Percepciones sobre la institucionalización de la persona adulta mayor en Barranquilla, Colombia / Perceptions about the Institutionalization of the Elderly in Barranquilla, Colombia

Resumen Introducción: El crecimiento demográfico global observado en personas adultas mayores plantea múltiples retos para el diseño de políticas de bienestar y salud pública, los cuales requieren introducir mejoras para su calidad de vida, la de la familia y la comunidad. El presente estudio resultado de investigación recoge las percepciones relacionadas con la disyuntiva entre vivir la vida en familia o la institucionalización de las personas adultas mayores en la ciudad de Barranquilla. Objetivo: Determinar la percepción que se tiene sobre la institucionalización de las personas adultas mayores desde la perspectiva del sujeto y la familia vinculados a los hogares geriátricos/gerontológicos y grupos de la tercera edad en la ciudad. Método: La investigación se realizó desde un enfoque hermenéutico, aplicando entrevistas semiestructuradas a las personas adultas mayores y las familias. Resultado: En la ciudad existe una heterogeneidad en relación con las percepciones sobre la forma de vivir esta etapa del desarrollo humano y que se encuentra estrechamente relacionada con aspectos como la salud, la economía, la funcionalidad familiar y el cuidado subrogado como un fenómeno social vinculado a la migración de las familias. Conclusión: El tema plantea desafíos que hay que enfrentar en Colombia y el mundo ante el envejecimiento, especialmente en el contexto de la pobreza, disfuncionalidad familiar y desigualdad. Se definen las causas y consecuencias de la institucionalización de las personas adultas mayores, así como las alternativas de cuidado familiar y social, explorando las características culturales y demográficas que influyen en la situación de las personas adultas mayores en el país.

Abstract Introduction: The global demographic growth observed in the segment of older adults poses multiple challenges for the design of well-being and public health policies in the countries, which requires introducing improvements that positively impact the quality of life of the older adult, the family and the community. The present study, a result of descriptive research, collects the perceptions related to the dilemma between living life as a family or the institutionalization of the elderly in the city of Barranquilla. Objective: To determine the perception of the institutionalization of the elderly from the perspective of the subject and the family linked to geriatric/gerontological homes and groups of the elderly in the city. Method: The research was carried out from a hermeneutic approach, applying semi-structured interviews to older adults and families. Result: There is heterogeneity in the city in relation to perceptions about the way of living this stage of human development and that it is closely related to aspects such as health, economy, family functionality, and the surrogate care as a social phenomenon linked to family migration. Conclusion: The topic raises challenges to be faced in Colombia and the world when it comes to aging, especially in the context of poverty, family dysfunction and inequality. The causes and consequences of the institutionalization of the elderly are defined, as well as the alternatives of family and social care, exploring the cultural and demographic characteristics that influence the situation of the elderly in the country.

Accessibility in video games for the visually impaired population in Colombia / Accesibilidad en los videojuegos para población con discapacidad visual en colombia

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ABSTRACT In recent years, the change in the design of video games has become evident, one of them is accessibility for people with different disabilities, despite the laws, which are very limited, there are no standards that require companies, industries and producers from different sectors implement this resource in their projects. From this research, the objective is to investigate the importance that these inclusion games comply with the response to stimuli provided by the industry, in this field, and that the support that the country is giving to this need to be felt is also felt. this visually impaired population. Based on the mixed research methodology, different sources are investigated in order to demonstrate how necessary it is that there are models of inclusion in video games, both entertainment and educational (serious), thus reaching an identity model that. The lack of laws and resources that promote this industry is evidenced. The project made it possible to describe the main strategies and resources that have been proposed and/or implemented in terms of accessibility for people with visual disabilities in Colombia, investigating and comparing the information obtained from the state of the art, and in this way conclude with the impact of these development methods, in the visually impaired population. An important impact has been the technological evolution that other countries have managed to develop for this type of population. As a conclusion, a disparity was found in the development of this project, which is precisely the little accessibility that people with visual disabilities have to video games in Colombia, because beyond the interaction that exists with some, much more access is required. And above all more investment and enactment of laws that support this resource. Using the mixed research methodology, different sources are investigated in order to demonstrate how necessary it is that there are models of inclusion in video games, both entertainment and educational (serious), thus reaching an identity pattern that gives as shows the lack of laws and resources that promote this industry. From this type of research, it was concluded that the lack of resources has been a legible mark that passes through these industries that have the panorama quite compromised by the demands of the market, but that due to this lack of economic resources they cannot reach the levels of implementation. to its mission and vision. Observing what was said above, it becomes complex to be able to carry out a research that clearly defines the inclusion processes for this type of people with said disability in Colombia. Each model of each industry is defined in a different way, since not all of them have this offer in their services. Common to this type of population. What, then, allowed us to conclude this research, finding social differences in each production of a video game? The project allowed us to describe the main strategies that have been proposed and/or implemented in terms of accessibility for people with visual disabilities in Colombia, investigating and comparing the information obtained from the state of the art, as mentioned above. Thus, then, different responses were found to this inclusion, not only in entertainment games but also in educational ones, which in the end are also very important in the classroom, because not only should one think about the distraction game, but also about the playful nature of teaching, thus helping teachers in the development of their classes. In this way, we conclude with the impact of these development methods on the visually impaired population. Another important point that could be evidenced is the evolution of technology, which has brought haptic systems, immersive and dynamic audio, as well as braille itself in digital systems, this, of course, has allowed progress towards much more logical and dynamic resources, but they continue to be limited precisely because they cannot be implemented correctly, due to their high purchasing value. We must think not of people who suffer from visual disabilities, but rather we must think of all social strata with this type of disability who can, with their resources, access this type of technology. Each part of the intervention exercise with state and private companies led to results that concluded in the population with visual disabilities that does not have the possibility of accessing this exercise of inclusion, and beyond the common interest in popularizing these video games, the limitation of certain sectors is seen that do not find in this undertaking a great industry, since the majority assures that it is more lucrative to invest in video games for people without no limitation or disability than investing in this other type of video game In conclusion, the disabled population in Colombia is 3,134,037; this number is very high if we also consider the rural populations that live without any type of resource or technological reach; Due to their socioeconomic condition and location, they are people who have a deterioration in services, then what is the extent of the disabled population in these areas that do not have the support and resources to improve their quality of life? It is almost null, there is no possibility that in the most vulnerable places and far from the reach of the government, inclusion exercises will be carried out with the visually disabled population, because simply in the last population census that was carried out in Colombia in 2018, more than 50% of the population They do not access the Internet, this added to governments that waste state money, it could be said that the level exceeds that percentage. If so, it is very possible that the reach of this population to these technological resources is very bad. A lot of economic investment is required on the part of the state, and for the designers of these technologies to expand to cover their creative enterprises, to the entire population, without the right to exclusion. For this reason, in this project a disparity is evident, which is precisely the little accessibility that people with visual disabilities have to video games in Colombia, not only from entertainment, but from their spaces in the classroom, which is what many demands. academics for their models and resources to work with this population, because beyond the interaction that exists with some (very few), much more access is still required and above all more investment and enactment of laws that support said resource.

