Miguel Richart Martínez

Factors associated to breastfeeding cessation before 6 months

O objetivo da pesquisa foi identificar os fatores associados ao abandono do aleitamento materno (AM) e do aleitamento materno completo (AMC). Foram acompanhadas 248 maes que fizeram visita pos-parto. Os dados foram coletados mediante entrevista pessoal durante o primeiro mes pos-parto e, pelo telefone, aos quatro e seis meses seguintes. A analise se realizou mediante a Regressao de Cox. Os resultados mostram associacao entre o abandono da AMC e do AM com o fato de nao se ter amamentado anteriormente, com AM anterior ≤4 meses, e, com pior avaliacao da experiencia anterior. O menor nivel de estudos se relaciona com maior abandono do AM e das chupetas, ou suplementos no hospital com o abandono da AMC. A educacao pre-natal e fator protetor para o AMC e o AM. Conclui-se que o apoio ao AM deveria intensificar-se nas maes: sem experiencia anterior, com experiencia negativa, e, com pior acesso a informacao; tambem deveria ser controlado o uso da chupeta e dos suplementos de leite artificial (LA) nao indicados.This research aimed to identify the determinants of full breastfeeding (FBF) and any breastfeeding (ABF) cessation before 6 months, through a six-month follow-up of 248 mothers going a postpartum visit. Data were collected by personal interview during the first month and telephone interviews at four and six months postpartum. Coxs proportional hazards model was used. Not having previous ABF experience, previous ABF duration <or=4 months and worse evaluation of previous experience were associated with cessation of ABF and FBF. Lower educational level was associated with cessation of ABF and the use of pacifiers or occasional breast-milk substitutes with cessation of FBF. Attending childbirth education was a protective factor against early FBF or ABF cessation. Activities supporting breastfeeding should be intensified for mothers with poorer access to information and with negative or without ABF previous experience. The use of pacifiers and not-medically indicated breast milk substitutes should be controlled.

Factor de impacto en las revistas de enfermería

Resumen Objetivo Se discute el uso y la validez del factor de impacto para valorar la investigacion cientifica de enfermeria en Espana. Como apoyo a esta discusion se analiza la evolucion del factor de impacto de las revistas de enfermeria indexadas en el Journal Citation Reports (JCR). Metodo Se analiza el JCR durante el quinquenio 1996–2000 en cuanto a las revistas de enfermeria y afines indexadas, algunas de sus caracteristicas, su factor de impacto medio y su evolucion. Resultados y conclusiones Casi todas las revistas de enfermeria estan ubicadas en el Social Science Citation Index (SSCI) lo que sugiere una consideracion de la disciplina como ciencia psicosocial de la salud. La validez del factor de impacto con relacion a la investigacion espanola de enfermeria se ve limitada por un sesgo de seleccion del JCR (las revistas de enfermeria recogidas en el JCR son casi exclusivamente anglosajonas y mas especificamente de los EE.UU.). Este sesgo de seleccion original se ve incrementado por otros factores encadenados y relativos a las revistas fuente del JCR. Algunos rasgos de la investigacion en enfermeria en general y otros de la investigacion en enfermeria espanola en particular limitan aun mas la validez del factor de impacto. Como alternativas: creacion de indices bibliometricos locales y sectoriales, mejora de la difusion, visibilidad, etc., de la produccion cientifica, pero tambien mejora de la calidad de la investigacion.

Investigar en enfermería. Concepto y estado actual de la investigación en enfermería

El texto que presentan los profesores Julio Cabrero y Miguel Richart ha sido concebido como una aportacion a la reflexion y el debate acerca de la metodologia de investigacion y su aplicacion en el area de la enfermeria. Este hecho queda patente en la estructura y contenidos de los ocho capitulos en los que se encuentra dividido. En efecto, se hace una exhaustiva revision de los conceptos de investigacion y su significado en la enfermeria, se presentan algunos conflictos en el abordaje metodologico del objeto propio de la enfermeria, se senalan las principales dificultades de la puesta en practica de los enfoques y procedimientos de investigacion en enfermeria y sus propuestas de solucion y, por ultimo, se revisa la situacion actual de la practica de la investigacion en enfermeria, tanto a nivel internacional como nacional. En este punto, hay que destacar que todas las cuestiones han sido revisadas desde un amplio conocimiento de la bibliografia mas destacada. Con ello los autores ponen de manifiesto su actualizacion y conocimiento de los problemas que mas preocupan a los metodologos en enfermeria sobre el estado de desarrollo de su disciplina.

