Conectar
by Izabel Alves das Chagas Valóta, Rafael Rodrigo da Silva Pimentel, Ana Paula Neroni Stina Saura, Rodrigo Marques da Silva, Ana Lucia Siqueira Costa Calache, Marcelo José dos Santos
The aim of this study was to analyze levels of fatigue and resilience of Brazilian graduate students during the COVID-19 pandemic and to determine whether there is an association between fatigue and resilience and sociodemographic and academic factors. Data were analyzed using descriptive and inferential statistics, and it was discovered that the variables associated with higher levels of resilience were age; having children; being retired; receiving income above five minimum wages; having had greater problems in other phases of the research schedule; coming from private universities; being from the north of Brazil; studying the area of Health; and having their research schedule unaffected during the pandemic. On the other hand, lack of resilience was associated with not having children; being less well-off financially; being younger; being a woman; studying in a public university; and having to postpone part of the research during the pandemic. The conclusion of the study indicated the need for graduate programs to design strategies to deal with fatigue and promote resilience in Master’s and PhD students.El 27 de septiembre de 2023 seis jóvenes portugueses llevaron ante el Tribunal Europeo de Derechos Humanos a 32 gobiernos por su inacción ante la crisis climática global.
A pesar de que las enfermeras somos titulares de obligaciones del derecho a la salud, sus protectoras y defensoras, este suceso, como muchas otras iniciativas que luchan por la salud global, ha pasado desapercibido para la mayoría de las compañeras de profesión. ¿Dónde estamos como colectivo sanitario mayoritario en estas causas? ¿Dónde está nuestro apoyo manifiesto a la lucha por la salud planetaria?
Como enfermeras debemos movernos con la realidad del planeta y responder a los retos de salud globales. Si queremos mirar al futuro de la profesión, la profesión del presente debe actuar.
by Rafaella Rabelo Polato, Cristino Carneiro Oliveira, Yuri Augusto de Sousa Miranda, Leandro Ferracini Cabral, Carla Malaguti, Anderson José
IntroductionSeveral individuals with post-COVID-19 syndrome referred for pulmonary rehabilitation did not participate. This study aimed to explore individuals’ barriers to participating in posthospitalization COVID-19 rehabilitation.
Materials and methodsThis was a qualitative, multicenter study performed using semistructured interviews. This study included 20 individuals hospitalized for COVID-19 who refused to participate in a pulmonary rehabilitation program at a university hospital.
ResultsIndividuals reported difficulties accessing the rehabilitation center, mainly due to distance, transport costs and conditions, and lack of companions. Health problems (e.g., surgeries, pain, and mobility difficulties) and lack of time due to work, commuting, and household work were also reported. Another reported theme was not perceiving the need for rehabilitation due to feeling well. Minor themes included the need for more information about rehabilitation and a lack of interest, motivation, and medical encouragement.
ConclusionIndividuals hospitalized for COVID-19 faced several barriers to participating in a pulmonary rehabilitation program. These barriers included difficulties in accessing the rehabilitation center, health problems, lack of time, and the perception that rehabilitation was unnecessary. There is a need for actions to overcome these barriers to make the program available to a larger number of individuals.
