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Study protocol: improving response to malaria in the Amazon through identification of inter-community networks and human mobility in border regions of Ecuador, Peru and Brazil

Por: Janko · M. M. · Araujo · A. L. · Ascencio · E. J. · Guedes · G. R. · Vasco · L. E. · Santos · R. O. · Damasceno · C. P. · Medrano · P. G. · Chacon-Uscamaita · P. R. · Gunderson · A. K. · OMalley · S. · Kansara · P. H. · Narvaez · M. B. · Coombes · C. · Pizzitutti · F. · Salmon-Mulano
Introduction

Understanding human mobility’s role in malaria transmission is critical to successful control and elimination. However, common approaches to measuring mobility are ill-equipped for remote regions such as the Amazon. This study develops a network survey to quantify the effect of community connectivity and mobility on malaria transmission.

Methods

We measure community connectivity across the study area using a respondent driven sampling design among key informants who are at least 18 years of age. 45 initial communities will be selected: 10 in Brazil, 10 in Ecuador and 25 in Peru. Participants will be recruited in each initial node and administered a survey to obtain data on each community’s mobility patterns. Survey responses will be ranked and the 2–3 most connected communities will then be selected and surveyed. This process will be repeated for a third round of data collection. Community network matrices will be linked with each country’s malaria surveillance system to test the effects of mobility on disease risk.

Ethics and dissemination

This study protocol has been approved by the institutional review boards of Duke University (USA), Universidad San Francisco de Quito (Ecuador), Universidad Peruana Cayetano Heredia (Peru) and Universidade Federal Minas Gerais (Brazil). Results will be disseminated in communities by the end of the study.

Scaling hypertension treatment in 24 low-income and middle-income countries: economic evaluation of treatment decisions at three blood pressure cut-points

Por: Hutchinson · B. · Walter · A. · Campbell · N. · Whelton · P. K. · Varghese · C. · Husain · M. J. · Nugent · R. · Kostova · D. · Honeycutt · A.
Objective

Estimate the incremental costs and benefits of scaling up hypertension care in adults in 24 select countries, using three different systolic blood pressure (SBP) treatment cut-off points—≥140, ≥150 and ≥160 mm Hg.

Intervention

Strengthening the hypertension care cascade compared with status quo levels, with pharmacological treatment administered at different cut-points depending on the scenario.

Target population

Adults aged 30+ in 24 low-income and middle-income countries spanning all world regions.

Perspective

Societal.

Time horizon

30 years.

Discount rate

4%.

Costing year

2020 USD.

Study design

Data sources

Institute for Health Metrics and Evaluation’s Epi Visualisations database—country-specific cardiovascular disease (CVD) incidence, prevalence and death rates. Mean SBP and prevalence—National surveys and NCD-RisC. Treatment protocols—WHO HEARTS. Treatment impact—academic literature. Costs—national and international databases.

Outcome measures

Health outcomes—averted stroke and myocardial infarction events, deaths and disability-adjusted life-years; economic outcomes—averted health expenditures, value of averted mortality and workplace productivity losses.

Results of analysis

Across 24 countries, over 30 years, incremental scale-up of hypertension care for adults with SBP≥140 mm Hg led to 2.6 million averted CVD events and 1.2 million averted deaths (7% of expected CVD deaths). 68% of benefits resulted from treating those with very high SBP (≥160 mm Hg). 10 of the 12 highest-income countries projected positive net benefits at one or more treatment cut-points, compared with 3 of the 12 lowest-income countries. Treating hypertension at SBP≥160 mm Hg maximised the net economic benefit in the lowest-income countries.

Limitations

The model only included a few hypertension-attributable diseases and did not account for comorbid risk factors. Modelled scenarios assumed ambitious progress on strengthening the care cascade.

Conclusions

In areas where economic considerations might play an outsized role, such as very low-income countries, prioritising treatment to populations with severe hypertension can maximise benefits net of economic costs.

