Estilo de vida y salud: Comunidad Hare Krishna de Santa Marta - Colombia

Hare Krishna are a group of people voluntarily gathered with the intention of leading a pure life and awakening the love for spirituality as their main purpose of life. The aim of this research is to describe and interpret the lifestyle of the Hare Krishna community and their vision for health. The ethnographic research was conducted in the second quarter of 2016, through observation and interviews with community members, a direct intervention was carried out, sharing with the community their daily activities, their food and their spiritual beliefs. For members of the community to find Krishna consciousness was their destiny, Krishna comes into their lives to fill their being fully. Changing their way of life was for them an act of surrender to the spiritual life, a renunciation of the material world and everything that could represent harm to their lives. Members of the Hare Krishna community feel that their lifestyle reflects superiority or a higher level within society. They believe that the principles that govern them are those that God in creating life wanted all his children to follow.Los Hare Krishna son una agrupación de personas voluntariamente reunidas con la intención de llevar una vida pura y despertar el amor por la espiritualidad como su propósito principal de vida. El objetivo de esta investigación es describir e interpretar el estilo de vida de la comunidad Hare Krishna y su visión hacia la salud. La investigación de corte etnográfico se realizó en el segundo trimestre del 2016, a través de la observación y entrevistas con los miembros de la comunidad, se realizó una intervención directa compartiendo con la comunidad sus actividades diarias, su alimentación y sus creencias espirituales. Para los miembros de la comunidad encontrar la conciencia de Krishna era su destino, llega krishna a sus vidas para llenar su ser plenamente. Cambiar su estilo de vida, fue para ellos un acto de entrega a la vida espiritual, una renuncia al mundo material y a todo lo que pudiera representarles daño para sus vidas. Los miembros de la comunidad Hare Krishna consideran que su estilo de vida refleja superioridad o un nivel más elevado dentro de la sociedad. Creen que los principios que los rigen son los que Dios al crear la vida quería que todos sus hijos siguieran

Habilidad del cuidado de los cuidadores familiares de pacientes con enfermedades crónicas de la clínica Nefrología ltda y el Instituto Neurociencias del Caribe ltda, Santa Marta 2007

Con el propósito de identificar la habilidad del cuidado de los familiares de pacientes con enfermedad crónica se desarrolló la presente investigación de tipo descriptivo, corte transversal y abordaje cuantitativo. La población fue conformada por 50 cuidadores principales de pacientes con enfermedad crónica Santa Marta, 2007. Se aplicó a los cuidadores el instrumento elaborado por Ngozi Nkongho, denominado Inventario de Habilidad de Cuidado (CAI), el cual identifica el grado de desarrollo de tres elementos: conocimiento, valor y paciencia. En la muestra seleccionada se aplicó el instrumento de caracterización de los cuidadores en el que se identificó que la mayoría de los cuidadores son mujeres con un porcentaje del 80%, las cuales están entre las edades de 36-59 años. El 62% de los pacientes son menores que el rango de edad del cuidador. El 34% tienen el bachillerato completo y el 22% la primaria incompleta lo cual indica una escolaridad baja, el 46% son casados, con una economía afectada al pertenecer el 40% al estrato 3 y el 26% al estrato 2. El 86% tienen a su cargo al paciente desde el momento de su diagnóstico y el tiempo que llevan como cuidador es en un 48% mayor de 37 meses, y el 42% de los cuidadores dedican diariamente las 24 horas al cuidado de su paciente y el 24% dedica sólo de 13 a 23 horas diarias. En cuanto a la relación entre el paciente y el cuidador el 40% de los cuidadores son madres o padres de los pacientes y el 20% son hijos, lo que muestra la existencia de lazos afectivos y de consanguinidad que puede influenciar un mayor grado de responsabilidad y compromiso. La habilidad del cuidado, incluyendo cada uno de los componentes de conocimiento, valor y paciencia, se encontró en un nivel alto con un porcentaje del 11 53%, lo que denota que el hecho que los cuidadores lleven un tiempo prolongado prestando su cuidado al paciente le permite fortalecer sus habilidades, sin embargo, se hace necesario que no sólo el tiempo se constituya en la escuela de estos familiares, sino que se creen grupos de apoyo que fortalezcan la habilidad del cuidado

Condiciones nutricionales de la primera infancia en Santa Marta, Colombia

Introduction: It is vital to be interested in early childhood's social determinants and different pathologies because this period is the most important for growth and physical-cognitive development. Objective: To describe the nutritional condition of children under six years in Santa Marta. Method: A descriptive study was conducted with a sample of participants from a neighborhood in Santa Marta, Colombia. Results: 112 children were evaluated, 54% were boys, and 35% presented nutritional alterations (risk of malnutrition, malnutrition, overweight, and obesity). Conclusions: Approximately one-third of preschool children in a neighborhood of Santa Marta, Colombia, present nutritional alterations. It is necessary to study the factors associated with these alterations.Introducción: es vital interesarse por los determinantes sociales de la primera infancia y sus diferentes patologías porque este período es el más importante para el crecimiento y desarrollo físico-cognitivo. Objetivo: describir el estado nutricional de los niños menores de seis años de Santa Marta. Método: se realizó un estudio descriptivo con una muestra de participantes de un barrio de Santa Marta, Colombia. Resultados: se evaluaron 112 niños y niñas, el 54% eran niños y el 35% presentó alteraciones nutricionales (riesgo de desnutrición, desnutrición, sobrepeso y obesidad). Conclusiones: aproximadamente un tercio de la niñez en edad preescolar de un barrio de Santa Marta, Colombia, presentan alteraciones nutricionales. Es necesario estudiar los factores asociados a estas alteraciones