Seguridad alimentaria y calidad de vida de la población en la provincia Cusco / Food security and quality of life the population in the Cusco Province / Segurança alimentar e qualidade de vida da população na província de Cusco

La seguridad alimentaria es cuando toda persona en todo momento tiene acceso económico y físico a suficientes alimentos inocuos y nutritivos para satisfacer sus necesidades alimentarias y preferencias en cuanto alimentos a fin de llevar una vida sana y activa. Por lo que el objetivo evaluar seguridad alimentaria y calidad de vida de la población vulnerable en la provincia Cusco, Perú. Para lo que se aplicó metodología con enfoque cuantitativo, con un diseño no experimental de corte transversal, basada en cuestionarios aplicados y entrevistas a una muestra de estudio (249 pobladores), la misma que previo a su aplicación superó las pruebas de validez y confiabilidad. Se realizó pruebas de frecuencia a los resultados de la opinión de los encuestados y correlación de Sperman's. Se evidencia que en un 65,9% la percepción de la población es que existe una inadecuada seguridad alimentaria, asimismo en un 85,1% que existe una mala calidad de vida, y desde una perspectiva estadística entre las citadas variables se obtuvo una significancia de 0,000 con un Rho de Sperman de 0,442, lo que demuestra la vulnerabilidad que se encuentra la población de Cusco. Concluyendo que entre las dos variables de estudio existe una relación directamente proporcional y de nivel moderado, denotando que en la media que se mejora los aspectos asociados a las dimensiones de la seguridad alimentaria, por consecuencia se tendría una mejora calidad de vida de la población de la provincia de Cusco, lo que evidencia que en la medida que se refuerce los aspectos asociados a la seguridad alimentaria, el bienestar físico y psicológico aspecto relacionado a la salud de dichas personas tendrá la oportunidad de mejorar.

Food security is when everyone at all times has economic and physical access to sufficient safe and nutritious food to meet their dietary needs and food preferences for a healthy and active life. Therefore, the objective is to evaluate food security and quality of life of the vulnerable population in the province of Cusco, Peru. For which a methodology with a quantitative approach was applied, with a non-experimental cross-sectional design, based on questionnaires applied and interviews to a study sample (249 residents), which, prior to its application, passed the validity and reliability tests. Frequency tests were carried out on the results of the respondents' opinion and Sperman's correlation. It is evident that in 65.9% the perception of the population is that there is inadequate food security, also in 85.1% that there is a poor quality of life, and from a statistical perspective, a significance was obtained between the aforementioned variables of 0.000 with a Sperman's Rho of 0.442, which demonstrates the vulnerability of the population of Cusco. Concluding that between the two study variables there is a directly proportional relationship and of a moderate level, denoting that on average the aspects associated with the dimensions of food security are improved, consequently there would be an improved quality of life for the population of the province of Cusco, which shows that to the extent that the aspects associated with food security are reinforced, the physical and psychological well-being, an aspect related to the health of these people, will have the opportunity to improve

A segurança alimentar é quando todos têm, em todos os momentos, acesso económico e físico a alimentos seguros e nutritivos suficientes para satisfazer as suas necessidades dietéticas e preferências alimentares para levar uma vida saudável e activa. Portanto, o objetivo é avaliar a segurança alimentar e a qualidade de vida da população vulnerável na província de Cusco, Peru. Para o qual foi aplicada uma metodologia de abordagem quantitativa, com desenho transversal não experimental, baseada na aplicação de questionários e entrevistas a uma amostra do estudo (249 residentes), que, antes da sua aplicação, passou em testes de validade e fiabilidade. Foram realizados testes de frequência sobre os resultados das opiniões dos entrevistados e correlação de Spearman. Evidencia-se que em 65,9% a percepção da população é que há segurança alimentar inadequada, também em 85,1% que há má qualidade de vida, e do ponto de vista estatístico obteve-se significância entre as variáveis citadas de 0,000, com um Speman Rho de 0,442, o que demonstra a vulnerabilidade da população de Cusco. Concluindo que entre as duas variáveis do estudo existe uma relação diretamente proporcional e moderada, denotando que em média os aspectos associados às dimensões da segurança alimentar são melhorados, consequentemente haveria uma melhoria na qualidade de vida da população do província de Cusco, o que mostra que à medida que se reforçam os aspectos associados à segurança alimentar, o bem-estar físico e psicológico, aspecto relacionado à saúde dessas pessoas, terá a oportunidade de melhorar

Ações de assistência à saúde ofertadas à população em situação de rua: estado da arte / Healthcare actions offered to homeless people: state of the art

Resumo A população em situação de rua (PSR) vem aumentando nos últimos anos. Ações governamentais são implementadas para melhorar as condições de vida dessa população, especialmente as voltadas à assistência à saúde. Este estudo tem como questão norteadora: quais são as estratégias de atenção à saúde dos serviços e programas voltados à população em situação de rua no Brasil? O objetivo é analisar quais são as estratégias de atenção à saúde adotadas pelos serviços e programas voltados à população em situação de rua no Brasil. Foi realizada uma revisão sistemática da literatura nas bases de dados Biblioteca Virtual em Saúde (BVS), Literatura Latino Americana e do Caribe em Ciências da Saúde (Lilacs) e Scientific Eletronic Library Online (SciELO), tendo como resultado 21 artigos. A análise revelou os alcances e desafios das redes de atenção à saúde, indicando o uso de drogas como principal motivo para busca dos serviços, sendo o Consultório na Rua (CnaR) um dispositivo importante, capaz de promover a criação de vínculos entre a PSR e os demais setores de saúde. A importância do trabalho em rede e a complexidade do cuidado com a saúde de populações foram temas recorrentes nas discussões, pois tratam de ações destinadas a pessoas vulnerabilizadas, estigmatizadas, apresentando necessidades e singularidades no modo de viver em sociedade.

