Perspectiva do enfermeiro ao paciente com câncer terminal em Tampico, Tamaulipas, México

En este trabajo se muestran los resultados de una investigación cualitativa que se realizó en tres hospitales de Tampico, Tamaulipas, en México. En ella se detalla una perspectiva distinta respecto a la última etapa de la vida humana. Específicamente, la labor de la enfermera en el cuidado del paciente oncológico terminal y su relación con él y su familia cuando se acerca el momento de la muerte. Dentro de la práctica de enfermería existe un asunto al que se le debe dar un énfasis especial: el cuidado de pacientes con enfermedades terminales. Durante esta fase, el enfermo experimenta diversos síntomas, que son complejos y cambiantes, por ello necesita tener una atención integral y ética para mejorar su calidad de vida dentro de lo posible. No obstante, los resultados de esta investigación mostraron que las enfermeras viven el proceso de muerte con dolor, tristeza e impotencia. El dolor y la tristeza se relacionan con lo que les significa el paciente y por el tiempo de convivencia mutua. La impotencia la experimentan al sentir que no pudieron hacer más por él o que no sirvieron de mucho todo el esfuerzo, tiempo y recursos dedicados a su atención.This paper presents the results of a qualitative study conducted in three hospitals in Tampico, Mexico. It details a different perspective from the last stage of human life, specifically, the work of the nurse in the care of terminal cancer patient, and her relationship with him and his families when he dies. Within nursing practice, it must be given special emphasis to the care of terminally ill patients. During this phase, the patient experience different symptoms, which are complex and changing, therefore he needs to have a holistic and ethical care to improve their quality of life wherever possible. However, the results of this inquiry showed that nurses experience the process of dying with pain, sadness and powerlessness. The pain and sadness are associated with the importance that nurses give the patient, also by their mutual relations. They experience impotence, feeling they could not do more for him, and believe that the effort, time and resources devoted for his attention were vain.Este artigo apresenta os resultados de uma pesquisa qualitativa foi realizada em três hospitais de Tampico, Tamaulipas, México. Ele detalha uma perspectiva diferente da última etapa da vida humana. Especificamente, o trabalho do enfermeiro no cuidado de pacientes terminais de câncer e sua relação com ele e sua família quando o tempo está se aproximando da morte. Dentro da prática de enfermagem não é uma questão que deve ser dada ênfase especial: o cuidado de doentes terminais. Durante esta fase, o paciente experimenta sintomas diferentes, que são complexas e em mudança, então você precisa de uma atenção integral e ética para melhorar sua qualidade de vida sempre que possível. No entanto, os resultados desta pesquisa mostram que as enfermeiras vivem o processo de morrer de tristeza, dor e desamparo. A dor ea tristeza que lhes estão associados significa que o paciente eo tempo de convivência mútua. A sensação de impotência experiência que poderia fazer mais por ele ou não serve muito de todos os tempo, esforço e recursos destinados a sua atenção

Cuidar desejando paz espiritual: análise qualitativa actancial de narrativas pessoais de enfermeiras que cuidam de pacientes em fase terminal

