Autonomy in labour and delivery in a Latin American urban centre: a qualitative phenomenological analysis.

The medicalisation of childbirth has diminished the role of labouring people. We conducted an exploratory phenomenological qualitative study, using purposive sampling, and then conducted 17 semi-structured interviews between December 2016 and October 2017 with people who had recently given birth in a public hospital in the Northern Metropolitan area of Santiago, Chile. The sufficiency of the study group was determined according to saturation criteria. Triangulated content analysis was applied to explore the clinical relationship and processes of autonomy and decision-making. The predominant clinical relationship observed was paternalism. The participation of labouring people in decision-making is scarce, with no evidence of ethically valid processes of informed consent.

Copper oxide nanoparticles doped with lanthanum, magnesium and manganese: optical and structural characterization.

Copper oxide (Cu2O) is a promising semiconductor for photovoltaic and photocatalytic applications since this material has a high optical absorption coefficient and lower band gap (2.17 eV). Doped lanthanum (La), magnesium (Mg) and manganese (Mn) Cu2O nanoparticles (Cu2O Nps) were prepared by a displacement reaction. The doped and undoped Cu2O Nps were characterized with scanning electron microscopy-energy dispersive X-ray spectroscopy (EDS), X-ray diffraction (XRD), transmission electron microscopy (TEM) and ultraviolet-visible spectroscopy. The EDS results confirm the presence of La, Mg and Mn in the Cu2O Nps. The XRD results confirm the formation a single cubic phase of Cu2O with a cuprite structure. TEM images confirm the formation of Nps with mean diameters between 12.0 ± 6.1 and 30.8 ± 11.0 nm. Doped and undoped Nps present a narrow band gap (2.40 eV), blue shifted with respect to bulk Cu2O.

Effect of the Concentration and the Type of Dispersant on the Synthesis of Copper Oxide Nanoparticles and Their Potential Antimicrobial Applications.

The bactericidal properties of copper oxide nanoparticles have growing interest due to potential application in the medical area. The present research investigates the influence of sodium dodecyl sulfate (SDS) and poly(vinylpyrrolidone) (PVP) on the production of copper oxide nanoparticles prepared from copper sulfate (CuSO4) and sodium borohydride (NaBH4) solutions. Different analytical techniques were used to determine the crystal nature, mean size diameter, and surface morphology of the copper oxide nanoparticles. The X-ray diffraction (XRD) patterns showed formation of nanoparticles of cuprite (Cu2O) and tenorite (CuO) when PVP and SDS were added at the beginning of the reaction. In fact, when the Cu/PVP ratio was 1.62, Cu2O nanoparticles were obtained. In addition, nanoparticles of CuO were synthesized when the Cu/PVP ratios were 0.54 and 0.81. On the other hand, a mixture of copper oxides (CuO and Cu2O) and cuprite (Cu2O) was obtained when PVP (Cu/PVP = 0.81 and 1.62) and SDS (Cu/SDS = 0.90) were added 30 min after the beginning of the reaction. Transmission electron microscopy (TEM) images show agglomerated nanoparticles with a size distribution ranging from 2 to 60 nm, while individual particles have sizes between 4.1 ± 1.9 and 41.6 ± 12.8 nm. The Kirby-Bauer method for the determination of antibacterial activity shows that small CuO (4.1 ± 1.9 nm) and Cu2O (8.5 ± 5.3 nm) nanoparticles inhibit the growth of Escherichia coli, Staphylococcus aureus MRSA, S. aureus and Pseudomonas aeruginosa bacteria. The antibacterial test of cotton fabric impregnated with nanoparticles shows positive results. The determination of the optimal ratio of copper oxide nanoparticles per cm2 of fabric that are able to exhibit a good antibacterial activity is ongoing.

Estresores que influyen desfavorablemente en estudiantes chilenos de Obstetricia y Puericultura, durante las prácticas clínicas / Stressors that unfavorably influence Chilean students of Obstetrics and Childcare, during clinical practices

Fundamento: las prácticas clínicas son un componente esencial para la formación de los estudiantes de Obstetricia y Puericultura, porque permiten aplicar los conocimientos teóricos adquiridos. Objetivo: identificar los estresores que influyen desfavorablemente en los estudiantes de segundo y tercer años de la carrera de Obstetricia y Puericultura de la Universidad de Chile, durante las prácticas clínicas. Métodos: se realizó un estudio transversal y descriptivo en la Escuela de Obstetricia y Puericultura de la Universidad de Chile durante el periodo marzo-diciembre, 2016. Se utilizaron métodos teóricos para la fundamentación de la investigación y empíricos: el cuestionario Stai para medir el nivel de ansiedad y el Kezkak, que mide estresores en las prácticas clínicas. Resultados: se identificaron los estresores que afectan la práctica clínica de los estudiantes de segundo y tercer años de Obstetricia; se constató, a través de la aplicación del cuestionario de Kezkak, que los más altos se relacionan con las competencias, la impotencia e incertidumbre; y como menos preocupantes, las relaciones interpersonales y la implicación emocional, entre ellas la muerte de un paciente, esta última dada por la inexperiencia en la atención a enfermos terminales; el cuestionario de Stai indica que la ansiedad/rasgo es mayor en comparación con la ansiedad/estado. Conclusiones: las situaciones de estrés que viven con mayor intensidad los estudiantes se deben a la inseguridad que representa enfrentarse a situaciones nuevas y al miedo a no saber responder con un dominio adecuado de las competencias, más que a un rasgo de su personalidad.

Background: clinical practices are an essential component for the training of students of Obstetrics and Childcare, because they allow applying the theoretical knowledge acquired. Objective: to identify the stressors that adversely affect the second and third year students of the Obstetrics and Child Care of the University of Chile, during the clinical practices. Methods: a cross-sectional and descriptive study was carried out at the School of Obstetrics and Child Care of the University of Chile during the period March-December, 2016. Theoretical methods were used for the foundation of the research and empirical: the Stai questionnaire to measure the level of anxiety and Kezkak, which measures stressors in clinical practices. Results: stressors that affect the clinical practice of the second and third year obstetrics students were identified; it was found, through the application of the Kezkak questionnaire, that the highest are related to competencies, impotence and uncertainty; and as less worrisome, interpersonal relationships and emotional involvement, including the death of a patient, the latter given by inexperience in the care of the terminally ill; Stai's questionnaire indicates that the anxiety / trait is greater compared to the anxiety / condition. Conclusions: the situations of stress that students live with greater intensity are due to the insecurity that represents facing new situations and the fear of not knowing how to respond with a proper mastery of the skills, rather than a feature of his personality.

Synthesis and antibacterial activity of silver nanoparticles against gram-positive and gram-negative bacteria.

Synthesis of nanosized particles with antibacterial properties is of great interest in the development of new pharmaceutical products. Silver nanoparticles (Ag NPs) are known to have inhibitory and bactericidal effects. In this article we present the synthesis of Ag NPs prepared by chemical reduction from aqueous solutions of silver nitrate, containing a mixture of hydrazine hydrate and sodium citrate as reductants and sodium dodecyl sulfate as a stabilizer. The results of the characterization of the Ag NPs show agglomerates of grains with a narrow size distribution (from 40 to 60 nm), whereas the radii of the individual particles are between 10 and 20 nm. Finally, the antibacterial activity was measured by the Kirby-Bauer method. The results showed reasonable bactericidal activity against Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus. The standard dilution micromethod, determining the minimum inhibitory concentration leading to inhibition of bacterial growth, is still under way. Preliminary results have been obtained. FROM THE CLINICAL EDITOR: In this paper the synthesis of Ag NPs via chemical reduction from aqueous solutions is discussed. Reasonable bactericidal activity against Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus was demonstrated.

[External evaluation of serology results in blood banks in Colombia]. / Evaluación externa de los resultados serológicos en los bancos de sangre de Colombia.

OBJECTIVE: To analyze the serological results found in Colombian blood banks that participate in the external quality program (EQP) of that country's National Institute of Health, in order to improve the quality of the screening of blood for the main serological markers of transfusion-transmitted infectious diseases. METHODS: Each blood bank received a panel of six sera with different reactivity and positivity to hepatitis B surface antigen (HBsAg), as well as to antibodies to HIV 1-2, Trypanosoma cruzi (the causative agent of Chagas' disease), Treponema pallidum (the causative agent of syphilis), hepatitis B core (HBc) antigen, hepatitis C virus (HCV), and human T-lymphotropic virus (HTLV). The screening techniques used were enzyme-linked immunosorbent assay (ELISA), microparticle enzyme immunoassay (MEIA), and hemagglutination. With the panel sera, the participating blood banks were asked to apply the same tests that they use on a daily basis to screen blood units and to send their results to the National Blood Banks Unit of the Colombian National Institute of Health. RESULTS: Of the 46 blood banks participating in the EQP, 43 of them (93%) returned their results within the requested timeframe. The ELISA test was the one that was used most often (83.0%). There were a total of 49 (5%) false positive results and 12 (3%) false negative results. Of those 12 false negative results, 6 of them corresponded to the detection of syphilis, 2 to Chagas' disease, 2 to anti-HBc antibodies, 1 to anti-HCV antibodies, and 1 to HBsAg. Eighty percent of the discordant results came from 23 blood banks that each collected fewer than 6 000 units of blood per year, and 15% came from 5 blood banks that collected 6 000 to 12 000 units per year. One of the blood banks that collected more than 12 000 units annually had three false positive results, and none of those larger blood banks had any false positive results. CONCLUSIONS: The percentage of false negative results (3%) found during the EQP can be considered high, since tests that are negative during blood screening are not repeated, and the decision to declare a unit of blood suitable for transfusion is based on that single result. There is a need to thoroughly review the procedures for screening blood in Colombia, particularly at the centers that performed poorly in this EQP exercise.

Evaluación externa de los resultados serológicos en los bancos de sangre de Colombia / External evaluation of serology results in blood banks in Colombia

OBJETIVO: Analizar los resultados serológicos obtenidos en los bancos de sangre colombianos que participan en el programa externo de calidad (PEC) con el fin de mejorar la calidad del tamizaje de la sangre según los principales marcadores serológicos de enfermedades infecciosas de posible transmisión sanguínea. MÉTODOS: Se evaluó un panel de seis sueros con diferente reactividad y positividad a anticuerpos contra los virus de la inmunodeficiencia humana (VIH) 1-2, el virus de la hepatitis C (VHC), Trypanosoma cruzi, Treponema pallidum y el virus linfotrópico de células T humanas (HTLV), y contra el antígeno de superficie del virus de la hepatitis B (HBsAg). Las técnicas de tamizaje utilizadas fueron el ensayo de inmunoadsorción enzimática (ELISA), el inmunoensayo enzimático de micropartículas (MEIA) y la hemaglutinación (HA). Se solicitó a los bancos de sangre participantes que aplicaran a los sueros las pruebas que diariamente realizaban para el tamizaje de unidades de sangre y que enviaran los resultados a la Coordinación Nacional de Bancos de Sangre del Instituto Nacional de Salud de Colombia. RESULTADOS: De 46 bancos de sangre que participaron, 43 (93 por ciento) devolvieron los resultados en el plazo indicado. La prueba de ELISA fue la más utilizada (83,02 por ciento). Se obtuvo un total de 49 (5 por ciento) resultados positivos falsos y 12 (3 por ciento) resultados negativos falsos. De estos últimos, 50 por ciento correspondieron a la detección de la sífilis; 16,7 por ciento a la de la enfermedad de Chagas; 16,7 por ciento a la de anticuerpos anti-HBc; 8,3 por ciento a la de anticuerpos anti-VHC y 8,3 por ciento a la del HBsAg. Ochenta por ciento de los resultados discordantes se presentaron en 23 bancos de sangre con un volumen de menos de 6 000 unidades de sangre al año, y 15 por ciento en 5 bancos de sangre con un volumen de 6 000 a 12 000 unidades de sangre al año. De los bancos de sangre que recogían más de 12 000 unidades anuales, solo uno notificó tres resultados positivos falsos. No se notificaron resultados negativos falsos. CONCLUSIONES: El porcentaje de resultados negativos falsos (3 por ciento) obtenidos durante el PEC puede considerarse elevado, ya que las pruebas que resultan negativas durante el tamizaje de los bancos de sangre no se repiten y la decisión de declarar una unidad de sangre apta para transfusión se basa en ese único resultado. Es preciso revisar minuciosamente los procedimientos para el tamizaje de la sangre,...