RESUMO
Resumen (analítico): El presente artículo analiza las diferentes formas en que jóvenes que asisten a fiestas electrónicas en la Ciudad Autónoma de Buenos Aires (CABA) hacen uso de discursos y terminologías en torno a procesos vinculados a las neurociencias para dar cuenta de sus consumos recreativos de drogas sintéticas, sus formas de sociabilidad y las formas de entenderse a sí mismos. Se realizaron entrevistas a un informante, y un grupo de discusión con jóvenes que forman parte de la movida. En los relatos de los jóvenes se exponen alusiones que remiten a una individualidad somática cerebral como gramática que permite hacer inteligible los procesos de subjetivación. Estas referencias se presentan en forma de mutaciones, donde fuentes biomédicas de diferente orden coexisten: desde el campo psi a las neurociencias.
Abstract (analytical): This article aims to analyze the different ways in which young people attending electronic music events in Buenos Aires use discourses and terminologies related to neuroscience to account for their recreational consumption of synthetic drugs, their forms of sociability and the various approaches they use to understand themselves. Interviews were conducted with an informant and a discussion group was organised with a group of young people who attend electronic music events. The author suggests that the narratives of these young people refer to a somatic cerebral individuality as a form of grammar that makes their processes subjectivization intelligible. However, these references occur in the form of mutations, where different biomedical sources coexist ranging from psychology to the neurosciences.
Resumo (analítico): O presente artigo analisa as diferentes formas nas quais os jovens que frequentam festas electrónicas na Cidade Autônoma de Buenos Aires fazem uso de discursos e terminologias em torno de processos relacionados com as neurociências para explicar seus consumos recreativos de drogas sintéticas, suas formas de sociabilidade, e de compreender à si mesmos. Foram realizadas entrevistas com um informante chave, e uma reunião de discussão com um grupo de jovens que frequentam festas eletrônicas. Nas narraçoes destes jovens é possível observar alusões que se referem a uma individualidade somática cerebral como gramática que permite fazer inteligível processos de subjetivação. No entanto, estas referências apresentam se na forma de mutações, onde coexistem fontes biomédicas de diferentes ordem: desde o campo psi até as neurociências.
Assuntos
Neurociências , Usuários de Drogas , MúsicaRESUMO
Objective: To estimate the 12-month prevalence of mental health services utilization (overall and by type of service sector), the adequacy of treatment provided, and sociodemographic correlates in the Argentinean Study of Mental Health Epidemiology (ASMHE). Methods: The ASMHE is a multistage probability household sample representative of adults in urban areas of Argentina. The World Health Organization World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to evaluate psychiatric diagnosis and service utilization. Results: Among those with a disorder, 27.6% received any treatment in the prior 12 months. Of these, 78.3% received minimally adequate treatment using a broad definition and only 43.6% using a stringent definition. For individuals with a disorder, more services were provided by mental health professionals (17.7%) than by general medical professionals (11.5%) or non-healthcare sectors (2.6%). Younger individuals with low education and income were less likely to receive treatment; those never married and those with an anxiety or mood disorder were more likely to receive treatment. Among those in treatment, treatment was least adequate among younger individuals with low education and low income. Conclusions: Policies to increase access to services for mental health disorders in Argentina are needed, as is training for primary care practitioners in the early detection and treatment of psychiatric disorders.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Transtornos Relacionados ao Uso de Substâncias/terapia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Mentais/terapia , Transtornos Mentais/epidemiologia , Serviços de Saúde Mental/estatística & dados numéricos , Argentina/epidemiologia , Psiquiatria/educação , Fatores Socioeconômicos , População Urbana/estatística & dados numéricos , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Prevalência , Inquéritos e Questionários , Inquéritos Epidemiológicos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Clínicos Gerais/educação , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Transtornos Mentais/diagnóstico , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To estimate the 12-month prevalence of mental health services utilization (overall and by type of service sector), the adequacy of treatment provided, and sociodemographic correlates in the Argentinean Study of Mental Health Epidemiology (ASMHE). METHODS: The ASMHE is a multistage probability household sample representative of adults in urban areas of Argentina. The World Health Organization World Mental Health Composite International Diagnostic Interview (WMH-CIDI) was used to evaluate psychiatric diagnosis and service utilization. RESULTS: Among those with a disorder, 27.6% received any treatment in the prior 12 months. Of these, 78.3% received minimally adequate treatment using a broad definition and only 43.6% using a stringent definition. For individuals with a disorder, more services were provided by mental health professionals (17.7%) than by general medical professionals (11.5%) or non-healthcare sectors (2.6%). Younger individuals with low education and income were less likely to receive treatment; those never married and those with an anxiety or mood disorder were more likely to receive treatment. Among those in treatment, treatment was least adequate among younger individuals with low education and low income. CONCLUSIONS: Policies to increase access to services for mental health disorders in Argentina are needed, as is training for primary care practitioners in the early detection and treatment of psychiatric disorders.