Introducción: El constructo “morir” y el proceso de la muerte, son vistos como un proceso de tránsito que está determinado socioculturalmente y que tiene implicaciones tanto en el paciente en fase terminal y su familia como en el personal de enfermería que lo atiende. Hasta la fecha, no existen investigaciones con enfoque cualitativo fenomenológico acerca de la experiencia vivida por parte del personal de enfermería. Objetivo: Conocer y comprender la estructura narrativa de la experiencia vivida por parte del personal de enfermería que atiende a pacientes en fase terminal. Materiales y Métodos: Estudio cualitativo mediante el análisis semiótico actancial greimasiano de narrativas. Éticamente sin riesgo, consentimiento informado y respetando principios éticos. Materiales y Métodos: Estudio cualitativo mediante el análisis semiótico actancial greimasiano de narrativas. Éticamente sin riesgo, consentimiento informado y respetando principios éticos. Resultados: Se identificó en la estructura argumentativa el “drama trágico”. Los actantes (entes o fuerzas que juegan un rol en la narrativa) más importantes fueron: enfermera, Dios, muerte y paciente. Las categorías centrales que definen el ser enfermera son: saber, ser y hacer. Se elaboró esquema actancial según roles o funciones: Objeto, Oponente, Auxiliar, Destinador y Destinatario. Discusión: Los hallazgos permiten establecer que el objeto deseado “bien morir” del paciente es alcanzado, pero no el de la “propia paz espiritual”. En el personal de enfermería, existen carencias formativas en tanatología, habiendo dilemas filosóficos en definición y formación profesional y tampoco obtienen reconocimiento ni apoyo institucional para afrontar y cumplir con esta misión de manera saludable. Conclusión: Urgente análisis y reformulación de los principios de la enfermería, incorporar la tanatología en los programas de capacitación y propiciar tanto el reconocimiento del valor que tienen los cuidados de enfermería en los pacientes en etapa terminal como el apoyo por parte de los servicios de salud.Introduction: The facing of death and the dying process is seen as a transit process, socioculturally determined. To die has implications for the patient and his/her family, but also for the nursery personnel and there is not any investigation approaching the experience of this, from a phenomenological qualitative focus. Objective: To know and understand the narrative structure by the description of their experience when they provide care to final stage patients. Material and Methods: Qualitative study, by means of semiotic actantial greimasian analysis from narratives obtained by deep interviews from 4 bachelor nurses from a second level hospital in Tampico, Tamaulipas, Mexico. From the ethic perspective the study was without any risk, informed consent was sought and it was developed according to the ethical principles. Results: Argumentative structure of a “tragic drama” from the existence was identified. The most important actants (entities or forces that play a role in the narrative): nurse, God, death and patient. The core categories that defines the being as nurse were to know, to be and to do. An actantial scheme was made according to the roles or functions: Object (what is sought), Opponent (which blocks to find the object), Auxiliary (that facilitate to find what is sought), Receiver (who owns or which oversees the acquisition of the object), and Addressee (who bears the benefit of the object). Discussion: The traces allow to establish that the desired object of the patient “good death” is actually obtained, but not the one of the own spiritual peace. There are lacks in knowledge about thanatological and philosophical dilemma and of values in definition and job training. They do not get recognition nor support in the face of the compliance of the mission to confront this in a healthy way. Conclusion: Urgent analysis and infirmary principles reformulation, to incorporate thanatology in curricula and recognition of the value an importance of the nursery care in the final stage for continuous improvement in health services.Introdução: A definição da morteé vista como um processo de transição, que é determinada de uma maneira sociocultural e que tem implicações tanto no paciente em fase terminal e sua família, assim como na equipe de enfermagem que o atende. Até o momento, não existem investigações com enfoque qualitativo sobre a experiência vivenciada por parte da equipe de enfermagem. Objetivo: Conhecer e compreender a estrutura narrativa das experiências vividas por parte da equipe de enfermagem que cuidam a pacientes em fase terminal. Metodologia: Estudo qualitativo através de análise semiótica actancial greimasiana de narrativas. Eticamente seguro, consentimento informado e respeitando princípios éticos. Resultados: Na estrutura argumentativa o “drama trágico" foi identificado. Os atuantes (entes ou forças que desempenham um papel na narrativa) mais importantes foram: enfermeira, Deus, a morte e paciente. As categorias centrais que definem o ser enfermeira são: saber, ser e fazer. O esquema actancial foi desenvolvido conforme papéis ou funções: Objeto, Adversário, Auxiliar, Emissor e Receptor. Discussão: Os resultados estabelecem que o objeto desejado “boa morte" do paciente foi atingido, mas não o da “própria paz espiritual”. Na equipe de enfermagem, existem carências formativas em tanatologia, havendo dilemas filosóficos na definição e na formação profissional e tampouco obtém reconhecimento e apoio da instituição para confrontar e cumprir com esta missão de maneira saudável. Conclusão: A análise urgente e reformulação dos princípios de enfermagem, incorporar a tanatologia nos programas de treinamento e fomentar tanto o reconhecimento do valor dos cuidados de enfermagem nos pacientesna fase terminal,assim como fornecer suporte por parte dos serviços de saúde

