FreshRSS

🔒
❌ Acerca de FreshRSS
Hay nuevos artículos disponibles. Pincha para refrescar la página.
AnteayerTus fuentes RSS

Population-based otoscopic and audiometric assessment of a birth cohort recruited for a pneumococcal vaccine trial 15-18 years earlier: a protocol

Por: Chan · K. · Carosone-Link · P. · Bautista · M. T. G. · Sanvictores · D. · Uhler · K. · Tallo · V. · Lucero · M. G. · De Jesus · J. · Simoes · E. A. F.
Introduction

A cohort of 12 000 children in the Philippines who had enrolled in a 2000–2004 (current ages 16 to 20 years) Phase 3 11-valent pneumococcal conjugate vaccine for the prevention of radiographically confirmed pneumonia are now being asked to participate in a separate study (expected completion date September 2021) to assess the cohort’s current long-term audiometric and otologic status. This new study would allow assessments of the utility of the pneumococcal vaccine in conferring its protective effects on the long-term sequelae of otitis media (OM), if any. Lack of trained local healthcare providers in otolaryngology/audiology and testing equipment in Bohol, Philippines, necessitates the development of a distinct methodology that would lead to meaningful data analysis.

Methods and analysis

Reliable data collection and transfer are achieved by a US otolaryngologist/audiologist team training local nurses on all procedures in a didactic and hands-on process. An assortment of portable otolaryngologic and audiologic equipment suitable for field testing has been acquired, including an operating otoscope (Welch-Allyn), a video-otoscope (JedMed), a tympanometer with distortion product otoacoustic emission measurements (Path Sentiero) and a screening audiometer (HearScreen). Data will then be uploaded to a Research Electronic Data Capture database in the USA.

Tympanometric and audiologic data will be codified through separate conventional algorithms. A team of paediatric otolaryngology advanced practice providers (APPs) have been trained and validated in interpreting video otoscopy. The protocol for classification of diagnostic outcome variables based on video otoscopy and tympanometry has been developed and is being used by APPs to evaluate all otoscopy data.

Ethics and dissemination

The study was approved by the Research Institute of Tropical Medicine, Alabang, Manila, Philippines, and the institutional review board and the Colorado Multiple Institutional Review Board of the University of Colorado School of Medicine, Aurora, Colorado, USA.

Research results will be made available to children and their caregivers with abnormal audiologic outcomes, the funders and other researchers.

Trial registration number

ISRCTN 62323832; Post-results.

Desarrollo de la simulación clínica en un centro de Boston

La simulación Clínica está en auge en los últimos tiempos, aunque hay estudios que acreditan su eficacia todavía falta trabajo para defenderla científicamente. No obstante, muchos hospitales y sobre todo universidades han apostado por esta metodología innovadora por el impacto positivo que tiene en los participantes a la hora de adquirir los conocimientos. Pero como toda metodología tienes sus luces y sus sombras, en el este relato presentamos la experiencia de Charles Pozner, director médico del centro de simulación Stratus vinculado a un hospital universitario de la escuela de medicina de Harvard, para que con comparta su experiencia en la creación de uno de los centros de simulación pioneros y más importantes. A través de diferentes entrevistas hemos sintetizado en el presente relato bibliográfico su opinión sobre el pasado y futuro de la simulación, así como las dificultades y los retos que se ha encontrado para llevar a cabo este apasionante proyecto.

Experience of Perinatal Death From the Father’s Perspective

imageBackground Although perinatal deaths are still a common pregnancy outcome in developing countries, little is known about the effect perinatal death has on fathers. Objective The aim of the study was to understand and describe the meaning of perinatal death in a sample of fathers from northeastern Colombia. Methods Using purposive and snowball sampling approaches, we identified 15 participants from northeastern Colombia who agreed to participate. We used a descriptive phenomenological design. Data were collected through in-depth, semistructured interviews. Results Men suffer in solitude and hide their emotions as they feel the need to be the main supporters of their partners. Three major themes emerged: experience of loss, coming to terms with an irreparable loss, and overcoming the loss. Discussion While women are receiving care, health staff may neglect or forget men. Men suffer alone while seeking ways of attunement with their partners’ emotions to support them during the grieving process. Fathers can overcome and adjust to the loss when they transcend it and find new meaning. Men felt neglected and marginalized at hospitals while their partners were receiving treatment. Health professionals should recognize and acknowledge the pain of fathers who face perinatal death and include them as much as possible in the standard of care. The results identify opportunities for healthcare providers in clinical and outpatient settings to acknowledge the importance of men within the context of pregnancy and to learn about their pain and suffering when they face a perinatal death.

Patrones culturales de cuidado familiar al adulto mayor en condición de discapacidad y pobreza

Objetivo: describir los patrones de cuidado familiar con adultos mayores en condición de discapacidad y pobreza de tres grupos culturalmente diversos en Colombia. Metodología: estudio cualitativo de análisis de datos secundarios basado en 35 documentos recopilados entre el 2007 al 2016. El material fue organizado en el programa N-Vivo. El análisis siguió las cuatro fases propuestas por Leininger. Resultados principales: el patrón cultural “Cuidar entre sufrimiento, generosidad y agradecimiento” evidencia el intenso sufrimiento del cuidador por “verlo así” a la situación del adulto mayor por los tres grupos colombianos, la tensión emocional para el cuidador y el sistema de creencias que moviliza el cuidador para ofrecer cuidado,  la constante tensión emocional para evitarle complicaciones en un entorno de exiguos recursos, así como, la gratitud del adulto mayor. Conclusión: el patrón familiar de los tres grupos en Colombia está determinado por el significado atribuido a la situación del adulto mayor y los valores, expectativas y sentimientos de obligación y reciprocidad que mueven a dar y recibir el cuidado. Sin embargo, el contexto de desprotección social debe ser considerado en la atención a éste tipo de población.

❌