Abstract The number of homeless people (HP) has been increasing in recent years. Government actions have been implemented to improve the living conditions for this population, especially those focused on health care. This study has as research question: What are the healthcare strategies of services and programs being offered to the homeless population in Brazil? Its objective is to analyze the health care strategies adopted by services and programs offered to the homeless population in Brazil. To achieve this purpose, a search was conducted in the Virtual Health Library (VHL), Latin American and Caribbean Literature in Health Sciences (Lilacs), and Scientific Electronic Library Online (SciELO) databases, resulting in 21 articles. The analysis revealed the scope and challenges of the health care networks, indicating drug use as the main reason for seeking the services, with the Street Clinics (CnaR, Consultório na Rua) being an important service capable of promoting the creation of links between the HP and other sectors. of health. The importance of networking and the complexity of population health care were recurring topics in the discussions, as they deal with actions aimed at vulnerable and stigmatized people, showing needs and singularities in the way of living in society.

Seguridad alimentaria y calidad de vida de la población en la provincia Cusco

La seguridad alimentaria es "cuando toda persona en todo momento tiene acceso económico y físico a suficientes alimentos inocuos y nutritivos para satisfacer sus necesidades alimentarias y preferencias en cuanto alimentos a fin de llevar una vida sana y activa". Por lo que el objetivo evaluar seguridad alimentaria y calidad de vida de la población vulnerable en la provincia Cusco, Perú. Para lo que se aplicó metodología con enfoque cuantitativo, con un diseño no experimental de corte transversal, basada en cuestionarios aplicados y entrevistas a una muestra de estudio (249 pobladores), la misma que previo a su aplicación superó las pruebas de validez y confiabilidad. Se realizó pruebas de frecuencia a los resultados de la opinión de los encuestados y correlación de Sperman's. Se evidencia que en un 65,9% la percepción de la población es que existe una inadecuada seguridad alimentaria, asimismo en un 85,1% que existe una mala calidad de vida, y desde una perspectiva estadística entre las citadas variables se obtuvo una significancia de 0,000 con un Rho de Sperman de 0,442, lo que demuestra la vulnerabilidad que se encuentra la población de Cusco. Concluyendo que entre las dos variables de estudio existe una relación directamente proporcional y de nivel moderado, denotando que en la media que se mejora los aspectos asociados a las dimensiones de la seguridad alimentaria, por consecuencia se tendría una mejora calidad de vida de la población de la provincia de Cusco, lo que evidencia que en la medida que se refuerce los aspectos asociados a la seguridad alimentaria, el bienestar físico y psicológico aspecto relacionado a la salud de dichas personas tendrá la oportunidad de mejorar.

Food security is "when everyone at all times has economic and physical access to sufficient safe and nutritious food to meet their dietary needs and food preferences for a healthy and active life." Therefore, the objective is to evaluate food security and quality of life of the vulnerable population in the province of Cusco, Peru. For which a methodology with a quantitative approach was applied, with a non-experimental cross-sectional design, based on questionnaires applied and interviews to a study sample (249 residents), which, prior to its application, passed the validity and reliability tests. Frequency tests were carried out on the results of the respondents' opinion and Sperman's correlation. It is evident that in 65.9% the perception of the population is that there is inadequate food security, also in 85.1% that there is a poor quality of life, and from a statistical perspective, a significance was obtained between the aforementioned variables of 0.000 with a Sperman's Rho of 0.442, which demonstrates the vulnerability of the population of Cusco. Concluding that between the two study variables there is a directly proportional relationship and of a moderate level, denoting that on average the aspects associated with the dimensions of food security are improved, consequently there would be an improved quality of life for the population of the province of Cusco, which shows that to the extent that the aspects associated with food security are reinforced, the physical and psychological well-being, an aspect related to the health of these people, will have the opportunity to improve.

A segurança alimentar é "quando todos têm, em todos os momentos, acesso económico e físico a alimentos seguros e nutritivos suficientes para satisfazer as suas necessidades dietéticas e preferências alimentares para levar uma vida saudável e activa". Portanto, o objetivo é avaliar a segurança alimentar e a qualidade de vida da população vulnerável na província de Cusco, Peru. Para o qual foi aplicada uma metodologia de abordagem quantitativa, com desenho transversal não experimental, baseada na aplicação de questionários e entrevistas a uma amostra do estudo (249 residentes), que, antes da sua aplicação, passou em testes de validade e fiabilidade. Foram realizados testes de frequência sobre os resultados das opiniões dos entrevistados e correlação de Spearman. Evidencia-se que em 65,9% a percepção da população é que há segurança alimentar inadequada, também em 85,1% que há má qualidade de vida, e do ponto de vista estatístico obteve-se significância entre as variáveis citadas de 0,000, com um Speman Rho de 0,442, o que demonstra a vulnerabilidade da população de Cusco. Concluindo que entre as duas variáveis do estudo existe uma relação diretamente proporcional e moderada, denotando que em média os aspectos associados às dimensões da segurança alimentar são melhorados, consequentemente haveria uma melhoria na qualidade de vida da população do província de Cusco, o que mostra que à medida que se reforçam os aspectos associados à segurança alimentar, o bem-estar físico e psicológico, aspecto relacionado à saúde dessas pessoas, terá a oportunidade de melhorar.