Diseño y validación de instrumento para la inserción del salario emocional ante la COVID-19

The labor sector has responsibly faced the effects of the coronavirus (COVID-19) and the adversities that this epidemic causes, however, this human group is not exempt from risks and psychological effects due to the seriousness of the situation in the workplace, which you can resettle into the family. His performance is consistent with reality, although he needs different emotional conditions that allow him to continue in his performance. The research had as objectives: to design an instrument to measure the emotional salary and validate the instrument created for the insertion of the emotional salary before COVID-19. The methodology used was non-experimental, descriptive, and transversal, and as a variable of study interest: the Emotional Salary. An instrument was designed and validated to measure emotional salary, with a Cronbach’s alpha of 0.925, which was applied to a sample of 207 workers. Respondents expressed a favorable predisposition to the instrument and their perception of emotional salary is considered high. As conclusions, the reaffirmation of the insertion of the emotional salary is obtained, with strategies of attention to human resources in a personalized way, with respect to their emotions in the workplace in the face of COVID-19.El sector laboral se ha enfrentado responsablemente ante las afectaciones del coronavirus (COVID-19) y las adversidades que esta pandemia ocasiona, no obstante, este grupo humano no está excepto de riesgos y de afectaciones psicológicas por la gravedad de la situación en el ámbito laboral, que puede reasentar en la familia. Su actuación es consecuente con la realidad, aunque necesita de condiciones emocionales diferentes que le permitan continuar en su desempeño. La investigación tuvo como objetivos: diseñar un instrumento para medir el salario emocional y validar el instrumento creado para la inserción del salario emocional ante la COVID-19. La metodología empleada fue de tipo no experimental, descriptivo y transversal, y como variable de interés de estudio: el salario emocional. Se diseñó y validó un instrumento para medir el salario emocional, con un alfa de Cronbach de 0,925, el cual fue aplicado a una muestra de 207 trabajadores. Los encuestados manifestaron una predisposición favorable al instrumento y su percepción de salario emocional es considerada como alta. Como conclusiones se obtiene la reafirmación de la inserción del salario emocional, con estrategias de atención al recurso humano de forma personalizada, con respecto a sus emociones del ámbito laboral ante la escalada de la COVID-1

Conjugation of cell-penetrating peptides with poly(Lactic-co-glycolic acid)-polyethylene glycol nanoparticles improves ocular drug delivery

In this work, a peptide for ocular delivery (POD) and human immunodeficiency virus transactivator were conjugated with biodegradable poly(lactic-co-glycolic acid) (PGLA)- polyethylene glycol (PEG)-nanoparticles (NPs) in an attempt to improve ocular drug bioavail- ability. The NPs were prepared by the solvent displacement method following two different pathways. One involved preparation of PLGA NPs followed by PEG and peptide conjugation (PLGA-NPs-PEG-peptide); the other involved self-assembly of PLGA-PEG and the PLGA-PEG- peptide copolymer followed by NP formulation. The conjugation of the PEG and the peptide was confrmed by a colorimetric test and proton nuclear magnetic resonance spectroscopy. Flur- biprofen was used as an example of an anti-inflammatory drug. The physicochemical properties of the resulting NPs (morphology, in vitro release, cell viability, and ocular tolerance) were studied. In vivo anti-inflammatory effcacy was assessed in rabbit eyes after topical instillation of sodium arachidonate. Of the formulations developed, the PLGA-PEG-POD NPs were the smaller particles and exhibited greater entrapment effciency and more sustained release. The positive charge on the surface of these NPs, due to the conjugation with the positively charged peptide, facilitated penetration into the corneal epithelium, resulting in more effective preven- tion of ocular inflammation. The in vitro toxicity of the NPs developed was very low; no ocular irritation in vitro (hen’s egg test-chorioallantoic membrane assay) or in vivo (Draize test) was detected. Taken together, these data demonstrate that PLGA-PEG-POD NPs are promising vehicles for ocular drug delivery.This work was supported by the Cooperation Research Program CSIC-CITMA and a project (MAT2011-26994) funded by the Spanish Ministry of Science and Technology. AV is a recipient of a PhD grant from the CSIC. The authors thank Nacho Pérez of the IQAC-CSIC for performing the cytotoxicity assays.Peer reviewe

