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Acceptability of HPV Vaccines: A Qualitative Systematic Review and Meta-Summary
(Multidisciplinary Digital Publishing Institute (MDPI), 2024-09-23) Urrutia, María-Teresa; Araya, Alejandra-Ximena; Gajardo, Macarena; Chepo, Macarena; Torres, Romina; Schilling, Andrea
In 2006, the human papillomavirus (HPV) vaccine was approved for use as an effective intervention for reducing the risk of developing cervical cancer; however, its successful implementation is dependent on acceptability. This study aims to provide a comprehensive understanding of the reasons that favor or do not favor the acceptability of HPV vaccines. Methods: We conducted a systematic review and meta-summary of qualitative research on 16 databases. A total of 32 articles that considered the perspectives of vaccine users, their parents, and the professionals who care for them were reviewed. Synthesis was conducted as described by Sandelowski and Barroso. Results: We used inductive and deductive methods to obtain a total of 22 dimensions, out of which three issues stood out that should be considered to improve acceptability and are formed by three groups of study, namely, information about the vaccine, fears and side effects, and sexuality associated with the vaccine. Conclusions: Acceptability, as well as adherence to HPV vaccination, is a complex concept. This review highlights the perspectives of the three sets of actors involved in the process (i.e., users, parents, and professionals) and views these factors in relation to acceptability as a guide for new interventions.
CALIDAD EN ENFERMERÍA: SU GESTIÓN, IMPLEMENTACIÓN Y MEDICIÓN
(Clínica Las Condes, 2018-05) Febré, N.; Mondaca-Gómez, K.; Méndez-Celis, P.; Badilla-Morales, V.; Soto-Parada, P.; Ivanovic, P.; Reynaldos, K.; Canales, M.
A nivel mundial, los profesionales de enfermería, representan el grupo ocupacional más grande de la fuerza de trabajo del cuidado para la salud (70% del total) (1) . Entregando el mayor porcentaje de atención en todos los niveles del continuo del cuidado, lo que representa una proporción significativa de los costos operativos de las respectivas instituciones de salud [2], [3]. Se calcula, que representan el 25% o más de los gastos operativos anuales y hasta el 40% de los costos de atención directa [4], [5]. El equipo de enfermería, exhibe el mayor involucramiento en los procesos de asistencia sanitaria, lo que permite que estos profesionales, por su mayor cercanía con los pacientes, tengan un rol relevante en la seguridad de éstos y en la calidad asistencial, pero también, sean agentes claves para reducir los resultados de los eventos adversos (6).La ciencia del cuidar se entiende como: “la aplicación de un juicio profesional en la planificación, organización, motivación y control de la provisión de cuidados, oportunos, continuos, seguros e integrales, en la atención en salud de las personas; que se sustentan en un conocimiento sólido que permite ofrecer, cuidados basados en la evidencia científica y demostrar su capacidad para cambiar de forma favorable el curso de la enfermedad o la mejora de las condiciones de salud de la población” (7). Enfermería entiende que la salud de la población y las desigualdades que ésta posee, se conceptualizan en un modelo de sistemas complejos, con elementos interdependientes en varios niveles dentro de un todo conectado. Esta perspectiva sugiere que los efectos variados sobre la salud, tales como los factores socioeconómicos, culturales, ambientales, sociales, del comportamiento y efectos biológicos, interactúan en la generación de resultados en la salud de la población. Para mejorar estos resultados, el comportamiento de los individuos debe ser reconocido como un elemento esencial y por lo tanto, las intervenciones sin una amplia comprensión de esa complejidad, significarían ignorar una parte clave de la ciencia del cuidar (8). En Chile, la legislación ha definido el rol social de las enfermeras, asignándole entre otras funciones, la “gestión del cuidado” (1997). A partir de la Reforma de la Salud (2004), que establece una nueva Autoridad Sanitaria, esta gestión del cuidado se constituye dentro de la estructura de los Servicios de Salud, en correspondencia con el Reglamento de los Servicios de Salud (2005) y la Norma Administrativa N° 19 (2007). Los que aportan antecedentes que otorgan las bases orgánicas funcionales de las Unidades de Gestión del Cuidado para la atención cerrada (9). Es así, que los profesionales enfermeros en Chile, poseen una responsabilidad legal, ética y social con la gestión del cuidado, lo que los obliga a asumir un compromiso y una responsabilidad basada en asegurar la continuidad y calidad de los cuidados entregados (10). El presente artículo, pretende contribuir a la calidad del cuidado enfermero, desde el punto de vista de su gestión, implementación y medición de resultados.
