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Asociación de cobertura de vacunación con factores sociodemográficos, en trabajadores de centros de salud de primer nivel de atención, Córdoba-Argentina./ Association of vaccination coverage with sociodemographic factors in workers of primary health care centers of Cordoba, Argentina.
| Idioma(s): Inglés
INTRODUCTION: The activities performed by the health personnel have specific occupational risks making it more susceptible to get infectious diseases. Therefore, all healthcare workers must be properly immunized against vaccinepreventable diseases. AIMS: Assessing the proportion of healthcare workers from the public subsector who are vaccinated and relating the sociodemographic factors with the proportion of the Meningitis vaccination condition of the workers from the primary care level of the city of Córdoba Methods: An observational analytical cross-sectional study was carried out with a sample of 157 workers of the municipal district of Cordoba. A self-administered survey was conducted and univariate and bivariate analyses were performed. For the evaluation of factors related with the vaccination a Chi-Square Test was implemented. RESULTS: The measures of immunization coverage found were: hepatitis B vaccine 67,5%, anti flu vaccine 66,25%, trabadouble bacterial vaccine 60,51% and triple or double viral vaccine 50,32%. The overall analysis showed higher levels of coverage among those workers with a higher level of education and less seniority. This was also evident among the youngest and the physicians. With important differences depending on the educational level for hepatitis B vaccine, for triple or double viral among the youngest workers and double bacterial for those with less seniority. CONCLUSION: The health personnel studied on this research has a vaccination status that is lower than that of the internationally recommended vaccination status. Although, this status is similar to the one reported in several countries it shows that the under-coverage of vaccination among these workers is an extended problem which must be prioritized by health authorities; given the implications for the health of workers and the population these workers assist.
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
| 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.
| Idioma(s): Inglés
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.
| 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.
Social Determinants of Health and Tobacco Use in Five Low and Middle-Income Countries - Results from the Global Adult Tobacco Survey (GATS), 2011 - 2012.
| Idioma(s): Inglés
BACKGROUND: Tobacco consumption continues to be the leading cause of preventable deaths globally. The objective of this study was to examine the associaton of selected socio-demographic variables with current tobacco use in five countries that participated in the Phase II Global Adult Tobacco Survey in 2011 - 2012. MATERIALS AND METHODS: We analysed internationally comparable representative household survey data from 33,482 respondents aged ≥ 15 years in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally. RESULTS: The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina. CONCLUSIONS: Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.
Potential human health risks from metals and As via Odontesthes bonariensis consumption and ecological risk assessments in a eutrophic lake.
| Idioma(s): Inglés
The concentration of Al, Cr, Fe, Mn, Ni, Cu, Zn, Hg, Sr, Mo, Ag, Cd, Pb and As was analyzed in water, sediment, and muscle of Odontesthes bonariensis from the eutrophic San Roque Lake (Córdoba-Argentina). The monitoring campaign was performed during the wet, dry and intermediate season. The concentration of Cr, Fe, Pb, Zn, Al and Cd in water exceeded the limits considered as hazardous for aquatic life. The highest metal concentrations were observed in sediment, intermediate concentrations, in fish muscle, and the lowest in water, with the exception of Cr, Zn, As and Hg, which were the highest in fish muscle. Potential ecological risk analysis of heavy metal concentrations in sediment indicated that the San Roque Lake posed a low ecological risk in all sampling periods. The target hazard quotients (THQs) and carcinogenic risk (CR) for individual metals showed that As in muscle was particularly hazardous, posing a potential risk for fishermen and the general population during all sampling periods. Hg poses a potential risk for fishermen only in the intermediate season. It is important to highlight that none of these two elements exceeded the limits considered as hazardous for aquatic life in water and sediment. This result proves the importance of performing measurements of contaminants, in both abiotic and biotic compartments, to assess the quality of food resources. These results suggest that the consumption of this fish species from this reservoir is not completely safe for human health.
| 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.
| 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.
| Idioma(s): Inglés
Every year around fourteen million people globally are infected with human papillomavirus (HPV), the sexually transmitted virus that is the cause of most cervical cancers. A number of vaccines have been developed to protect against HPV, but in many countries, HPV vaccination rates have been low compared with rates for other recommended vaccines. Parental concerns, cost, and lack of information and awareness among both health professionals and parents are cited as important barriers to HPV vaccination. In Argentina the HPV vaccine has been provided to all eleven-year-old girls since 2011 as part of a comprehensive national program to prevent cervical cancer. Coverage increased from negligible levels before 2011 to a national average of 87.9 percent for the first dose, 71.6 percent for the second dose, and 52.2 percent for the third dose in 2013. There was a large variance in HPV vaccine coverage across the country's provinces. This article describes key strategies to overcome barriers to implementation of HPV vaccination and provides recommendations for policy makers.
Immunological and health-state parameters in the Patagonian rockfish Sebastes oculatus. Their relation to chemical stressors and seasonal changes.
| Idioma(s): Inglés
We present the results of a field study that evaluates whether exposure to anthropogenic pollution impacts immunological and health-state parameters of wild marine fish during the breeding and non-breeding periods. We assessed aspects of innate immunity (bactericidal capacity, bacterial agglutination, and leukocyte profile) and general health-related parameters (neutrophil to lymphocyte ratio, hematocrit, and condition factor) in the Patagonian rockfish (Sebastes oculatus) sampled from polluted (exposed) and reference (control) sites during winter (i.e., coolest temperatures and active reproductive period) and in summer (i.e., warmest temperatures and non-reproductive period). Results showed lower bactericidal competence, hematocrit, and condition factor in fish from exposed sites independently of season, whereas lymphocytes were higher and monocytes lower at the exposed site only during summer. Moreover, fish sampled during winter displayed lower bactericidal competence, hematocrit, and condition factor than those sampled in summer independently of site, whereas the opposite pattern was found for bacterial agglutination. These results could be explained by life-history theory, which predicts a re-allocation of resources between reproduction and other physiological functions (including immunity) during the most energetically demanding season. The present results show an alteration in immunological and health-state parameters of wild marine fish exposed to anthropogenic pollution independently of season, which could potentially result in higher susceptibility to disease and in turn population decline.