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2.

Cuando la alegría entra al centro de salud: una experiencia de promoción de salud en Buenos Aires, Argentína/ When joy enters into the health center: an experience of health promotion in Buenos Aires, Argentina/ Quando a alegria entra no centro de saúde: uma experiência de promoção da saúde em Buenos Aires, Argentina

Bang, Claudia; Corín, Marcela; Stolkiner, Alicia
| Idioma(s): Español
Como parte de una investigación posdoctoral, el presente trabajo describe y analiza una experiencia de promoción y educación para la salud integral desarrollada por un Centro de Salud y Acción Comunitaria en una zona marginal urbana del sur de la Ciudad de Buenos Aires. Se trata de un estudio exploratorio-descriptivo que utiliza técnicas cualitativas para el trabajo de campo y análisis del material. En articulación con las dimensiones de la APS integral, se describe y analiza un dispositivo vincular, centrado en la interdisciplina y la articulación intersectorial como elementos clave de la organización de los cuidados en salud, con la inclusión de la dimensión intercultural y la participación comunitaria. Se incorporan actividades de promoción de salud integral centradas en el arte, creatividad y juego, constituyéndose en una experiencia resistencial al modelo biomédico de atención, con fuerte impacto subjetivo en los profesionales y la comunidad participante. As part of a postdoctoral research, this paper describes and analyzes an experience of promotion and education for comprehensive health, carried out by a Community Health Center in a slum of the City of Buenos Aires. This is an exploratory and descriptive study based on qualitative research methodologies in the fieldwork and also to examine the results. A linkage artifact is described and analyzed in the perspective of the dimensions of comprehensive PHC, focusing on the interdisciplinary and intersectoral articulation as key elements of the organization of health care, with the inclusion of the intercultural dimension and community participation. This experience incorporates health promotion activities focused on art, creativity and games, becoming an experience of resistance to the biomedical model of services, with a strong subjective impact on the professionals and the participant community. Como parte da pesquisa de pós-doutorado, o trabalho descreve e analisa uma experiência de promoção e educação para a saúde integral, desenvolvida por um Centro de Saúde e Ação Comunitária em uma zona marginal urbana do sul da Cidade de Buenos Aires. Trata-se de um estudo exploratório-descritivo, que utiliza técnicas qualitativas para o trabalho de campo e análise do material. Articulado com as dimensões da APS integral, descreve-se e se analisa um dispositivo vincular, centralizado na interdisciplina e na articulação intersetorial como elementos-chave da organização dos cuidados com a saúde, com a inclusão da dimensão intercultural e a participação comunitária. Incorporam-se atividades de promoção de saúde integral com o foco na arte, na criatividade e no jogo, constituindo uma experiência resistencial ao modelo biomédico de atenção, com forte impacto subjetivo nos profissionais e na comunidade participante.
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3.

Evolución de la mortalidad infantil en Argentina en el marco de los Objetivos de Desarrollo del Milenio./ Evolución de la mortalidad infantil en Argentina en el marco de los Objetivos de Desarrollo del Milenio./ Trend in infant mortality rate in Argentina within the framework of the Millennium Development Goals.

Finkelstein, Juliana Z; Duhau, Mariana; Speranza, Ana
| Idioma(s): Inglés; Español
INTRODUCTION: Infant mortality rate (IMR) is an indicator of the health status of a population and of the quality of and access to health care services. In 2000, and within the framework of the Millennium Development Goals, Argentina committed to achieve by 2015 a reduction by two thirds of its 1990 infant mortality rate, and to identify and close inter-jurisdictional gaps. The objective of this article is to describe the trend in infant mortality rate in Argentina and interjurisdictional gaps, infant mortality magnitude and causes, in compliance with the Millennium Development Goals. POPULATION AND METHODS: A descriptive study on infant mortality was conducted in Argentina in 1990 and between 2000 and 2013, based on vital statistics data published by the Health Statistics and Information Department of the Ministry of Health of Argentina. RESULTS: The following reductions were confirmed: 57.8% in IMR, 52.6% in neonatal mortality rate and 63.8% in post-neonatal mortality rate. The inter-provincial Gini coefficient for IMR decreased by 27%. The population attributable risk decreased by 16.6% for IMR, 38.8% for neonatal mortality rate and 51.5% for post-neonatal mortality rate in 2013 versus 1990. CONCLUSIONS: A significant reduction in infant mortality and its components has been shown, but not enough to meet the Millennium Development Goals. The reduction in IMR gaps reached the set goal; however, inequalities still persist.
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4.

The Economic Impact of Cystic Echinococcosis in Rio Negro Province, Argentina.

Bingham, Glenda M; Larrieu, Edmundo; Uchiumi, Leonardo; Mercapide, Carlos; Mujica, Guillermo; Del Carpio, Mario; Hererro, Eduardo; Salvitti, Juan Carlos; Norby, Bo; Budke, Christine M
| Idioma(s): Inglés
Cystic echinococcosis (CE), a parasitic zoonosis with substantial human health and economic consequences, is highly endemic in Rio Negro Province, Argentina. The objective of this study was to estimate the direct and indirect human and livestock-associated monetary losses attributable to CE, in Rio Negro Province, for the year 2010. Human costs were estimated using data obtained from hospital chart reviews, patient interviews, and government reports. Livestock-associated losses were estimated using data from government reports and scientific publications. Spreadsheet models were developed utilizing Latin Hypercube sampling to account for uncertainty in the input parameters. In 2010, the estimated total cost of CE, in Rio Negro Province, ranged from US$4,234,000 (95% credible interval [CI]: US$2,709,000-US$6,226,000) to US$5,897,000 (95% CI: US$3,452,000-US$9,105,000), with livestock-associated losses representing between 80% and 94% of the total losses, depending on whether non-healthcare-seeking human cases were included and if livestock slaughter values were adjusted to account for underreporting. These estimates suggest that CE is responsible for considerable human and livestock-associated monetary losses in Rio Negro Province. Stakeholders and policymakers can use these data to better allocate public health and agricultural resources for this region.
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5.

Impact of Universal Health Coverage on Child Growth and Nutrition in Argentina.

Nuñez, Pablo A; Fernández-Slezak, Diego; Farall, Andrés; Szretter, María Eugenia; Salomón, Oscar Daniel; Valeggia, Claudia R
| Idioma(s): Inglés
OBJECTIVES: To estimate trends of undernutrition (stunting and underweight) among children younger than 5 years covered by the universal health coverage programs Plan Nacer and Programa Sumar. METHODS: From 2005 to 2013, Plan Nacer and Programa Sumar collected high-quality information on birth and visit dates, age (in days), gender, weight (in kg), and height (in cm) for 1.4 million children in 6386 health centers (13 million records) with broad coverage of vulnerable populations in Argentina. RESULTS: The prevalence of stunting and underweight decreased 45.0% (from 20.6% to 11.3%) and 38.0% (from 4.0% to 2.5%), respectively, with differences between rural versus urban areas, gender, regions, age, and seasons. CONCLUSIONS: Undernutrition prevalence substantially decreased in 2 programs in Argentina as a result of universal health coverage.
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6.

Conocimiento y actitudes hacia la diabetes mellitus en la Argentina./ [Knowledge and attitude towards diabetes mellitus in Argentina].

Rodríguez, Martín; Puchulu, Félix
| Idioma(s): Español
A population survey was conducted in 9 provinces of Argentina in 2012 aimed at determining the level of knowledge of diabetes mellitus and the risk of developing the disease. This was a cross-sectional study based on the general population and including men and women aged 18-70 years from all socioeconomic backgrounds. Results showed that 30.5% of participants without diabetes mellitus were at risk of developing the disease. Fifty-nine percent of participants had a body mass index = 25 kg/m2. Forty-nine percent did less than 30 minutes of daily physical activity. Only 34% of the population ate fruits and vegetables every day. Ninety-eight percent of participants had once heard of diabetes, and 67% defined it as a severe or very severe disease. In view of the findings resulting from this survey, healthcare services are expected to improve prevention and effective control of cardiovascular risk factors as well as to enhance preventive actions in order to encourage the adoption of healthier lifestyles from an earlier age and to achieve greater knowledge not only among patients living with diabetes, but also within the general population.
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7.

Human health risk characterization of petroleum coke calcining facility emissions.

Singh, Davinderjit; Johnson, Giffe T; Harbison, Raymond D
| Idioma(s): Inglés
Calcining processes including handling and storage of raw petroleum coke may result in Particulate Matter (PM) and gaseous emissions. Concerns have been raised over the potential association between particulate and aerosol pollution and adverse respiratory health effects including decrements in lung function. This risk characterization evaluated the exposure concentrations of ambient air pollutants including PM10 and gaseous pollutants from a petroleum coke calciner facility. The ambient air pollutant levels were collected through monitors installed at multiple locations in the vicinity of the facility. The measured and modeled particulate levels in ambient air from the calciner facility were compared to standards protective of public health. The results indicated that exposure levels were, on occasions at sites farther from the facility, higher than the public health limit of 150 µg/m(3) 24-h average for PM10. However, the carbon fraction demonstrated that the contribution from the calciner facility was de minimis. Exposure levels of the modeled SO2, CO, NOx and PM10 concentrations were also below public health air quality standards. These results demonstrate that emissions from calcining processes involving petroleum coke, at facilities that are well controlled, are below regulatory standards and are not expected to produce a public health risk.
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8.

Conocimientos de salud bucodental en relación con el nivel socioeconómico en adultos de la ciudad de Corrientes, Argentina/ Oral health knowledge in relation to socio-economic level in adults from Corrientes city, Argentina/ Conhecimentos de saúde bucal em relação ao nível socioeconômico em adultos dacidade de Corrientes, Argentina

Silvina Dho, María
| Idioma(s): Español
OBJETIVO: analizar los conocimientos de salud bucodental y su relación con el nivel socioeconómico en individuos adultos. METODOLOGIA: se realizó un estudio transversal. A través de una encuesta domiciliaria se recolectó información referente a las variables de estudio. Se determinó el tamaño de la muestra estableciéndose un nivel de confianza del 95% (381 individuos) para la generalización de los resultados. Se aplicó un diseño muestral aleatorio simple para la selección de las viviendas a encuestar, que se complementó con un muestreo no probabilístico por cuotas para la selección de los individuos a entrevistar. RESULTADOS : Los individuos adultos de la Ciudad de Corrientes presentan en general un nivel de conocimientos de salud bucodental aceptable, pues en una escala de 0 a 28 puntos utilizada para valorar los conocimientos, se registró un mínimo de 15 puntos. Los individuos de NSE bajo presentan un nivel de conocimientos de salud bucodental similar a los individuos de NSE medio-alto/alto. Las personas de NSE medio-bajo presentaron un nivel significativamente menor de conocimientos de salud bucodental. CONCLUSION: Estos resultados deberían contemplarse en el diseño estrategias de intervención que incidan en los determinantes socioculturales del proceso salud-enfermedad. OBJECTIVE: to analyze the knowledge of oral health and its relationship with the socioeconomic status in adults. Methodology: a cross-sectional study was carried out. Information on sociodemographic and oral health knowledge was collected through a household survey using the technique of direct observation by the "face to face" interviewer. The sample size was determined by establishing a confidence level of 95% for the generalization of results (381 individuals). Simple random sampling design was used for the selection of households to be surveyed, which was supplemented with a non-probability sampling procedure for selecting individuals to be interviewed, based on data provided by the 2010 census. We used a SPSS 21.0 program for the analysis of data. RESULTS : the adults of the city of Corrientes have an acceptable level of knowledge of oral health. The scale of 0-28 points used to measure knowledge, checked a minimum of 15 points. Individuals of low socioeconomic status have a similar level of knowledge about oral health than those of medium-high/high status. People of medium-low status had a significantly lower level of knowledge about oral health. CONCLUSION: these results should be considered in the design of intervention strategies that affect the social and cultural determinants of the health-disease process. Objetivo: analisar os conhecimentos de saúde bucal e sua relação com o nível socioeconômico em indivíduos adultos. Metodologia: realizou-se um estudo transversal. Através de um questionário domiciliário foram coletadas informações referentes às variáveis do estudo. Foi determinado o tamanho da amostra estabelecendo-se um nível de confiança de 95% (381 indivíduos) para a generalização dos resultados. Aplicouse um desenho amostral aleatório simples para a seleção de domicílios a pesquisar, que se complementou com uma amostragem não probabilística por quotas para a seleção dos indivíduos a entrevistar. Resultados : os indivíduos adultos da Cidade de Corrientes apresentam em geral um nível de conhecimentos de saúde dental aceitável, pois em uma escala de 0 a 28 pontos utilizada para avaliar os conhecimentos, registrou-se um mínimo de 15 pontos. Os indivíduos de NSE baixo apresentam um nível de conhecimentos de saúde dental similar aos indivíduos de NSE médio-alto/alto. As pessoas de NSE médio - baixo apresentaram um nível significativamente menor de conhecimentos de saúde dental. Conclusão: estes resultados deveriam ser considerados no desenho de estratégias de intervenção que afetam os determinantes socioculturais do processo saúde-doença.
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10.

Feasibility and barriers of treating clubfeet in four countries.

van Wijck, Suzanne F M; Oomen, A Marjanne; van der Heide, Huub J L
| Idioma(s): Inglés
PURPOSE: The purpose of this study was to elucidate why neglected clubfeet still exists despite the availability of a highly (cost)-effective treatment-the Ponseti treatment. METHODS: A qualitative and partly quantitative study with semi-structured interviews was conducted in four countries: the Netherlands, South Africa, Argentina and Indonesia with both caregivers, mostly parents, of children with clubfoot and practitioners treating clubfoot. The topics discussed with the caregivers (n = 51) were the conceptions of the cause of clubfeet, received information, accessibility, financial aspects, and social stigma. With the practitioners (n = 11) the focus of the interviews was the treatment protocol and finance. RESULTS: Several barriers towards the start of the treatment were highlighted. At all places treatment was financed by the government, insurance or charity. Nevertheless, the cost of transport and missed working days formed a barrier, although there is a large difference between and within countries. Poverty, long travel duration, and beliefs of supernatural causes for the clubfoot result in delay in the start of treatment. CONCLUSION: These are problems we need to address when making effective treatment available for every child to diminish the burden of neglected clubfoot; especially accessible clinics in rural areas can be a good alternative to highly specialized hospitals in large cities. We as a community should try to find and overcome the barriers to treat these patients, because we have a relatively easy and highly cost-effective treatment option which can be given by trained non-physicians supervised by an interested medical doctor.
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