Assuntos
Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Serviços de Saúde Mental/estatística & dados numéricos , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/terapia , Adolescente , Adulto , Idoso , Argentina/epidemiologia , Feminino , Clínicos Gerais/educação , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Inquéritos Epidemiológicos , Humanos , Masculino , Transtornos Mentais/diagnóstico , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Prevalência , Psiquiatria/educação , Fatores Socioeconômicos , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Adulto JovemRESUMO
Los mecanismos y variables que determinan la elección de una especialidad son complejos e incluyen factores individuales, características de las instituciones que moldean las experiencias y las percepciones sobre las especialidades que circulan en la comunidad. El objetivo del estudio fue analizar los determinantes vinculados a la elección de una especialidad entre estudiantes de medicina próximos a graduarse de la Universidad de Buenos Aires, la Universidad de Nacional de La Plata y la Universidad Nacional de La Matanza. El diseño del estudio fue descriptivo con un abordaje cuali-cuantitivo o triangulación de métodos, mediante la realización de encuestas y entrevistas en profundidad. Entre los resultados de la encuesta realizada (N= 425) se destaca que al incorporar al análisis de los componentes resultantes la potencial elección de la especialidad médica agrupada según el criterio de estrategia Atención Primaria de la Salud orientada al primer nivel de atención (PNA), es posible observar como quienes responden con mayor intensidad el componente generalista, eligen también especialidades del PNA. Al contrario, entre quienes el componente quirúrgico presenta mayor intensidad, su elección no está signada por especialidades del PNA. El relevamiento cualitativo (N=18) profundiza en este sentido y agrega los principales elementos que inciden en la elección de la especialidad entre los entrevistados; la remuneración, el prestigio, la vocación, la carga laboral en residencia y guardias, el estilo de vida durante el ejercicio profesional, la ausencia de maltrato y la versatilidad de la especialidad. Además, emerge la valoración de las acciones tangibles de la práctica, el trato con las personas destinatarias de la atención, las especialidades asociadas de forma predominante según un criterio sexo-genérico como obstáculo de despliegue de trayectoria y la impronta y el recorrido institucional vivenciado. Los resultados de esta investigación son un aporte al campo de las políticas de formación de los recursos humanos en salud a nivel de las autoridades sanitarias y de las instituciones formativas. La difusión de los mismos contribuirá a diseñar políticas que apunten a la diversidad de factores involucrados
Assuntos
Estudantes de MedicinaRESUMO
PURPOSE: Although the Global Burden of Disease Study estimated that depressive disorders and anxiety disorders are the second and fifth leading causes of disability in Argentina, these estimates were based on imputations rather than epidemiological data. The policy implications of these results for the necessary expansion of mental health services in Argentina are sufficiently great that more direct estimates of the population burdens of common mental disorders are needed. Therefore, the purpose is to present the first results regarding lifetime prevalence, projected lifetime risk up to age 75, age-of-onset, cohort effects and socio-demographic correlates of DSM-IV mental disorders among adults (18+) from the general population of urban areas of Argentina. METHOD: A multistage clustered area probability household survey was administered to 3927 individuals using the World Mental Health Composite International Diagnostic Interview. RESULTS: Lifetime prevalence of any disorder was 29.1% and projected lifetime risk at age 75 was 37.1%. Median age-of-onset of any disorder was 20 years of age. Disorders with highest lifetime prevalence were major depressive disorder (8.7%), alcohol abuse (8.1%), and specific phobia (6.8%). Anxiety disorders were the most prevalent group of disorder (16.4%) followed by mood (12.3%), substance (10.4%), and disruptive behavior disorders (2.5%). Women had greater odds of anxiety and mood disorders; men had greater odds of substance disorders. Age-at-interview was inversely associated with lifetime risk of any disorder. DISCUSSION: The results provide direct evidence for high lifetime societal burdens of common mental disorders in Argentina due to a combination of high prevalence and early age-of-onset.
