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En nuestro medio el proceso salud-enfermedad está determinado por la biología humana, medio ambiente, forma de vida de la comunidad y el sistema de prestación de servicios de salud, y siendo el medio ambiente uno de los factores en el que se involucran una serie de problemas, a veces incontrolables, (ecológicos, económicos, sociales) debemos elaborar programas para prevenir desastres y planes de atención para cuando se presenten. Teniendo un conocimiento amplio del tipo de emergencias que se puedan presentar y los riesgos concomitantes al mismo, podemos hacer prevención primaria, es decir, educar a la comunidad anticipadamente y muy seguramente los resultados serán más efectivos. A nivel de prevención secundaria se elaboran los planes de atención en emergencia cuyo objetivo es dar un cuidado integral y oportuno en situaciones de demanda potencializada de servicios de salud. Podemos definir Emergencia como toda situación imprevisible que altere súbita o inesperadamente la prestación de servicios.

En Colombia la seguridad del paciente es una prioridad en la atención en salud; los eventos adversos e incidentes son una muestra de atención insegura en las instituciones. El compromiso interdisciplinario es fundamental para trabajo proactivo en promoción de prácticas seguras, prevención y detección de fallas latentes y activas en un hospital. Objetivo: determinar la frecuencia de eventos adversos mediante revisión de historias clínicas de un hospital pediátrico de tercer nivel de Bogotá, con el fin de fomentar prácticas seguras. Metodología: investigación cuantitativa, transversal y descriptiva, dirigida a pacientes hospitalizados el 16 de mayo de 2013, sobre factores de riesgo, antecedentes hospitalarios, eventos adversos y complicaciones relacionados al cuidado de la salud. Resultados: hubo 169 casos clasificados para algún suceso, de los cuales 59 Eventos Adversos, 57 incidentes, y 53 descartados por falsos positivos. Discusión: se evidencia responsabilidad de prevención y control de infecciones por los profesionales de la salud, encargados de minimizar el riesgo del paciente vulnerable y, ante todo, proporcionar un manejo y mantenimiento adecuado de dispositivos médicos invasivos. Conclusiones: el 34,4% de historias clínicas presentaban algún tipo de evento adverso o incidente, revelando que algunos de estos fueron causados por la asistencia hospitalaria

Resumen Objetivo: Comprender el modo de vida de un grupo de trabajadores informales vendedores de productos agrícolas en carreta, en el territorio de Corabastos, Bogotá D.C., como aproximación al perfil epidemiológico del grupo. Metodología: Estudio cualitativo con participación de 29 trabajadores informales. La recolección de la información se realizó por medio de cuatro técnicas cualitativas y fue analizada por medio del método de análisis de contenido temático. Resultados: El MV se describió a partir del reconocimiento del territorio, las condiciones grupales de trabajo, la calidad y disfrute de bienes de consumo del grupo, capacidad para crear y reproducir valores culturales e identidad, capacidad para empoderamiento, organización y soporte en beneficios del grupo y calidad de las relaciones ecológicas de estos trabajadores informales Discusión y conclusiones: El concepto de MV que se describió es amplio y recoge categorías que no han sido evaluadas en otras investigaciones, específicamente en relación a los trabajadores informales y la inserción en un espacio social, un espacio ambiental, en la relación con instituciones estatales, valores culturales y su capacidad organizativa. Abstract Objective: To understand the mode of life of a group of informal work sellers of agricultural products, who use, as a working tool, a wooden cart. The place for this economical activity is a place named Corabastos, a gathering place of agricultural products. It is located in Bogotá D.C. This is an approximation to the epidemiological profile of the group. Methodology: Qualitative, 29 informal workers participated, Data collection was conducted through four qualitative techniques and it was analyzed using the method of analysis of thematic content. Results: The mode of life of this group, was described taking a as a starting point some specific aspects: The recognition of the territory (Corabastos), the group working conditions, the quality and enjoyment of consumer goods in the group, the ability to create and reproduce cultural values and identity, the ability to empowerment, organization and support in order to benefit the group Finally, the ecological relationships of the group were also taken into account. Discussion and conclusions: The concept was described MV is broad and includes categories that have not been evaluated in other investigations, specifically in relation to informal workers and insertion in a social space, environmental space, in the relationship with state institutions, cultural values and its organizational capacity.