Effects of a therapeutic lifestyle modification intervention on cardiometabolic health, sexual functioning and health-related quality of life in perimenopausal Chinese women: protocol for a randomised controlled trial

Por: Wang · Y. · Miao · X. · Viwattanakulvanid · P.
Introduction

Perimenopause is a critical transitional period in reproductive ageing. A set of physiological and psychological changes can affect perimenopausal women’s quality of life and further threaten their older adult health conditions. In China, less than one-third of midlife women with menopausal symptoms have actively sought professional healthcare. Regarding the public health significance of comprehensive menopause management, the current study aims to investigate the effects of a therapeutic lifestyle modification (TLM) intervention on cardiometabolic health, sexual functioning and health-related quality of life among perimenopausal Chinese women.

Method and analysis

A randomised controlled trial with two parallel arms will be conducted at the gynaecology outpatient department of Yunnan Provincial Hospital of Traditional Chinese Medicine in China. 94 eligible perimenopausal women aged between 40 and 55 years will be recruited for the study. The TLM intervention consists of four elements: menopause-related health education, dietary guidance, pelvic floor muscle training and Bafa Wubu Tai Chi exercise. Participants will be randomly assigned (1:1) to receive either the 12-week TLM intervention or routine care via stratified blocked randomisation. The primary outcome is quality of life; secondary outcomes of interest include sexual functioning and cardiometabolic health. The outcome measures will be assessed at baseline and post-intervention. To explore the effects of the intervention, linear mixed models will be applied to test the changes between the two groups over time in each outcome based on an intention-to-treat analysis.

Ethics and dissemination

The Research Ethics Review Committee of Chulalongkorn University (COA No 178/66) and the Medical Ethics Committee of Yunnan Provincial Hospital of Traditional Chinese Medicine (IRB-AF-027-2022/02-02) approved the study protocol. Written informed consent will be obtained from all participants. Results will be published in peer-reviewed journals and disseminated through conferences.

Trial registration number

ChiCTR2300070648.

Systematic RADaR analysis of responses to the open-ended question in the Culture of Care Barometer survey of a Dutch hospital

Objectives

Systematically measuring the work environment of healthcare employees is key to continuously improving the quality of care and addressing staff shortages. In this study, we systematically analyse the responses to the one open-ended question posed in the Dutch version of the Culture of Care Barometer (CoCB-NL) to examine (1) if the responses offered new insights into healthcare employees’ perceptions of their work environment and (2) if the original CoCB had any themes missing.

Design

Retrospective text analysis using Rigorous and Accelerated Data Reduction technique.

Setting

University hospital in the Netherlands using the CoCB-NL as part of the annual employee survey.

Participants

All hospital employees were invited to participate in the study (N=14 671). In total, 2287 employees responded to the open-ended question.

Results

2287 comments were analysed. Comments that contained more than one topic were split according to topic, adding to the total (n=2915). Of this total, 372 comments were excluded because they lacked content or respondents indicated they had nothing to add. Subsequently, 2543 comments were allocated to 33 themes. Most comments (n=2113) addressed the 24 themes related to the close-ended questions in the CoCB-NL. The themes most commented on concerned questions on ‘organisational support’. The remaining 430 comments covered nine additional themes that addressed concerns about work environment factors (team connectedness, team effectiveness, corporate vision, administrative burden and performance pressure) and themes (diversity and inclusion, legal frameworks and collective bargaining, resilience and work–life balance, and personal matters).

Conclusions

Analysing responses to the open-ended question in the CoCB-NL led to new insights into relevant elements of the work environment and missing themes in the COCB-NL. Moreover, the analysis revealed important themes that not only require attention from healthcare organisations to ensure adequate improvements in their employees’ work environment but should also be considered to further develop the CoCB-NL.

