Creative support for death grief in a hospital context: the experience in a Bogotá hospital

Resumen: El artículo presenta los resultados de un proceso de investigación participativa basada en las artes, en el que se buscó incorporar el arte y la creatividad en siete unidades de un hospital universitario de alta complejidad, para el acompañamiento en final de vida y duelo. Esto se hizo a través de la disposición de kits con materiales con potencial creativo y el desarrollo de talleres de sensibilización y creación con personal sanitario, administrativo, pacientes y familiares. El proceso se registró a través de observación participante y diarios de campo. También se realizaron reuniones periódicas, entrevistas informales, semiestructuradas de seguimiento y un grupo de discusión para identificar las principales barreras y facilitadores de la propuesta. Concluimos que, para poder integrar este tipo de recursos y para una atención centrada en la persona y las familias, los servicios de salud requieren transformaciones de fondo que incluyan la muerte como experiencia signifi-cante, dando espacio a sus propios duelos y emociones, lo que reduciría la fatiga por compasión muy frecuente en personal de salud enfrentado a la muerte de manera sistemática. El proyecto contó con la aprobación del comité de ética respectivo. Palabras clave: Investigación basada en artes; duelo; muerte; personal de salud.Q2Q2Abstract: The article presents the results of a participatory research process based on the arts, which sought to incorporate art and creativity in seven units of a high-complexity university hospital, for support at the end of life and bereavement. This was done through the provision of kits with mate-rials with creative potential and the development of awareness and creation workshops with health and administrative staff, patients, and family members. The process was produced through partic-ipant observation and field diaries. Informal, semi-structured interviews and a discussion group were also conducted to identify the main barriers and facilitators of the proposal. We conclude that, in order to integrate this type of resources and for care centered on the person and families, health services require deep transformations that include death as a significant experience, giving space to their own mourning and emotions, which would reduce Fatigue due to inflammation is very fre-quent in health personnel confronted with death in a systematic way. The project was approved by the respective ethics committee. Keywords: Arts-based research; grief; death; health personnel.https://orcid.org/0000-0002-9132-0557https://scholar.google.com/citations?user=SH-SFzMAAAAJ&hl=eshttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000274801Revista Nacional - IndexadaS

Compassion fatigue and burnout in healthcare facing of grief and death in hospital

Este artículo pretende identificar y analizar en la literatura la producción relacionada con la fatiga por compasión y el agotamiento psicológico presente en el personal sanitario que brinda atención y cuidado a personas durante los procesos de muerte y duelo de pacientes y sus familiares, respectivamente. Esta es una revisión integradora en las bases de datos JSTOR, ProQuest, Medline (vía PubMed), LILACS y Google Scholar en el periodo 2005-2018. La revisión permitió la identificación de tres cuerpos importantes de producción académica: trabajos de corte cualitativo que describen el fenómeno; los que desarrollan escalas y herramientas de medición del problema; y los que describen estrategias desarrolladas frente al mismo. En los contextos hospitalarios al personal de salud que acompaña a persona durante el proceso de muerte se le impide demostrar sentimientos y vivir el duelo por la pérdida de sus pacientes. Los trámites administrativos, la despersonalización sanitaria, el número de pacientes a cargo y la baja conciencia en relación con la muerte regulan de cierta forma lo acontecido, impidiendo que exista por parte del personal de salud descarga de sentimientos, llevándolos a presentar agotamiento psicológico y fatiga por compasión. Palabras clave: Agotamiento Profesional; Muerte; Duelo; Personal de SaludQ3To identify and analyze in the literature the production related to comparison fatigue and psychological exhaustion present in healthcare personnel who provide care and attention to people during the death and grief processes of patients and their families, respectively. Integrative review in the JSTOR, ProQuest, Medline (vía PubMed), LILACS y Google Scholar databases in the period 2005-2018. The review identified the identification of three important bodies of academic production: on the one hand, qualitative studies that describe the phenomenon, secondly, those that scale and measurement tools of the problem and finally those that analyze strategies developed against the same. In hospital settings, health personnel accompanying a person during the death process are prevented from showing feelings and mourning the loss of their patients. The administrative procedures, the depersonalization of health, the number of patients in charge and the low conscience in relation to death regulated in a certain way, what happened, preventing health personnel from unloading feelings, leading them to present psychological exhaustion and fatigue. out of compassion. Keywords: Professional Burnout; Death; Grief; Health Personnel.https://orcid.org/0000-0002-9132-0557https://scholar.google.com/citations?user=SH-SFzMAAAAJ&hl=eshttps://scienti.minciencias.gov.co/cvlac/visualizador/generarCurriculoCv.do?cod_rh=0000274801&lang=esRevista Internacional - Indexad

La mujer en posparto: un fenómeno de interés e intervención para la disciplina de enfermería