by Amy Huang, Ellen Wang, Stephanie Sanger, Alexandra Papaioannou, Isabel B. Rodrigues
Most older adults 65 years and older accumulate over 8.5 hours/day of sedentary time, which is associated with increased risk of metabolic syndromes and falls. The impact of increased sedentary time in older adults has prompted development of sedentary behaviour guidelines. The purpose of our review was to compare national and international sedentary behaviour and physical activity guidelines for older adults and appraise the quality of guidelines using AGREE II. We conducted our search in Medline, Embase, Global Health, Web of Science, CINAHL, and relevant grey literature. We included the most recent guidelines for older adults written in English. We identified 18 national and international guidelines; ten of the 18 guidelines included sedentary behaviour recommendations while all 18 included physical activity recommendations for older adults. The ten sedentary behaviour guidelines were developed using cohort studies, knowledge users’ opinions, systematic reviews, or other guidelines while the physical activity guidelines were developed using randomized controlled trials, systematic reviews, meta-analysis, and overview of reviews. The definition of sedentary behaviour and the recommendations were inconsistent between the guidelines and were based on very low to low quality and certainty of evidence. All guidelines provided consistent recommendations for aerobic and resistance training; the recommendations were developed using moderate to high quality and certainty of evidence. Only eight physical activity guidelines provided recommendations for balance training and six on flexibility training; the balance training recommendations were consistent between guidelines and based on moderate quality evidence. Further work is needed to develop evidenced-based sedentary behaviour recommendations and flexibility training recommendations for older adults.Treatment for multidrug-resistant/rifampicin-resistant tuberculosis (MDR/RR-TB) is increasingly transitioning from hospital-centred to community-based care. A national policy for decentralised programmatic MDR/RR-TB care was adopted in South Africa in 2011. We explored variations in the implementation of care models in response to this change in policy, and the implications of these variations for people affected by MDR/RR-TB.
A mixed methods study was done of patient movements between healthcare facilities, reconstructed from laboratory records. Facility visits and staff interviews were used to determine reasons for movements.
People identified with MDR/RR-TB from 13 high-burden districts within South Africa.
Geospatial movement patterns were used to identify organisational models. Reasons for patient movement and implications of different organisational models for people affected by MDR/RR-TB and the health system were determined.
Among 191 participants, six dominant geospatial movement patterns were identified, which varied in average hospital stay (0–281 days), average patient distance travelled (12–198 km) and number of health facilities involved in care (1–5 facilities). More centralised models were associated with longer delays to treatment initiation and lengthy hospitalisation. Decentralised models facilitated family-centred care and were associated with reduced time to treatment and hospitalisation duration. Responsiveness to the needs of people affected by MDR/RR-TB and health system constraints was achieved through implementation of flexible models, or the implementation of multiple models in a district.
Understanding how models for organising care have evolved may assist policy implementers to tailor implementation to promote particular patterns of care organisation or encourage flexibility, based on patient needs and local health system resources. Our approach can contribute towards the development of a health systems typology for understanding how policy-driven models of service delivery are implemented in the context of variable resources.
by Gioulinta S. Alimani, Sachin Ananth, Cristina Boccabella, Ekaterina Khaleva, Graham Roberts, Nikolaos G. Papadopoulos, Chris Kosmidis, Jørgen Vestbo, Effie Papageorgiou, Apostolos Beloukas, Alexander G. Mathioudakis
IntroductionViruses are detected in over 50% of acute asthma attacks and in a notable proportion of patients with asthma during stable disease state They are associated with worse outcomes. We will conduct a series of systematic reviews and meta-analyses to quantify the prevalence and clinical burden of various respiratory viruses in stable asthma and acute asthma attacks. In addition, we will assess the viral loads of respiratory viruses during stable and acute asthma, to explore whether viral load could differentiate attacks triggered by viruses versus those where viruses are present as “innocent bystanders”.
Materials and methodsBased on a prospectively registered protocol (PROSPERO, ID: CRD42023375108) and following standard methodology recommended by Cochrane, we will systematically search Medline/PubMed, EMBASE, the Cochrane Library and relevant conference proceedings for studies assessing the prevalence or clinical burden of respiratory viruses in asthma. Methodological rigour of the included studies will be appraised using a tool specific for prevalence studies and the Newcastle-Ottawa Scale respectively. In anticipation of significant clinical and methodological heterogeneity, we will conduct random effect meta-analyses. For evaluating the prevalence of viruses, we will perform meta-analyses of proportions using the inverse variance method, and the Freeman-Tukey transformation. We will conduct meta-regression analyses for exploring heterogeneity.