The performance of a 2×2 all-fiber electrooptical switch is characterized in a system at up to 40 Gb/s. Error-free transmission is demonstrated. The device was also employed as a protection switch at 10 Gb/s in an installed fiber link. [ABSTRACT FROM PUBLISHER]

Objective: Medication management in home hospice is challenging for family caregivers (FCGs). We tested a patient-centered medication review and FCG support program delivered by hospice staff called "Shared Medication PLanning In (SiMPLIfy) Home Hospice." Methods: A pilot cluster-randomized trial at two U.S. home hospice agencies measured the primary outcome of reduction in Medication Regimen Complexity Index (MRCI) (range 0 [no medications]-no upper limit) and secondary outcome of Family Caregiver Medication Administration Hassle Scale (FCMAHS) (range 0 [no hassle-120 [greatest hassle]). Results: Twenty-two patient-FCG dyads enrolled. Mean baseline MRCI in the intervention group = 39 (95% CI: 30.9, 47.1) and control group = 25.5 (95% CI: 21.0-30.1). Half of intervention patients (3 of 6) had reduced MRCI compared with 26.7% (4 of 15) control patients ( p = 0.07). MRCI was not significantly associated with caregiver burden. FCMAHS differed between spousal and nonspousal FCGs ( p = 0.12). Conclusion: A clinician-FCG-patient communication program in home hospice is feasible and may reduce medication complexity. SiMPLIfy has the potential to reduce polypharmacy.

Language access barriers for individuals with limited-English proficiency are a challenge to advance care planning (ACP). Whether Spanish-language translations of ACP resources are broadly acceptable by US Spanish-language speakers from diverse countries is unclear. This ethnographic qualitative study ascertained challenges and facilitators to ACP with respect to Spanish-language translation of ACP resources. We conducted focus groups with a heterogeneous sample of 29 Spanish-speaking persons who had experience with ACP as a patient, family member, and/or medical interpreter. We conducted thematic analysis with axial coding. Themes include: (1). ACP translations are confusing; (2). ACP understanding is affected by country of origin; (3). ACP understanding is affected by local healthcare provider culture and practice; and (4). ACP needs to be normalized into local communities. ACP is both a cultural and clinical practice. Recommendations for increasing ACP uptake extend beyond language translation to acknowledging users' culture of origin and local healthcare culture.

Objectives: To describe the development and refinement of an implicit bias recognition and management training program for clinical trainees., Methods: In the context of an NIH-funded clinical trial to address healthcare disparities in hypertension management, research and education faculty at an academic medical center used a participatory action research approach to engage local community members to develop and refine a "knowledge, awareness, and skill-building" bias recognition and mitigation program. The program targeted medical residents and Doctor of Nursing Practice students. The content of the two-session training included: didactics about healthcare disparities, racism and implicit bias; implicit association test (IAT) administration to raise awareness of personal implicit bias; skill building for bias-mitigating communication; and case scenarios for skill practice in simulation-based encounters with standardized patients (SPs) from the local community., Results: The initial trial year enrolled n  =  65 interprofessional participants. Community partners and SPs who engaged throughout the design and implementation process reported overall positive experiences, but SPs expressed need for greater faculty support during in-person debriefings following simulation encounters to balance power dynamics. Initial year trainee participants reported discomfort with intensive sequencing of in-person didactics, IATs, and SP simulations in each of the two training sessions. In response, authors refined the training program to separate didactic sessions from IAT administration and SP simulations, and to increase safe space, and trainee and SP empowerment. The final program includes more interactive discussions focused on identity, race and ethnicity, and strategies to address local health system challenges related to structural racism., Conclusion: It is possible to develop and implement a bias awareness and mitigation skills training program that uses simulation-based learning with SPs, and to engage with local community members to tailor the content to address the experience of local patient populations. Further research is needed to measure the success and impact of replicating this approach elsewhere., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2023.)