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1.
Rev Salud Publica (Bogota) ; 20(6): 670-676, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206888

RESUMEN

Public health policy in Colombia has been guided by the purpose of achieving universal coverage. Law 100 of 1993 set the goal of guaranteeing access to health services for the entire population, at all levels of care, with a plan of equal benefits for all. Despite this promise, universal coverage was not achieved in the year 2000 as established, and there have been barriers to effective access. In consequence, citizens have resorted to tutela (writ for the protection of fundamental rights) as a mechanism by which judges protect the right to health. In 2008, amidst an overwhelming growth in the number of actions for immediate protection of constitutional rights, the Constitutional Court issued Sentence T-760, by which health was recognized as a fundamental right and ordered several State agencies to guarantee its effective enjoyment and enforce universal coverage and effective access. After ten years, compliance with these orders is medium, with important advances in terms of coverage and equalization of the benefits plan, but there are still barriers to access and concerns regarding sustainability and the flow of resources.

2.
Rev Salud Publica (Bogota) ; 20(6): 677-683, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206889

RESUMEN

OBJECTIVE: To describe the experience of Primary Healthcare System nurses of Viña del Mar, Chile, when participating in the Comprehensive Care Model, in order to analyze strengths and weaknesses from the point of view of health professionals. MATERIALS AND METHODS: Qualitative-descriptive study with a theoretical sample composed by 10 primary care nurses. Focal groups and semi-structured interviews were conducted. Data were analyzed using content analysis. RESULTS: In the context of the Comprehensive Care Model, a professional nurse was defined as a competent person who also establishes aid ties with families, making them feel satisfied. However, it was demonstrated that the shortage of this type of professionals is an obstacle to performance in the territorial areas of the community. It was evidenced that the Healthcare Model is still at a theoretical level rather than at a practical one, where assistance and the achievement of goals are above promotion and prevention activities. CONCLUSIONS: Better staffing of professional nurses in the Primary Healthcare System will allow relying on a wider team of experts for promotion and prevention purposes, without weakening their assistance role. Cross-sectional work needs to be rooted in community institutions, strengthening joint efforts between authorities, care facilities and community representatives to support the work of the health team.

3.
Rev Salud Publica (Bogota) ; 20(6): 684-691, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206890

RESUMEN

OBJECTIVE: To analyze the Quality of Life at Work (QOL) of dentists in Antioquia, Colombia, based on objective and subjective components. MATERIALS AND METHODS: A sample of 323 dentists was used for a descriptive study using a structured survey. Data were processed using in SPSS 17.0 and Epidat 3.1 software. RESULTS: Significant trends (p<0.05) were found for the decrease of male, home-based and postgraduate professionals. Fewer and fewer professionals earn more than five times the legal monthly minimum wage, have access to private health services, and enjoy more than 15 vacation days per year. On the other hand, the number of dentists that cover their social security expenses and updating courses costs by themselves Increased, as well as the number of professionals that moved to different municipalities to work (p<0.05). Working conditions and the distance between dreams and reality have meaningful differences for the periods observed. DISCUSSION: Findings ratify the incidence of health and education reforms over the practice of dentistry, revealing significant supply and demand conflicts that exacerbate the deterioration of working conditions and push professionals to merely accommodate, more and more, distancing from the once dreamed profession. CONCLUSION: The QOL for dentists in Antioquia has deteriorated due to negative tendencies on working conditions derived from the complexity and crisis of the working environment. In addition, professionals do not attempt to associate to face and transform this reality.

4.
Rev Salud Publica (Bogota) ; 20(6): 692-698, 2020 Nov 16.
Artículo en Portugués | MEDLINE | ID: mdl-33206891

RESUMEN

OBJECTIVE: To understand the challenges faced by workers in the daily activities related to psychosocial care, considering affective relationships, care management and interdisciplinarity. MATERIALS AND METHODS: Reflective qualitative research of phenomenological nature from a hermeneutic perspective, carried out with mental health professionals of the Psychosocial Support Center of Fortaleza-CE, Brazil. RESULTS: Subjectivities related to the precariousness of health work, determined by deficient physical infrastructure, quantity and quality of material, arose from the daily routine of psychosocial care, exposing discouragement in the exercise of practices and quality care. CONCLUSIONS: The management of care as a guide to innovative mental health practices provides sustainability for a practice that is necessary to consolidate and solve the social life demands of users and of work processes in the field of mental health.