The N-LVA Study: effectiveness and cost-effectiveness of lymphaticovenous anastomosis (LVA) for patients with cancer who suffer from chronic peripheral lymphoedema - study protocol of a multicentre, randomised sham-controlled trial

Por: Kleeven · A. · Jonis · Y. M. J. · Tielemans · H. · van Kuijk · S. · Kimman · M. · van der Hulst · R. · Vasilic · D. · Hummelink · S. · Qiu · S. S.
Introduction

Cancer-related lymphoedema is one of the most debilitating side-effects of cancer treatment with an overall incidence of 15.5%. Patients may suffer from a variety of symptoms, possibly resulting in a diminished health-related quality of life (HRQoL). A microsurgical technique known as lymphaticovenous anastomosis (LVA) might be a promising treatment option. The objective of this study is to evaluate whether LVA is effective and cost-effective compared with sham surgery in improving the HRQoL.

Methods and analysis

A multicentre, double-blind, randomised sham-controlled trial conducted in three university hospitals in the Netherlands. The study population comprises 110 patients over the age of 18 years with unilateral, peripheral cancer-related lymphoedema, including 70 patients with upper limb lymphoedema and 40 patients with lower limb lymphoedema. A total of 55 patients will undergo the LVA operation, while the remaining 55 will undergo sham surgery. The follow-up will be at least 24 months. Patients are encouraged to complete the follow-up by explaining the importance of the study. Furthermore, patients may benefit from regular monitoring moments for their lymphoedema. The primary outcome is the HRQoL. The secondary outcomes are the limb circumference, excess limb volume, changes in conservative therapy, postoperative complications, patency of the LVA and incremental cost-effectiveness.

Ethics and dissemination

The study was approved by the Medical Ethical Committee of Maastricht University Medical Center on 20 September 2023 (NL84169.068.23). The results will be presented at scientific conferences and published in peer-reviewed medical journals.

Trial registration number

NCT06082349.

The role of orthobiologics in chronic wound healing

Abstract

Chronic wounds, characterized by prolonged healing processes, pose a significant medical challenge with multifaceted aetiologies, including local and systemic factors. Here, it explores the complex pathogenesis of chronic wounds, emphasizing the disruption in the normal phases of wound healing, particularly the inflammatory phase, leading to an imbalance in extracellular matrix (ECM) dynamics and persistent inflammation. Senescent cell populations further contribute to impaired wound healing in chronic lesions. Traditional medical management focuses on addressing underlying causes, but many chronic wounds resist to conventional treatments, necessitating innovative approaches. Recent attention has turned to autologous orthobiologics, such as platelet-rich plasma (PRP), platelet-rich fibrin (PRF) and mesenchymal stem cells (MSCs), as potential regenerative interventions. These biologically derived materials, including bone marrow aspirate/concentrate (BMA/BMAC) and adipose tissue-derived stem cells (ADSCs), exhibit promising cytokine content and regenerative potential. MSCs, in particular, have emerged as key players in wound healing, influencing inflammation and promoting tissue regeneration. This paper reviews relevant scientific literature regarding basic science and brings real-world evidence regarding the use of orthobiologics in the treatment of chronic wounds, irrespective of aetiology. The discussion highlights the regenerative properties of PRP, PRF, BMA, BMAC and SVF, showcasing their potential to enhance wound healing. Despite advancements, further research is essential to elucidate the specific roles of each orthobiologic and determine optimal applications for different wound types. The conclusion underscores the evolving landscape in chronic wound management, with a call for more comprehensive studies to refine treatment strategies and maximize the benefits of regenerative medicine.

Association of antibiotic duration and all-cause mortality in a prospective study of patients with ventilator-associated pneumonia in a tertiary-level critical care unit in Southern India

Por: Stanley · N. D. · Jeevan · J. A. · Yadav · B. · Gunasekaran · K. · Pichamuthu · K. · Chandiraseharan · V. K. · Sathyendra · S. · Hansdak · S. G. · Iyyadurai · R.
Objectives

To estimate all-cause mortality in ventilator-associated pneumonia (VAP) and determine whether antibiotic duration beyond 8 days is associated with reduction in all-cause mortality in patients admitted with VAP in the intensive care unit.