ConclusionWe envisage that these systematic reviews and meta-analyses will quantify the prevalence and burden of respiratory viruses in stable and acute asthma and will drive future research and clinical practice.
This study aimed to examine concurrent polysubstance use of alcohol, tobacco and marijuana and determine correlations with access to marijuana, friend and familial drug use habits, risk perception and the age of initiation associated with the singular use of these substances.
A secondary data analysis.
Used the Jamaica National Drug Prevalence Survey 2016 dataset.
Involved the entire dataset comprising 4623 randomly selected respondents between 12 and 65 years old.
Primary outcome: concurrent polysubstance use recorded as using two or more of alcohol, tobacco and marijuana. Predictor variables include risk perception and age of initiation of singular alcohol, tobacco and marijuana use, ease of marijuana access and family and friend alcohol and illegal drug use.
Approximately 58%–66% of respondents commenced singular alcohol, tobacco or marijuana use under 17. Participants commencing marijuana use at 11 years and under and between 12 and 17 were 3.346 and 4.560 times more likely to report past month concurrent polysubstance use (p=0.030 and p
Decreased perceived risk, childhood and adolescent age of initiation and easy access to marijuana were significantly associated with polysubstance use among Jamaicans. The influence of friends and family members’ drug and alcohol use behaviours on individuals developing polysubstance use habits further endorses the need for interventions.
To analyse fall prevalence, risk factors and perceptions among Thai older adults to design a prevention model.
Quantitative and qualitative data were collected using a convergent parallel mixed-methods design.
A cross-sectional analysis was conducted using secondary data from health screenings of older adults in 20 subdistrict hospitals in southern Thailand from January 2018 to September 2019 (n = 12,130). In-depth interviews (IDIs) and focus group discussions (FGDs) were conducted with purposively sampled participants who were representatives of older adults and stakeholders (n = 50).
The quantitative analysis showed that the prevalence of falls was 12.1%. The independent risk factors were female gender, employment status, cognitive impairment, semi-dependent functional ability, balance problems, vision impairment, hearing difficulties, use of medications, reliance on assistive devices and access to outdoor toilets. The qualitative analysis revealed misconceptions on falls and fall prevention measures among older adults and community stakeholders. In Thailand, healthcare providers and community nurses play a crucial role in providing primary advice and conducting interventions, yet they encounter obstacles due to lack of personnel, time constraints, limited resources, inadequate support and unclear policies. Stakeholders stress the urgency of improving practice guidelines, developing evidence-based strategies and aligning with government policies.
Fall risk factors and prevention challenges among older adults were identified. Effective fall prevention programmes are needed.
The identified fall events may guide public health agencies and local administrations in planning fall prevention programmes. For implementation in Thai communities, teamwork among leaders and stakeholders is key.
IDIs and FGDs were conducted with older adults, village health volunteers, nurses, healthcare providers, local organization administrators and village headmen.
The study aims to analyse the principal causes of patients' care calls and compare differences before and after inpatient beds' technological modernization in a surgical breast oncological ward.
A prospective observational study was conducted under the STROBE guidelines. Data were collected from June to September 2022.
Statistical analyses were performed to compare each reason for care calls, by shifts and pre and post-inpatient bed modernization.
Two thousand five hundred and fifty-nine care request calls were analysed during the 202 observed shifts. The most frequent reason was related to the requests for positions.
Technological modernization of the beds has not led to effective—positive—changes; on the contrary, it seems at first glance to show an upward trend in calls above all in the short period after the changes.
What problem did the study address? By analysing the principal causes of care calls and comparing the differences before and after inpatient beds' technological modernization, this study evaluates if inpatient gear or device modernization can impact care call requests. What were the main findings? The results show that the most frequent reasons for care calls were position, possession and other. These findings seem not superimposable; the hypothesis supported by the international literature in which the causes relating to potty and pain were found among the main reasons. Where and on whom will the research have an impact? These results could impact the care organizational area in nursing care and could improve care quality, patient satisfaction and safety.
