73 research outputs found

    Cuidados paliativos na América Latina

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    This review described the development of palliative care in Latin America, based on education, availability of opioids, research, public policies and implementation of services.Esta revisión describió el desarrollo de los cuidados paliativos en Latinoamérica basado en la educación, disponibilidad de opioides, investigación, políticas públicas e implementación de servicios.O objetivo desta revisão é descrever o desenvolvimento dos cuidados paliativos na América Latina. Foram considerados os seguintes temas: educação, disponibilidade de opioides, pesquisa, políticas públicas e implantação de serviços

    Impact of the COVID-19 Pandemic and Psychosocial Coping Strategies in Health Sciences Students at the University of Seville: A Pilot Study

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    The new infection by coronavirus has supposed a challenge to all health systems worldwide, affecting our psychosocial health. Education as we knew it has changed, which is why university students, attending Health Sciences courses in this case, have been affected by the pandemic. This study aimed to analyze the impact of the preventative measures and restrictions associated with COVID-19 on multiple mental health and psychological well-being indicators in Health Sciences students at the University of Seville. A descriptive and cross-sectional pilot study in the University of Seville by means of an online questionnaire elaborated was conducted. Of the final sample (n = 68), more than 60% of the students acknowledged having received specific training by their university and/or health institution where they perform practices on COVID-19 measures; however, they negatively emphasized not having received psychosocial aid or support in most of the cases (94.12%). As the health situation imposed by COVID-19 is considered long-lasting, the proposal is to plan short- and long-term strategies for promotion and intervention in the mental health of students and future health care workers

    Percepciones del impacto de la pandemia de Covid-19 en los profesionales de la salud en Latinoamérica

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    La pandemia COVID-19, ha producido un gran impacto sobre la salud mental y emocional de los profesionales. En situaciones de crisis, todo esfuerzo por cuidar al que cuida es un imperativo ético. Desde la Asociación Latinoamericana de Cuidados Paliativos,  indagamos las  percepciones del equipo de salud, focalizando en: los desafíos de los cuidados en salud, la perspectiva de género, y el impacto emocional de los que cuidan.Metodología: entre marzo y junio/2020, se utilizó un cuestionario semi estructurado, auto administrado, en línea a profesionales de Cuidados Paliativos, de 44 preguntas sobre cambios de vida, impacto emocional, estrés y comentarios abiertos. Se realizó un análisis descriptivo, bivariado de asociaciones entre variables sociodemográficas e impacto emocional. El análisis cualitativo se realizó según la teoría fundamentada.Resultados: 726 encuestas de 19 países latinoamericanos. El 76% eran de género femenino, 58% médico/as, 62,5% consideró que su profesión lo/a ponía en riesgo, 76% no habían recibido apoyo psicológico, 30% estaba muy estresado/as. La ansiedad, miedo a contagiarse o contagiar, sueño, cansancio, dificultad para concentrarse y desánimo, mostraron diferencias significativas entre los grupos de edad siendo mayor en lo/as más jóvenes y en enfermero/s (p<0.05 a p<0.001). El análisis cualitativo demostró miedo, sobrecarga, incertidumbre, impotencia de los profesionales individual y colectivamente y preocupaciones sobre el  sistema de salud  y la sociedad.Conclusión: A partir de este estudio proponemos incorporar las dimensiones del cuidado en las políticas proactivas preventivas de estrés post traumático para afrontar la post pandemia para todos los profesionales

    Implementation and Knowledge of the Clinical Practice Guide for Palliative Care in the Ecuadorian Primary Care Level

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    Ecuador assumed the commitment of including Palliative Care (PC) in its health policies. In 2014, the Ministry of Public Health (Ministerio de Salud Pública, MSP) approved the Clinical Practice Guide for Palliative Care (Guía de Práctica Clínica sobre Cuidados Paliativos, GPCCP), with application at the national level, as a mandatory internal regulation in all institutions belonging to the National Health System. In 2021, there is no evidence about the degree of implementation. The objective was to evaluate the implementation (I) of the GPCCP guide and the knowledge (C) of the health personnel working in the Zone 7 Health Centers (HCs). This is a cross-sectional, descriptive, and prospective study. A total of 292 professionals were interviewed: managers (38), physicians (150), and nurses (104). Three surveys based on the GPCCP guide were elaborated: one for the implementation, which was applied to the individuals in charge, and the others to assess the health professionals’ knowledge. The SPSS program was used, version 25. In the three groups, more than half of the participants had no training in PC, 91.2% of the HCs have the GPCCP guide, there is PC medical history (MH) in 38.2%, and morphine is used in 14.7%. The implementation of the GPCCP guide was inadequate in 52.9% of the cases. Only 25% treat the agony symptoms and 30%, delirium; 4.4% acknowledge the use of morphine in dyspnea, and 13.3% identify the subcutaneous route as the first choice for hydration at the end-of-life phase. Strategies to implement the GPCCP guide and to improve the health personnel’s knowledge must be implemented in Zone 7 centers

    Impulsos desde abajo para las transiciones energéticas justas: género, territorio y soberanía

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    En el discurso hegemónico sobre transición energética predomina una comprensión tecno-económica, que la reduce a un cambio tecnológico en la generación de energía por fuentes renovables y limpias, y priorizando la construcción de megaproyectos en energía solar, eólica o hidroeléctrica, sin abandonar la explotación de combustibles fósiles. En el marco de un proceso de investigación participativa y diálogo de saberes con cuatro comunidades rurales y étnicas en regiones carboníferas de los departamentos de La Guajira, Cesar y Boyacá, esta obra profundiza en sus demandas desde tres perspectivas interrelacionadas: género, territorio y soberanía comunitaria. A partir de estos ejes de discusión, se identifican diversos impulsos desde las bases para construir transiciones energéticas más allá de los combustibles fósiles en Colombia. Un libro clave para entender el papel de las comunidades ancestrales en los procesos de transición energética del país

    Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

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    Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

    Gestión del conocimiento. Perspectiva multidisciplinaria. Volumen 8

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    El libro “Gestión del Conocimiento. Perspectiva Multidisciplinaria”, volumen 8, de la Colección Unión Global, es resultado de investigaciones. Los capítulos del libro, son resultados de investigaciones desarrolladas por sus autores. El libro es una publicación internacional, seriada, continua, arbitrada de acceso abierto a todas las áreas del conocimiento, que cuenta con el esfuerzo de investigadores de varios países del mundo, orientada a contribuir con procesos de gestión del conocimiento científico, tecnológico y humanístico que consoliden la transformación del conocimiento en diferentes escenarios, tanto organizacionales como universitarios, para el desarrollo de habilidades cognitivas del quehacer diario. La gestión del conocimiento es un camino para consolidar una plataforma en las empresas públicas o privadas, entidades educativas, organizaciones no gubernamentales, ya sea generando políticas para todas las jerarquías o un modelo de gestión para la administración, donde es fundamental articular el conocimiento, los trabajadores, directivos, el espacio de trabajo, hacia la creación de ambientes propicios para el desarrollo integral de las instituciones
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