Introducción: El posparto constituye un fenómeno de interés para la disciplina de enfermería, y ostenta una trayectoria histórica desde el inicio de las prácticas de cuidado; es una etapa determinante para la mujer por la complejidad que deriva el proceso de convertirse en madre. El objetivo del artículo es reconocer y analizar las necesidades de la mujer en pos parto, como base para la  construcción de herramientas para la planeación del cuidado y auto cuidado de la diada, que fomenten la activación del rol maternal y la disminuyan de la morbi-mortalidad materno- perinatal; a parir de la revisión sistemática e integrativa de literatura científica. Materiales y Métodos: Revisión de bases de datos LILACS, PUBMED, SciELO, SCOPUS, SCIENCE DIRECT, EBSCO; Para guiar la revisión de artículos se formuló la siguiente pregunta ¿Cuáles son los productos científicos relacionados con las necesidades de la mujer en pos parto, que lleven a la construcción de intervenciones de enfermería? Resultados: Se seleccionaron 70 artículos y se realizó la lectura exploratoria para la selección de textos para el análisis; La muestra final de esta revisión fueron 50 artículos  citados en el estudio. Discusión y Conclusiones: Enfermería como profesión, debe estructurar  intervenciones sustentadas en teoría disciplinar que permitan actuar sobre las necesidades de la mujer en pos parto a partir del apoyo social que  hace referencia a la cantidad de ayuda que recibe realmente, la satisfacción que produce esa ayuda y las personas (enfermería) que la proporcionan, el cual permitirá brindar cuidado humanizado, individual, personalizado de reciprocidad a la mujer ,recién nacido, pareja y/o familia como medio para disminuir la morbi-mortalidad al mejorar su calidad de vida.Palabras clave: Puerperio, Cuidado de Enfermería, Cuidado Domiciliario. (Fuente: DeCS BIREME).Cómo citar este artículo: Moreno C, Rincón T, Arenas YM, Sierra D, Cano ÁP, Cárdenas DL. La mujer en  posparto: un fenómeno de interés e intervención para la disciplina de enfermería. Rev Cuid. 2014; 5(2): 739-47. http://dx.doi.org/10.15649/cuidarte.v5i2.8

Cross-cultural validation of the HypoA-Q to measure hypoglycemic awareness in diabetic patients

Introducción: La hipoglucemia inadvertida incrementa el riesgo de la hipoglucemia severa en pacientes con diabetes. Una medición objetiva de la misma requiere instrumentos como el HypoA-Q, que, a diferencia de otros, mide conciencia de episodios nocturnos; sin embargo, no se dispone de una versión en español. Objetivo: Traducir y adaptar culturalmente la escala HypoA-Q para la medición de conciencia de la hipoglucemia en pacientes colombianos con Diabetes Mellitus. Metodología: Estudio de Adaptación transcultural del instrumento HypoA-Q. Se obtuvo la autorización de la autora para su traducción y adaptación a la población colombiana. Se siguió la metodología de la European Organisation for Research and Treatment for Cancer (EORTC). Al respecto, se realizaron dos traducciones directas por hablantes nativos del español, una versión reconciliada, dos traducciones inversas por dos hablantes nativos del inglés y una prueba piloto en 15 pacientes con diagnóstico de diabetes. Resultados: Aunque las traducciones directas al español fueron similares, se hicieron ajustes para obtener una versión reconciliada con palabras más fáciles de comprender cambiando las unidades de mmol/L a mg/dl. Las traducciones inversas fueron similares al original en inglés. La prueba piloto, realizada en 15 pacientes, no requirió ajustar ningún ítem, pues la frecuencia de ítems con dificultades de comprensión, confusión o palabras ofensivas fue menor al 15%. Conclusiones: Se dispone de la versión en español para Colombia de la escala HypoA-Q. Se aconseja realizar un estudio de evaluación de sus propiedades psicométricas antes de ser usada en investigaciones o en la práctica clínica.Pacientes con DiabetesIntroduction: hypoglycemia unawareness increases the risk of severe hypoglycemia in pa-tients with diabetes. HypoA-Q is a questionnaire which allows us to evaluate hypoglycemia awareness including night time. However, a Spanish version is not available. Our objective is to translate and culturally adapt the HypoA-Q in order to be able to measure hypoglycemia awareness in Colombian patients with diabetes. Methodology: It is a cross-cultural adaptation study of the HypoA-Q instrument. Authorization was obtained from the author for its translation and adaptation to the Colombian population. The European Organization for Research and Treatment of Cancer (EORTC) methodology was followed. The researchers obtained a reconciled Spanish version with simple vocabulary. Two direct translations were performed by native Spanish speakers, one reconciled version, two reverse translations by two native English speakers, and a pilot test in 15 patients diagnosed with diabetes. Results: The direct translations into Spanish were similar. Adjustments were made to obtain a reconciled version with simple words. Also, glucose units were changed from mmol/L to mg/dl. The reverse translations were similar to the original in English. 15 patients older than 18 years read the Spanish version of HypoA-Q and answered a questionnaire to verify if each of the items were understandable, confusing, annoying or if it had difficult words. It did not require adjusting any item, since the frequency of items with comprehension difficulties, confusion or offensive words was less than 15%. Conclusions: The Spanish version of the HypoA-Q is available. An evaluation study of its psychometric properties must be carried out before being used in research studies or in clinical practice.https://orcid.org/0000-0002-1353-148Xhttps://orcid.org/0000-0002-8907-3470Revista Nacional - IndexadaN