Acoso escolar en la zona metropolitana de Guadalajara, México: prevalencia y factores asociados

This paper seeks to determine the prevalence of victims of school bullying among youth enrolled in public secondary schools in the metropolitan area of Guadalajara, Mexico and to identify the factors associated with being a victim of bullying in the period 2009-2011. An analytic cross-sectional study was carried out. A multistage probability sampling was designed for the public secondary schools, in which 1,706 students between 11 and 16 years old were studied. A questionnare with four sections was applied in order to identify victims of bullying. A logistic regression model was then used to measure the association between the factors analyzed and being a victim of bullying. The prevalence of school bullying was 17.6% (95% CI 15.8; 19.5). Personal factors, such as the feeling of not being accepted by peers or not spending much time with friends, were the factors with the strongest statistically significant association with being a victim of bullying.Este estudio tiene como objetivos determinar la prevalencia de víctimas de acoso escolar en alumnos de escuelas secundarias públicas de la zona metropolitana de Guadalajara, México, e identificar factores asociados al hecho de ser víctima en el período2009-2011. Se realizó un estudio de tipo transversal analítico. Se diseñó una muestra probabilística polietápica de escuelas secundarias públicas y se estudiaron 1.706 alumnos entre 11 y 16 años. Se aplicó un instrumento con cuatro apartados que permitió identificar a las víctimas de acoso y se utilizó un modelo de regresión logística para medirla asociación entre los factores analizados y el ser víctima de acoso. La prevalencia de acoso escolar fue del 17,6% (IC95% 15,8; 19,5). Factores de carácter personal, como sentir que no es aceptado por el grupo o no pasar mucho tiempo con amigos, fueron los que tuvieron una asociación más fuerte y estadísticamente significativa con el hecho de ser víctima de acoso en la escuela

Glutathione determination and a study of the activity of glutathione-peroxidase, glutathione-transferase, and glutathione-reductase in renal transplants

Producción CientíficaThe aim of this work is to study the temporary variation of oxidative stress in renal transplants, both in plasma andin erythrocytes (CR). In order to do so, we determined total glutathione (GST) levels, both oxidized (GSSG) and reduced (GSH), and the activity of enzymes, glutathione peroxidase (G-px), glutathione reductase (G-red) and glutathione transferase (GSt), in renal transplant patients. Determinations were made 48 h before the transplant 1 week and 2 weeks after the renal transplant. The results obtainedconfirm a high ‘‘oxidative stress’’ rate, resulting from the equilibrium between the production of free radicals andthe activity of antioxidants, the former being higher proportionally. Immediately after the transplant there is an increase of oxidative stress, which results in an increase of G-red, a marked decrease of G-px in plasma andin erythrocytes (CR) andan abrupt drop both in GST levels in plasma andin GSG (as well as in the [GSH]/[GSSG] relationship). As times goes on, after the transplant, there is a significant improvement in the activity of antioxidant enzymes, but there is no normalization, which is easily seen in the fact that total glutathione levels andthe activity of the various enzymes approach the average values of the control group

