Prácticas familiares en el cuidado de los menores de la zona rural de Sopetrán, Antioquia / Family practices in the care of children from the rural areas of Sopetrán, Antioquia / Práticas familiares no cuidado dos menores da zona rural de Sopetrán, Antioquia

Objetivo: determinar la aplicación de prácticas familiares clave de la estrategia de atención integral a las enfermedades prevalentes en la infancia, por parte de los padres de niños inscritos en hogares del Instituto Colombiano de Bienestar Familiar, en la zona rural del municipio de Sopetrán, Antioquia, en 2014. Metodología: estudio descriptivo, transversal. La fuente primaria fue el universo de padres o cuidadores. Resultados: participaron 79 padres o cuidadores de nueve Hogares comunitarios de ocho veredas del municipio. En promedio, las madres tenían 28 años y los padres 32. El 74.7% de las familias fue de estrato socioeconómico nivel uno; la frecuencia de familias de tipo nuclear fue del 48%. Las verduras, los vegetales, los lácteos, las calabazas y las zanahorias fueron los alimentos menos consumidos por los menores. El 54.4% de las familias obtiene el agua de nacimiento y el 21.5% no le realiza tratamiento antes de consumirla. El 5.1% deposita excretas a campo abierto. El 15.2% y el 35.4% desconocen los signos de peligro que ponen en riesgo la vida del menor por infección respiratoria y por enfermedad diarreica aguda, respectivamente. En el 89.9% de los casos las madres se encargan del cuidado de los menores, con poca o nula participación del padre. Conclusión: los padres desconocen las prácticas clave relacionadas con la identificación temprana de signos de alarma de enfermedades prevalentes en la infancia. Además, el derecho al agua potable y saneamiento básico no es una realidad para todas las familias participantes. Adicionalmente, muchas no hierven el agua para consumirla, lo que podría incrementar algunas enfermedades prevalentes.

Objective: To determine to what extent the parents of children participating in the Colombian Institute for Family Wellbeing community homes implemented key family practices as a part of integrated management of childhood illness in the rural areas of Sopetrán, Antioquia in 2014. Methodology: cross-sectional descriptive study. The main source was the universe of parents or caregivers. Results: Seventy-nine parents or caregivers participated from nine community wellbeing homes in eight rural communities. The average age of mothers and fathers was 28 and 32, respectively. Of all families, 74.7% belonged to the lowest socioeconomic strata, and 48% of families were nuclear families. Vegetables, dairy products, pumpkins, and carrots were the least consumed foods by children. Over half of families (54.4%) get water from springs, 21.5% do not treat the water before drinking it, and 5.1% still practice open defecation. In fact, 15.2% and 35.4% remain unaware of the warning signs of infant respiratory infection and acute diarrhea, respectively. In 89.9% of cases, mothers care for children with little or no help from fathers. Conclusion: Parents are unaware of the key practices related to the early identification of warning signs in diseases common to children. In addition, not all participating families have access to treated drinking water and basic sanitary conditions. Lastly, many families do not boil water prior to drinking it, which could increase the prevalence of certain diseases.

Objetivo: determinar a aplicação de práticas familiares chave da estratégia de atenção integral às doenças prevalentes na infância, por parte dos pais de crianças inscritas nos lares do Instituto Colombiano de Bienestar Familiar, na zona rural do município de Sopetrán, Antioquia, em 2014. Metodologia: estudo descritivo, transversal. A fonte primária foi o universo de pais ou cuidadores. Resultados: participaram 79 pais ou cuidadores de nove Lares comunitários de oito bairros rurais do município. Em média, as mães tinham 28 anos e os pais 32. 74.7% das famílias foi de estrato socioeconômico nível um; a frequência de famílias de tipo nuclear foi de 48%. As verduras, os vegetais, os lácteos, as abóbora e as cenouras foram os alimentos menos consumidos pelos menores. 54.4% das famílias obtém a água de nascimento e 21.5% não se realiza tratamento antes de consumir. 5.1% deposita resíduos a campo aberto. 15.2% e o 35.4% desconhecem os signos de perigo que colocam em risco a vida do menor por infecção respiratória e por doença diarreica aguda, respectivamente. Em 89.9% dos casos as mães se encarregam do cuidado dos menores, com pouca ou nula participação do pai. Conclusão: os padres desconhecem as práticas chave relacionadas com a identificação precoce de signos de alarme de doenças prevalentes na infância. Ademais, o direito à água potável e saneamento básico não é uma realidade para todas as famílias participantes. Adicionalmente, muitas não fervem a água para consumir, o que poderia aumentar algumas doenças prevalentes.

Intercostal and forearm muscle deoxygenation during respiratory fatigue in patients with heart failure: potential role of a respiratory muscle metaboreflex

The purpose of this study was to determine the effect of respiratory muscle fatigue on intercostal and forearm muscle perfusion and oxygenation in patients with heart failure. Five clinically stable heart failure patients with respiratory muscle weakness (age, 66±12 years; left ventricle ejection fraction, 34±3%) and nine matched healthy controls underwent a respiratory muscle fatigue protocol, breathing against a fixed resistance at 60% of their maximal inspiratory pressure for as long as they could sustain the predetermined inspiratory pressure. Intercostal and forearm muscle blood volume and oxygenation were continuously monitored by near-infrared spectroscopy with transducers placed on the seventh left intercostal space and the left forearm. Data were compared by two-way ANOVA and Bonferroni correction. Respiratory fatigue occurred at 5.1±1.3 min in heart failure patients and at 9.3±1.4 min in controls (P<0.05), but perceived effort, changes in heart rate, and in systolic blood pressure were similar between groups (P>0.05). Respiratory fatigue in heart failure reduced intercostal and forearm muscle blood volume (P<0.05) along with decreased tissue oxygenation both in intercostal (heart failure, -2.6±1.6%; controls, +1.6±0.5%; P<0.05) and in forearm muscles (heart failure, -4.5±0.5%; controls, +0.5±0.8%; P<0.05). These results suggest that respiratory fatigue in patients with heart failure causes an oxygen demand/delivery mismatch in respiratory muscles, probably leading to a reflex reduction in peripheral limb muscle perfusion, featuring a respiratory metaboreflex.