Sex Determination from the Patella in a Thai Population / Determinación del Sexo a Partir de la Rótula en una Población Tailandesa

SUMMARY: The aim of this study was to derive the equations for sex determination and to test the accuracy of discrimination between sexes using measurements of the patella in the Thai population. The sample comprised 254 Thai skeletons (134 males and 120 females) aged between 22 and 97 years, with an average age of 63.3years, obtained from the Osteology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai. Six variables were measured in 254 pairs of normal patellae. The mean values of patellar measurements in males were significantly greater than those in females for all variables (P<0.05). Statistical analysis further showed that all variables were useful in sex determination. Stepwise discriminant function analysis yielded an accuracy of 83.2 % (83.8 % male, 82.5 % female) and 85.5 % (85.3 % male, 85.8 % female) for the left and right patellae, respectively. These results suggested that measurement of the right patella is preferable for skeletal sexing. If this is not available, the forensic specialist can use the left patella instead, with an average accuracy of more than 80.0 % in giving a correct classification. The findings of this study demonstrate that the patella is an important bone in sex determination. They suggest that either the left or right patella can be used for sex determination, especially in the Northern Thai population.

El objetivo de este estudio fue derivar las ecuaciones para la determinación del sexo y probar la precisión de la discriminación entre sexos utilizando mediciones de la patela en la población tailandesa. La muestra estuvo compuesta por 254 esqueletos tailandeses (134 hombres y 120 mujeres) con edades comprendidas entre 22 y 97 años, con una edad promedio de 63,3 años, del Centro de Investigación y Capacitación en Osteología de la Facultad de Medicina de la Universidad de Chiang Mai, Chiang Mai. Se midieron seis variables en 254 pares de patelas normales. Los valores medios de las mediciones patelares en los hombres fueron significativamente mayores que los de las mujeres, para todas las variables (P <0,05). Además, el análisis estadístico mostró que todas las variables fueron útiles para la determinación del sexo. El análisis de la función discriminante por pasos arrojó una precisión del 83,2 % (83,8 % hombres, 82,5 % mujeres) y 85,5 % (85,3 % hombres, 85,8 % mujeres) para las patelas izquierda y derecha, respectivamente. Estos resultados sugieren que la medición de la patela derecha es preferible para la determinación del sexo en esqueletos. En caso de no estar disponible y para dar una clasificación correcta, el especialista forense puede utilizar la patela izquierda, con una precisión promedio de más del 80,0 %. Los hallazgos de este estudio demuestran que la patela es un hueso importante en la determinación del sexo. Se sugiere que se pueda utilizar la patela izquierda o derecha para determinar el sexo, especialmente en la población del norte de Tailandia.

Study of the morbidity profile including depression among the elderly in the rural area, East Bangalore

Background: Old age is associated with diminished physiological reserve; so any physical illness, metabolically derangement or pharmacological challenge can worsen cognitive and physical function. The only way to minimize or avoid these will be to be on the lookout and have a proactive approach and assessment in every older patient irrespective of the presenting complaint. This study aimed to assess the socio-demographic profile and self reported morbidity pattern of the elderly population and to estimate the prevalence of depression among the elderly population using the geriatric depression scale. Methods: A pre-designed, pretested and semi-structured questionnaire was used in the study. The data collection technique is by personal interview of the study subjects. A pre-designed, pretested and semi-structured questionnaire was used in the study. The data collection technique is by personal interview of the study subjects. Results: In our study more women were under depression than the men. The most common physical morbidity among the elderly population was cataract (59.7%), followed by arthritis (57.1%), non- specific body pains (40.1%) and hypertension (39%). Conclusions: Prevalence of depression among the elderly population is reported to be high (84.3%) in this study. Multi morbidity, socio economic factors and financial dependence were factors associated with depression in elderly.

Comparative analysis of leukemia and risk estimation in working age population between provinces of Ecuador / Análisis comparativo de leucemia y estimación del riesgo en la población en edad laboral entre provincias del Ecuador

Leukemia is associated with exposure to radiation, benzene derivatives, and pesticides. Previous research has documented an increase in work-related leukemia in the Latin American Andean region. To date, there are only few studies in Ecuador on the impact of oil exploitation on adjacent indigenous communities. Our study aims to show the impact of leukemia on the working-age population. For the calculation of morbidity and mortality rates, we used hospital discharge and death records from the National Institute of Statistics of Ecuador. These data were collected and adjusted to the corresponding province's population for further analysis. Large differences were observed between provinces in adjusted rates of leukemia mortality and morbidity in the working-age population. The variations in altitude among different areas in Ecuador give the provinces a distinct geographic identity. Likewise, the provinces with the highest morbidity and mortality rankings, such as Azuay, Loja, Imbabura, and Tungurahua, have an average altitude above 2000 meters. As a result, there are variations in the average temperature, exposure to solar and cosmic radiation, and mining and farming methods. The observed differences warrant the future collection of geolocation data for affected individuals. This could help to better understand how leukemia cases have demogrpahic hotspots in the country, identify possible risk factors associated with the disease in each region, and design more effective prevention and control strategies.

La leucemia es una enfermedad a consecuencia, además de factores genéticos, de la exposición a radiaciones, derivados del benceno y pesticidas. Investigaciones anteriores han documentado un aumento de la leucemia ocupacional en la región andina de América Latina. Hasta la fecha, existen sólo unos pocos estudios en Ecuador sobre el impacto de la explotación petrolera en las comunidades indígenas. Nuestro objetivo es mostrar el impacto de la leucemia en la población en edad de trabajar. Para el cálculo de las tasas de morbimortalidad se utilizaron los registros de altas hospitalarias y defunciones del Instituto Nacional de Estadística del Ecuador. Estos datos fueron recopilados y estimadas las tasas ajustadas. Se observaron grandes diferencias entre provincias en las tasas ajustadas de mortalidad y morbilidad por leucemia en la población en edad de trabajar. Asimismo, las provincias con mayor ranking de morbilidad y mortalidad, como Azuay, Loja, Imbabura y Tungurahua, coinciden en tener una altitud promedio superior a los 2000 metros. Hay provincias de baja altitud en la costa y provincias por encima de los 2000 metros en la sierra, lo que le da a las provincias del Ecuador una identidad geográfica distintiva. Como resultado, existen variaciones en la temperatura promedio, la exposición a la radiación solar y cósmica, y actividades de minería y agricultura. Las diferencias observadas, recomiendan la recopilación futura de datos de geolocalización de las personas afectadas. Esto podría ayudarnos a comprender mejor cómo se distribuyen los casos de leucemia, identificar posibles factores de riesgo asociados a la enfermedad en cada región y diseñar estrategias de prevención y control más efectivas.