This prospective observational study was conducted following STROBE guidelines.
After adequate information (presentation, design methods and objectives), all unit healthcare staff agreed to collaborate in the study.
To explore how nurses working in general practice experienced remote and technology-mediated working during the COVID-19 pandemic.
Exploratory qualitative study with nursing team members working in general practices in England and national nurse leaders.
Data were collected between April and August 2022. Forty participants took part in either semi-structured interviews or focus groups. Data were analysed using Framework Analysis informed by the PERCS (Planning and Evaluating Remote Consultation Services) Framework. University of York ethics approval [HSRGC/2021/458/I] and Health Research Authority approval were obtained [IRAS:30353. Protocol number: R23982. Ref 21/HRA/5132. CPMS: 51834]. The study was funded by The General Nursing Council for England and Wales Trust.
Participants continued to deliver a significant proportion of patient care in-person. However, remote and technology-mediated care could meet patients' needs and broaden access in some circumstances. When remote and technology-mediated working were used this was often part of a blended model which was expected to continue. This could support some workforce issues, but also increase workload. Participants did not always have access to remote technology and were not involved in decision-making about what was used and how this was implemented. They rarely used video consultations, which were not seen to add value in comparison to telephone consultations. Some participants expressed concern that care had become more transactional than therapeutic and there were potential safety risks.
The study explored how nurses working in general practice during the COVID-19 pandemic engaged with remote and technology-mediated working. It identifies specific issues of access to technology, workload, hybrid working, disruption to therapeutic relationships, safety risks and lack of involvement in decision-making. Changes were implemented quickly with little strategic input from nurses. There is now an opportunity to reflect and build on what has been learned in relation to remote and technology-mediated working to ensure the future development of safe and effective nursing care in general practice.
The paper contributes to understanding of remote and technology-mediated working by nurses working in general practice during the COVID-19 pandemic and indicates to employers and policy makers how this can be supported moving forward.
Standards for Reporting Qualitative Research (O'Brien et al., 2014).
This was a workforce study so there was no patient or public contribution.
The paper highlights specific issues which have implications for the development of remote, technology-mediated and blended working for nurses in general practice, care quality and patient safety. These require full attention to ensure the future development of safe and effective nursing care in general practice moving forward.
Exploration of experiences of nurses working in general practice during the COVID-19 pandemic to evaluate the impact on nurses' professional well-being.
An exploratory qualitative study comprised of case studies of three general practice sites in England and a nationwide interview study of nurses working in general practice and nurse leaders. The study was funded by The General Nursing Council for England and Wales Trust. University of York ethics approval (HSRGC/2021/458/I) and Health Research Authority approval was obtained (IRAS: 30353, Protocol number: R23982, Ref 21/HRA/5132, CPMS: 51834).
Forty participants took part. Case site data consisted of interviews/focus groups and national data consisted of semi-structured interviews. Data collection took place between April and August 2022. Analysis was underpinned by West et al.'s The courage of compassion. Supporting nurses and midwives to deliver high-quality care, The King's fund, 2020 ABC framework of nurses' core work well-being needs.
The majority of participants experienced challenges to their professional well-being contributed to by lack of recognition, feeling undervalued and lack of involvement in higher-level decision-making. Some participants displayed burnout and stress. Structural and cultural issues contributed to this and many experiences pre-dated, but were exacerbated by, the COVID-19 pandemic.
By mapping findings to the ABC framework, we highlight the impact of the COVID-19 pandemic on the well-being of nurses working in general practice and contributing workplace factors. The issues identified have implications for retention and for the future of nursing in general practice. The study highlights how this professional group can be supported in the future.
The study contributes to our understanding of the experiences of nurses working in general practice during the COVID-19 pandemic and beyond. Findings have implications for this skilled and experienced workforce, for retention of nurses in general practice, the sustainability of the profession more broadly and care quality and patient safety.
