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1.

Educar para mejorar en la prevención de infecciones de vías urinarias en pacientes con sonda vesical instalada/ Educate to heal in the prevention of urinary tract infections in patients with bladder catheter installed

Ortiz-Luis Silvia Rubí
| Idioma(s): Español
Resumen Introducción: educar para mejorar en la prevención de infecciones relacionadas con la atención de la salud, asegura un progreso social por su trascendencia económica y un desafío para las instituciones de salud y para el personal responsable del cuidado. Objetivo: evaluar el efecto de una estrategia de capacitación para la mejora en el cumplimiento del indicador Prevención de infecciones de vías urinarias en pacientes con sonda vesical instalada. Metodología: estudio de intervención con 39 enfermeras, para la evaluación inicial y final del cumplimiento de criterios básicos se utilizó el formato No. 1 de recolección de datos (Fl-PIVUPSVI/05). Los datos se procesaron con SPSS V-17, se realizó análisis descriptivo e inferencial con t de Student, análisis de varianza y coeficiente de correlación de Pearson. Resultados: se logró un incremento de 21 puntos porcentuales (42 a 63%) en el cumplimiento posterior a la capacitación; el mayor incremento (de 31 a 77%) fue en criterio de registro de las medidas higiénicas del paciente. Conclusión: la estrategia de capacitación produjo cambios a favor del cumplimiento del indicador Prevención de infecciones urinarias en pacientes con sonda vesical instalada.(AU) Abstract Introduction: Educate to heal in the prevention of infections related to health care, ensures social progress for its economic importance and a challenge for health institutions and care personnel. Objective: To evaluate the effect of a training strategy to improve compliance with the indicator Prevention of urinary tract infections in patients with installed bladder catheter. Methods: Intervention study, with 39 nurses, for the initial and final evaluation of compliance with basic criteria, the data collection format No. 1 (Fl-PIVUPSVI /05) was used. Data were processed with SPSS V-17, descriptive and inferential analyzes were performed with Student's t-test, analysis of variance and Pearson's correlation coefficient. Results: An increase of 21 percentage points (42% to 63%) was achieved in post-training compliance; the largest increase of 46% (31%-77%) was in the criteria for recording the patient's hygienic measures. Conclusion: The training strategy produced changes in favor of compliance with the indicator Prevention of urinary tract infections in patients with installed bladder catheter.(AU)
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2.

Los determinantes sociales de la salud, el caso de enfermería/ The social determinants of health, the case of nursing

Salcedo-Álvarez, Rey Arturo; Zárate-Grajales, Rosa Amarilis; González-Caamaño, Blanca Consuelo; Rivas-Herrera, José Cruz
| Idioma(s): Español
Resumen En enfermería, sus teóricas disciplinares describen diferentes abordajes para el cuidado de las personas, recurriendo siempre al metaparadigma, obteniendo así una perspectiva teorizada del cuidado. En este sentido, los discursos que institucionalizan y sustentan su práctica tratan generalmente sobre apoyo, ayuda, autodeterminación, autonomía, confort, enseñanza del cuidado, humanismo, integralidad, limitación del daño, prevención de la enfermedad y/o promoción de la salud. No obstante, en la práctica diaria se demuestra que más que procurar acciones preventivas que tomen como punto de partida de intervención los determinantes sociales de salud para aportar un cuidado incluyente, transcultural y humanizado, la mayoría del quehacer cotidiano que se realiza se fundamenta en acciones que en el mejor de los casos son para la curación, o bien, para la contención de la enfermedad, es por ello que en la práctica diaria las acciones de prevención son minúsculas. Finalmente, la suficiencia de recursos humanos, materiales y financieros son el factor más importante para poder proveer cuidados seguros; la idoneidad o escasez de estos es el resultado conjunto de las políticas públicas prevalecientes, mismas que favorecen, o no, un sistema de salud justo e incluyente y son también las que mayormente impactan la realidad nacional en salud.(AU) Abstract In nursing, their disciplinary theorists describe different approaches to caring for people always using the metaparadigm, thus obtaining a theorized care perspective. In this sense the speeches that institutionalize and sustain their practice usually deal on support, help, self-determination, autonomy, comfort, care education, humanism, integrity, damage limitation, disease prevention and/or health promotion. However, in daily practice it is shown that rather than taking preventive actions that have as an intervention starting point social determinants of health to provide an inclusive, transcultural and humanized care, most of the daily work done is based on actions that in best-case scenario are for healing or for containing the disease, which is why in daily practice prevention actions are tiny. Finally, the adequacy of human, material and financial resources are the most important factor to provide safe care; the suitability or lack of these is the combined result of the prevailing public policies that favor or not a fair and inclusive health system and are also those that mostly impact the national health reality.(AU)
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3.

Análisis de la mortalidad por VIH/SIDA en México en el periodo 1990-2013: ¿se cumplirá la meta establecida en los Objetivos de Desarrollo del Milenio (ODM) para el año 2015?/ [Analysis of HIV/AIDS mortality in Mexico from 1990 to 2013: An assessment of the feasibility of millennium development goals by 2015].

Bravo-García, Enrique; Ortiz-Pérez, Hilda
| Idioma(s): Español
OBJECTIVE: We aimed to assess the feasibility of achieving the goal of Mexican AIDS mortality in the Millennium Development Goals, nationally and by state. METHODS: For the period 1990-2013, we estimated annual rates of decline/increase in AIDS mortality according to five-year interval, using published data from the Mexican Instituto Nacional de Estadística y Geografía and Consejo Nacional de Población. Subsequently, we analyzed the feasibility of achieving the Millennium Development Goals target by 2015 by estimating the year in which the country and each state could achieve them. RESULTS: We estimated that only 13/32 states (40%) would achieve the goal established for AIDS mortality by Millennium Development Goals. Mexico, as a country, and the remaining 19 states (60%) did not will attain it. It is important to emphasize that seven states, rather than decrease, had an upward trend in mortality in the last five years analyzed. CONCLUSIONS: The free and universal access to antiretroviral treatment against HIV/AIDS has failed to reduce mortality as expected in Mexico. It is urgent to improve access to HIV testing by using more aggressive strategies. Also, it is necessary to apply interventions to link and retain persons in care until they are virologically suppressed.
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4.

Cost of glaucoma treatment in a developing country over a 5-year period.

Lazcano-Gomez, Gabriel; Ramos-Cadena, María de Los Angeles; Torres-Tamayo, Margarita; Hernandez de Oteyza, Alejandra; Turati-Acosta, Mauricio; Jimenez-Román, Jesús
| Idioma(s): Inglés
The aim of the study was to disclose a realistic estimate of primary open-angle glaucoma treatment, follow-up costs, and patients' monthly glaucoma-economic burden in an ophthalmology hospital in Mexico City.Prospective survey of 462 primary open-angle glaucoma patients from 2007 to 2012 was carried out. Costs from visits, glaucoma follow-up studies, laser, and glaucoma surgical procedures were obtained from hospital pricings. Education, employment, and monthly income were interrogated. Total cost was divided into hypotensive treatment cost, nonpharmacologic treatment cost (laser and surgeries), and follow-up studies and consults. Average wholesale price for drugs analyzed was obtained from IMS Health data; monthly cost was calculated using: Monthly cost  = ([average wholesale price/number of drops per eye dropper] × number of daily applications) × 30 days.Patients were classified according to their glaucoma severity, and data were analyzed based on monthly income (average annual exchange rate: 12.85 Mexican pesos = 1 USD).The mean age was 70 ±â€Š10 years, women = 81%, elementary school = 39%, and unemployed = 53%. Low-income group = 266 patients (57%), 146 with mild glaucoma; moderate-income group = 176 patients (38%), 81 with mild glaucoma; high-income group = 20 patients (4.3%), 10 with mild glaucoma. Patients' monthly average economic burden in glaucoma treatment: low-income patients = 61.5%, moderate-income patients = 19.5%, and high-income patients = 7.9%.Glaucoma-economic burden is substantial not only for health systems, but for the family and the patient. Therefore, screening plans for earlier diagnosis, and health policies that lessen the cost of disease management and increase adherence to treatment, and reduce the prevalence of blindness attributed to glaucoma are essential. These would improve quality of life, reduce personal and national expenditure, and help increase national economy.
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5.

Mercury and selenium concentrations in marine shrimps of NW Mexico: health risk assessment.

Frías-Espericueta, M G; Ramos-Magaña, B Y; Ruelas-Inzunza, J; Soto-Jiménez, M F; Escobar-Sánchez, O; Aguilar-Juárez, M; Izaguirre-Fierro, G; Osuna-Martínez, C C; Voltolina, D
| Idioma(s): Inglés
We determined total Hg and Se contents of hepatopancreas, exoskeleton, and muscle, and the Se:Hg molar ratios in the muscle of shrimps Farfantepenaeus californiensis and Litopenaeus stylirostris caught in NE Pacific Mexican waters. Total Hg mean values in muscle, hepatopancreas, and exoskeleton were 0.31 ± 0.26, 0.28 ± 0.29, and 0.24 ± 0.06 µg g , and 0.46 ± 0.46, 0.41 ± .034, and 0.24 ± 0.06 µg g for F. californiensis and L. stylirostris, respectively. In all tissues, the mean concentrations of Se tended to be close to one order of magnitude higher than the respective Hg values. In F. californiensis, the hepatopancreas of the larger commercial size had significantly (p < 0.05) higher Hg content than smaller sizes, but correlations size-Hg concentration calculated for each tissue of either species were not significant. The Hg content of the muscle of all commercial sizes of both species was lower than the permissible limit and their Se:Hg ratios in all sizes were higher than 1, indicating low risk for human consumption.
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6.

