Trabalhadora e mãe: papéis, identidade, consciência política e democracia

Faced to the complexity of contemporary women's life, we raised some questions about the main conflicts of working and motherhood conjunction. The increasing inclusion of women in the market, occupying positions previously exclusive for males, highlights their work skills, but entirely ignores the individuality of women compared to the man, who had not experienced body transformations imposed by the generation of a family, and does not play the same responsibility to the offspring care. Based on a brief literature review about maternity and women's work, we noted the motherhood representation is persistent, demanding women keeping to be mothers even while working - despite the adverse conditions which make those functions painful - and censure the choice for one of those experiences: the maternity exclusively; or primary work and do not include maternity plan. It has been shown the importance of that debate to reinforce the working policies aiming equity of gender in the modern society.Face à la la complexité de la vie des femmes contemporaines, quelques questions se posent sur les principaux conflits qui résultent de la conjonction entre le travail et la maternité. De nos jours, la plus grande inclusion des femmes dans le marché du travail - et leur ascension à des postes auparavant exclusivement masculins - indique la reconnaissance de leurs compétences professionnelles, mais ignore totalement la particularité de leur statut par rapport à l'homme qui travaille, qui ne subit pas dans son corps les transformations imposées pour la génération d'une famille, et ne joue pas avec la même responsabilité de prendre soin de la progéniture. A partir d'une bref analyse de la littérature sur la maternité et le travail des femmes, nous avons constaté la persistance de représentations exaltées de la maternité, qui font pression sur les femmes pour qu'elles soyent mères tout en travaillant - en dépit des conditions défavorables qui rendent pénible cette conciliation - et reprochent la femme qui choisit une de ces expériences: la maternité exclusive; ou le travail comme une priorité complète, qui ne comprend pas la concéption de la maternité. Les auteurs signalent l'importance de ce débat pour le renforcement des politiques de travail en tant que proposition objective envers l'équité des sexes dans la société actuelle.Diante da complexidade da vida da mulher contemporânea, levantou-se algumas questões sobre os principais conflitos que surgem da conjunção entre trabalho e maternidade. A maior inclusão da mulher no mercado de trabalho - e sua ascensão a cargos antes exclusivamente masculinos - aponta para o reconhecimento de suas competências laborais, mas desconsidera inteiramente a peculiaridade da sua condição em relação ao trabalhador homem, que não vivencia em seu corpo as transformações impostas pela geração de uma família, e não desempenha com a mesma responsabilidade o cuidado com a prole. A partir de uma breve revisão bibliográfica sobre maternidade e trabalho feminino, observou-se a persistência de representações enaltecedoras da maternidade, que pressionam as mulheres para que sejam mães enquanto trabalham - apesar das condições adversas que tornam penosa essa conciliação - e recriminam a escolha por uma destas vivências: a maternidade exclusiva ou o trabalho como prioridade integral, que não inclua o projeto de maternidade. Apontou-se a importância desse debate para o fortalecimento das políticas trabalhistas como proposição objetiva rumo à equidade de gênero na sociedade atual.Frente a la complejidad de la vida de la mujer contemporánea, planteamos algunas preguntas sobre los principales conflictos que surgen de la conjunción entre el trabajo y la maternidad. La mayor inclusión de las mujeres en el mercado laboral - y su ascenso a posiciones antes exclusivamente masculinas - puntos clave para el reconocimiento de sus habilidades al trabajo, pero ignora por completo la peculiaridad de su situación en relación al trabajador hombre, que no experimenta las transformaciones corporales impuestas por la formación de una familia y no desarrolla con la misma responsabilidad el cuidado de la prole. A partir de una breve revisión literaria de la maternidad y el trabajo de las mujeres, se ha señalado la persistencia de representaciones consolidadoras de la maternidad al presionarlas a que sean madres mientras trabajadoras - a pesar de las condiciones adversas que hacen dolorosa esta combinación - y la recriminación a la elección de uno de los roles: la maternidad exclusiva; o el trabajo como prioridad integral que no incluya el escenario del ser madre. Este trabajo apunta la importancia sobre este debate para la fortificación de las políticas laborales como proposición objetiva rumbo a la equidad de géneros en la sociedad actual

Frecuencia de los tipos de infarto agudo de miocardio según la tercera definición