Assuntos
Idade de Início , Transtornos Mentais/epidemiologia , Adolescente , Adulto , Idoso , Alcoolismo/epidemiologia , Transtornos de Ansiedade/epidemiologia , Argentina/epidemiologia , Análise por Conglomerados , Transtorno Depressivo Maior/epidemiologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/epidemiologia , Transtornos Fóbicos/epidemiologia , Prevalência , Adulto JovemRESUMO
PURPOSE: Community surveys of mental disorders and service use are important for public health policy and planning. There is a dearth of information for Latin America. This is the first representative community survey in the Argentinean population. The purpose is to estimate the 12-month prevalence and severity of mental disorders, socio-demographic correlates and service use in a general population survey of adults from urban areas of Argentina. METHODS: The World Mental Health Composite International Diagnostic Interview was administered to 3927 individuals aged 18 years and older participating in a multistage clustered area probability household survey. The response rate was 77%. RESULTS: The 12-month prevalence of any disorder was 14.8%, and a quarter of those disorders were classified as severe. Younger participants and those with lower education had greater odds of any disorder and most classes of disorder. 11.6% of the total population received treatment in the prior 12 months and only 30.2% of those with a severe disorder. Women and those never married were more likely to receive or seek treatment, whereas those with low and low-average education were less likely. CONCLUSION: Most individuals with a mental disorder in the past year, even those with a severe disorder, have not received treatment. Because low education is a barrier to treatment, initiatives aimed at mental health education might help timely detection and treatment of these disorders in Argentina.
Assuntos
Transtornos Mentais/epidemiologia , Serviços de Saúde Mental/estatística & dados numéricos , Adolescente , Adulto , Idoso , Argentina/epidemiologia , Escolaridade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores Socioeconômicos , Inquéritos e Questionários , População Urbana/estatística & dados numéricos , Adulto JovemRESUMO
In this paper we report the findings of the first "Epidemiological study of mental health in the general population of Argentina" in the framework of the World Mental Health Survey Initiative WHO / Harvard, in collaboration with the Faculty of Medicine of the University of Buenos Aires and the Asociación de Psiquiatras Argentinos (APSA) with funding from the Ministry of Health. Methodology: A multistage probabilistic household survey was conducted using the Composite International Diagnostic Interview (CIDI). The survey was conducted on 3,927 people aged 18 and over (no age limit), with fixed residence in one of the eight largest urban areas in the country (Buenos Aires, Córdoba, Corrientes-Resistencia, Mendoza, Neuquén, Rosario, Salta and Tucumán), representing approximately 50.1% of the adults living in the country. The response rate was 77%. Results: The lifetime prevalence of any mental disorder in the general population of Argentina over 18 years of age was 29.1% and the projected life risk up to 75 years of age was 37.1%. The disorders with the highest life prevalence were Major Depressive Disorder (8.7%), Alcohol Abuse Disorder (8.1%) and Specific Phobia (6.8%). Anxiety Disorders were the most prevalent group (16.4%), followed by Mood Disorders (12.3%), Substance Disorders (10.4%), and Impulse Control Disorders (2.5%). The prevalence in the last 12 months of any mental disorder was 14.8%, a quarter of wich were classified as severe. 11.6% received treatment in the previous 12 months and only 30.2% of those who suffered a severe disorder received it. The results provide essential data for health planning and implementation and the training of the mental health workforce.
Assuntos
Transtorno Depressivo Maior , Transtornos Mentais , Adolescente , Adulto , Idoso , Argentina/epidemiologia , Estudos Epidemiológicos , Humanos , Transtornos Mentais/epidemiologia , Saúde Mental , Pessoa de Meia-Idade , Transtornos do Humor , Prevalência , Adulto JovemRESUMO
Resumen En este artículo analizamos los procesos de vulnerabilidad y las prácticas de cuidado individuales y grupales en relación a los consumos de drogas de jóvenes que asisten a fiestas electrónicas en la Ciudad Autónoma de Buenos Aires, Argentina. Los resultados provienen de una investigación cualitativa más amplia en la que realizamos entrevistas individuales a jóvenes de entre 18 y 25 años y grupos focales que estuvieron conformados por grupos preexistentes de amigos. En contraposición a la idea de un "descontrol generalizado" y a cierta banalización del consumo de sustancias, el análisis de las experiencias de los jóvenes nos permitió observar el desarrollo de estrategias de control de los riesgos que son inherentes a estos consumos. Estas estrategias concurren, en muchas ocasiones, con la maximización de las experiencias sensoriales placenteras. Partiendo de algunos conceptos de la Salud Colectiva y la Teoría Social, analizamos las experiencias de consumo de drogas sintéticas de los jóvenes para abordar los sentidos asociados a las instancias de cuidado y las demandas por cuidado emergentes; las estrategias que emplean para la maximización del placer; y las sabidurías prácticas que despliegan y el diálogo de éstas con los conocimientos del campo de la biomedicina.