Standards for Reporting Qualitative Research (O'Brien et al. in Journal of the Association of American Medical Colleges, 89(9), 1245–1251, 2014).
As this was a workforce study there was no patient or public contribution.
by Xiaojun Fan, Ying Wang, Changsheng Tang, Xiaolin Zhang, Jianyu He, Isabella Buttino, Xiaojun Yan, Zhi Liao
Mytilus coruscus is an economically important marine bivalve mollusk found in the Yangtze River estuary, which experiences dramatic pH fluctuations due to seasonal freshwater input and suffer from shell fracture or injury in the natural environment. In this study, we used intact-shell and damaged-shell M. coruscus and performed metabolomic analysis, free amino acids analysis, calcium-positive staining, and intracellular calcium level tests in the mantle to investigate whether the mantle-specific metabolites can be induced by acute sea-water acidification and understand how the mantle responds to acute acidification during the shell repair process. We observed that both shell damage and acute acidification induced alterations in phospholipids, amino acids, nucleotides, organic acids, benzenoids, and their analogs and derivatives. Glycylproline, spicamycin, and 2-aminoheptanoic acid (2-AHA) are explicitly induced by shell damage. Betaine, aspartate, and oxidized glutathione are specifically induced by acute acidification. Our results show different metabolic patterns in the mussel mantle in response to different stressors, which can help elucidate the shell repair process under ocean acidification. furthermore, metabolic processes related to energy supply, cell function, signal transduction, and amino acid synthesis are disturbed by shell damage and/or acute acidification, indicating that both shell damage and acute acidification increased energy consumption, and disturb phospholipid synthesis, osmotic regulation, and redox balance. Free amino acid analysis and enzymatic activity assays partially confirmed our findings, highlighting the adaptation of M. coruscus to dramatic pH fluctuations in the Yangtze River estuary.Objetivo principal: Analizar el papel de la enfermera pediátrica en el abordaje del neonato con gastrosquisis en un contexto de consumo de opioides durante el embarazo. Presentación del caso: Neonato con gastrosquisis, en cuyos antecedentes destaca el consumo de marihuana, por parte de la madre, durante el embarazo. Valoración: Según los 11 patrones funcionales de M. Gordon, se observó una alteración en los patrones 1, 2, 3, 5 y 7. Plan de cuidados: Destaca la identificación los diagnósticos NANDA Deterioro de la integridad tisular, Riesgo de motilidad gastrointestinal disfuncional y Síndrome de abstinencia neonatal. Se planificaron los criterios de resultado e intervenciones pertinentes, observándose una mejoría sustancial del paciente a las tres semanas. Discusión: El papel de la enfermera pediátrica en casos de este tipo, se basa en el cuidado integral del neonato, con intervenciones dirigidas, especialmente, al mantenimiento del confort y del estado hemodinámico, respiratorio y gastrointestinal del neonato.
Introducción. Actualmente el timbre conecta a los pacientes con la expectativa de una asistencia inmediata cuando perciben una necesidad, ya sea para asistencia de rutina o tengan un cambio agudo en su condición. El tiempo de atención al timbre impacta en la calidad de atención, satisfacción del paciente, y el flujo de trabajo. El objetivo fue describir el tiempo promedio de la respuesta al timbre en la Unidad Coronaria. Metodología. Estudio transversal del tiempo de respuesta al timbre estratificado por turno. Se recogieron datos sociodemográficos de los pacientes, los motivos de la llamada al timbre, y la satisfacción de los pacientes de forma anónima y digital. Resultados. Se analizaron 200 timbres, con un tiempo promedio de 5’42”. El promedio de edad de los pacientes que accionaron el timbre fue de 56 años, de los cuales 51% eran mujeres. Los principales motivos de llamada fueron la movilización (24.9%) e higiene/eliminación (19.2%), y los pacientes se mostraron satisfechos siempre o casi siempre (81%) con el tiempo de atención al timbre. No se halló una asociación entre los días de internación y la cantidad de llamadas al timbre. Discusión. A pesar de que el tiempo es superior a los “minutos dorados”, los pacientes presentan un elevado grado de satisfacción. La variabilidad de los tiempos en los distintos turnos y los principales motivos de llamada por turno muestran un enorme desafío en la gestión de enfermería para anticipar y priorizar las necesidades que el paciente transmite a través del timbre.