La medición de los autocuidados: una revisión de la bibliografía

Objetivo. Realizar una revision de la bibliografia de los diferentes instrumentos disenados para medir los autocuidados, atendiendo a sus aspectos conceptuales, propiedades psicometricas y normas de aplicabilidad. Metodo. Se realizo una busqueda en las bases de datos CINAHL y MEDLINE desde el ano 1994 a 2003. La busqueda se centro en 2 conceptos: self-care y questionnaire. En cada instrumento se analizo la base conceptual, las caracteristicas de las personas y el ambito de estudio, la fiabilidad, la validez y la responsividad. Resultados y conclusiones. Se identificaron y analizaron 27 instrumentos. Los resultados evidencian un marcado enfasis teorico-conceptual, poca claridad en sus diferentes dimensiones, las normas de aplicabilidad son practicamente inexistentes, y las propiedades psicometricas son insuficientes para recomendar la utilizacion de alguno de los instrumentos analizados. Las teorias de Bandura, Orem y Lazarus y Folkman destacan en el desarrollo de la mayoria de las medidas

Fatores associados ao abandono do aleitamento materno durante os primeiros seis meses de vida

O objetivo da pesquisa foi identificar os fatores associados ao abandono do aleitamento materno (AM) e do aleitamento materno completo (AMC). Foram acompanhadas 248 maes que fizeram visita pos-parto. Os dados foram coletados mediante entrevista pessoal durante o primeiro mes pos-parto e, pelo telefone, aos quatro e seis meses seguintes. A analise se realizou mediante a Regressao de Cox. Os resultados mostram associacao entre o abandono da AMC e do AM com o fato de nao se ter amamentado anteriormente, com AM anterior ≤4 meses, e, com pior avaliacao da experiencia anterior. O menor nivel de estudos se relaciona com maior abandono do AM e das chupetas, ou suplementos no hospital com o abandono da AMC. A educacao pre-natal e fator protetor para o AMC e o AM. Conclui-se que o apoio ao AM deveria intensificar-se nas maes: sem experiencia anterior, com experiencia negativa, e, com pior acesso a informacao; tambem deveria ser controlado o uso da chupeta e dos suplementos de leite artificial (LA) nao indicados.This research aimed to identify the determinants of full breastfeeding (FBF) and any breastfeeding (ABF) cessation before 6 months, through a six-month follow-up of 248 mothers going a postpartum visit. Data were collected by personal interview during the first month and telephone interviews at four and six months postpartum. Coxs proportional hazards model was used. Not having previous ABF experience, previous ABF duration <or=4 months and worse evaluation of previous experience were associated with cessation of ABF and FBF. Lower educational level was associated with cessation of ABF and the use of pacifiers or occasional breast-milk substitutes with cessation of FBF. Attending childbirth education was a protective factor against early FBF or ABF cessation. Activities supporting breastfeeding should be intensified for mothers with poorer access to information and with negative or without ABF previous experience. The use of pacifiers and not-medically indicated breast milk substitutes should be controlled.

Factores asociados al abandono de la lactancia materna durante los primeros 6 meses de vida

O objetivo da pesquisa foi identificar os fatores associados ao abandono do aleitamento materno (AM) e do aleitamento materno completo (AMC). Foram acompanhadas 248 maes que fizeram visita pos-parto. Os dados foram coletados mediante entrevista pessoal durante o primeiro mes pos-parto e, pelo telefone, aos quatro e seis meses seguintes. A analise se realizou mediante a Regressao de Cox. Os resultados mostram associacao entre o abandono da AMC e do AM com o fato de nao se ter amamentado anteriormente, com AM anterior ≤4 meses, e, com pior avaliacao da experiencia anterior. O menor nivel de estudos se relaciona com maior abandono do AM e das chupetas, ou suplementos no hospital com o abandono da AMC. A educacao pre-natal e fator protetor para o AMC e o AM. Conclui-se que o apoio ao AM deveria intensificar-se nas maes: sem experiencia anterior, com experiencia negativa, e, com pior acesso a informacao; tambem deveria ser controlado o uso da chupeta e dos suplementos de leite artificial (LA) nao indicados.This research aimed to identify the determinants of full breastfeeding (FBF) and any breastfeeding (ABF) cessation before 6 months, through a six-month follow-up of 248 mothers going a postpartum visit. Data were collected by personal interview during the first month and telephone interviews at four and six months postpartum. Coxs proportional hazards model was used. Not having previous ABF experience, previous ABF duration <or=4 months and worse evaluation of previous experience were associated with cessation of ABF and FBF. Lower educational level was associated with cessation of ABF and the use of pacifiers or occasional breast-milk substitutes with cessation of FBF. Attending childbirth education was a protective factor against early FBF or ABF cessation. Activities supporting breastfeeding should be intensified for mothers with poorer access to information and with negative or without ABF previous experience. The use of pacifiers and not-medically indicated breast milk substitutes should be controlled.