Factors associated with the perception of loneliness among older people living in the community
(Sociedad Medica de Santiago, 2023) Alejandra-Ximena, Araya; Iriarte, Evelyn
Background: Chilean community-dwelling older people are a vulnerable population with a high risk of being self-perceived as lonely. Aim: To examine the factors associated with the self-perception of loneliness in a group of Chilean community-dwelling older people. MaterialandMethods: Cross-sectionalstudy design with 540 participants aged 65 years and above (72.20 ± 6.22). Measures for sociodemographic, health status, and integral geriatric assessment were assessed. Correlations and multiple linear regression models were conducted. Results: Factors such as low perception of social support in everyday situations or cases of emergency, experiencing high depressive symptoms, and perceiving a poor quality of life were significantly associated with a higher self-perception of loneliness. Discussion: Preventive strategies and age-appropriate psychosocial interventions to mitigate or reverse the impact of these factors may be essential to reduce the self-perception of loneliness and consequently improve older people's well-being. © 2023 Sociedad Medica de Santiago. All rights reserved.
Multimodal strategy for the prevention of COVID 19 in a mining site
(Sociedad Chilena de Infectologia, 2022) Paredes, Erick; Cabezas-Rosales, Diego; Rojas, Rodrigo; Montes, Marcelo; Rodriguez, Viviana; Pedrero, Víctor; Febré, Naldy
Background: Mining companies must implement management sys-tems dedicated to health and safety at work to prevent the transmission of SARS-CoV-2 among their workers, however, the literature on this is scarce. Aim: To describe a multimodal strategy for the management of health and safety at work, to address the risk of COVID-19 in large mining. Methods: Descriptive cross-sectional study, carried out in a large mining company. A management system was structured that considered administrative measures, of an environmental nature, risk screening, and management of risk cases within the company. The data analysis was done using descriptive statistics. Results: The administrative measures resulted in 8,116 (34%) workers at the site being suspended from their usual work. Risk screening before entering the site identified 450 suspected cases that were referred to their home. In the case management procedure, 1,073 people were classified in some of the risk groups. 10 cases of workers with PCR were detected in the follow-up period. Environmental measures were not very sensitive. Conclusions: These results shed light on the importance of implementing a multimodal strategy, adapted to the local reality, in preventing the spread of SARS-CoV-2 in the period under study, at the mining site intervened. © 2022, Sociedad Chilena de Infectologia. All rights reserved.
Intention to use pre-exposure prophylaxis in men who have sex with men in Chile: a view from the planned behavior theory
(Editorial Salud, Ciencia y Tecnologia, 2023-01) Silva-Sánchez, Camilo Andrés; Castillo, Víctor Pedrero
Introduction: pre-exposure prophylaxis (PrEP) effectively prevents HIV in men who have sex with men (MSM). Chile recently incorporated PrEP as a strategy against HIV/AIDS. Despite its effectiveness, worldwide PrEP utilization among MSM is low. The theory of planned behavior (TPB) is one of the most popular psychosocial models used to predict and explain sexual risk behaviors. Objective: to analyze the intention to use PrEP among MSM using the TPB in Chile. Methods: 183 MSM were recruited online. The TPB constructs (attitude, subjective norms, behavioral control, and intention to use) were measured in addition to knowledge variables, sociodemographic aspects, and sexual risk behaviors. We use linear regression models to analyze the relationship between intention to use and other variables. Results: the perception of favorable social norms (B=0,356 p<0,01), higher perception of behavioral control (B=0,4 p<0,01), and positive PrEP attitudes (B=0,189 p<0,01) were significantly related to intention to use PrEP. Knowledge, the presence of sexual ri.sk behaviors, and sociodemographic variables were not associated with intention to use PrEP. Conclusion: the TPB contributes to understanding the intention to use PrEP in MSM in Chile. © 2023; Los autores.