Bolzano/Bozen Corpus: Coding Information about the Speaker in IMDI Metadata Structure

The paper introduces a new collection of spoken data (the Bolzano/Bozen Corpus) available through The Language Archive of Max Planck Institute of Nijmegen. It shows an example of the issues encountered in accommodating information of an existent corpus into IMDI metadata structure. Finally, it provides preliminary reflections on CMDI: a componentbased metadata format.Questo contributo presenta una nuova raccolta di dati di parlato (il Bolzano/Bozen Corpus) che è ora disponibile per la consultazione tramite il Language Archive del Max Planck Institute di Nimega. Vi si mostra un esempio dei problemi che si possono incontrare nell’inserimento all’interno della struttura di metadati IMDI delle informazioni relative a un corpus già esistente. Infine, vi si presentano alcune considerazioni preliminari riguardanti il formato di metadatazione CMDI, basato su componenti

Expediciones Humboldt: Honda-Méndez, Tolima

Este informe presenta los resultados de la caracterización biológica de uno de los bosques secos con mejor estado de conservación en el departamento del Tolima, ubicado entre los municipio de Honda, Méndez y Armero-Guayabal. Estos bosques se encuentran en una matriz de ganadería y producción agropecuaria, donde las coberturas boscosas son conservadas por los propietarios, conscientes de la importancia de este ecosistema para la provisión de bienes y servicios ecosistémicos. Esperamos que esta información producto de la capacidad científica del Instituto Humboldt, sea relevante y útil en las decisiones de planificación estratégica tanto en el ordenamiento territorial de los municipios de Honda, Méndez y Armero-Guayabal, como para las decisiones de conservación que se tomen en la regiónBogotáCiencias Básicas de la Biodiversida

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Colombian consensus recommendations for diagnosis, management and treatment of the infection by SARS-COV-2/ COVID-19 in health care facilities - Recommendations from expert´s group based and informed on evidence

La Asociación Colombiana de Infectología (ACIN) y el Instituto de Evaluación de Nuevas Tecnologías de la Salud (IETS) conformó un grupo de trabajo para desarrollar recomendaciones informadas y basadas en evidencia, por consenso de expertos para la atención, diagnóstico y manejo de casos de Covid 19. Estas guías son dirigidas al personal de salud y buscar dar recomendaciones en los ámbitos de la atención en salud de los casos de Covid-19, en el contexto nacional de Colombia

The global abundance of tree palms

Aim Palms are an iconic, diverse and often abundant component of tropical ecosystems that provide many ecosystem services. Being monocots, tree palms are evolutionarily, morphologically and physiologically distinct from other trees, and these differences have important consequences for ecosystem services (e.g., carbon sequestration and storage) and in terms of responses to climate change. We quantified global patterns of tree palm relative abundance to help improve understanding of tropical forests and reduce uncertainty about these ecosystems under climate change. Location Tropical and subtropical moist forests. Time period Current. Major taxa studied Palms (Arecaceae). Methods We assembled a pantropical dataset of 2,548 forest plots (covering 1,191 ha) and quantified tree palm (i.e., ≥10 cm diameter at breast height) abundance relative to co‐occurring non‐palm trees. We compared the relative abundance of tree palms across biogeographical realms and tested for associations with palaeoclimate stability, current climate, edaphic conditions and metrics of forest structure. Results On average, the relative abundance of tree palms was more than five times larger between Neotropical locations and other biogeographical realms. Tree palms were absent in most locations outside the Neotropics but present in >80% of Neotropical locations. The relative abundance of tree palms was more strongly associated with local conditions (e.g., higher mean annual precipitation, lower soil fertility, shallower water table and lower plot mean wood density) than metrics of long‐term climate stability. Life‐form diversity also influenced the patterns; palm assemblages outside the Neotropics comprise many non‐tree (e.g., climbing) palms. Finally, we show that tree palms can influence estimates of above‐ground biomass, but the magnitude and direction of the effect require additional work. Conclusions Tree palms are not only quintessentially tropical, but they are also overwhelmingly Neotropical. Future work to understand the contributions of tree palms to biomass estimates and carbon cycling will be particularly crucial in Neotropical forests

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection