcionada durante su asistencia a recibir atención a enfermedades crónicas no transmisibles en el Centro de Salud Pedro Altamirano, enfocado en el Modelo de Salud Familiar Comunitario, Managua, III Trimestre 2015. Se realizó estudio descriptivo, cuantitativo, de corte transversal, con 68 adultos mayores, se aplicó cuestionario estructurado por medio de entrevista para la información sociodemográfica, percepción de la atención recibida, la percepción con respecto al club de crónicos. Los datos se procesaron en programa estadístico SPSS, analizando los resultados mediante estadística descriptiva, distribuciones de frecuencias y porcentaje, presentadas en tablas y gráficos. Los principales resultados fueron: el 85.3% son de procedencia urbana, con edades entre 60 a 85 años, predominando el sexo femenino, con 14.7% de analfabetismo y 7.4% universitarios, solo el 2.9% reciben remuneración por el trabajo realizado. El 100% recibió buen trato y el 50% son usuarios del club, el 67.6% les gusta todo lo que se hace en el club. Las principales recomendaciones del estudio fueron: Sensibilizar a los trabajadores de la salud la necesidad de atender con responsabilidad, eficiencia, eficacia y ética a los adultos mayor, sensibilizar a la población en general sobre los problemas del envejecimiento y sus necesidades de atención por parte de la familia y la comunidad

La retórica y el debate como herramientas de aprendizaje

Convocatoria proyectos de innovación de Extremadura 2019/2020Se describe un proyecto llevado a cabo en el IES San Fernando (Badajoz) surgido del Departamento de Filosofía que tiene como objetivo principal mejorar las habilidades comunicativas del alumnado. Se pretendía que supieran hablar, transmitir ideas y opiniones, saber escuchar, compartir posturas, rebatir y estar preparados para cambiar de opinión. Otros objetivos del trabajo fueron: transmitir una visión de sociedad que se basa en el diálogo constructivo a través de una interacción respetuosa, rigurosamente fundamentada, reflexiva e inclusiva; lograr en los alumnos el desarrollo del pensamiento crítico y conseguir que comprendan la información que reciben, las inferencias y que sean capaces de evaluarla y generar nuevas propuestasExtremaduraES

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0–4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2–6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates

Weaning from mechanical ventilation in intensive care units across 50 countries (WEAN SAFE): a multicentre, prospective, observational cohort study

Background: Current management practices and outcomes in weaning from invasive mechanical ventilation are poorly understood. We aimed to describe the epidemiology, management, timings, risk for failure, and outcomes of weaning in patients requiring at least 2 days of invasive mechanical ventilation. Methods: WEAN SAFE was an international, multicentre, prospective, observational cohort study done in 481 intensive care units in 50 countries. Eligible participants were older than 16 years, admitted to a participating intensive care unit, and receiving mechanical ventilation for 2 calendar days or longer. We defined weaning initiation as the first attempt to separate a patient from the ventilator, successful weaning as no reintubation or death within 7 days of extubation, and weaning eligibility criteria based on positive end-expiratory pressure, fractional concentration of oxygen in inspired air, and vasopressors. The primary outcome was the proportion of patients successfully weaned at 90 days. Key secondary outcomes included weaning duration, timing of weaning events, factors associated with weaning delay and weaning failure, and hospital outcomes. This study is registered with ClinicalTrials.gov, NCT03255109. Findings: Between Oct 4, 2017, and June 25, 2018, 10 232 patients were screened for eligibility, of whom 5869 were enrolled. 4523 (77·1%) patients underwent at least one separation attempt and 3817 (65·0%) patients were successfully weaned from ventilation at day 90. 237 (4·0%) patients were transferred before any separation attempt, 153 (2·6%) were transferred after at least one separation attempt and not successfully weaned, and 1662 (28·3%) died while invasively ventilated. The median time from fulfilling weaning eligibility criteria to first separation attempt was 1 day (IQR 0-4), and 1013 (22·4%) patients had a delay in initiating first separation of 5 or more days. Of the 4523 (77·1%) patients with separation attempts, 2927 (64·7%) had a short wean (≤1 day), 457 (10·1%) had intermediate weaning (2-6 days), 433 (9·6%) required prolonged weaning (≥7 days), and 706 (15·6%) had weaning failure. Higher sedation scores were independently associated with delayed initiation of weaning. Delayed initiation of weaning and higher sedation scores were independently associated with weaning failure. 1742 (31·8%) of 5479 patients died in the intensive care unit and 2095 (38·3%) of 5465 patients died in hospital. Interpretation: In critically ill patients receiving at least 2 days of invasive mechanical ventilation, only 65% were weaned at 90 days. A better understanding of factors that delay the weaning process, such as delays in weaning initiation or excessive sedation levels, might improve weaning success rates. Funding: European Society of Intensive Care Medicine, European Respiratory Society

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

non present