Condiciones nutricionales de la primera infancia en Santa Marta, Colombia

Introducción: es vital interesarse por los determinantes sociales de la primera infancia y sus diferentes patologías porque este período es el más importante para el crecimiento y desarrollo físico-cognitivo. Objetivo: describir el estado nutricional de los niños menores de seis años de Santa Marta. Método: se realizó un estudio descriptivo con una muestra de participantes de un barrio de Santa Marta, Colombia. Resultados: se evaluaron 112 niños y niñas, el 54% eran niños y el 35% presentó alteraciones nutricionales (riesgo de desnutrición, desnutrición, sobrepeso y obesidad). Conclusiones: aproximadamente un tercio de la niñez en edad preescolar de un barrio de Santa Marta, Colombia, presentan alteraciones nutricionales. Es necesario estudiar los factores asociados a estas alteraciones

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83-7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97-2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14-1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25-1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

Background: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs). Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support. Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83–7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97–2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14–1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25–1.30]). Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Respiratory support in patients with severe COVID-19 in the International Severe Acute Respiratory and Emerging Infection (ISARIC) COVID-19 study: a prospective, multinational, observational study

International audienceBackground: Up to 30% of hospitalised patients with COVID-19 require advanced respiratory support, including high-flow nasal cannulas (HFNC), non-invasive mechanical ventilation (NIV), or invasive mechanical ventilation (IMV). We aimed to describe the clinical characteristics, outcomes and risk factors for failing non-invasive respiratory support in patients treated with severe COVID-19 during the first two years of the pandemic in high-income countries (HICs) and low middle-income countries (LMICs).Methods: This is a multinational, multicentre, prospective cohort study embedded in the ISARIC-WHO COVID-19 Clinical Characterisation Protocol. Patients with laboratory-confirmed SARS-CoV-2 infection who required hospital admission were recruited prospectively. Patients treated with HFNC, NIV, or IMV within the first 24 h of hospital admission were included in this study. Descriptive statistics, random forest, and logistic regression analyses were used to describe clinical characteristics and compare clinical outcomes among patients treated with the different types of advanced respiratory support.Results: A total of 66,565 patients were included in this study. Overall, 82.6% of patients were treated in HIC, and 40.6% were admitted to the hospital during the first pandemic wave. During the first 24 h after hospital admission, patients in HICs were more frequently treated with HFNC (48.0%), followed by NIV (38.6%) and IMV (13.4%). In contrast, patients admitted in lower- and middle-income countries (LMICs) were less frequently treated with HFNC (16.1%) and the majority received IMV (59.1%). The failure rate of non-invasive respiratory support (i.e. HFNC or NIV) was 15.5%, of which 71.2% were from HIC and 28.8% from LMIC. The variables most strongly associated with non-invasive ventilation failure, defined as progression to IMV, were high leukocyte counts at hospital admission (OR [95%CI]; 5.86 [4.83-7.10]), treatment in an LMIC (OR [95%CI]; 2.04 [1.97-2.11]), and tachypnoea at hospital admission (OR [95%CI]; 1.16 [1.14-1.18]). Patients who failed HFNC/NIV had a higher 28-day fatality ratio (OR [95%CI]; 1.27 [1.25-1.30]).Conclusions: In the present international cohort, the most frequently used advanced respiratory support was the HFNC. However, IMV was used more often in LMIC. Higher leucocyte count, tachypnoea, and treatment in LMIC were risk factors for HFNC/NIV failure. HFNC/NIV failure was related to worse clinical outcomes, such as 28-day mortality. Trial registration This is a prospective observational study; therefore, no health care interventions were applied to participants, and trial registration is not applicable

Thrombotic and hemorrhagic complications of COVID-19 in adults hospitalized in high-income countries compared with those in adults hospitalized in low- and middle-income countries in an international registry

Background: COVID-19 has been associated with a broad range of thromboembolic, ischemic, and hemorrhagic complications (coagulopathy complications). Most studies have focused on patients with severe disease from high-income countries (HICs). Objectives: The main aims were to compare the frequency of coagulopathy complications in developing countries (low- and middle-income countries [LMICs]) with those in HICs, delineate the frequency across a range of treatment levels, and determine associations with in-hospital mortality. Methods: Adult patients enrolled in an observational, multinational registry, the International Severe Acute Respiratory and Emerging Infections COVID-19 study, between January 1, 2020, and September 15, 2021, met inclusion criteria, including admission to a hospital for laboratory-confirmed, acute COVID-19 and data on complications and survival. The advanced-treatment cohort received care, such as admission to the intensive care unit, mechanical ventilation, or inotropes or vasopressors; the basic-treatment cohort did not receive any of these interventions. Results: The study population included 495,682 patients from 52 countries, with 63% from LMICs and 85% in the basic treatment cohort. The frequency of coagulopathy complications was higher in HICs (0.76%-3.4%) than in LMICs (0.09%-1.22%). Complications were more frequent in the advanced-treatment cohort than in the basic-treatment cohort. Coagulopathy complications were associated with increased in-hospital mortality (odds ratio, 1.58; 95% CI, 1.52-1.64). The increased mortality associated with these complications was higher in LMICs (58.5%) than in HICs (35.4%). After controlling for coagulopathy complications, treatment intensity, and multiple other factors, the mortality was higher among patients in LMICs than among patients in HICs (odds ratio, 1.45; 95% CI, 1.39-1.51). Conclusion: In a large, international registry of patients hospitalized for COVID-19, coagulopathy complications were more frequent in HICs than in LMICs (developing countries). Increased mortality associated with coagulopathy complications was of a greater magnitude among patients in LMICs. Additional research is needed regarding timely diagnosis of and intervention for coagulation derangements associated with COVID-19, particularly for limited-resource settings