Abstract In this article we analyze the vulnerability processes and the individual and group care practices related to drug consumption on young people that go to electronic music festivals in Buenos Aires, Argentina. The findings come from a wider qualitative research project. For the construction of the empirical evidence, we interviewed young people from 18 to 25 years and we conducted focus groups with preexistent groups of friends that hang out together. In opposition to the idea of a generalized lack of control and a certain banalization of drug use, the analysis of young people experiences showed how they develop strategies to control the risks that are inherent to this drug use. These strategies frequently go together with the maximization of pleasurable sensorial experiences. Employing some theoretical concepts from the Collective Health and the Social Theory, we analyze the experiences of synthetic drug use by young people to approach the meanings that are associated with care practices and the emerging demands for care; the strategies that they employ to maximize the pleasure; and the practical knowledge that they develop and its dialogue with the knowledge that comes from the field of the biomedicine.
Resumo Neste artigo analisamos os processos de vulnerabilidade e as práticas de cuidado individual e grupal relacionados ao consumo de drogas em jovens que frequentam festivais de música eletrônica em Buenos Aires, Argentina. Os resultados vêm de um projeto de pesquisa qualitativa mais amplo. Para a construção da evidência empírica, entrevistamos jovens de 18 a 25 anos e conduzimos grupos focais com grupos preexistentes de amigos que saem juntos. Em oposição à ideia de um descontrole generalizado e de certa banalização do uso de drogas, a análise das experiências dos jovens mostrou como eles desenvolvem estratégias para controlar os riscos inerentes a esse uso de drogas. Essas estratégias frequentemente acompanham a maximização de experiências sensoriais prazerosas. Empregando alguns conceitos teóricos da Saúde Coletiva e da Teoria Social, analisamos as experiências do uso de drogas sintéticas pelos jovens para abordar os significados que estão associados às práticas de cuidado e às demandas emergentes por cuidado; as estratégias que eles empregam para maximizar o prazer; e o conhecimento prático que desenvolvem e o diálogo com o conhecimento que vem do campo da biomedicina.
Assuntos
Humanos , Adolescente , Adulto , Argentina , Autocuidado , Drogas Ilícitas , Adolescente , Comportamento do Adolescente/efeitos dos fármacos , Transtornos Relacionados ao Uso de Substâncias , Vulnerabilidade em Saúde , Comportamentos de Risco à Saúde , Atividades de LazerRESUMO
INTRODUCCIÓN La reducción de la mortalidad infantil en el período 1990-2015 ha experimentado un importante descenso, sin embargo este gran esfuerzo no alcanzó la meta de 2/3 establecida en el país. La mortalidad neonatal constituye un evento sumamente relevante y reducible en países en desarrollo. En marco de los Objetivos de Desarrollo Sostenible se retoma la necesidad de reducir la mortalidad neonatal. OBJETIVO Analizar la evolución de la mortalidad neonatal y algunas de sus causas principales en Argentina, en el período comprendido entre 1990 y 2016. MÉTODOS Estudio ecológico, de series temporales y vinculación con las intervenciones específicas para reducción de mortalidad infantil. RESULTADOS La reducción de la TMI (Tasa de Mortalidad Infantil) en el período fue del 61.9.%. La contribución de la TMN (Tasa de Mortalidad Neonatal) creció del 63.1% al 66.5%. La TMN se redujo un 59.9%. A nivel país, las TMN, TMN precoz, TMN tardía y TMN en varones y mujeres, muestran una tendencia global decreciente estadísticamente significativa, sin embargo las tendencias presentan cambios en diferentes períodos. La reducción en el período 1990-2016 de la TMN fue en términos generales del 3.4% anual; de 1990 a 1999 descendió 4.15% anual, entre 1999 y 2002 casi no se observa descenso, del 2005 a 2005 desciende 6.81% y de 2005 a 2016 continúa la tendencia a la baja morigerando su velocidad (2.71%). El ritmo de descenso fue semejante para mujeres y varones y superior en la TMN precoz (3.9%) que en la tardía (1.8%). El análisis de las series temporales muestra que el grupo de causas perinatales y el de malformaciones presentaron reducciones globales significativas (AAPC -3.9 y -1.1 respectivamente). El grupo de causas perinatales presenta 3 puntos de inflexión. Se observa un descenso importante entre 1990 y 1999 (PCA -4.78), un estancamiento entre 1999 y 2002 (PCA -0.06), un descenso pronunciado entre 2002 y 2006 (PCA -6.7) y un cambio en el ritmo de descenso entre 2006 y 2016 (PCA -3.05). El grupo de malformaciones presenta también 3 puntos de inflexión; entre 1990 y 2002 se observa un estancamiento (PCA 0.24), un descenso importante entre 2002 y 2005 (PCA -4.12), seguido de un estancamiento entre 2005 y 2014 (-0.77) y un descenso entre 2014 y 2016 (PCA -5.84). Este importante descenso en el grupo de las malformaciones 2002-2005 se refleja en el subgrupo de malformaciones del sistema nervioso, donde la anencefalia representa entre el 52 y 70% en el período