Design

A prospective cohort study of patients diagnosed with VAP based on the National Healthcare Safety Network definition and clinical criteria.

Setting

Single tertiary care hospital in Southern India.

Participants

100 consecutive adult patients diagnosed with VAP were followed up for 28 days postdiagnosis or until discharge.

Outcome measures

The incidence of mortality at 28 days postdiagnosis was measured. Tests for association and predictors of mortality were determined using 2 test and multivariate Cox regression analysis. Secondary outcomes included baseline clinical parameters such as age, underlying comorbidities as well as measuring total length of stay, number of ventilator-free days and antibiotic-free days.

Results

The overall case fatality rate due to VAP was 46%. There was no statistically significant difference in mortality rates between those receiving shorter antibiotic duration (5–8 days) and those on longer therapy. Among those who survived until day 9, the observed risk difference was 15.1% between both groups, with an HR of 1.057 (95% CI 0.26 to 4.28). In 70.4% of isolates, non-fermenting Gram-negative bacilli were identified, of which the most common pathogen isolated was Acinetobacter baumannii (62%).

Conclusion

In this hospital-based cohort study, there is insufficient evidence to suggest that prolonging antibiotic duration beyond 8 days in patients with VAP improves survival.

Robustness of radiomic features in <sup>123</sup>I-ioflupane-dopamine transporter single-photon emission computer tomography scan

by Viktor Laskov, David Rothbauer, Hana Malikova

Radiomic features are usually used to predict target variables such as the absence or presence of a disease, treatment response, or time to symptom progression. One of the potential clinical applications is in patients with Parkinson’s disease. Robust radiomic features for this specific imaging method have not yet been identified, which is necessary for proper feature selection. Thus, we are assessing the robustness of radiomic features in dopamine transporter imaging (DaT). For this study, we made an anthropomorphic head phantom with tissue heterogeneity using a personal 3D printer (polylactide 82% infill); the bone was subsequently reproduced with plaster. A surgical cotton ball with radiotracer (123I-ioflupane) was inserted. Scans were performed on the two-detector hybrid camera with acquisition parameters corresponding to international guidelines for DaT single photon emission tomography (SPECT). Reconstruction of SPECT was performed on a clinical workstation with iterative algorithms. Open-source LifeX software was used to extract 134 radiomic features. Statistical analysis was made in RStudio using the intraclass correlation coefficient (ICC) and coefficient of variation (COV). Overall, radiomic features in different reconstruction parameters showed a moderate reproducibility rate (ICC = 0.636, p 0.9, p

Using interoperable nursing care data to improve outcomes for multiple traumas patients with Impaired Physical Mobility

Abstract

Aim(s)

To demonstrate how interoperable nursing care data can be used by nurses to create a more holistic understanding of the healthcare needs of multiple traumas patients with Impaired Physical Mobility. By proposing and validating linkages for the nursing diagnosis of Impaired Physical Mobility in multiple trauma patients by mapping to the Nursing Outcomes Classification (NOC) and Nursing Interventions Classification (NIC) equivalent terms using free-text nursing documentation.

Design

A descriptive cross-sectional design, combining quantitative analysis of interoperable data sets and the Kappa's coefficient score with qualitative insights from cross-mapping methodology and nursing professionals' consensus.

Methods

Cross-mapping methodology was conducted in a Brazilian Level 1 Trauma Center using de-identified records of adult patients with a confirmed medical diagnosis of multiple traumas and Impaired Physical Mobility (a nursing diagnosis). The hospital nursing free-text records were mapped to NANDA-I, NIC, NOC and NNN linkages were identified. The data records were retrieved for admissions from September to October 2020 and involved medical and nursing records. Three expert nurses evaluated the cross-mapping and linkage results using a 4-point Likert-type scale and Kappa's coefficient.