Proceso educativo de enfermería para promover el autocuidado de la mujer durante el puerperio/ Nursing educational process to promote self-care of women during the postpartum period

Acevedo-Hernández, Beatriz Adriana; Pizarro, Norma; Moriel-Corral, Bernardina Leticia; González-Carrillo, Eliazar; Berumen-Burciaga, Luz Verónica
| Idioma(s): Español
Resumen: Introducción: en investigaciones referentes al cuidado de enfermería a la mujer durante el posparto, se han abordado diversas temáticas sin embargo, se identifica que la educación en el proceso de cuidado no ha sido una de ellas. Objetivo: explorar el desarrollo del proceso educativo del profesional de enfermería que promueva el autocuidado de la mujer durante el puerperio. Metodología: se realizó investigación cualitativa con el diario de campo, entrevista a profundidad y observación participante. El análisis se realizó con base en la Teoría Fundamentada de Strauss y Corbin. Resultados: socialmente el puerperio es un evento cotidiano influenciado por creencias personales, sociales y culturales, situación que el legado sociocultural no satisface con el cuidado genérico influenciado por la familia. Conclusiones: El puerperio es un evento único y transitorio en la mujer, mismo que se refleja en la actitud y las acciones que realiza con respecto al cuidado de sí misma y del recién nacido. La educación es una oportunidad para el profesional de enfermería en relación con la comunicación y educación de la mujer en puerperio.(AU) Abstract: Introduction: Research related to nursing care to women during the postpartum period have addressed various topics however, it is identified that education in the care process has not been one of them. Objective: To explore the development of educational process of professional nursing that promotes self-care of women during the postpartum period. Methods: Qualitative research was conducted with field notes, depth interviews and participant observation. The analysis was based on the Strauss and Corbin Grounded Theory. Results: Puerperium is socially a daily event influenced by personal, social and cultural beliefs, it is a socio-cultural legacy situation that does not meet with the generic influenced by family care. Conclusions: The postpartum period is a unique and temporary event in women; it is reflected in the attitude and the actions taken regarding care for herself and the newborn. Education is an opportunity for professional nursing in relation to communication and education of women in postpartum period.(AU)
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7.

Evaporative concentration of arsenic in groundwater: health and environmental implications, La Laguna Region, Mexico.

Ortega-Guerrero, Adrián
| Idioma(s): Inglés
High arsenic concentrations in groundwater have been documented in La Laguna Region (LLR) in arid northern Mexico, where arsenic poisoning is both chronic and endemic. A heated debate has continued for decades on its origin. LLR consisted of a series of ancient connected lakes that developed at the end of a topographic depression under closed basin conditions. This study addresses the isotopic, chemical composition of the groundwater and geochemical modeling in the southeasternmost part of the LLR to determine the origin of arsenic. Groundwater samples were obtained from a carbonate and granular aquifers and from a clayey aquitard at terminal Viesca Lake. Results show that groundwater originated as meteoric water that reached the lakes mainly via abundant springs in the carbonate aquifer and perennial flooding of the Nazas-Aguanaval Rivers. Paleo-lake water underwent progressive evaporation as demonstrated by the enrichment of δ O, δ H and characteristic geochemical patterns in the granular aquifer and aquitard that resulted in highly saline (>90,000 mS/cm), arsenic-rich (up to 5000 µg/L) paleo-groundwater (>30,000 years BP). However, adsorption or co-precipitation on iron oxides, clay-mineral surfaces and organic carbon limited arsenic concentration in the groundwater. Arsenic-rich groundwater and other solutes are advancing progressively from the lacustrine margins toward the main granular aquifer, due to reversal of hydraulic gradients caused by intensive groundwater exploitation and the reduction in freshwater runoff provoked by dam construction on the main rivers. Desorption of arsenic will incorporate additional concentrations of arsenic into the groundwater and continue to have significant negative effects on human health and the environment.
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8.

Preliminary human health risk assessment of arsenic and fluoride in tap water from Zacatecas, México.