5.
Rev Salud Publica (Bogota) ; 20(6): 699-706, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206892

RESUMEN

OBJECTIVE: To characterize maternal deaths in the department of Santander, Colombia, and the delays that contributed to these deaths during the period 2012-2015, through a systematic review of health care, in order to offer an input that allows proposing actions that contribute to reduce these fatal outcomes. MATERIALS AND METHODS: Descriptive, retrospective, cross-sectional study that determines the characteristics of maternal mortality in pregnant or postpartum women who were administered complete analysis units and whose death was not caused by external or violent causes. RESULTS: The most frequent delay in the 49 cases of maternal deaths was type IV, which refers to the delay in receiving adequate and timely medical treatment (87.8%), mainly due to deficiencies in promotion and prevention strategies (63.2%). The majority of the deaths were avoidable (61.2%) in the puerperium (84%), and in users of the subsidized insurance scheme (57.1%). CONCLUSIONS: Although 98% of mothers were affiliated to the health system (subsidized, contributory, special or exceptional schemes), it was possible to demonstrate that women who were affiliated to the subsidized regime showed a greater frequency of the event, which reflects that there are important opportunities for improvement in the care provided to pregnant women in this type of scheme.

6.
Rev Salud Publica (Bogota) ; 20(6): 707-710, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206893

RESUMEN

OBJECTIVE: To analyze the intake of macronutrients and its relationship with age and sex in higher education students. MATERIALS AND METHODS: A cross-sectional study was carried out with 218 higher education students, aged between 18 and 30 years. A validated and reliable instrument was used to measure macronutrient consumption. RESULTS: Regarding the intake of macronutrients, a statistical difference by sex was observed in favor of men (p>0.05), except for the consumption of proteins in students older than 25 years. In the group under 20 years of age, men showed better protein intake. Finally, in students between 20 and 25 years, the consumption of macronutrients is similar among men and women. DISCUSSION: The results show that the percentage of consumption with respect to ideal value of the estimated requirement for light activity according to FAO/WHO/UN 2004 is below the recommendations, with a macronutrient consumption deficit that ranges between 20% and 60%.

7.
Rev Salud Publica (Bogota) ; 20(6): 711-717, 2020 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-33206894

RESUMEN

OBJECTIVE: To evaluate the effect of a participative educational intervention on the clinical competence of Mexican family physicians regarding the nutritional management of patients with diabetes mellitus Type 2. MATERIALS AND METHODS: Quasi-experimental study with a before-and-after control group. Convenience sample included 60 family physicians distributed in two social security primary health care units, randomly selected: 30 in the "A" unit and 30 in the "B" unit. Unit "A" was assigned randomly as control group, and "B" unit as intervention group. The intervention consisted of a theoretical-practical course-workshop that lasted six months where real cases were discussed and solved. Clinical competence was evaluated by means of an instrument designed ex professo, with a maximum theoretical value of 100 and 94% reliability according to the Kuder-Richardson test. Medians of clinical competence were compared among groups, before and after intervention, using the Mann-Whitney U test, while frequencies distribution of clinical competence level were analyzed with the Kolmogorov-Smirnov test (p≤0.05). RESULTS: Overall medians and intervals for unit "A" were 28 (9-45) pre-intervention and 34 (11-51) pos-intervention, with before-after difference p>0.05; for unit "B", values were 32 (12-50) pre-intervention, 61 (36-82) pos-intervention, and before-after difference p≤0.05. No significant differences were found among groups pre-intervention (p>0.05), although they were observed pos-intervention (p≤0.05). CONCLUSIONS: The educational intervention evaluated proved to improve, in a statistically significant way, the overall and by dimensions clinical competence level of Mexican family physicians for nutritional management of patients with diabetes mellitus type 2.