Results

The de-identified records of 44 patients were evaluated and then were mapped to three NOCs related to nurses care planning: (0001) Endurance; (0204) Immobility Consequences: Physiological, and (0208) Mobility and 13 interventions and 32 interrelated activities: (6486) Environmental Management: Safety; (0840) Positioning; (3200) Aspiration Precautions; (1400) Pain Management; (0940) Traction/Immobilization Care; (3540) Pressure Ulcer Prevention; (3584) Skincare: Topical Treatment; (1100) Nutrition Management; (3660) Wound Care; (1804) Self-Care Assistance: Toileting; (1801) Self-Care Assistance: Bathing/Hygiene; (4130) Fluid Monitoring; and (4200) Intravenous Therapy. The final version of the constructed NNN Linkages identified 37 NOCs and 41 NICs.

Conclusion

These valid NNN linkages for patients with multiple traumas can serve as a valuable resource that enables nurses, who face multiple time constraints, to make informed decisions efficiently. This approach of using evidence-based linkages like the one developed in this research holds high potential for improving patient's safety and outcomes.

No Patient or Public Contribution

In this study, there was no direct involvement of patients, service users, caregivers or public members in the design, conduct, analysis and interpretation of data or preparation of the manuscript. The study focused solely on analysing existing de-identified medical and nursing records to propose and validate linkages for nursing diagnoses.

Adherence to pharmacological therapy in patients with hypertension: protocol of a qualitative study by focus groups

Por: Rosendo-Silva · B. · Prazeres · F. · Santiago · L. M. · Rosendo · I.
Introduction

Non-adherence to antihypertensive medication significantly contributes to inadequate blood pressure control. Regarding non-pharmacological interventions to improve medication adherence, the question remains of which interventions yield the highest efficacy.

Understanding the complementary perspectives of patients and healthcare professionals can be valuable for designing strategies to enhance medication adherence. Few studies explored the perspectives of patients and healthcare professionals regarding medication adherence. None of them focused specifically on adherence to pharmacological therapy for hypertension in Portugal.

Considering the high prevalence of non-adherence and its location-specific aspects, the priority should be identifying its barriers and developing tactics to address them.

This study aims to gather the perspectives of patients with hypertension and healthcare professionals such as family doctors, nurses and community pharmacists from Portugal, regarding the most effective strategies to enhance antihypertensive medication adherence and to understand the factors contributing to non-adherence.

Methods and analyses

We will conduct qualitative research through synchronous online focus groups of 6–10 participants. Some groups will involve patients with hypertension, while others will include family doctors, nurses and community pharmacists. The number of focus groups will depend on the achievement of theoretical saturation. A purposive sample will be used. Healthcare participants will be recruited via email, while patients will be recruited through their family doctors.

The moderator will maintain neutrality while ensuring interactive contributions from every participant. Participants will be encouraged to express their opinions on the meeting summary. Meetings will be recorded and transcribed.

Two researchers will perform content analyses using MAXQDA V.12 through comparative analyses and subsequent consensus. A third researcher will review the analyses. The results will be presented narratively.

Ethics and dissemination

The Ethics Committee of the University of Coimbra has approved this study with the number: CE-026/2021. The results will be disseminated via peer-reviewed publications and national and international conferences.

Creencias sobre prácticas de alimentación y obesidad de madres con hijos menores de 5 años del noroeste de México