Búsquedas bibliográficas en enfermería y otras ciencias de la salud. Bases de datos en Internet

Busqueda bibliografica en enfermeria y otras ciencias de la salud. Bases de datos en Internet esta dirigido principalmente al profesional y al estudioso de la enfermeria que quiera localizar, identificar y acceder a informacion relevante, solida, util y cientifica sobre un tema, un problema, una pregunta de interes relacionada con su disciplina: enfermeria, o ciencias afines. Los autores se han esforzado en escribir un texto claro, sencillo y util: una guia practica sobre como hacer una busqueda.

Therapeutic measures in a moving ambulance: Qualitative study of professional opinions regarding prehospital emergencies

Background:current organization of the prehospital emergency teams, decreasing the prehospital times, given the possibility of working during the patient’s transport and, therefore, the consequence...Background:current organization of the prehospital emergency teams, decreasing the prehospital times, given the possibility of working during the patient’s transport and, therefore, the consequences that may result from the same improving the prognostic.Objectives:To explore the opinion of professional healthcare experts regarding prehospital emergencies arising when forced to assist a critical patient in a moving vehicle, based on a high-fidelity clinical simulation, as well as the factors influencing them.Methods:An exploratory study of content analysis with qualitative methodology, via semi-structured questionnaires that are self-completed anonymously, before and after the clinical simulation intervention in which participants intubate a mannequin in a moving ambulance. The sample consisted of 36 experts in prehospital emergencies from the province of Alicante (Spain). Codification and assessment of the data obtained was carried out via triangulation, respecting the language and literal expressions of ...

Dynamic Models of Geographic Environment using Ontological Relations

The geographic environment contains different types of entities: for instance, cars, considered as geographical objects, as well as entities such as storms, considered as geographical phenomena. With these entities occurs something commonly called events. These represent the dynamics of a geographical environment. If these entities are modeled based on an object-oriented approach, only properties and relations between other entities are considered, but the dynamic aspects are not. However, if they are modeled based on an event-oriented approach, the semantic relations of the dynamic aspects are indispensably needed to model the environment, considering instantly changed geographic entities, properties and relations as well as the subsequent effects they may cause to the environment and to other entities. We use Ontology Relations to explicitly describe changes in the properties and relations of geographic entities modified by events. A proposed algorithm generates a semantic chain that represents a whole episode about events over different duration time intervals.

Representing the Semantic Content of Topological Relations into Spatial Databases

An approach focused on incorporating semantic content into Spatial Databases is proposed. Our methodology is based on a conceptualization of a geospatial domain restricted to retrieve the meaning of topological relations between geographic objects by means of concepts. Indeed, in spatial databases only a small set of topological relations is explicitly represented and they are identified when the geospatial data are displayed or analyzed. While, a semantically enriched set of such relations may be required, sometimes this can be identified at the time when the geospatial data are manipulated by the user. Thus, we define six relations, which are obtained considering the behavior of diverse thematics such as Hydrology, Land Use, Transportation Networks, and Settlements. Geospatial objects are analyzed to identify the topological relationships. We consider two analysis levels: intrinsic and extrinsic. The intrinsic level consists of the analysis between geographic objects that belong to the same thematic. The extrinsic level is composed of relations between pairs of geographic objects that belong to different thematics. Therefore, descriptions are automatically generated in form of tuples {O i, R O j}, where O i and O j represent a pair of geospatial objects, and R represents the concept (relation). Each tuple represents the meaning of a topological relation. For example, a highway (O 1) crosses (R) a roadway (O 2). We consider that this method adds a partial semantic content to the geographic databases, because the concepts represent the meaning of topological relations. The conceptual representation has some advantages with respect to the traditional approaches: the conceptualization does not depend on the data scale, geo-reference system, dimension, etc. In addition, we propose a native format that has been designed to appropriately represent and analyze the topological relations.