Martínez-Acuña, Mónica I; Mercado-Reyes, Marisa; Alegría-Torres, Jorge A; Mejía-Saavedra, José J
| Idioma(s): Inglés
Zacatecas state is located in the central area of Mexico, where the underground water contains elevated quantities of natural arsenic and fluoride. In order to estimate health risk associated with human exposure to these pollutants, tap water samples from the southern-central region of the state were analyzed. Ninety percent of the samples exceeded the levels of arsenic established by the World Health Organization (WHO) of 0.01 mg/L and 43 % exceeded the limit established by the NOM-127-SSA1(1) of 0.025 mg/L. Forty-three percent of the samples had fluoride levels above the Mexican regulation limit of 1.5 mg/L (NOM-127-SSA1). We used WHO and EPA's health risk assessment method, we estimated 80 % of the inhabitants of sites studied could be exposed to arsenic levels higher than those recommended by EPA and the WHO, 22 % could be exposed to fluoride levels higher than those recommended by EPA, and 16 % of the local population may be in risk of suffering dental fluorosis.
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9.

Community Interventions for Health can support clinicians in advising patients to reduce tobacco use, improve dietary intake and increase physical activity.

Anthony, Denis; Dyson, Pamela A; Lv, Jun; Thankappan, Kavumpurathu R; Champgane, Beatriz; Matthews, David R
| Idioma(s): Inglés
AIMS AND OBJECTIVES: To increase clinical interventions to reduce modifiable risk factors for noncommunicable disease in low- and middle-income countries. BACKGROUND: Noncommunicable disease is the leading cause of death in the world and is common in low- and middle-income countries. Risk factors for noncommunicable disease are modifiable and health professionals are in an unique position to intervene and influence them. DESIGN: Clinical interventions were used as part of the Community Interventions for Health programme, a nonrandomised, controlled study undertaken in three communities - one each in China, India and Mexico. METHODS: All clinicians in intervention and control areas of the study were invited to complete surveys. A total of 2280 completed surveys at baseline and 2501 at follow-up. Culturally appropriate interventions to reduce tobacco use, improve dietary intake and increase physical activity were delivered in the intervention areas. RESULTS: Clinicians in the intervention group felt more prepared to advise smoking cessation and improvement of diet. They were more likely to test serum cholesterol and blood pressure, but less likely to take measurements of height, hip, waist and skin-fold thickness. There were more resources available to clinicians in the intervention group and they used counselling more and complementary medicine less than those in the control group. CONCLUSIONS: Community interventions which have been shown to have a positive effect in the community and workplace also change clinical practice. RELEVANCE TO CLINICAL PRACTICE: Community interventions make clinicians, including nurses, more likely to feel prepared to offer advice and more likely to use counselling. This would be expected to reduce risk factors in patients.
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10.

Determinants of Anemia among School-Aged Children in Mexico, the United States and Colombia.

Syed, Sana; Addo, O Yaw; De la Cruz-Góngora, Vanessa; Ashour, Fayrouz A Sakr; Ziegler, Thomas R; Suchdev, Parminder S
| Idioma(s): Inglés
Anemia affects approximately 25% of school-aged children (SAC-aged 5.00-14.99 years) globally. We determined in three countries the prevalence and determinants of anemia in SAC. Data on sociodemographics, inflammation and nutrition status were obtained from the 2006 Mexican National Nutrition Survey, the 2003-6 US National Health and Nutrition Examination Surveys, and the 2010 Encuesta Nacional de Nutrición Situación Colombia. In the US, vitamin A and iron deficiency (ID) were available only for girls aged 12.00-14.99 years to which our analysis was limited. Associations were evaluated by country using multivariable logistic regression adjusting for confounders and complex survey design. The prevalence of anemia and ID were: Mexico 12% (ID 18%), n = 3660; US 4% (ID 10%), n = 733; and Colombia 4% (ID 9%), n = 8573. The percentage of anemia associated with ID was 22.4% in Mexico, 38.9% in the US and 16.7% in Colombia. In Mexico, anemia was associated with ID (adjusted OR: 1.5, p = 0.02) and overweight (aOR 0.4, p = 0.007). In the US, anemia was associated with black race/ethnicity (aOR: 14.1, p < 0.0001) and ID (aOR: 8.0, p < 0.0001). In Colombia, anemia was associated with black race/ethnicity (aOR: 1.6, p = 0.005), lowest socio-economic status quintile (aOR: 1.8, p = 0.0005), ID (aOR: 2.7, p < 0.0001), and being stunted (aOR: 1.6, p = 0.02). While anemia was uniformly associated with iron deficiency in Mexico, Columbia, and the United States, other measured factors showed inconsistent associations with anemia. Additional data on anemia determinants in SAC are needed to guide interventions.
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