Introducción: Existe una tendencia mundial de incremento en los índices de sobrepeso y obesidad en niños menores de 5 años. Las creencias, percepciones y actitudes de las madres hacia las prácticas de alimentación y la obesidad tienen implicaciones directas sobre la salud del hijo. Objetivo: Explorar creencias sobre prácticas de alimentación y obesidad infantil entre madres con hijos menores de cinco años del noroeste de México. Metodología: Estudio cualitativo de aproximación etnográfica. Mediante un muestreo propositivo se realizaron nueve entrevistas semiestructuradas a mujeres que contaban con un promedio de 12 años de educación. Resultados: Las creencias incluyeron inseguridad para asumir el rol de madre, una baja percepción de apoyo familiar y creencias que no se alineaban con las recomendaciones de la lactancia materna exclusiva e introducción de alimentos complementarios. Además, estas tenían la creencia de que la obesidad no es un problema debido a la corta edad de sus hijos. Conclusiones: Existe una ambivalencia entre las creencias de las participantes y sus prácticas con relación a la alimentación y la obesidad infantil. Es imperativo desarrollar estrategias de educación y comunicación que proporcionen información basada en evidencia, de fácil acceso y disponible para madres con la intención de prevenir problemas de nutrición durante la primera infancia.

Espiritualidad, vocación y sentido. Recursos generales de resistencia para profesionales de enfermería según la figura de San Juan de Dios

Este artículo tiene como objetivo elaborar una reflexión hacia aquellos elementos que actuaron como recursos espirituales en el proceso de formación de San Juan de Dios como enfermero y elaborar una serie de aportaciones actuales para reforzar el sentido de coherencia de las enfermeras post pandemia. Se utilizó la metodología historiográfica aplicada a historia de la enfermería para la reconstrucción de la memoria profesional, tomando como referencia y ejemplo la figura de San Juan de Dios y se recogieron los elementos siguiendo la herramienta de valoración espiritual FICA. Los textos muestran a Juan de Dios con un sentido de coherencia interna que se hizo posible a través de los recursos psico-espirituales de la época. Éstos facilitaron encontrar y desarrollar la vocación propia y la motivación para desarrollarla y alcanzar la autorrealización. La propuesta es contemplar en la profesionalización enfermera un cuidado por paraklesis, que implica presencia personal, actitud dialogal y palabra sapiencial, luminosa y alentadora siguiendo el modelo de San Juan de Dios, y su relación con el modelo de valoración espiritual FICA.

Comunidad compasiva para la inclusión social y calidad de vida de las personas con esclerosis múltiple y sus cuidadores familiares

Objetivo: Evaluar cualitativamente la experiencia de pacientes con esclerosis múltiple (PEM) y cuidadores familiares (CFPEM) vinculados al programa de esclerosis múltiple del Hospital Universitario Nacional de Colombia (PrEM-HUNC), durante la formación y consolidación de una comunidad compasiva (CC), para la inclusión social y promoción de calidad de vida. Materiales y Método: estudio cualitativo interpretativo, con entrevistas a profundidad a nueve colaboradores. Con el método de análisis de espiral de Creswell y Poth, emergieron cuatro categorías y un tema. Resultados: el tema “Un nido comunitario de crecimiento y transformación” señala el proceso de conformación de la CC como una experiencia que posibilitó cambios de significados en torno a la enfermedad, la situación personal y familiar; revela un proceso de descubrimiento y aprendizaje de conformación de diferentes relaciones y roles. Conclusiones: La CC es una opción para construcción de redes de apoyo, fortalecimiento de las capacidades personales y familiares, una forma para hacer frente a los diferentes impactos y retos que implica vivir con esclerosis múltiple, se constituye en una alternativa para la promoción de la calidad de vida y la inclusión social.

Necesidades humanas básicas en gestantes con alto riesgo obstétrico analizado bajo la Teoría de Wanda Horta