Resumen: Introducción y objetivos: El infarto agudo de miocardio (IAM) es una patología muy prevalente con una morbimortalidad significativa en Colombia y en el mundo. Es por esto que desde el 2011 en la Fundación Santa Fe de Bogotá se inició la recolección de datos demográficos y clínicos de pacientes con patologías cardiovasculares en una base de datos denominada Registro Colombiano de Enfermedades Cardiovasculares. Actualmente se tienen 736 registrados según el tipo de IAM que presentan de acuerdo con la tercera clasificación de infarto. Por lo anterior, se quiso conocer la frecuencia de cada tipo de infarto en nuestra población y su asociación con diferentes variables. Métodos: Se realizó un estudio descriptivo observacional de corte transversal en el cual se revisaron los datos de los pacientes pertenecientes a RECODEC y se evaluó el tipo de IAM que presentaban. Resultados: Se encontró alta frecuencia para el infarto tipo 1, intermedia para el tipo 2 y baja para los otros tipos de infarto, además una asociación positiva entre ser hombre y presentar infarto tipo 1 (n=427, 85,7% con un OR 1,91 IC95% 1,29-2,82) y una asociación entre infarto tipo 2 y ser mujer (n=51, 21,4% con un OR 0,51 IC95% 0,33-0,76). Conclusiones: Una adecuada clasificación del tipo de infarto permite definir una mejor ruta terapéutica para el paciente y predecir posibles complicaciones. Con este estudio se logró realizar la caracterización de la población en cada grupo establecido por la tercera definición. Abstract: Introduction and objectives: Acute myocardial infarction is a disease associated with a high prevalence and morbidity in Colombia and worldwide. Since 2011, at the Fundación Santa Fe de Bogotá, a registry known as RECODEC began to be used to collect data in order to characterise the population with cardiovascular diseases. A total of 736 patients have currently been registered according to the type of myocardial infarction, taking into account its third universal definition. The application of this definition has been related with an increase in the number of cases diagnosed, with prediction of 10 year mortality, and with improvement of care. The prevalence is presented of each type of infarction and its association with different kind of variables. Methods: A descriptive, observational, cross sectional study was conducted using the patient data from RECODEC registry, in order to evaluate the type of infarction each patient presented. Results: A high prevalence was found for type 1 infarction, with intermediate for type 2, and low for the other types of myocardial infarction. A positive association was also found between being male and having a type 1 infarction (n=427, 85.7% and OR: 1.91, 95% CI: 1.29-2.82, P<.001) and an association between being female and type 2 infarction (n=51, 21.4% and OR: 0.51, 95% CI: 0.33-0.76, P<.001). Conclusions: It is important to classify the type of infarction presented by the patients, so that the type of population that suffers from each type could be characterised, so that it may be possible to offer a more specific treatment for each disease. Palabras clave: Enfermedad cardiovascular, Isquemia, Infarto de miocardio, Keywords: Cardiovascular disease, Ischaemia, Myocardial infarctio

Evaluation of a quality improvement intervention to reduce anastomotic leak following right colectomy (EAGLE): pragmatic, batched stepped-wedge, cluster-randomized trial in 64 countries

Background Anastomotic leak affects 8 per cent of patients after right colectomy with a 10-fold increased risk of postoperative death. The EAGLE study aimed to develop and test whether an international, standardized quality improvement intervention could reduce anastomotic leaks. Methods The internationally intended protocol, iteratively co-developed by a multistage Delphi process, comprised an online educational module introducing risk stratification, an intraoperative checklist, and harmonized surgical techniques. Clusters (hospital teams) were randomized to one of three arms with varied sequences of intervention/data collection by a derived stepped-wedge batch design (at least 18 hospital teams per batch). Patients were blinded to the study allocation. Low- and middle-income country enrolment was encouraged. The primary outcome (assessed by intention to treat) was anastomotic leak rate, and subgroup analyses by module completion (at least 80 per cent of surgeons, high engagement; less than 50 per cent, low engagement) were preplanned. Results A total 355 hospital teams registered, with 332 from 64 countries (39.2 per cent low and middle income) included in the final analysis. The online modules were completed by half of the surgeons (2143 of 4411). The primary analysis included 3039 of the 3268 patients recruited (206 patients had no anastomosis and 23 were lost to follow-up), with anastomotic leaks arising before and after the intervention in 10.1 and 9.6 per cent respectively (adjusted OR 0.87, 95 per cent c.i. 0.59 to 1.30; P = 0.498). The proportion of surgeons completing the educational modules was an influence: the leak rate decreased from 12.2 per cent (61 of 500) before intervention to 5.1 per cent (24 of 473) after intervention in high-engagement centres (adjusted OR 0.36, 0.20 to 0.64; P &lt; 0.001), but this was not observed in low-engagement hospitals (8.3 per cent (59 of 714) and 13.8 per cent (61 of 443) respectively; adjusted OR 2.09, 1.31 to 3.31). Conclusion Completion of globally available digital training by engaged teams can alter anastomotic leak rates. Registration number: NCT04270721 (http://www.clinicaltrials.gov)