Aproximación a la actitud ante la malaria, etnias Yanomami, Piaroa y Yekuana, comunidades del Alto Orinoco. Amazonas, Venezuela - 2013 / Approach to the attitude to malaria,etnias Yanomami, Piaroa and Yekuana, High Orinoco communities. Amazon, Venezuela - 2013

En los últimos 20 años se registró una alarmante progresión de la Malaria en el continente americano. Se investigó el Municipio Autónomo Alto Orinoco por ser un área hiperendémica y completamente aislada. Existen 17 grupos étnicos, destacando los Yanomami, Piaroa, Yekuana y Guahibo, cada uno con su lenguaje, religiones, tradiciones y costumbres diferentes. Se exploró a los indígenas encuestados desde el punto de vista epidemiológico y existencial, a través de la encuesta aplicada por Rifá en comunidades maláricas de Asia. Un total de 452 individuos fueron censados (58 % del total de la población de las comunidades visitadas), de las cuales 257 pobladores mayores de 19 años, fueron entrevistados, 53% de los Yanomamis, 26% de los Piaroas, y 21% del total eran Yecuanas. 48% fueron hembras y 52% hombres, predominaron los menores de 44 años, las viviendas de las cinco comunidades estudiadas de Yanomami fueron shaponos, y hubo mayor vulnerabilidad en las comunidades Yanomami a la adquisición de otras enfermedades transmisibles. En relación a la creencia acerca de la intervención de los espíritus en la evolución de la Malaria, 60% de los encuestados de la etnia Yanomami consideraron necesaria la intervención del Chaman en el tratamiento de la Malaria. La etnia más afectada es la Yanomami por estar muy dispersa, convivir en viviendas multifamiliares y abiertas denominadas shapono, sin servicios sanitarios básicos y la mayoría distante de escuelas, ambulatorios de salud y actividades de intercambio económico El chamán continúa jugando un papel vital en las comunidades de la etnia Yanomami estudiadas.(AU)

In the past 20 years was recorded an alarming increase of Malaria in the Americas. It investigated the autonomous high Orinoco communities for being a hyperendemic area completely isolated. There are 17 ethnic groups, prominence Piaroa, Yanomami, Yekuana and Guahibo, each one with its language, religions, traditions and different customs. It explored the Indians surveyed from the existential, and epidemiological perspective through the survey by raffle in malarious from Asian communities. A total of 452 individuals were surveyed (58% of the total population of the communities visited), of which 257 residents over the age of 19, were interviewed, 53 per cent of the Yanomami, 26% of the Piaroas, and 21% of the total were Yecuanas. 48% were females and 52% men, predominated minors aged 44, dwellings of the five communities studied of Yanomami were shaponos, and there was increased vulnerability in the Yanomami communities in the acquisition of other communicable diseases. In relation to the belief about the intervention of the spirits in the evolution of Malaria, 60% of respondents of the Yanomami ethnic group considered necessary the intervention of the shaman in the treatment of Malaria. The ethnic group most affected is the Yanomami be very spread, live together in open and multi-family dwellings called shapono, without basic health services and the most distant of schools, health clinics and economic exchange activities the shaman continues to play a vital role in the communities of the Yanomami ethnic group studied.(AU)

Actitud ante la muerte en estudiantes de medicina al inicio y final de la carrera / Attitude toward death in medical students at the beginning and end of career

La muerte es un fenómeno natural y alcanza un nivel relevante en el personal sanitario. Se planteó analizar la actitud de los estudiantes de medicina acerca de la muerte, al inicio y final de la carrera. Estudio comparativo en estudiantes del primero y quinto año de Medicina de una Universidad pública, en el año 2012. Se aplicó el Cuestionario Actitudes sobre la Muerte de Templer con 33 proposiciones, de 6 diferentes actitudes: evitación, aceptación, temor, salida o solución y perspectiva profesional. Muestra de 188 y 112 estudiantes voluntarios, respectivamente realizándose comparación de proporciones. 68,10% mujeres y 31,9% masculinos, edad promedio 17,56±1,27años. Se encontró diferencias significativas en las respuestas sobre evitación, aceptación, temor, pasaje y salida. Se concluye que la actitud ante la evitación del hecho fatal es muy dispersa, la aceptación tuvo la tendencia a disminuir en la medida en que los estudiantes están en el nivel de estudio más alto. El temor a la muerte se incrementó en función al año estudiado y la actitud de la vida como un pasaje en los estudiantes de 1er año tiende a ser mayor que los de 5to. Finalmente, pensar en la muerte como una salida es más común en los estudiantes del año más avanzado.(AU)

The death is a natural phenomenon and a relevant level in medical personnel. He was raised to analyze the attitude of medical students about the death, at the beginning and end of the race. Comparative study on students of the first and fifth year of medicine at a public University, in 2013. Applied the questionnaire attitudes about the death of Templer with 33 propositions, 6 different attitudes: avoidance, acceptance, fear, output or solution and professional perspective. Sample of 188 and 112 student volunteers, respectively performing comparison of proportions. 68.10% women and 31.9% male, average age 17. 56±1, 27 years. We found significant differences in responses about avoidance, acceptance, fear, passage and exit. We concluded that the attitude towards the avoidance of the fact is fatal very scattered, acceptance had the tendency to decrease in that students are at the level of higher study. The fear of death increased in function to the studied year and the attitude of life as a passage in the 1st year students tends to be higher than the 5th. Finally, think of death as an output is more common in the later-year students.(AU)

Motivación para estudiar medicina en dos universidades públicas desde una visión integral