Objetivo: identificar las necesidades humanas básicas de las embarazadas de alto riesgo hospitalizadas con base en la Teoría de Wanda Horta. Método: investigación asistencial realizada con dieciséis gestantes de alto riesgo hospitalizadas en una maternidad de referencia en Ceará entre septiembre y noviembre de 2019. Se recolectó información a través de diario de campo y ficha de caracterización de las gestantes y registros de necesidades humanas básicas. Los resultados se analizaron mediante estadística descriptiva simple y un enfoque integral a la luz del marco de Wanda Horta. Resultados: las gestantes presentaron necesidades psicobiológicas, psicosociales y psicoespirituales, siendo prevalentes: ausencia de actividades de ocio, inseguridad emocional, escaso conocimiento, sueño y descanso perjudicados, y actividades físicas restringidas por indicación de descanso. Consideraciones finales: se cree que el razonamiento crítico y el juicio clínico de los enfermeros se centraron en la individualidad de las gestantes, identificando necesidades en los tres niveles propuestos por la teoría, apuntando caminos para cualificar el cuidado de enfermería a las gestantes de alto riesgo.

Experiencias de las enfermeras en primera línea contagiadas con COVID-19 que recibieron atención domiciliaria

Introducción: Las enfermeras han brindado cuidados a los pacientes con COVID-19, y muchas tuvieron que lidiar con este virus al ser infectadas. Objetivo: Describir las experiencias de las enfermeras en primera línea contagiadas con COVID-19 que recibieron atención domiciliaria. Método: Investigación cualitativa descriptiva, el tamaño de la muestra fue con 12 enfermeras infectadas con COVID-19 que recibieron tratamiento domiciliario en Chiclayo, Perú. El muestreo fue por la técnica de bola de nieve. Para recolectar los datos se utilizó la entrevista semiestructurada a través de los medios virtuales previo consentimiento informado. Resultados: Surgieron tres categorías: a) Incertidumbre ante modo de contagio, medios de diagnóstico, sintomatología y evolución por la COVID-19, b) Cuidados recuperativos en el hogar: tratamiento médico, uso de medicina tradicional y medidas de bioseguridad, y c) Impacto en la vida familiar, laboral, social, emocional y espiritual al sufrir de la COVID-19. Conclusiones: Las enfermeras presentaron síntomas leves de la COVID-19 y se recuperaron en su domicilio, cumplieron con el tratamiento médico, algunas usaron remedios caseros. Practicaron estrictamente las medidas de bioseguridad para evitar que su familia se contagie. Utilizaron la tecnología digital y reforzaron su fe para afrontar el impacto familiar, emocional y social.

La labor del Protomedicato en la salud pública en el virreinato del Perú

El objetivo de la presente investigación es conocer el papel que cumplió el Protomedicato en la salud publica en el virreinato del Perú. La metodología utilizada fue la narración histórica siguiendo el método heurístico y hermenéutico, utilizando fuentes primarias documentales de archivos históricos peruanos y españoles. El resultado obtenido fue confirmar que el Protomedicato veló por la salud de los vecinos y que tenía carácter administrativo judicial y sus funciones principales fueron regularizar la labor de los que ejercieran cualquier tipo de atención sanitaria, otorgando licencias, fijando aranceles y vigilando el trabajo realizado en las boticas y la calidad de los medicamentos, a través de visitas periódicas. La conclusión determina que hubo mejoras sanitarias como consecuencia de la gestión del Protomedicato en el virreinato del Perú, proponiendo medidas salubres e, incluso, disponía la movilización de personal médico a través del virreinato y participaba ante cualquier consulta de otras entidades coloniales, como el cabildo, referentes a salud pública, como eliminación de acequias, declaración de pestes, y otros.

Pérdida significativa como factor del alcoholismo

La relación de la pérdida significativa de un ser querido y el alcoholismo ha minimizado las implicaciones sobre mecanismos de afrontamientos para generar conductas saludables. Este artículo se basa en entrevistas semiestructuradas a profundidad en hombres de entre 30 y 70 años, con más de 10 años en Alcohólicos Anónimos del Estado de Tamaulipas, México. El objetivo fue reflexionar sobre los significados de la pérdida significativa de un ser querido y el alcoholismo. En la búsqueda del significado, se explica que un factor que lleva al alcoholismo no es una sola pérdida significativa de personas queridas, sino un cúmulo también de pérdidas materiales y no materiales, se reflejaron recursos limitados para afrontar las pérdidas, la relación entre la pérdida significativa con el alcoholismo fue mediado por dos principales aspectos, las creencias sobre los efectos que produce el consumo de alcohol como formas de escapar de la realidad y las influencia de la familia al inicio del consumo de alcohol. Por otra parte, la presencia de lo espiritual, la conciencia y las emociones que experimentan durante su proceso de duelo y alcoholismo, los llevó a identificar el problema de la adicción, que permitió influir en el proceso de rehabilitación.

