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Objetivo: Describir los cuidados de enfermería en la zona centro de Chile luego de la formación del Subdepartamento de Enfermería del Servicio Nacional de Salud (SNS) en el año 1955.
Metodología: Método histórico. Las fuentes primarias son relatos de vida de enfermeras, que se construyeron como crónica, combinadas con fuentes secundarias documentales, que dieron contexto desde 3 ángulos: la autoridad del estado, el colectivo de enfermeras y escritos personales de enfermeras líderes del periodo.
Resultados: Se organizaron 3 categorías: la política pública de los servicios de enfermería del SNS, el desarrollo de los cuidados de enfermería en las unidades sanitarias y en las unidades hospitalarias. En la primera categoría, destaca que para enfermería, este periodo constituyó una sinergia entre la política pública y la consolidación de su profesionalización, dentro del inicio del proceso de descentralización y escasez de enfermeras. En la segunda categoría, en las unidades sanitarias, enfocadas en la prevención, los cuidados de enfermería se caracterizaron por la atención en consultorios y comunidades, especialmente a recién nacidos y sus madres, en contexto de pobreza. En la tercera categoría, en los hospitales de baja y alta complejidad, la prioridad era la población infantil, afectada por desnutrición y enfermedades infectocontagiosas. Los cuidados de enfermería abordaban funciones asistenciales, de gestión y educación, además de actividades del rol médico cuando no existía otro recurso.
Conclusiones: Enmarcado en el SNS, el Subdepartamento de Enfermería fue una estructura que permitía a las enfermeras profesionales sistematizar el quehacer desde la prevención, promoción y curación de la salud, en servicios hospitalarios y comunitarios. Destaca la escasez de las enfermeras, el inicio del proceso de descentralización y el rigor y profesionalismo histórico de la enfermería chilena. Es necesario seguir profundizando en investigaciones que revelen la memoria de las enfermeras chilenas de este tiempo.
Glial fibrillar acidic protein (GFAP) and ubiquitin carboxy-terminal hydrolase L1 (UCH-L1) have been shown to rule out CT-detectable intracranial lesions in patients with mild traumatic brain injury (mTBI) when assessed within the first 12 hours after injury. These biomarkers have been validated across different laboratory-based and point-of-care testing platforms. The combined biomarker test has been incorporated into several mTBI management algorithms in Europe. However, data regarding its real-world application, including patients with neurological comorbidities and its impact on reducing CT utilisation or emergency department (ED) length of stay, are lacking. This study will evaluate the performance of an automated laboratory-based assay for serum GFAP and UCH-L1 when integrated into a standardised clinical pathway for the diagnostic management of patients with mTBI. In addition, the study will assess its potential value in reducing CT scan prescription and ED time.
This single-centre observational study, with prospective data collection before and after the implementation of a combined test measuring GFAP and UCH-L1 in the clinical laboratory, will be conducted at Hospital Universitario 12 de Octubre, Madrid, Spain. Patients with clinically defined mTBI will be managed according to a newly implemented clinical pathway including biomarker testing. mTBI will be defined using predefined clinical criteria including a plausible traumatic mechanism, Glasgow Coma Scale score 13–15 assessed 30 min or more after injury, and compatible signs and/or symptoms of brain injury. Eligible patients must undergo blood sampling within 12 hours of injury and before imaging prescription. The effectiveness of this management approach will be compared with a previously established cohort of patients, prospectively enrolled under identical inclusion and exclusion criteria. A cohort of 1000 patients with mTBI, in whom biomarker testing was used in their management, will be included in the post implementation group. The pre-implementation cohort will be drawn from a comparable time period. The primary outcome measures are: the diagnostic performance of GFAP and UCH-L1, measured using an automated assay, for discriminating between patients with positive and negative findings on brain CT scans; the safety of the new clinical pathway in terms of complications such as unexpected surgery or deterioration, as well as the reduction in CT use after the implementation. Secondary objectives will be reduction in ED times and direct costs, as well as physicians’ compliance with the algorithms.
The study was reviewed by the Institutional Research Committee of Hospital 12 de Octubre, Madrid, Spain (Ref TP25/0144) and deemed exempt from formal ethical approval and informed consent requirements. This study’s results will be presented at national and international meetings, including meetings of patient associations, and published in peer-reviewed journals.
by Wen-Jui Han, Johanna Carrasco Saravia, Matthias Pollmann-Schult, Tinh Doan, Jianghong Li
Study aimsUsing a cross-country lens, we investigate the links between longitudinal work trajectories and health among parents with children under age 18.
BackgroundEmployment serves as a valuable resource, affording us a decent standard of living. The rising dominance of digital and technology, together with the service economy since the 1980s, has transformed the utility of employment from a resource to a vulnerability, subjecting more families to uncertain, unstable, and insecure work. Nonstandard work schedules or shiftwork, which often fall outside regular 9-to-5 daytime hours and can be unpredictable, carry potential health consequences.
MethodsUsing the longitudinal data from Australia (HILDA), Germany (SOEP), the UK (UKHLS), and the US (NLSY79), we used sequence analysis to first chart parental work schedule patterns between three stages of the life course, 25–34, 35–44, and 45–54, to show the changes and transitions in work patterns. We then conducted multivariate regression analysis to examine how variations in parental work patterns may shape individual health (i.e., physical and mental health) at ages 35/40, 45/50, and 55/60 while controlling for a rich set of sociodemographic characteristics.
ResultsOur sequence analyses uncovered roughly 4–6 work patterns during those three periods, revealing the heterogeneities of parental work trajectories that might correspond to childrearing demands and their sociodemographic backgrounds. We also found that mainly not-working pattern or volatile work arrangements (e.g., switching between daytime and non-daytime hours) were associated with significantly poorer physical and mental health; however, the persistence and magnitude of these associations varied by country.
ConclusionsThis study advances our understanding of the critical role of employment in our health from a cross-country perspective and bears important implications for the intergenerational transmission of employment and health vulnerabilities.
Objetivo principal: Describir los conocimientos, actitudes y prácticas sobre el autoexamen de mamas en mujeres de una zona rural. Metodología: Estudio cuantitativo de diseño no experimental, descriptivo, transversal. La muestra fue de 139 mujeres que viven en una zona rural en Lambayeque-Perú. Para la recolección de datos se empleó un cuestionario adaptado, validado por juicio de expertos y con α de Cronbach 0,88. Los datos fueron procesados y analizados mediante el uso del programa SPSS versión 25. Resultados principales: Se encontró que el 94,96% desconocen sobre el autoexamen de mamas, 93,6% de las participantes tienen actitud positiva para realizarlo, sin embargo, el 64,7% nunca se lo ha realizado. Conclusión principal: Las mujeres del estudio presentan conocimientos incorrectos sobre el autoexamen de mamas, una actitud positiva hacia esta técnica, pero una práctica inadecuada. Es necesario ampliar las coberturas y estrategias educativas en salud para que esta población conozca y practique el autoexamen de mama.
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