8.
Rev Salud Publica (Bogota) ; 20(6): 718-724, 2020 Nov 16.
Artículo en Portugués | MEDLINE | ID: mdl-33206895

RESUMEN

OBJECTIVE: To characterize sociodemographic and clinical aspects of elderly women with cervical cancer in Maranhão, Brazil. MATERIALS AND METHOD: Retrospective and descriptive study of secondary sources. RESULTS: 559 elderly women with cervical cancer from 2009 to 2013 and registered in the hospital-based cancer registry were included in the study. The mean age was 69.91 years, with a predominance of brown women (46%), with incomplete primary education (42%), married (45.4%), and without drinking and smoking habits (58.3% and 39.4%, respectively). Squamous cell carcinoma was the most frequent type pf cancer (80.5%) with advanced stage 3B in 29.0% of the cases. At the end of the first treatment, 43.6% did not show any evidence of disease or complete remission. CONCLUSION: Results point to the need to improve campaigns for the age group studied, as well as the coverage through campaigns to promote cytopathological examination. Also health professionals should be encouraged to identify women who are behind in the examination when attending health services, thus avoiding the loss of prevention opportunities.

9.
Rev Salud Publica (Bogota) ; 20(6): 725-729, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206896

RESUMEN

OBJECTIVE: To estimate and analyze the regional patterns of life expectancy at birth in Mexico for the period 1990-2010 using multiple regression. MATERIALS AND METHODS: Multiple regression analysis is used to obtain life expectancy rates at state level. This method considers variables such as crude death rate and population over 65 years of age to know the level of convergence between states. RESULTS: There is a pattern of convergence that suggests that the differences in the life expectancy levels decreased among states during the analyzed period. This trend is also observed at the regional level. DISCUSSION: It could be said that this analysis is useful to evaluate the public health policies in Mexico that focus on the reduction of health inequalities among the poorest and most vulnerable populations. Likewise, this type of method allows having an alternative method to know the conditions of access to health services and the life expectancy of the population.

10.
Rev Salud Publica (Bogota) ; 20(6): 730-734, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206897

RESUMEN

OBJECTIVE: To determine the effect of alfalfa extract consumption on induced iron deficiency anemia in mice. MATERIALS AND METHODS: Thirty M. musculus albino mice of the BALB/c strain were used for this study. All of them were males, with a mean weight of 23±33.7 g. Three groups of 10 mice each were formed: a) negative control group with sufficient iron (HS), which received 40g/d of balanced feed for seven weeks; b) positive control group with iron deficiency (HD), which received 40g/d of a diet plan for anemia for seven weeks; and c) experimental group with iron deficiency (HD), which received 40g/d of a diet plan for anemia for seven weeks and 20g/d of alfalfa extract (EA) from week five. Hemoglobin levels were measured. RESULTS: At the end of the treatment, a significant difference was observed in hemoglobin levels between the positive (8.41±3.9 g/dL) and experimental (13.4±3.3 g/dL) control groups (T student, p<0.05). There was no significant difference in hemoglobin levels at the end of the induction period between the positive (8.76±3.9 g /dL) and experimental (8.59±3.1 g/dL) groups (T student, p>0.05). CONCLUSIONS: Under experimental conditions, alfalfa has an antianemic effect based on the results of hemoglobin levels.

11.
Rev Salud Publica (Bogota) ; 20(6): 735-740, 2020 Nov 16.
Artículo en Portugués | MEDLINE | ID: mdl-33206898

RESUMEN

OBJECTIVE: To identify the prevalence of metabolic syndrome in users of the hypertension and diabetes mellitus program at a Health Center in Jequié City, Bahia, Brazil. MATERIALS AND METHODS: This is a descriptive cross-sectional study. The sample consisted of 100 patients enrolled in HIPERDIA. This study was approved by the Research Ethics Committee of the State University of Southwest of Bahia (Minutes no. 013/2011). RESULTS: The prevalence of metabolic syndrome in these users was 43%. Regarding sex, the prevalence was 35% among men and 47% among women, considering that in 23% of the medical records there were insufficient data for classification. CONCLUSIONS: It was evidenced that the metabolic syndrome reaches proportionately more women than men, whereas, in relation to age, a higher prevalence of the disease was verified in individuals older than 60 years.

12.
Rev Salud Publica (Bogota) ; 20(6): 741-744, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206899

RESUMEN

OBJECTIVE: A descriptive, correlational, retrospective cross-sectional study was carried out to determine if there was any dependence between sex and the results of HIV/AIDS screening tests in the 08D01 district of the city of Esmeraldas, Ecuador, for the period covered January-December 2016. MATERIALS AND METHODS: 100% of the people who were screened for HIV/AIDS were included in the study. Central tendency measures such as mean, rank and percentage were used, as well as Chi square tests to determine dependence between both variables. CONCLUSIONS: There is a higher prevalence in men than in women, reaching a ratio of one woman infected with HIV/AIDS for every 1.2 men, as well as a tendency to have a significant increase of reactive results in males and a decrease of reactive results in the female sex when performing the test.