Acesso e cuidado a saúde de mulheres privadas de liberdade na penitenciária cearense / Access to health care among female prisoners in a penitentiary in Ceará, Brazil

Resumo O estudo analisa o acesso ao cuidado em saúde de mulheres encarceradas no estado do Ceará, rastreando transtornos mentais comuns. Estudo analítico, transversal, de natureza quantitativa, desenvolvido na única penitenciária feminina do Ceará. Participaram 90 detentas, todas com alguma das seguintes questões de saúde: gestantes, puérperas, portadoras de hipertensão arterial sistêmica, diabetes mellitus, tuberculose, sífilis, hepatite B ou HIV/Aids. Os dados foram coletados por entrevista estruturada. Evidenciou-se acesso limitado à atenção à saúde das detentas, violando direitos básicos sob tutela do Estado. Foram constatadas limitações de exames de rastreamento de doenças nas presidiárias na ocasião de seu acesso ao cárcere, principalmente as que não se encontravam grávidas no momento do encarceramento. Houve diferenças entre as distintas condições de saúde analisadas, com prioridade da atenção às gestantes e puérperas. Entre as detentas, 68,24% apresentavam risco de transtornos mentais comuns (SRQ > 7). Houve correlação positiva entre idade e saúde mental (p = 0,0002). Embora exista legislação pertinente de garantia de acesso à saúde no cárcere, o sistema prisional está despreparado para atender às necessidades de portadoras de comorbidades, gestantes e puérperas.

Abstract This study investigated access to health care among female prisoners in the state of Ceará, Brazil, and screened for common mental disorders. We conducted an analytical cross-sectional study in the only female prison in the state. Ninety detainees participated in the study. All participants were either pregnant or postpartum women or had one or more of the following health problems: hypertension, diabetes mellitus, tuberculosis, syphilis, hepatitis B, HIV/AIDS. The data were collected using a structured questionnaire. The findings reveal that access to health care was limited, violating the fundamental rights of the prisoners. Screening for diseases on admission to prison was limited, especially among non-pregnant women. Differences in health care were found between health conditions, with priority being given to pregnant and postpartum women. Most of the inmates (68.24%) were found to be at risk for common mental disorders (SRQ score > 7). A positive correlation was found between age and mental health problems (p = 0.0002). Despite legislation guaranteeing access to health care in prisons, the prison system is unprepared to meet the health needs of female prisoners with comorbidities and pregnant and puerperal women.

Validismo en el anciano. Contexto social y capacidad funcional

Fundamento: el envejecimiento es un hecho que afecta a toda la población mundial, y de manera considerable, a los países más desarrollados, en los que la esperanza de vida ha ido aumentando tal y como se refleja en el informe de Naciones Unidas. Objetivo: describir el contexto social y capacidad funcional en gerontos del consultorio # 8 del Área de Salud I del municipio Cienfuegos durante el año 2022. Método: se realizó un estudio descriptivo de corte transversal. Se seleccionó aleatoriamente una muestra del 30 % para un total de 131 ancianos. Se realizó una entrevista estructurada, que recogió las variables generales: edad, sexo, nivel de escolaridad, ocupación, antecedentes patológicos personales, la colaboración de apoyo y para completar la valoración social se aplicó el Cuestionario de Funcionamiento Familiar. Resultados: el grupo de edad de 60 a 65 años tuvo más prevalencia, el 45,5 % estudió hasta la primaria terminada, seguidos de los de secundaria terminada con el 29,0 %. Los jubilados estuvieron representados en un 38,9 %, las principales enfermedades no transmisibles que prevalecieron fueron: la hipertensión arterial, la cardiopatía isquémica y la diabetes mellitus tipo 2, el 40,4 % vivía solo, el 19,8 % tenía cuidador, el 14,5 % no recibían apoyo y el 9,9 % de los ancianos que se encontraban en probable estado de necesidad social. Conclusiones: un adulto mayor bien nutrido, querido, apoyado, con todas las necesidades básicas satisfechas, así como todas las enfermedades asociadas propias de esta etapa de la vida compensadas, tendrá en cualquier sociedad una mejor calidad de vida.

Foundation: aging is a fact that affects the entire world population, and considerably, the most developed countries, in which life expectancy has been increasing as reflected in the United Nations report. Objective: to describe the social context and functional capacity in gerontos of clinic # 8 of Health Area I of the Cienfuegos municipality during the year 2022. Method: a descriptive cross-sectional study was carried out. A 30 % sample was randomly selected for a total of 131 elderly people. A structured interview was carried out, which included the general variables: age, sex, level of education, occupation, personal pathological history, support collaboration and to complete the social assessment, the Family Functioning Questionnaire was applied. Results: the age group of 60 to 65 years had the most prevalence, 45.5 % studied until they completed primary school, followed by those who completed secondary school with 29.0 %. Retirees were represented at 38.9 %, the main non-communicable diseases that prevailed were: high blood pressure, ischemic heart disease and type 2 diabetes mellitus, 40.4 % lived alone, 19.8 % had a caregiver, 14.5 % did not receive support and 9.9 % of the elderly who were in a probable state of social need. Conclusions: a well-nourished, loved, supported older adult, with all basic needs satisfied, as well as all associated diseases typical of this stage of life compensated, will have a better quality of life in any society.

Programa SONQO-CALCHAQUÍ 2022: Evaluación de variables cardiovasculares en una población Calchaquí de media y alta montaña de Tucumán / 2022 SONQO-CALCHAQUÍ Program: Evaluation of Cardiovascular Variables in a Mid- and High Mountain Calchaquí Population of Tucumán

RESUMEN Introducción: La comunidad de Quilmes (Tucumán) consta de 2400 habitantes de media y alta montaña (1800 a 4000 metros sobre el nivel del mar). En el año 2018 se realizó un estudio sobre su estado de salud cardiovascular (Programa SONQO-CALCHAQUÍ 2018). Objetivo: Actualizar y amplificar el relevamiento realizado en el año 2018, para obtener un panorama más completo de la salud cardiovascular de la comunidad. Material y métodos: Se efectuó un estudio descriptivo transversal en la comunidad Quilmes, en personas que asistieron voluntariamente a consultorios especialmente establecidos, en el mes de septiembre de 2022. Se realizaron cuestionarios, dosajes de laboratorio, ECG, ecocardiograma, determinaciones antropométricas, y pruebas de resistencia y fuerza muscular. Resultados: Concurrieron 186 pobladores (119 mujeres y 67 varones) con edad 45,0±1,3 años. La prevalencia referida de factores de riesgo cardiovascular (hipertensión 17,8%, tabaquismo 14,1%, diabetes 4,9%, dislipidemia 30,6%) fue aceptable, pero con alta proporción sin exámenes en el último año. La alimentación estaba constituida principalmente por derivados de harinas, con escasa fruta y verdura fresca. La prevalencia de sobrepeso (34,3%) y obesidad (35,4%) fue elevada. El 40% de los encuestados tenía educación secundaria o superior. Se refirió buena calidad de vida (69,5±1,1% del valor máximo posible de satisfacción en la escala de autopercepción). El Minimental Test arrojó un valor promedio de 15,7±0,2 puntos. La fuerza prensil en el 55,8% de los casos estuvo por debajo del rango normal. Conclusiones: la población Quilmes presenta un estado físico aceptable, pero con alto índice de sobrepeso y obesidad, debido al régimen alimentario. Esta situación debería ser contemplada en los programas de salud futuros.

ABSTRACT Background: The community of Quilmes (Tucumán) encompasses 2400 mid- and high mountain inhabitants (1800 to 4000 meters above sea level). In 2018, a study was carried out on their cardiovascular health status (2018 SONQO-CALCHAQUÍ Program). Objective: The aim of this study is to update and expand the survey carried out in 2018, to obtain a broader panorama of the cardiovascular health of this community. Methods: A descriptive cross-sectional study was carried out in the Quilmes community, in people who voluntarily attended specially established clinics in September 2022. Questionnaires, laboratory tests, ECG, echocardiogram, anthropometric measurements, muscular resistance and strength tests were carried out. Results: A total of 186 patients (119 women and 67 men) aged 45.0±1.3 years attended the study. The prevalence of cardiovascular risk factors (hypertension 17.8%, smoking 14.1%, diabetes 4.9% and dyslipidemia 30.6%) was acceptable, but a high proportion of cases had not been examined in the last year. The diet consisted mainly of flour products, with little fresh fruit and vegetables. The prevalence of overweight (34.3%) and obesity (35.4%) was high. Forty percent of respondents had secondary or higher education. Good quality of life (69.5±1.1% of the maximum possible value of satisfaction on the self-perception scale) was reported. The Minimental Test average was 15.7±0.2 points. Prehensile strength in 55.8% of cases was below the normal range. Conclusions: The Quilmes population presents an acceptable physical condition, but with a high rate of overweight and obesity, due to the diet, a condition that should be considered in future health programs.

Research and Publish. 2. Answering the Question: Study Design / Investigar y publicar. 2. Cómo responder la pregunta "diseño del estudio"

Abstract Introduction: Study design guides the methodology for obtaining an answer to a research question. Understanding the different types of research, their advantages, and disadvantages will help ensure the validity of our results. Objective: To describe experimental and non-experimental research designs, along with their respective advantages and disadvantages, in order to guide researchers in selecting the most appropriate design based on their research question. Results and Conclusions: The literature is reviewed to describe the main characteristics, the simplest and most useful classifications for determining the best study design. The study population, internal and external validity of the studies are also determined, in order to understand, based on our research question, the possible extrapolation of our results.

Resumen Introducción: El diseño del estudio dirige la metodología para obtener la respuesta a la pregunta de investigación, y tener claro cuáles son los tipos de investigación, sus ventajas y desventajas, ayuda a la validez de los resultados. Objetivo: Describir los diseños de investigación experimental y no experimental, las ventajas y desventajas de cada uno de estos diseños con el fin de guiar al investigador a la mejor escogencia de este con base en la pregunta de investigación. Resultados y conclusiones: Se revisa la literatura con el fin de describir las características principales, las clasificaciones más sencillas y de mayor utilidad para determinar el mejor diseño de estudio. Se determina además la población de estudio, validez interna y externa de los estudios a fin de entender, basados en la pregunta de investigación, la posible extrapolación de los resultados.

Influence of demographic parameters and dietary habits on the cytome assay biomarkers in lymphocytes and buccal epithelial cells from a group of argentine adolescents / Influencia de parámetros demográficos y hábitos alimentarios sobre biomarcadores del ensayo citoma en linfocitos y células epiteliales bucales de adolescentes argentinos

ABSTRACT The use of the cytome assay in monitoring studies on children has increased in recent years. For this reason, it is necessary to know the role of possible confounding factors that could affect its outcomes. The objective was to evaluate the influence of some demographic variables and diet on the baseline values of the cytome assay biomarkers in lymphocytes and buccal mucosa cells from a group of Argentine adolescents. Following the calculation of the biomarkers, a multivariate regression analysis including confounders was performed. In lymphocytes it was observed that micronuclei (MNi) had a negative association with a moderate consumption of roots and tubers, while the number of nuclear buds (NBUDs) was higher in minors not exposed to second-hand smoke (SHS). Regarding epithelial cells, MNi had a negative relationship with the intake of tropical fruits and red meat; on the contrary, this parameter increased with the moderate ingestion of legumes. In addition, oral NBUDs had a positive association with citrus and red meat consumption, whereas cereals and oil decreased its frequency. Furthermore, an increased number of binucleated cells was observed for adolescents who ate white meat and an increase in pyknotic cells for those exposed to SHS. These results revealed that in adolescents the baseline level of the cytome assay biomarkers, especially of those related to genotoxicity, can be influenced by exogenous variables, for instance, dietary habits. Thus, such factors need to be considered when carrying out biomonitoring studies on child populations.

