Doble jornada laboral y percepción de la salud en mujeres: investigación cualitativa / Double working day and perception of health in women: qualitative investigation

Introducción. El trabajo ocupa un lugar clave en la vida de la mujer, y a su vez comprende varias dimensiones. Dos de ellas son el trabajo doméstico no remunerado (TDNR) e invisibilizado, y el trabajo productivo remunerado (TPR) fuera dela casa. El objetivo de esta investigación fue comprender cómo es la percepción de salud en la mujer actual de clase media urbana con doble jornada laboral y cómo ella jerarquiza su TPR. Métodos. Investigación con enfoque cualitativo realizada en un hospital privado universitario de la Ciudad de Buenos Aires, mediante entrevistas individuales a mujeres adultas y alfabetas de 30 a 60 años de edad, seleccionadas a través del método de bola de nieve a partir de sus médicos de cabecera. Se utilizaron fichas demográficas estructuradas y entrevistas en profundidad. Se registraron datos personales y prácticas médicas realizadas en los últimos años. Se realizó un análisis de contenido. Resultados. Entrevistamos a 47 mujeres, la mayoría con hijos y la mitad, a cargo de las tareas domésticas en su hogar. Ninguna de ellas reconoció la tarea doméstica (TDNR) como trabajo, 76 % refirió no realizar controles habituales de salud,aunque más del 90 % hizo las prácticas preventivas recomendadas para su edad. Las mujeres entrevistadas expresaron diferentes significados atribuidos por ellas al TPR como independencia, desarrollo personal, mejoría en autoestima, calidad de vida, y sociabilidad. Sin embargo, ante su ausencia en el hogar se mostraron ambivalentes y con sentimientos de culpabilidad. Conclusiones. Este estudio permite reconocer que las mujeres con trabajo TDNR y TPR valoran positivamente a este último, pero se cuestionan que éste les quite tiempo a su participación en el ámbito familiar. Esto resulta en una mayor autoexigencia y perpetúa la invisibilidad del TDNR. En relación al autocuidado, sienten que no realizan sus cuidados médicos, pero tienen buenos indicadores de prácticas preventivas. Quizás sea necesario propiciar la reflexión acerca del rol que tiene el TPR en su bienestar. (AU)

Introduction. Work occupies a key place in the life of women, and in turn, comprises several dimensions. Two of them are unpaid domestic work (UDW) and paid productive work (PPW) outside the home. The objective of this research was to understand how the perception of health is in the current urban middle-class woman with a double working day and how she prioritizes her PPW. Methods. Research with a qualitative approach carried out in a private university hospital in the City of Buenos Aires, through individual interviews with adult and literates women aged 30 to 60, selected through the snowball method from their general practitioners. Structured demographics and in-depth interviews were used. Personal data and medical practices carried out in recent years were recorded. A content analysis was performed. Results. We interviewed 47 women, the majority with children and half of them, in charge of housework in their home. None of them recognized housework (UDW) as work, 76 % reported not doing regular health checks, although more than 90 % did the recommended preventive practices for their age. The women interviewed expressed different meanings attributed bythem to the PPW such as independence, personal development, improvement in self-esteem, quality of life, and sociability. However, in their absence at home, they were ambivalent and guilty. Conclusions. This study allows us to recognize that women with UDW and PPW value the latter positively, but question whether it takes time away from their participation in the family environment. This results in increased self-demand and perpetuates the invisibility of the UDW. In relation to self-care, they feel that they do not perform their medical care, buthave good indicators of preventive practices. It may be necessary to encourage reflection on the role of the PPW in theirwell-being. (AU)

Influencia de los lazos sociales en la salud de las personas / Influence of social ties on people's health

Se denomina apoyo social (AS) a la información y/o ayuda que recibe o percibe recibir una persona, con repercusión conductual y emocional. El AS estructural se refiere a los aspectos objetivos y/o cuantitativos de la red social, mientras que el funcional hace hincapié en los efectos que generan en un sujeto la conservación de su relaciones sociales. Se denomina AS objetivo a los recursos, las provisiones y las transacciones reales a los que las personas pueden recurrir. El AS percibido integra aspectos subjetivos de apoyo social y se centra en lo que percibe la persona en cuestión respecto de la ayuda con la que cree contar, existiendo creciente evidencia de su importancia pronóstica a través de caminos causales conductuales, psicológicos y fisiológicos. (AU)

Social support (AS) includes information and/or help received or perceived by a person, with behavioral and emotional conse-quences. Structural AS refers to objective and/or quantitative aspects of the social network, while functional AS emphasizes the effects generated by the preservation of social relations.Objective AS means resources, provisions and actual transactions to which people can turn. Perceived AS integrates subjective aspects of social support and focuses on what the person in question feels with respect to the help he or she believes they have; and there is growing evidence of its prognostic importance through behavioral psychological and physiological causal paths. (AU)

Estratégias da medicina preventiva / Strategies of preventive medicine

Este livro reflete o trabalho pioneiro de Geoffrey Rose, que influenciou e impulsionou o desenvolvimento da prática clínica preventiva e das políticas públicas de saúde. Esta edição comentada reúne ao texto clássico de Rose os comentários de Kay-Tee Khaw e Michael Marmot, que acrescentam suas próprias perspectivas sobre a importância das ideias do autor para a medicina atual, trazendo novos exemplos de como essa teoria pode ser aplicada.

Estratégias da medicina preventiva

Este livro reflete o trabalho pioneiro de Geoffrey Rose, que influenciou e impulsionou o desenvolvimento da prática clínica preventiva e das políticas públicas de saúde. Esta edição comentada reúne ao texto clássico de Rose os comentários de Kay-Tee Khaw e Michael Marmot, que acrescentam suas próprias perspectivas sobre a importância das ideias do autor para a medicina atual, trazendo novos exemplos de como essa teoria pode ser aplicada.

