Mi Gente, Nuestra Salud: Protocol for a People's Movement for Health Ownership.

BACKGROUND: Community-based participatory research (CBPR) is an increasingly recognized approach to address health inequities. Although in CBPR all processes occur within the community context, its diagrammatic model places the intervention/research outside of the community rather than conceptualizing it as an event in a complex web of system components. OBJECTIVES: We sought to 1) introduce a systems-oriented community ownership conceptual framework that integrates a systems perspective with CBPR and 2) to describe an application of this framework in the form of the Mi Gente, Nuestra Salud initiative, a research-based, action-oriented collaboration between Cal Poly investigators and community partners in Santa Maria and Guadalupe, California. METHODS: We conducted a stocktake of community assets and partnerships in Santa Maria and Guadalupe, among California's poorest and most medically underserved cities; created marketing materials; launched the initiative in December 2020; and collected survey and interview data on community health concerns. An advisory board guides direction of the work. Activities are intended to affect partnerships (who is involved in actions and decisions) and processes (what actions will be taken), as well as resources (e.g., building human and social capital by changing narratives of local, historically rooted power dynamics and offering peer learning opportunities on advocacy and health care interactions). Implementation challenges within this framework are also discussed. CONCLUSIONS: By de-centering specific interventions and conceptualizing them as single events in a complex web, our system-oriented community ownership model brings the focus back to the system itself, and to system-based processes and solutions, while still guided by CBPR principles.

Presentation and Management of Giant Fibrovascular Polyps of the Hypopharynx and Esophagus.

OBJECTIVE: Fibrovascular polyps of the hypopharynx and esophagus are rare, with few case reports in the literature. In this article, we present our institutional experience with a focus on airway and surgical management. STUDY DESIGN: Case series. SETTING: Tertiary academic institution. METHODS: A retrospective review was conducted of 4 patients that presented to a tertiary medical center with fibrovascular polyps between 1990 and 2012. Patient demographics, clinical presentation, diagnostic studies, and surgical approaches were reviewed. A review of the published literature was also performed. RESULTS: The average age at presentation was 72 years (range, 59-85 years). Among the 4 patients, 2 presented with airway compromise requiring tracheotomy. All patients had removal of the polyp shortly after presentation; 2 underwent transcervical approaches with lateral pharyngotomy/esophagotomy, and the other 2 had endoscopic removal. The polyps arose from the hypopharynx in 3 patients and upper esophagus in 1. Three patients had complete resolution of their symptoms and remained disease free. One patient had recurrence of the polyp 2 years later and is currently being observed. CONCLUSION: Fibrovascular polyps are rare tumors of the hypopharynx/esophagus that present in older adults. Although benign, they can cause life-threatening airway compromise that may necessitate tracheotomy. We present 4 cases of fibrovascular polyps and discuss our evolving surgical management, including endoscopic removal.

Programa de orientacion sexual al paciente con lesion medular / Program of sexual orientation for patients with spinal cord injury

La sexualidad es un concepto muy amplio, que merece ser estudiado y analizado en toda su extension, con el fin de que posteriormente se pueda tener como base para la educacion sexual del ser humano cualquiera que sea su condicion fisica, social o economica. La poblacion de estudio, la constituyo la totalidad de pacientes con lesion medular hospitalizados en el servicio de rehabilitacion dela UPI 03 Clinica San Pedro Claver, durante los meses de abril, mayo de 1986. See aplico un cuestionario que a manera de pre-test, la post-test midio los conocimientos antes y despues del proceso educativo. Los resultados mas importantes obtenidos por el estudio fueron los siguientes: -En el pre-test de anatomia y fisiologia del aparato reproductor masculino y femenino se encontraron conocimientos deficientes sobre el tema, en el post-test hubo un incremento en la asimilacion de conocimientos, lo que conduce a pensar que la instruccion fue adecuada. -En el pre-test de lesion medular se observa que el 50% carece de conocimientos sobre el tema y la muestra restante tiene algun conocimiento, lo que indica que el paciente no conoce su patologia. En el post-test se concluyo que la instruccion dada fue asimilada, es satisfactorio por que el paciente se mostro interesado por su estado de salud. Aunque para algunos fue dificil por la complejidad del tema. -En el pre-test de sexualidad se obseva que el paciente no conoce el significado de la sexualidad. En el post-test dada la instruccion hubo un incremento menor del esperado, resultado influenciado por: -Hecho reciente del trauma..