RESUMEN El uso del ensayo de citoma en estudios de seguimiento en niños se ha incrementado en los últimos años y resulta necesario conocer el papel de posibles factores de confusión que podrían afectar sus resultados. El objetivo fue evaluar la influencia de algunas variables demográficas y de la dieta en los valores basales de los biomarcadores de este ensayo en linfocitos y células de mucosa bucal de un grupo de adolescentes argentinos. Luego del cálculo de los biomarcadores, se realizó un análisis de regresión multivariada incluyendo factores de confusión. En linfocitos se observó que los micronúcleos (MN) se asociaron negativamente con un consumo moderado de raíces y tubérculos, mientras que los brotes nucleares (BrN) aumentaron en los menores no expuestos al humo de segunda mano (HSM). En células epiteliales, los MN tuvieron una relación negativa con el consumo de frutas tropicales y carnes rojas, aunque aumentaron con el consumo moderado de legumbres. Los BrN orales tuvieron una asociación positiva con el consumo de cítricos y carnes rojas, mientras que los cereales y el aceite disminuyeron su frecuencia. Además, se encontró un mayor número de células binucleadas para quienes comieron carne blanca y un aumento de células picnóticas para los expuestos a HSM. Estos resultados revelaron que en los adolescentes el nivel basal de los biomarcadores del ensayo de citoma, especialmente de aquellos relacionados con la genotoxicidad, puede verse influenciado por variables exógenas como los hábitos alimentarios. Por lo tanto, dichos factores deben considerarse al realizar estudios de biomonitoreo en poblaciones infantiles.

Prevalence of atrial fibrillation without diagnosis or treatment in Primary Health Care in Joinville, Brazil

Introduction: Estimation of the prevalence of undiagnosed or untreated atrial fibrillation (AF) is crucial for the prevention of AF-related ischemic stroke. Objective: To assess the prevalence of undiagnosed or untreated AF in primary care. Methods: We conducted a prospective cross-sectional non-randomized study in Joinville, Brazil, among elderly individuals in primary care units (PCUs). Results: One thousand individuals were included, with a mean age of 69±7 years, and 57% women. Prevalence of AF was 3%, with 50% of AF patients being previously undiagnosed and 33% of previously diagnosed AF patients not receiving oral anticoagulation despite clinical indication. Using agestandardized prevalences, we estimated 68 and 27,342 strokes per year due to untreated or undiagnosed AF in Joinville and Brazil, respectively. Conclusion: The observation that two out of three AF patients were either undiagnosed or untreated is very alarming. Screening strategies to uncover this population are urgently needed.

Integrative geriatric assessment. A narrative review of the scales and their use in Ecuador

This study aims to describe the main tools for integrative geriatric assessment and their use in Ecuador. We performed a narrative review with a comprehensive and systematic literature search. 261 original articles were obtained from the primary search, and after the discrimination by the researchers, 76 articles were included in the final analysis. Integrative geriatric assessments cover different areas, including cognitive function, affective function, nutritional status and functionality, and seve-ral tools that are used worldwide for this purpose. In Ecuador, a deeper analysis of their use is required to evaluate their diagnostic efficacy and applicability to impro-ve health outcomes for the elderly population.

Este estudio tiene como objetivo describir las principales herramientas de evalua-ción integral geriátrica y su uso en el Ecuador. Realizamos una revisión narrativa con una búsqueda bibliográfica exhaustiva y sistemática. De la búsqueda primaria se obtuvieron 261 artículos originales, y luego de la discriminación por parte de los investigadores, se incluyeron 76 artículos en el análisis final. La evaluación ge-riátrica cubre diferentes áreas, incluida la función cognitiva, la función afectiva, el estado nutricional y la funcionalidad, y se utilizan varias herramientas en todo el mundo para este propósito. En Ecuador se requiere un análisis más profundo de su uso para evaluar su eficacia diagnóstica y aplicabilidad con el fin de mejorar los resultados de salud de la población adulta mayor.

Benefits of core strengthening exercise in osteoarthritis knee patients: a narrative review

Osteoarthritis is a degenerative joint disease results from breakdown of cartilage that covers the ends of bones in joint. Breakdown causes bones to rub each other leading to pain, stiffness, swelling, loss of function in joint and can be accompanied by synovitis with or without joint fluid effusion. Muscle atrophy may develop if patient was inactive and did not perform exercises, which will affect functionality and stability of joint including activities of daily life. The aim of the study was to evaluate current literature and provide comprehensive overview of benefits of core muscle strengthening exercise in managing OA. The objective of this study was to discuss effectiveness of core muscle strengthening exercise in reducing pain, improving physical function, and enhancing quality of life in individuals with osteoarthritis knee. A systematic search was conducted to identify all relevant studies related to core muscle strengthening, database such as Pubmed, Cochrane library, Scopus had been used. Studies demonstrating clinical importance of core strengthening in treatment of osteoarthritis knee are limited. By performing randomized controlled trials with a big sample size, new researchers should produce more unique findings.

SICKLE CELL DISEASE IN JHABUA AND KHARGONE DISTRICT: UNVEILING PREVALENCE AND SEVERITY

Objective: To assess the prevalence among Sickle cell disease (SCD) affected individuals emphasizing the neglected health challenges in various tribes.Methods: Cross-sectional, observational study was conducted during the district residency program for 9 mo. The data has been collected from the record room of patients diagnosed with Sickle cell Anemia. Statistical analysis was done using Microsoft Excel.Results: A total of 295 patients’ data revealed demographic skew toward Jhabua (50%), with Sickle cell anemia diagnosed at the mean age of 23±3.9. Most patients (72.3%) were Hindu, with Bhil and Bhilaya tribes having higher frequencies. Symptoms varied; 94% had Sickle cell trait, 16.3% had sickle cell disease, and 60% experienced painful crises. Treatment included prophylactic care for all, 37.57% required blood transfusions and 29.7% were on hydroxyurea.Conclusion: The study underscores the significant SCD burden and the need for heightened awareness and targeted interventions in socio-economically disadvantaged tribal regions to mitigate the impact of SCD.