Abstract
Introduction. Currently, the call light connects patients with the expectation of immediate assistance when they perceive a need, whether it is for routine assistance or a sudden change in their condition. The response time to the call bell impacts the quality of care, patient satisfaction, and workflow. The objective of this study was to describe the average response time to the call bell in the Coronary Unit. Methodology. A cross-sectional study of response time to the call bell stratified by shift, over 3 days, with a minimum of 7 days between each day. Sociodemographic data of patients, reasons for the call bell, and patient satisfaction were collected anonymously and digitally. Results. 200 call bells were analyzed, with an average response time of 5'42". The average age was 56 years, with 51% being female. The main reasons for calling were mobilization (24.9%) and hygiene/elimination (19.2%). Most patients were satisfied with the response time to the call bell (81% always or almost always). There was no association found between length of stay and the number of call bells. Discussion. Despite the response time being longer than the "golden minutes," patients show a high degree of satisfaction. The variability of response times in different shifts and the main reasons for calling by shift show a huge challenge in nursing management to anticipate and prioritize the needs that the patient expresses through the call bell.
To identify changes in mental health status among nursing professionals in a Brazilian municipality during the COVID-19 pandemic.
An observational and longitudinal study.
Using the Patient Health Questionnaire-9, the presence of depressive symptoms was evaluated among 690 nursing professionals in the city of Pelotas, Brazil, at two moments: June/July 2020 and June/July 2021.
13.0% incidence of depressive symptoms was identified; as well as 12.2% remission; 24.1% persistence and 50.7% absence. Among the factors associated with the worst prognoses we can mention female gender, greater workload, feeling of overload, illness of family members or friends due to COVID-19 and use of psychotropic drugs
There was significant mobility in the diagnosis of depression among the professionals studied during the period analysed, with incidence of new cases of significant depression and greater than the number of remissions. In addition to sociodemographic aspects, traumatic experiences and exposure to continuous overload were associated with persistence and incidence of new cases.
With the advent of the COVID-19 pandemic, several studies have shown an increase in depressive symptoms among nursing professionals; however, understanding the long-term effects of this scenario is still a challenge.
What problem did the study address? This study investigates changes in the mental health status of nursing professionals working at different care levels, taking the prevalence of screening for depression as a proxy, during a period of a year during the COVID-19 pandemic.
What were the main findings? Between both data collection moments, 2020 e 2021, there was a significant percentage of professionals with persistent depression, in addition to a significant proportion of incident cases that slightly exceeded the number of remissions and the factors associated with the worst prognoses were sociodemographic aspects such as gender and emotional stressors like illness of family members or close friends due to COVID-19, in addition to those related to the organisation and support provided by the services, such as workload and feeling of overload.
Where and on whom will the research have an impact? This study will impact the nursing professionals and in role of the health services in order to establishing actions that contribute to minimising the deleterious effects of the pandemic on the mental health of their Nursing teams.
The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines were adopted in this study.
No Patient or Public Contribution.
Ecuador es un país pluricultural y multiétnico, caracterizado por la búsqueda de promover la propiedad comunal, la toma de decisiones colectiva y prácticas de vida sostenibles en sus comunidades autónomas. A través de este enfoque principal que enfatiza la solidaridad y la cooperación, estas comunas han podido crear soluciones alternativas a los problemas que enfrentan sus comunidades. A pesar de estos éxitos, las comunidades de los diversos grupos indígenas, aún enfrentan desafíos, como acceso limitado a recursos básicos, apoyo gubernamental, estigmatización y conflictos con comunidades vecinas. Sin embargo, continúan abogando por su derecho a la autodeterminación y trabajan para crear una sociedad más equitativa. Explorando los temas y experiencias de estas comunas, podemos comprender mejor el potencial de los movimientos de base para abordar las injusticias sociales y allanar el camino hacia comunidades más sostenibles e inclusivas. Cabe destacar que esta es solo una pequeña comuna indígena, y que hay muchos más grupos en todo el país, como los Shuar, Tsáchilas, Huaorani, Chachi, entre otros.
Introducción: Existen algunos estudios sobre los beneficios de ZhiNeng QiGong, pero aún muy pocos en el contexto de la pandemia por la COVID-19 y relacionados con el cuidado holístico. Objetivo: Describir los beneficios de Zhineng Qigong en la salud integral de adultos practicantes durante la COVID-19. Método: Investigación cualitativa descriptiva exploratoria. La muestra fue no probabilística por conveniencia, lograda por técnica de la saturación y redundancia de datos, participaron 13 practicantes de disciplina incorporados en la tercera Certificación Internacional de Zhineng Qigong, previo consentimiento informado. La información fue recolectada por entrevista online y procesada según el análisis de contenido. Resultados: Se encontraron cinco categorías: salud física, mental, social, espiritual y ecológica, donde en todas se encontró cambios positivos de fortalecimiento y sanación individual con irradiación hacia su entorno familiar y social. Conclusiones: Todos los practicantes de Zhineng Qigong experimentaron sanación física y emocional, mejoras en sus relaciones familiares y laborales. Asimismo, sienten vitalidad, paz interior, conexión con el universo y la naturaleza. La mayoría indicaron que no contrajeron la COVID-19 porque con la práctica mejoraron su sistema inmunológico y la respiración.
Ecuador es un país pluricultural y multiétnico, caracterizado por la búsqueda de promover la propiedad comunal, la toma de decisiones colectiva y prácticas de vida sostenibles en sus comunidades autónomas. A través de este enfoque principal que enfatiza la solidaridad y la cooperación, estas comunas han podido crear soluciones alternativas a los problemas que enfrentan sus comunidades. A pesar de estos éxitos, las comunidades de los diversos grupos indígenas, aún enfrentan desafíos, como acceso limitado a recursos básicos, apoyo gubernamental, estigmatización y conflictos con comunidades vecinas. Sin embargo, continúan abogando por su derecho a la autodeterminación y trabajan para crear una sociedad más equitativa. Explorando los temas y experiencias de estas comunas, podemos comprender mejor el potencial de los movimientos de base para abordar las injusticias sociales y allanar el camino hacia comunidades más sostenibles e inclusivas. Cabe destacar que esta es solo una pequeña comuna indígena, y que hay muchos más grupos en todo el país, como los Shuar, Tsáchilas, Huaorani, Chachi, entre otros.
Objetivo principal: Analizar la influencia del contacto piel con piel (CPP) en el éxito de la lactancia materna exclusiva (LME) hasta los 6 meses de vida. Metodología: Estudio analítico descriptivo y prospectivo, realizado mediante entrevista directa con 500 puérperas seleccionadas por muestreo de casos consecutivos. Resultados principales: Cuando se realizó el CPP de manera ininterrumpida la LME a los 6 meses de vida fue del 17,40% y la de lactancia artificial del 12,60%. En los casos en que no se realizó, eran mayores las tasas de lactancia artificial (10,80%) frente a las de LME (4,40%). Las variables con mayor influencia en el éxito de la lactancia materna exclusiva a los 6 meses de vida, el tipo de alimentación en hijos anteriores y el tipo de alimentación al alta hospitalaria. Conclusión principal: Se deben evitar rutinas hospitalarias que interrumpan el CPP así como procurar que al alta hospitalaria la LME esté correctamente establecida.
FreshRSS 