13.
Rev Salud Publica (Bogota) ; 20(6): 745-751, 2020 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-33206900

RESUMEN

OBJECTIVE: To evaluate the case report forms and times elapsed between the surveillance steps for dengue virus (DENV) infection in a large Colombian city before the emergence of other arbovirus epidemics. MATERIALS AND METHODS: The descriptive epidemiology of DENV infection cases was analyzed from 2009 to 2013. The completeness of the case report forms filed at the Primary Units of Data Generation (PUDG) were evaluated, as well as the accuracy and suitability of the tests (PPV: positive predictive value). The average time-lags between each step were then calculated. RESULTS: There were 7.3, 12.38, 4.66, 6.25 and 29.9 annual cases of dengue infection per 10 000 inhabitants in 2009 to 2013, respectively. In this study, only 57.76% of the cases were classified correctly by the physicians and 26.32% of them were questioned about their home conditions and whether their family/friends had similar symptoms. Patients visited a clinic/hospital on average 4.76 days after developing symptoms and the health system was notified on average 1.75 days later, while 70.6% of them were reported within the one-day target period. There were only minor changes in case reporting times even during a DENV epidemic. Some (12.85%) of the case forms were later modified (average 16.7 days). In the period 2009-2013, the IgM confirmed PPV was 58.60%, while 20 mandatory criteria were absent on more than 25% of the forms. CONCLUSIONS: The system was accurate, simple, flexible, stable and acceptable, but a number of ways are suggested to improve this case detection and reporting system.

14.
Rev Salud Publica (Bogota) ; 20(6): 752-758, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206901

RESUMEN

OBJECTIVE: To design a composite health indicator on the risk of rabies virus transmission in the department of Meta, Colombia. MATERIALS AND METHODS: Ecological, exploratory study. Data from secondary sources were collected from the databases of the Meta Department of Health and the Colombian Agricultural Institute (ICA) for the period 2009 - 2014. The composite health indicator was created based on the normalization (logX) of the data and the selection of measures for the elaboration of three thematic indexes in the 29 municipalities of the department. They were integrated by means of the aggregation method, and their distribution was reflected in a geographical mapping with the zoning of the risk for rabies virus transmission in the department. RESULTS: In the classification of the composite health indicator on the risk of rabies transmission, the high level corresponds to 34% of the municipalities of the department, the middle level involves 17%, the low level, 28%. The municipalities without risk are La Macarena, Mapiripán, Vistahermosa, Villavicencio, Puerto Concordia, Granada and Puerto Rico, representing 21%. CONCLUSION: The high level of the composite health indicator on the risk of rabies virus transmission is found in municipalities of the Meta River sub-region, the Cordillera sub-region and the upper Ariari sub-region. These areas are characterized by high concentrations of animals, decreased coverage of rabies vaccination and circulating confirmation of the virus.

15.
Rev Salud Publica (Bogota) ; 20(6): 759-763, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206902

RESUMEN

In 1992, Chile implemented for the first time a health program for indigenous peoples, the Health Program for the Mapuche Population (PROMAP), whose objective was to provide health care with cultural relevance, favoring the complementarity between the indigenous medical systems and the official system The current version of this initiative - named PESPI - has managed to reach almost all the Health Services in the country with this approach. The review that the academic world has made of these experiences, based on public health or medical anthropology, has focused on the analysis of the initiatives taken in rural indigenous contexts, from the point of view of the difficulties they have had to face and the meaning of the interculturality in health that they have managed to consolidate. However, little has been said about this program in urban contexts (currently, a space which our indigenous peoples are occupying progresively) or from the point of view of the notions of interculturality in health that they imply. Considering the above, the article offers a thematic review of national and international scientific publications on the subject, a critical analysis of intercultural health programs developed in Chile and a reflection on their challenges in the framework of urban indigenous dynamics.

16.
Rev Salud Publica (Bogota) ; 20(6): 764-770, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206903

RESUMEN

OBJECTIVES: To describe and interpret the methodologies and results of the main studies related to the monitoring of exposure of cyclists to air pollution. METHODS: Research and analysis of national and international research of the last ten years in the Cochrane, Scopus, Embase, Science Direct and Pubmed databases. The search was conducted in August and September 2017 using the following search descriptors for MeSH: air pollution, bicycle riding, environmental exposure, environmental health, exposure by inhalation, environmental pollutants, transportation, public health and toxicology. For DeCS: air Pollution, cycling, exposure to environmental risks, environmental pollutants, inhalation, transportation, public health and toxicology. RESULTS: Nineteen eligible published articles were identified. Most studies were conducted in Europe and the United States. Four studies have been reported in South America. Other studies seek comparisons on different bicycle routes, compare exposure during variations of the same route, and others determine the distance-exposure relationship. In the same way, variables such as vehicular traffic, distance to the emission sources and the type of bike path, play a fundamental role in the exposure to pollutants in cyclists. CONCLUSIONS: Several variables were found that influence, directly or indirectly, the cyclists exposure to air pollution, as well as some factors that can reduce this exposure.

17.
Rev Salud Publica (Bogota) ; 20(6): 771-777, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206904

RESUMEN

OBJECTIVE: To explore the elements that should be considered in post-conflict zones to guarantee the right to health of populations immersed or living in areas near the concentrations of former combatants. MATERIALS AND METHODS: A retrospective study was carried out by searching databases, obtaining 26 relevant articles. RESULTS: The literature review made evident that not only the legal or normative framework is important, but also the needs and interests of the people of the community, of both the civilian population and the victims of war. The right to health in these areas also involves the exercise of power, of dialogue of knowledge, forgiveness, non-repetition and respect. In addition, health promotion and disease prevention services, treatment and rehabilitation based on the primary care strategy should be offered, that is, they should be adapted to the cultural realities, the environments and the interests of the communities. CONCLUSIONS: The challenge lies in the way how these goals can be achieved within a context of a weak health system, in financial, administrative and technical terms. Basic multidimensional elements in the field of primary health care are proposed to face this challenge for the Colombian public health.

18.
Rev Salud Publica (Bogota) ; 20(6): 778-783, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206905

RESUMEN

The recent occurrence of vaccinia virus infections in humans and animals in Colombia, together with that reported for this and other species of the genus Orthopoxvirus in some South American, African, Asian and European countries, is supporting evidence of the emergence and re-emergence of the genus. This fact has become of great interest for public health around the world due to its biological and an epidemiological features, as was in the past the variola virus, one of its representatives. The emergence and re-emergence of the genus Orthopoxvirus may be a consequence of stopping vaccination against the variola virus in the 1970s and 1980s. This vaccination unsuspectedly induced cross-protective immunity to other species of that genus. This is a review of the history, biology and epidemiology of the main species of the genus Orthopoxvirus, together with its clinical presentation, social context and public health impact in the past, present and future.

19.
Rev Salud Publica (Bogota) ; 20(6): 784-786, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206906

RESUMEN

Transitional care aims to facilitate the effective transfer of children suffering from chronic diseases to the medical staff in charge of adult care, ensuring appropriate long-term management, early identification of possible complications, and reduction of morbidity and costs associated with the provision of health services. In several countries, significant progress in this regard has been made, and even consensus on the aspects necessary for the development of transitional care has been reached, including the general principles from the policy to its implementation, with good results in the patients. Despite these advances, in many countries such as Colombia, where the pediatric population suffering from chronic diseases that reach adolescence and then adulthood Is on the rise, little is known about transitional care. It is necessary to generate research and interdisciplinary works to meet the multiple needs of this emerging population, their families and caregivers.

20.
Rev Salud Publica (Bogota) ; 20(6): 787-791, 2020 Nov 16.
Artículo en Español | MEDLINE | ID: mdl-33206907

RESUMEN

The influenza pandemic that ravaged the planet in 1918-1919 is, undoubtedly, the most virulent and lethal infectious disease that the human species has ever overcome. This essay was to evaluate the medical interpretation of this phenomenon and the response given by doctors in terms of diagnostic and therapeutic technology based on the data published in the medical literature of two of the most important journals of the time, BMJ (The British Medical Journal) and JAMA (The Journal of the American Medical Association). It was found that the arsenal of knowledge, diagnosis and therapeutics of the time offered very few tools to address clinical management and curb contagion and mortality. However, the difficulties that clinicians and health authorities had to overcome were a solid incentive to make significant progress in the understanding and management of infectious diseases, particularly of viral etiology, in a short period of time.

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