Replacing screen time, with physical activity and sleep time: influence on cardiovascular indicators and inflammatory markers in Brazilian children

Abstract Objective: To examine if the substitution of different screen time intervals with light physical activity (LPA), moderate to vigorous physical activity (MVPA) and sleep is associated with cardiovascular indicators and inflammatory markers in children. Methods: This is a cross-sectional study developed with 186 children aged between six and 11 years old from public schools in southern Brazil. CRF was measured with the 6-minute running and walking test, following the Brazil Sports Project procedures. The percentage of fat was evaluated through DXA. LPA and MVPA were measured using accelerometers. Sleep and screen time were assessed by questionnaires answered by parents. Leptin and C-reactive protein were measured by fasting blood collection. Systolic and diastolic blood pressure were determined through a digital sphygmomanometer. Isotemporal substitution models were used for statistical analysis. Results: Replacing 1 h of screen time with MVPA was associated with lower BMI, systolic and diastolic blood pressure, fat percentage, leptin, and C-reactive protein. When screen time was substituted for sleep time, lower waist circumference was observed. Regarding the substitution of 1 h of screen time with LPA, significant values were found only for leptin. Conclusion: The replacement of screen time with physical activities of different intensities and sleep time was associated with benefits in cardiovascular indicators and inflammatory markers in childhood.

Pilomatrixomas: experiencia de 31 años en población menor y mayor de 18 años / Pilomatrixomas: 31 years of experience in population under and over 18 years of age

Resumen Introducción: El pilomatrixoma o epitelioma calcificado de Malherbe es una neoplasia cutánea benigna que muestra diferenciación hacia la porción de la matriz de los folículos pilosos. Es la neoplasia cutánea benigna más frecuente en la infancia y la juventud, aunque puede ocurrir a cualquier edad. Tiene una incidencia general que oscila entre el 0.001% y el 0.0031% de todos los tumores cutáneos. Se reporta una ligera predilección por el sexo femenino, con una relación mujer: hombre de 1.15:1. Métodos: Estudio observacional, descriptivo, retrospectivo y transversal en el que se utilizó la base de datos electrónica del departamento de dermatopatología del Hospital General Dr. Manuel Gea González, entre enero de 1992 y julio de 2023. Para la búsqueda de los casos solo se incluyeron aquellos con diagnóstico histopatológico de pilomatrixoma, pilomatricoma o epitelioma calcificado de Malherbe. Resultados: Se registraron 200 pilomatrixomas en 177 pacientes. El tumor predominó en mujeres de edad pediátrica; el promedio de edad de la población estudiada fue 22.98 años. La topografía más frecuente fue la cabeza (región periorbitaria), seguida de las extremidades superiores y el tronco. Al separar la población en pediátricos y adultos, se encontraron 111 y 89 casos, respectivamente. Conclusiones: Presentamos un estudio detallado sobre pilomatrixomas con una visión exhaustiva de las características demográficas, clínicas y epidemiológicas de esta neoplasia cutánea benigna. Los resultados revelaron datos estadísticos sólidos, destacando la distribución por edades, sexo, topografía, morfología, síntomas acompañantes y frecuencia de diagnósticos diferenciales clínicos. Este estudio contribuye significativamente al conocimiento existente sobre los pilomatrixomas y sirve como una referencia valiosa para futuras investigaciones y para la práctica clínica.

Abstract Background: Pilomatrixoma, also known as calcifying epithelioma of Malherbe, is a benign cutaneous neoplasm that demonstrates differentiation towards the matrix portion of hair follicles. It is the most common benign cutaneous neoplasm in childhood and youth, although it can occur at any age. With a general incidence ranging from 0.001% to 0.0031% of all cutaneous tumors. There is a slight predilection for females, with a female-to-male ratio of 1.15:1. Methods: Observational, descriptive, retrospective, and cross-sectional study conducted using the electronic database of the dermatopathology department of Dr. Manuel Gea González General Hospital, from January 1992 to July 2023. Only cases with a histopathological diagnosis of pilomatrixoma, pilomatricoma, and Malherbe's calcifying epithelioma were included. Results: A total of 200 pilomatrixomas were recorded in 177 patients. The tumor predominantly affected females in the pediatric age group, with an average age of 22.98 years in the studied population. The most common location was the head (periorbital region), followed by the upper extremities and trunk. Upon separating the population into pediatric and adult groups, 111 and 89 cases were identified, respectively. Conclusions: We present a detailed study on pilomatrixomas with a comprehensive overview of the demographic, clinical, and epidemiological characteristics of this benign cutaneous neoplasm. The results revealed robust statistical data highlighting the distribution by age, gender, topography, morphology, accompanying symptoms, and frequency of clinical differential diagnoses. This study significantly contributes to the existing knowledge of pilomatrixomas and serves as a valuable reference for future research and clinical practice.

Protocolo de validación del instrumento Examen Dental Preventivo del Adulto Mayor / Validation protocol for the Preventive Dental Examination of the Elderly instrument

Los desafíos del envejecimiento de la población y la acumulación de daño oral nos obligan a desarrollar herramientas diagnosticas validas y confiables que nos permitan caracterizar a la población, evaluar sus necesidades terapéuticas, planificar intervenciones significativas y realizar seguimiento de su condición. Con este propósito realizamos una revisión sistemática de la literatura relevante para establecer una metódica secuencial para la validación de la herramienta diagnostica Examen Dental Preventivo del Adulto Mayor. Seleccionamos 48 artículos relevantes, cuya heterogeneidad impidió la realización de un metaanálisis. Sin embargo, los artículos seleccionados fueron sometidos a una síntesis cuantitativa analítica, que nos permitió identificar los dominios y estrategias relevantes para la validación y proponer un protocolo de cinco fases secuenciales que presentamos en extenso en el presente artículo.

The challenges of population aging and the accumulation of oral damage force us to develop valid and reliable diagnostic tools to characterize the population, evaluate their therapeutic needs, plan significant interventions, and monitor their condition post treatment. We carried out a systematic review of the relevant literature to establish a sequential method for the validation of the Preventive Dental Examination of the Elderly diagnostic tool. We selected 48 relevant articles, whose heterogeneity prevented us from performing a meta-analysis. However, the selected articles were subjected to an analytical quantitative synthesis, which allowed us to identify the relevant domains and strategies for validation and then propose a protocol of five sequential phases that we present in detail in this article.