Acoso escolar y autoconcepto en personas trans

Introduction. Bullying is a phenomenon present in all schools and its consequences on the mental health of victims can be very important. Trans people often live with a social stigma that makes them more prone to discrimination. The objective of this study is to analyze the characteristics of bullying in trans people and its relationship with self-concept, as well as to establish a comparison with a cisgender control group. Method: The sample was made up of 68 participants. The experimental group was made up of 34 trans people. The control group was made up of 34 people with similar sociodemographic characteristics. Results: The prevalence of bullying is 20.1% in trans people. There are no significant differences in bullying compared to the control group. There were also no differences regarding self-concept or other sociodemographic variables. Conclusions: Our results do not support the idea, pointed out by other authors, that trans people experience more bullying or less self-concept. They have been found to receive more object-based assaults and physical abuse than harassed cisgender peopleIntroducción: El acoso escolar es un fenómeno presente en todos los centros escolares y sus consecuencias sobre la salud mental de las víctimas pueden ser muy importantes. Las personas trans viven muchas veces con un estigma social que las hace más proclives a sufrir discriminación. El objetivo de este estudio es analizar las características del acoso escolar en personas trans y su relación con el autoconcepto, así como establecer una comparación con un grupo control cisgénero. Método: La muestra estuvo compuesta por 68 participantes. El grupo experimental estuvo compuesto por 34 personas trans. El grupo control estuvo compuesto por 34 personas de características sociodemográficas similares. Resultados: La prevalencia del acoso escolar es del 20,1% en personas trans. No hay diferencias significativas en acoso escolar respecto al grupo control. Tampoco se encontraron diferencias respecto al autoconcepto ni otras variables sociodemográficas. Conclusiones: Nuestros resultados no apoyan la idea, señalada por otros autores, de que las personas trans experimentan mayor acoso escolar ni un menor autoconcepto. Se ha hallado que reciben más agresiones basadas en objetos y maltrato físico que las personas cisgénero acosadas

Comparative antioxidant, antiproliferative and apoptotic effects of Ilex laurina and Ilex paraguariensis on colon cancer cells

ABSTRACT: To determine and compare the antioxidant, antiproliferative and apoptotic effects of leaf infusions of Ilex laurina and Ilex paraguariensis in colon cancer cells. Methods: Antioxidant activity was determined by ORAC (Oxygen Radical Absorbance Capacity) and FRAP (Ferric Reducing Antioxidant Power). Cytotoxic and antiproliferative effects were analyzed using MTT ((3-(4, 5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide) and sulfhorodamine-B respectively. Cell death and apoptosis of human colon adenocarcinoma cells SW480 and their metastatic-derived SW620 cells, were analyzed by flow cytometry using propidium iodide and Annexin-V. Results: Although their flavonoid levels were similar, I. laurina infusion contained 2.2 and 4.4 times higher amounts of total phenolic and caffeoyl derivatives, respectively, than I. paraguariensis. FRAP and ORAC values for I. laurina infusion were 1.6 and 2.0 more active than I. paraguariensis. Both plant infusions inhibited viability and cell growth of SW480 and SW620 cells. These results may be associated to cell cycle-arrest and apoptosis because of the comparable increase of hypodiploid and annexin-V positive colon cancer cells. Conclusion: These data highlight the antioxidant and promising anticancer activities of I. laurina and Ilex paraguariensis

Ansiedad y Depresión como Indicadores de Calidad de Vida en Adultos Mayores

La ansiedad y la depresión pueden ser consideradas como indicadores o síntomas que reflejan la calidad de vida, modificando la  percepción y significado que el adulto mayor tiene  de su vida. El objetivo fue evaluar la ansiedad y  depresión como indicadores relevantes de la calidad de vida. Se evaluaron a 333 adultos mayores con los cuestionarios: de Ansiedad Cognitivo-Somática y WHOQOL-BREF.  Se encontró que el 83.5% de  333 adultos mayores señalaron algunas condiciones de la vivienda inadecuadas,  30.6% expresaron sentimientos negativos por su vivienda, 60.1% percibieron su calidad de vida como buena, 85.8%  señalaban que las  dimensiones:  ambiente  y relaciones sociales inadecuadas,  11.1%  mostraron una ansiedad de tipo cognitiva, las mujeres tuvieron  altos puntajes de depresión 70.0% rasgo y 67.7% estado,  la edad  fue  determinante para la  buena calidad de vida. Se detectaron al sexo, edad y depresión como indicadores significativos asociados a la calidad de vida. Palabras Claves: Calidad de Vida; Depresión; Ansiedad; vivienda; adultos mayores