Estratificação de risco cardiovascular no paciente assintomático por tomografia computadorizada cardíaca de múltiplos detectores / Cardiovascular risk stratification by multidetector computed tomography in the asymptomatic patient

Os atuais métodos de previsão de eventos cardiovasculares são muito imprecisos, somente explicando aproximadamente metade dos eventos. Isso é ainda mais acentuado no grupo de pacientes assintomáticos. A tomografia computadorizada por múltiplos detectores tem se mostrado um valioso aliado do cardiologista, fornecendo em um só exame, diversas informações sobre o sistema cardiovascular que, combinadas, têm o potencial de aumentar muito a acurácia na previsão de eventos cardiovasculares, diminuindo a morbimortalidade. No presente artigo será examinado o presente e potencial futuro desse novo método na avaliação de pacientes assintomáticos do ponto de vista cardiovascular.

Fight against cancer in countries with limited resources: the post-genomic era scenario.

The enormous advances in science and technology in the 20th century have facilitated the process of globalization with the aim of a better quality of life for all. Paradoxically, the gap between the rich and the poor, for both nations and people, is constantly widening. The actual trends in human genome research are leading towards promising genomic medicine, but it will be expensive and inaccessible for many. Also, it may not offer a quick fix "cure" for various types of cancers. The biggest challenge before the clinicians now is the management of the rising incidence of cancer in developing countries, with little prospect of more resources becoming available to fight the disease. The death rate from cancer in the developing countries is set to rise at least 3-fold by the year 2025 largely due to the increased life expectancy, containment of infectious diseases and changing lifestyles. It is estimated that about 50% of cancers are curable if they are detected early and treated appropriately. Screening has a major role in early diagnosis. However, in the developing world around 80% of cancer patients have late stage incurable disease when they are diagnosed. Moreover, in a developing country like India, about 70% of the population obtain medical help from private practitioners. Nearly half of those who seek medical help utilize alternative and traditional systems of medicine. Appalling poverty, poor hygiene and complex social dynamics, pose major hurdles in this regard. Many in the private sector who call themselves doctors have no medical degree. By 2030 tobacco is expected to kill 10 million people worldwide, out of which 70% of the deaths will occur in the developing countries. Control of usage of tobacco has still not achieved a conducive atmosphere. It is now realized that the research information and knowledge generated in the west may neither be relevant nor applicable to developing countries, due to differences in social and cultural attitudes, lifestyles and lack of sophisticated technologies. Though the sequencing of the human genome will have a major impact on the prevention, diagnosis, treatment, monitoring, and outcome of cancer, the cancer scenario in the developing countries for the next 20 years is likely to be more or less the same, rather than presenting a radically different picture. Cancer awareness and screening programs for early detection thus should be continue to be given utmost attention.

Prevention and health education: how recent advances in the science and art of health education have been applied in practical ways within medical and other settings for prevention and public health.

The terms health education, patient education, self-care education, school health education, and health promotion are distinguished from each other as follows. Health education is a subset or strategy within each of these but is the primary and dominant strategy in health promotion. Health education occurs through the health care providers in various settings: worksites, medical, community agencies and schools. Nurses and midwives are the most important health care providers to train people for health promotion and cancer prevention. We appreciate the importance of the "Fight against Cancer" movement in the primary health care centre and its health care providers who inform people about cancer and its symptoms, how to find lesions and early stages, and how to avoid hazardous factors. This is as process of continuous information transfer by in-service education. Primary prevention should encompass all actions aimed to reducing the occurrence of cancer. In reviewing recent advances in science and how the art of health education has been applied in practical ways within medical and other settings for prevention and public health, we can point ot the necessity for facilities like an APOCP Training Centre as a venue for scientific courses.

Prevención de las enfermedades en la práctica clínica: avances recientes y perspectivas / Diseases prevention in clinical practice

El objetivo de la prevención clínica de las enfermedades es evitar o cuando menos reducir la exposición del individuo y la población frente a "causas" conocidas y evitables, por medio de una intervención apropiada, y evitar el inicio de la enfermedad (prevención primaria). Otro objetivo es modificar la historia natural de la enfermedad por medio de la detección y tratamiento oportuno, en la fase preclínica y de ese modo prevenir el desarrollo de la enfermedad avanzada (prevención secundaria). Hay varias medidas disponibles para realizar ese objetivo: la identificación de riesgos seguido de la pronta aplicación de medidas correctivas; la educación sanitaria que estimule a la gente a mantener y promover su salud; la legislación antitabáquica; la seguridad e higiene laboral; la identificación temprana en los asintomáticos para tratarlos, eso se puede efectuar a través de: búsqueda de casos aplicando una prueba(s) adecuada cuando la persona visita a su médico; y el cribado (detección) usando pruebas de efectividad probada que se aplican de manera organizada. Este trabajo pretende difundir los conocimientos sobre las intervenciones preventivas disponibles, para apoyar la decisión del clínico, dirigidas a las varias categorías de clientes en la práctica cotidiana.

A transiçäo da perimenopausa / The perimenopausal transition

Os objetivos deste artigo säo: 1- Definir idade de início e duraçäo da transiçäo da perimenopausa. 2- Descrever as alteraçöes hormonais, lipídicas e ósseas que ocorrem durante a transiçäo da perimenopausa. 3- Atentar para os principais requisitos de cuidados preventivos com a saúde no período da vida correspondente à perimenopausa.