Trait Self-Esteem and Emotional Intelligence in the In-Person Return of Nursing Students
(Editorial Salud, Ciencia y Tecnologia, 2023-01) Ardiles-Irarrázabal, Rodrigo-Alejandro; Pérez-Díaz, Pablo; Valencia-Contrera, Miguel; Ajeno, Rosella Santoro
Introduction: psycho-emotional risks in nursing students are a persistent problem over time, describing the protective factors in this population is an increasingly important need. Objective: to describe the relationship of Self-esteem with Trait Emotional Intelligence in the return of post-confinement face-to-face academic activities in Nursing students at a public university in Chile. Methods: quantitative, correlational, cross-sectional, non-experimental study. The TEIQue-SF Emotional Intelligence questionnaire and the Rosenberg self-esteem scale were applied; both questionnaires cross-culturally adapted for use in the target population; the final sample was 213 nursing students from 1st to 5th year. Results: There was a prevalence of 68,1 % with low self-esteem, likewise, in trait Emotional Intelligence, 37 % were found in the very high percentile. In addition, a positive weak correlation was associated between the total self-esteem and the emotionality factor (r=0,268; p<0,000). Likewise, a strong negative correlation was observed between total self-esteem and the trait Emotional Intelligence Well-being factor (r=-0,705; p<0,000). Conclusions: there is a psycho-emotional risk associated with the reported low self-esteem and biosociodemographic factors. Trait emotional intelligence is considered a protective factor and influences self-esteem. Universities and academic teachers should be a source of training in emotional management, trying to develop this construct as an important protective factor in this student body at risk. © Este es un artículo en acceso abierto.
Vaccine against COVID-19 and menstruation, from ignorance to information: a systematic review
(Sociedad Chilena de Obstetricia y Ginecologia, 2023) Aldana-Vásquez, Belén; González-Labadie, Gabriela; González-Labadie, Gabriela; López-Jorquera, Valentina; Ramos-Berenguer, Miguel; López-Alegría, Fanny
The creation of a vaccine to face the COVID-19 pandemic, led to an information gap on possible alterations of the menstrual cycle. The objective was to verify the possible alterations that could have been generated in the menstrual cycle of women, after the inoculation of the vaccine against COVID-19. A systematic review was carried out in the Medline, Medline Complete, LILACS, CINAHL and ScIELO bibliographic databases, using the descriptors“Women”,“Woman”,“Fertile period”,“Vaccination”, “Mass vaccination”,“Immunization”,“COVID-19 vaccines”,“SARS-CoV-2 infection”,“COVID-19”,“Menstrual cycle”,“Menstruation”, “Endometrial cycle”,“Dysmenorrhea”and“Menstruation disturbances”. Using the PRISMA protocol, of the 319 articles located, 17 were included in the analysis. Most of the studies mainly included the Pfizer, Moderna, AstraZeneca and Johnson&Johnson/ Janssen vaccines with one to three doses administered. The percentage of altered menstrual cycles ranged from 8.0% to 77.8%, and the most frequently reported alteration was the length of the menstrual cycle, which occurred from 0.3 to 12 days late in menstruation. All the studies refer to changes in the menstrual cycle with different prevalences, with and without statistical significance; however, the same studies also conclude that these alterations are reversible and in a short period of time. © 2023 Sociedad Chilena de Obstetricia y Ginecologia. All rights reserved.
Predictors of unmet needs in Chilean older people with dementia: A cross-sectional study
(BMC, 2019-04-15) Tapia Muñoz, Thamara; Slachevsky, Andrea; León-Campos, María O.; Madrid, Michel; Caqueo-Urízar, Alejandra; Rohde, Gustav C.; Miranda-Castillo, Claudia
Background: The needs of people with dementia (PWD) have not been assessed in any Latin American country. Several European countries have already related unmet needs with quality of life, caregiver's age, burden, stress, anxiety and depression. The aim of this study was to identify met and unmet needs in Chilean older adults with dementia and to determine if those needs were associated with PWD's, their informal caregivers' and social factors. Method: This was a cross-sectional study. One-hundred and sixty-six informal caregivers and their care recipients were interviewed. PWD was assessed about cognitive function and their caregivers answered instruments about PWD's needs, functional status and behavioral and psychological symptoms. Caregiver's burden, depression, anxiety and social support were also evaluated. A stepwise multiple linear regression analysis was performed to determine predictors of unmet needs in Chilean PWD. Results: The most frequent met needs were "Looking after home" (81.3%%), "Food" (78.9%) and "Selfcare" (75.3%). Most common unmet needs were "Daily living activities" (39.2%), "Company" (36.1%), and "Memory" (34.9%). Caregivers' lower age was correlated to a higher number of PWD's unmet needs (r s = -.216; p < 0.005). Higher PWD's dependence was associated with higher number of unmet needs (r s =.177; p < 0.05). The best predictors of unmet needs were caregivers' low level of social support, high burden, young age and high level of anxiety. Conclusion: It is necessary to address psychological and social needs of PWD. The fact that PWD's unmet needs were associated mostly with caregivers' factors, highlights the importance of considering both, the PWD and their informal caregivers as targets of institutional support. It is expected that recently launched national public policies decrease PWD's unmet needs by the provision of new services for them and their informal caregivers. © 2019 The Author(s).
Exchange of secondary data in research with human beings: Ethical aspects
(Editorial Salud, Ciencia y Tecnologia, 2023-01) Rojas-Avila, Javier; Reynaldos-Grandón, Katiuska Lídice
Introduction: currently, there is a call from the scientific community for a responsible exchange of data, being relevant to promote innovation in research through the reuse of secondary data. However, the data exchange is not free of difficulties since it imposes relevant ethical challenges. On the other hand, the data exchange is also limited by legislative aspects of each country in terms of data privacy; for example, the Chilean legal system is presented. Objective: to identify the ethical aspects of exchanging secondary data in research with human beings. Methods: integrative review. Data sources: WoS, PUBMED, Scopus, and publications were searched between 2017 and 2022. Results: the final sample consisted of 12 articles, and they were organized according to ethical aspects, concerns of the research subject, and the researcher’s position in the exchange of data in research with human beings. Discussion: the creation of a Data Access Committee (DAC) and an international ethical framework are initiatives that are promoted to advance the exchange of data in research with humans. However, the legal frameworks become relevant in the context of data protection in each country, as is the Chilean case. Conclusion: progress must be made in aspects of broad informed consent, which is directly related to the legal framework of each country. © 2023; Los autores.
Prevalence of pre-sarcopenic obesity in Chilean older people. Results of the National Health Survey 2016-2017
(Asociacion Espanola de Dietistas-Nutricionistas, 2023) Concha-Cisternasa, Yeny; Diaz, Felipe; Castro-Pinero, Jose; Lanuza, Fabian; Laserre, Nicole; Leiva-Ordohez, Ana Maria; Cigarroa, Igor; Nazar, Gabriela; Parra-Soto, Solange; Celis-Morales, Carlos; Petermann-Rocha, Fanny
Introduction: There are no studies in Chile that quantify the prevalence of pre-sarcopenic obesity. Therefore, this study aimed to determine the prevalence of pre-sarcopenic obesity in Chilean older adults.Methodology: 240 people >60 years from the Chilean National Health Survey 2016-2017 were included. Pre-sarcopenia was estimated with the handgrip test and obesity was defined using waist circumference. As a sensitivity analysis, obesity was classified in a subsample of 129 people using body mass index (BMI). Based on the obesity and muscle strength criteria, the participants were categorized as: normal; obesity/ normal; normal/ pre-sarcopenia and obesity/pre-sarcopenia. Results: 22.6% of the population presented obesity/pre-sarcopenia using waist circumference as a diagnostic parameter. The prevalence of pre-sarcopenic obesity was higher in women (22.9%), in older people (33.0%), with urban residence (22.8%), and lower educational levels (37.3%). By incorporating the BMI as an obesity criterion, a decrease in the prevalence of pre-sarcopenic obesity (12.2%) and a higher percentage of women with this phenotype were identified. Conclusions: The prevalence of pre-sarcopenic obesity was identified in 22.6% of the older Chilean population included. Considering the role of obesity and sarcopenia in the development of non-communicable diseases, its identification and early detection could allow the creation of interventions that favours the survival and health of the elderly. © 2023 Asociacion Espanola de Dietistas-Nutricionistas. All rights reserved.
Stressors, Job Resources, Fear of Contagion, and Secondary Traumatic Stress Among Nursing Home Workers in Face of the COVID-19: The Case of Spain
(SAGE Publications Inc., 2021-03) Blanco-Donoso, Luis Manuel; Moreno-Jiménez, Jennifer; Amutio, Alberto; Gallego-Alberto, Laura; Moreno-Jiménez, Bernardo; Garrosa, Eva
This study aimed to analyze the psychological consequences of the COVID-19 pandemic on nursing home workers, as well as the influence of certain related stressors and job resources. Two-hundred twenty-eight nursing home workers in Spain participated in this cross-sectional study. High levels of workload, social pressure from work, contact with suffering, and fear of contagion were found. In nursing homes where cases of COVID-19 had been detected, workers experienced higher levels of secondary traumatic stress. Social pressure from work, high doses of exposure to suffering, lack of personnel and personal protective equipment, and minimal supervisor support were significant in explaining traumatic stress. Supervisor and coworker support moderated some of these relationships. The results are discussed in terms of the need to implement urgent psychosocial protection strategies and to provide personal protective equipment (PPE) to help prevent future psychological disorders in this worker population.
Critical analysis of Imogene King’s theory of goal attainment
(Escola Superior de Enfermagem de Coimbra, 2023-12) Rivera-Rojas, Flérida; Valencia-Contrera, Miguel; Villa-Velásquez, Jenifer; Reynaldos-Grandon, Katiuska; González-Palacios, Yan
Background: Imogene King’s theory of goal attainment has proven to be useful for nursing development, however, its use is limited, which highlights the need to critically analyze its contribution to the discipline. Objective: To critically analyze Imogene King’s goal attainment theory, as proposed methodologically by Chinn and Kramer. Main topics under analysis: An analysis was carried out according to the criteria for theoretical reflection proposed by Chinn and Kramer, which consists of two phases: 1) description of the theory, considering the purpose, concepts and definitions, relationships, structure, and assumptions; and 2) critical reflection, including clarity, simplicity, generality, accessibility, and importance. Conclusion: The theory is clear, simple, generalizable, accessible, and important for professional practice. However, it has limitations in its scope with patients who are unable to interact, and it is not parsimonious due to the incorporation of many concepts. More empirical evidence is required to demonstrate its use in practice.
Care management and prevention of falls in people with cancer
(Editorial Salud, Ciencia y Tecnologia, 2023) Silva-Sánchez, Camilo Andrés
We understand nursing care management as the professional practice based on the discipline. Its objectives are to improve accessibility, coverage and timeliness through the good use of resources, clinical management and nursing care, by means of an integrated health care model. An oncology unit involves a multidisciplinary team of specialists who are responsible for the study, diagnosis, treatment and follow-up of the disease. People with oncological pathologies have an undetermined time of hospitalization, which increases the risk of presenting a fall. Applying daily fall risk scales, in addition to wearing appropriate footwear, maintaining adequate physical activity, eliminating or moving any element that may alter free mobility in the room, maintaining well-lit environments and using assistive devices such as: handrails, grab bars for shower and bath, bath booster seats and resistant seats for the shower would be sufficient to prevent a fall. However, the Ministry of Health (MINSAL) suggests additional measures as a strategy to reduce the risk of falls during hospitalization in people with cancer. Despite the evidence and application of all these measures, there is no effective evidence for the prevention of falls, and the interventions to be carried out will depend on each person and the associated health risk. Therefore, the simultaneous use of all the prevention measures would help to reduce the eventuality of a fall during hospitalization. © 2023; Los autores.
Discriminación racial determinantes sociales de la salud en niños y niñas migrantes: revisión narrativa
(Universidad del Norte, 2023-01) Venegas León, Camila; Pedrero Castillo, Víctor; Chepo Chepo, Macarena
Objetivo: Analizar la relación entre Determinantes Sociales de la Salud (DSS) y discrimi nación en niños, niñas y adolescentes migrantes a partir de la información disponible en la literatura científica. Método: Revisión narrativa de estudios primarios publicados entre 2008 y 2021 en las ba ses de datos PubMed y Web of Science. Se utilizaron los descriptores “Psychological/Social Discrimination”, “Racism”, “Social Stigma”, “Social Determinants of Health”, “Public Heal th”, “Health Equity”, “Transients and Migrants”, “Refugees”, “Emigrants and Immigrants”, “Undocumented Immigrants”, “Child”, “Adolescent”, “Child, “Preschool”. Los operadores booleanos utilizados fueron AND y OR. Se incluyeron artículos observacionales (analíticos o descriptivos) que evaluaran la relación entre discriminación racial y DSS, publicados en inglés o español. La población de estudio fueron niños, niñas y adolescentes. La selección de artículos se realizó siguiendo las recomendaciones PRISMA. La calidad de la evidencia fue evaluada mediante la herramienta MMAT. Resultados: De un total de 1249 artículos identificados, se incluyeron 55. La mayor can tidad de artículos identificó el efecto de la relación entre discriminación racial y migración en ámbitos de salud mental negativa. Fue escasa la evidencia respecto de determinantes estructurales, sin embargo, destaca la relación entre discriminación racial y el efecto mode rador de la familia y la escuela. Conclusiones: Analizar la discriminación racial que perciben niños y niñas migrantes me diante un enfoque de DSS permite identificar áreas sensibles al desarrollo estrategias de reducción de inequidades en este grupo.
Association between a lifestyle score and all-cause mortality: a prospective analysis of the Chilean National Health Survey 2009–2010
(Cambridge University Press CODEN, 2024-12-06) Petermann-Rocha, Fanny; Diaz-Toro, Felipe; Troncoso-Pantoja, Claudia; Martínez-Sanguinetti, María Adela; Leiva-Ordoñez, Ana María; Nazar, Gabriela; Concha-Cisternas, Yeny; Martínez, Ximena Díaz; Lanuza, Fabian; Carrasco-Marín, Fernanda; Martorell, Miquel; Ramírez-Alarcón, Karina; Labrana, Ana María; Parra-Soto, Solange; Villagran, Marcelo; Lasserre-Laso, Nicole; Cigarroa, Igor; Mardones, Lorena; Vásquez-Gómez, Jaime; Celis-Morales, Carlos A.
Objective: To investigate the association between a lifestyle score and all-cause mortality in the Chilean population. Design: Prospective study. Settings: The score was based on seven modifiable behaviours: salt intake, fruit and vegetable intake, alcohol consumption, sleep duration, smoking, physical activity and sedentary behaviours. 1-point was assigned for each healthy recommendation. Points were summed to create an unweighted score from 0 (less healthy) to 7 (healthiest). According to their score, participants were then classified into: less healthy (0–2 points), moderately healthy (3–4 points) and the healthiest (5–7 points). Associations between the categories of lifestyle score and all-cause mortality were investigated using Cox proportional hazard models adjusted for confounders. Nonlinear associations were also investigated. Participants: 2706 participants from the Chilean National Health Survey 2009–2010. Results: After a median follow-up of 10·9 years, 286 (10·6 %) participants died. In the maximally adjusted model, and compared with the healthiest participants, those less healthy had 2·55 (95 % CI 1·75, 3·71) times higher mortality risk due to any cause. Similar trends were identified for the moderately healthy group. Moreover, there was a significant trend towards increasing the mortality risk when increasing unhealthy behaviours (hazard ratio model 3: 1·61 (95 % CI 1·34, 1·94)). There was no evidence of nonlinearity between the lifestyle score and all-cause mortality. Conclusion: Individuals in the less healthy lifestyle category had higher mortality risk than the healthiest group. Therefore, public health strategies should be implemented to promote adherence to a healthy lifestyle across the Chilean population.
Latent class analyses of multimorbidity and all-cause mortality: A prospective study in Chilean adults
(Public Library of Science, 2023-01) Nazar, Gabriela; Díaz-Toro, Felipe; Concha-Cisternas, Yeny; Leiva-Ordoñez, Ana María; Troncoso-Pantoja, Claudia; Celis-Morales, Carlos; Petermann-Rocha, Fanny
Multimorbidity patterns can lead to differential risks for all-cause mortality. Within the Chilean context, research on morbidity and mortality predominantly emphasizes individual diseases or combinations thereof, rather than specific disease clusters. This study aimed to identify multimorbidity patterns, along with their associations with mortality, within a representative sample of the Chilean population. 3,701 participants aged ≥18 from the Chilean National Health Survey 2009–2010 were included in this prospective study. Multimorbidity patterns were identified from 16 chronic conditions and then classified using latent class analyses. All-cause mortality data were extracted from the Chilean Civil Registry. The association of classes with all-cause mortality was carried out using Cox proportional regression models, adjusting by sociodemographic and lifestyle variables. Three classes were identified: a) Class 1, the healthiest (72.1%); b) Class 2, the depression/cardiovascular disease/ cancer class (17.5%); and c) Class 3, hypertension/chronic kidney disease class (10.4%). Classes 2 and 3 showed higher mortality risk than the healthiest class. After adjusting, Class 2 showed 45% higher mortality risk, and Class 3 98% higher mortality risk, compared with the healthiest class. Hypertension appeared to be a critical underlying factor of all-cause morbidity. Particular combinations of chronic diseases have a higher excess risk of mortality than others.
Single-pass albumin dialysis as treatment of acute on chronic liver failure during COVID-19 pneumonia. report of one case
(Sociedad Medica de Santiago, 2022-11) Ramírez-Guerrero, Gonzalo; Zurita-Poza, Anita; Baghetti-Hernández, Romyna; Villagrán-Cortés, Francisco; Segovia-Hernández, Bárbara; Aguirre-Adones, Lisette; Garay, Osvaldo
Liver transplantation is the only effective therapy to reduce the high mortality associated with acute liver failure and acute on chronic liver failure (ACLF). Single-pass albumin dialysis (SPAD) is an extracorporeal supportive therapy used as a bridge to liver transplantation or regeneration. We report a 44-year-old man with alcoholic cirrhosis admitted for critical COVID-19 pneumonia that evolves with ACLF. SPAD technique was performed completing six sessions, with a reduction of bilirubin and ammonia levels. He evolved with severe respiratory failure and refractory septic shock, dying. SPAD is a safe and efficient technique aimed to eliminate liver toxins, preventing multiorgan damage interrupting the process known as the "autointoxication hypothesis". It is easy to implement in any critical patient unit and has lower costs than other extracorporeal liver support therapies. © 2022 Sociedad Medica de Santiago. All rights reserved.
Establishing the health and wellbeing needs of mining host community in Brazil, Chile and Peru: a mixed-method approach to identify priority areas for action to help communities meet their SDG3 targets
(BioMed Central Ltd, 2023-12) Rice, Brian; Buller, Ana Maria; Boccia, Delia; Bazan, Cesar; Miranda, Rafael; Cea, Ximena; Laro, Rodrigo; Fontes, Miguel; Hayes, Rosalie; de Wit, Mariken; Carter, Daniel J.; Plowright, Alexandra; Chadwick, Matthew; Gafos, Mitzy
Background: The global mining industry is an important partner in advancing the 2030 Agenda for Sustainable Development. In 2018, Anglo American plc published their Sustainable Mining Plan, containing a goal for improving health and wellbeing aligned with the Sustainable Development Goal 3 (SDG3) targets. Having formed an independent multidisciplinary research consortium, we designed and implemented a mixed-methods approach to attain a deeper understanding of SDG3 priorities within the local context of communities hosting Anglo American mining operations located in Latin America. Methods: In 2019, within the host communities of three mining operations in Chile, three in Brazil, and one in Peru, we conducted a qualitative study which included stakeholder workshops and key informant interviews. We also quantitatively appraised existing health data. Findings emerging from the qualitative and quantitative assessments were compared to identify health and wellbeing priority areas for action relevant to each community. Results: Across the three countries, 120 people took part in workshops and 35 in interviews. In these workshops and interviews, non-communicable diseases (SDG3.4), harmful alcohol consumption (SDG3.5), and pollution, particularly air pollution (SDG3.9), were consistently identified as areas for priority action. There were similarities in the reporting of individual, interpersonal, community, societal, and structural factors underlying these priority areas across the different communities. The availability of quantitative data was generally good at the state level, becoming increasing sparse as we focused on smaller geographies. The priorities identified in the quantitative assessments generally aligned with those highlighted in the qualitative data. Conclusions: We highlight the importance of engaging with local populations to understand and address health needs. To address the priorities identified, intervention packages tailored to the specific needs of host communities, that tackle associated upstream societal level factors, are required. To facilitate this, appropriate monitoring systems and epidemiological investigations should be implemented to better understand the local context and quantify health issues. In the host communities, it is essential for the mining sector to be a key health partner in promoting integrated programmes that contribute to achieving the priority objectives and targets aligned with the SDG3 agenda. © 2023, The Author(s).
Who cares for the carer? Codesigning a carer health and wellbeing clinic for older care partners of older people in Australia
(John Wiley and Sons Inc, 2023-12) Layton, Natasha; Lalor, Aislinn; Slatyer, Susan; Lee, Den‐Ching A.; Bryant M. A., Christina; Watson, Moira; Khushu, Anjali; Burton, Elissa; Oliveira R. N., Déborah; Brusco P. T., Natasha L.; Jacinto M. D., Alessandro; Tiller, Elizabeth; Hill, Keith D.
Older carers or ‘care partners’ of older people experiencing care needs often provide essential support, at times while neglecting their own health and well-being. This is an increasingly frequent scenario due to both demographic changes and policy shifts towards ageing in place. Multiple community stakeholders within the care and support ecosystem hold valuable expertise about the needs of older care partners, and the programme and policy responses that may better support their health and well-being. The aim of this study was to identify the perspectives of stakeholders obtained through the codesign phase of a multicomponent research project investigating new models of care and support for older care partners suitable for the Australian context. Methods: Principles of codesign were used to engage a purposeful sample of older care partners, health professionals, researchers, policy makers and health service administrators. Participants took part in a series of three codesign workshops conducted remotely via video conferencing. The workshops were supported with briefing material and generated consensus-based summaries, arriving at a preferred service model. Findings: This paper reports the research design and structure of the codesign panels, the range of findings identified as important to support the health and well-being of older carers of older people, and the resulting service model principles. The codesigned and preferred model of care is currently being prepared for implementation and evaluation in Australia. Public Contribution: This study was conducted using codesign methodology, whereby stakeholders including older care partners and others involved in supporting older carers, were integrally involved with design, development, results and conclusions.
Methodological update of integrative reviews: an emphasis on the quality of the results
(Editorial Salud, Ciencia y Tecnologia, 2022-06-05) Valencia Contrera, Miguel Andrez
To date, there are numerous proposals of methodologies that guide secondary research of the integrative review type, which have made great contributions and have served as a basis for other methodological proposals. This article proposes a methodological emphasis on the quality of integrative reviews, which, in the opinion of the present author, are the ones that should be followed to achieve an integral review with excellent quality; to facilitate its learning, a mnemonic “Integra” has been generated: (I) Idea or study problem; (N) Question or aim; (T) Search tactics; (E) Execution or use of the search; (G) Degree and quality control of the results; (R) Filtered results; and finally, (A) Analysis and discussion. The proposed resource serves as a methodological tool for a critical and congruent synthesis of the literature, in a novel and related way, showing evidence of reflection or critical thinking; without detracting from the fact that an exhaustive search must be carried out as a previous step in order to identify the relevant articles published on the subject; a systematic integration of the results; and a critique of the scope, nature and quality of the literature in relation to the proposed research question. © Este es un artículo en acceso abierto, distribuido bajo los términos de una licencia Creative Commons.

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