Las necesidades que motivan el comportamiento humano producen patrones de conducta que varían de un individuo a otro. Se realizó una investigación exploratoria con la representación de lo que serían los cuatro cuadrantes de Wilber (1996), en 207 y 107 estudiantes universitarios de las Universidades de Carabobo UC (Venezuela) y Autónoma de Madrid UAM (España) respectivamente, siendo una muestra intencional, Como instrumentos de recolección de datos se utilizaron el SODEMEM, MAPE-3 y Graffar modificado. Se encontró promedio de edad 18,95 ± 1,22años en la UC y 19,16±0,73años en la UAM; predominio del sexo femenino (cuadrante II). La mayoría manifestó ser católicos y no becados, preponderancia en las actividades o contenidos desarrollados durante sus estudios de secundaria como influencia en su decisión para de estudiar medicina (cuadrante III), y coincidieron que el motivo que los impulsó a elegir la carrera de Medicina fue la vocación de servicio, el interés clínico por la ciencia y la salud pública (cuadrante I). Estrato social en su mayoría alto, y bajo porcentaje de estudiantes trabajando, con más de 75% que solo se dedicaban solo al estudio (cuadrante IV). Se encontraron diferencias estadísticamente significativas en la religión (porcentaje de ateos) y de familiares médicos (p< 0,05). Se recomienda investigar otros aspectos no desarrollados, inclusive con metodologías y paradigmas distintos.(AU)

Needs that motivate human behaviour produce behavior patterns that vary from one individual to another. He was conducted an exploratory research with the representation of what would be the four quadrants of Wilber (1996), at 207 and 107 University students from the University of Carabobo UC (Venezuela) and Autónoma de Madrid UAM (Spain) respectively, being an intentional example. As instruments of data collection were used by the SODEMEM, MAPE-3 and two modified. Found average age 18.95 ± 1, 22años at UC and 19, 16±0, 73años at the UAM, predominio female (quadrant II). Lmajority said be Catholic and not scholarships, preponderance in the activities or content developed during high school as an influence in his decision to study medicine (quadrant III), and they agreed that the reason that drove them to choose the career of medicine was the vocation of service, clinical interest in science and public health (quadrant I). Social stratum most high, and low percentage of students working with more than 75% only involved only in the study (quadrant IV). We found statistically significant differences in religion (percentage of atheists) and medical families (p < 0,05). It is recommended researching other aspects not developed, including with methodologies and different paradigms.(AU)

[Health in the prison system: representations and practices by prison guards in Rio de Janeiro, Brazil]. / Saúde em prisões: representações e práticas dos agentes de segurança penitenciária no Rio de Janeiro, Brasil.

The role of prison guards in limiting access to health services by inmates and the impact of their representations on daily health practices were investigated through an action-research program. The program aimed to produce knowledge and improve the guards' involvement in tuberculosis and HIV/AIDS control by raising their awareness. Developed in three prisons and two hospitals, the study included individual interviews and group discussions and showed that representations of health and illness, risk hierarchy, and preventive strategies are related to actors' status in the prison's social organization, the conflicts and tensions between them, and the sense of group belonging that reinforces identities and antagonisms. Such representations have a major influence on the guards' daily practices and inmates' access to health services. The denial of inmates' right to health and their limited autonomy contributed to the implementation of essentially prescriptive health actions. The guards' awareness of their own health representations and practices may contribute to the deconstruction of stereotypes and increase their involvement in prevention and care. Further, improvement of inmates' health depends on changes in prison conditions.

Saúde em prisões: representações e práticas dos agentes de segurança penitenciária no Rio de Janeiro, Brasil / Health in the prison system: representations and practices by prison guards in Rio de Janeiro, Brazil

O papel limitante dos agentes de segurança penitenciária no acesso dos detentos aos serviços sanitários e o impacto de suas representações e práticas de saúde no cotidiano prisional foram objeto de pesquisa-ação visando tanto à produção de conhecimento como à melhoria das ações de controle da tuberculose e HIV/AIDS pela participação e conscientização. Desenvolveu-se em três prisões e dois hospitais por meio de entrevistas individuais e grupos de discussão. Revelou que concepções de saúde e doença, hierarquização de riscos e estratégias de preservação no contexto carcerário relacionam-se às posições nessa organização social, aos conflitos e tensões ali existentes e aos pertencimentos grupais que reforçam identidades e antagonismos, refletindo-se nas práticas rotineiras e no acesso aos serviços. A negação da saúde como um direito dos presos e a restrição de sua autonomia contribuem para ações de saúde prescritivas. A tomada de consciência dos agentes de segurança penitenciária quanto às representações e práticas de saúde pode contribuir para a desconstrução de idéias estereotipadas e aumentar seu envolvimento nas ações de prevenção e assistência. A melhoria das condições de saúde dos detentos implica também mudanças nas condições de encarceramento.

The role of prison guards in limiting access to health services by inmates and the impact of their representations on daily health practices were investigated through an action-research program. The program aimed to produce knowledge and improve the guards' involvement in tuberculosis and HIV/AIDS control by raising their awareness. Developed in three prisons and two hospitals, the study included individual interviews and group discussions and showed that representations of health and illness, risk hierarchy, and preventive strategies are related to actors' status in the prison's social organization, the conflicts and tensions between them, and the sense of group belonging that reinforces identities and antagonisms. Such representations have a major influence on the guards' daily practices and inmates' access to health services. The denial of inmates' right to health and their limited autonomy contributed to the implementation of essentially prescriptive health actions. The guards' awareness of their own health representations and practices may contribute to the deconstruction of stereotypes and increase their involvement in prevention and care. Further, improvement of inmates' health depends on changes in prison conditions.