La psiquiatría del primer franquismo: una historia del olvido de la salud mental

En esta investigación presentamos una aproximación al cambio de mentalidad respecto a la enfermedad mental propugnada desde las obras de psiquiatras del primer franquismo como Antonio Vallejo-Nágera o Juan José López Ibor. Sus ideas, publicaciones e investigaciones ofrecieron al régimen la posibilidad de modificar las listas de internos e internas de las instituciones psiquiátricas del momento, cuyas camas comenzaron a ser ocupadas por personas procedentes de las cárceles, los hospitales militares o las calles, con el fin de someterlas a tratamientos y medicaciones para modificar unos comportamientos y actitudes señaladas por el saber psiquiátrico franquista como apartadas de lo “correcto” y “normal”.

Necesidades de cuidado en la persona consumidora de alcohol en un contexto hospitalario

Introducción: El consumo de alcohol es considerado uno de los transcendentales factores de riesgo de discapacidad y muerte prematura. Develar el sentido de la experiencia de la persona consumidora de alcohol en cuanto a las necesidades de cuidado en el contexto hospitalario e incentiva que enfermería brinde un cuidado humano. Objetivo: Comprender las necesidades de cuidado de una persona consumidora de alcohol durante la estancia hospitalaria. Método: Investigación cualitativa fenomenológica. Muestreo por conveniencia, participaron 07 hombres y 02 mujeres que consumen alcohol e ingresaron al hospital. Para recolectar los datos se utilizó una entrevista fenomenológica, previo consentimiento informado. El análisis se realizó mediante el círculo hermenéutico de Martin Heidegger. Resultados: Fueron develadas cinco categorías: 1) Necesidades físicas ante deterioro corporal, 2) Necesidades emocionales y de apoyo con traspaso de energía para vivir, 3) Necesidades de confort humano dentro de la hospitalización, 4) Agradecimiento verbalizado y escrito ante acompañamiento y preocupación, 5) Anhelos de ser cuidado como persona. Conclusiones: Enfermería se encuentra con un ser vulnerable que muestra necesidades físicas debilitadas, necesidades emocionales que requieren apoyo y confort humano, un ser que anhela y agradece al ser enfermera.

Salud Mental en enfermeras al cuidado de pacientes en área COVID: estudio de caso

La enfermería es la labor que abarca la atención autónoma a personas de todas las edades, familias, grupos y comunidades, la principal característica y esencia es el cuidado, implica establecer una relación de comprensión y acompañamiento de manera integral, convirtiéndolos en los principales cuidadores formales en la asistencia, lo que pone de manifiesto la necesidad de mirar su salud mental y bienestar del personal de enfermería. El objetivo fue describir el impacto en la salud mental de un profesional de la enfermería en la atención a pacientes del área COVID en tiempos de pandemia, en el periodo 2022-2023. Se realizó un estudio cualitativo, primero mediante el análisis documental y posteriormente mediante el método fenomenológico, descriptivo con base en el estudio de caso, considerando la temporalidad en tres momentos, antes, durante y después de la pandemia por COVID. Los hallazgos dan constancia, de cambios e impactos a nivel biológico, psicológico, social y espiritual que derivan en afectaciones en salud mental que se experimentaron, y, por otro lado, de la escasez acciones para dotar a los profesionales de la salud de un acompañamiento, capacitación y sensibilización en salud mental para la mejora de su labor y bienestar personal.

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