RESUMO

Objectives: To describe the characteristics and outcomes of COVID-19 cases in Jamaica and to explore the risk factors associated with severe COVID-19 from 9 March to 31 December 2020. Methods: A cross-sectional analysis of national surveillance data was conducted using confirmed COVID-19 cases in Jamaica. Definitions of a confirmed case, disease severity, and death were based on World Health Organization guidelines. Chi-square and Fisher exact tests were used to determine association with outcomes. Logistic regression models were used to determine predictors of severe COVID-19. Results: This analysis included 12 169 cases of COVID-19 (median age, 36 years; 6 744 females [ 55.4%]) of which 512 cases (4.2%) presented with severe disease, and of those, 318 patients (62.1%) died (median age at death, 71.5 years). Severe disease was associated with being male (OR 1.4; 95% CI, 1.2-1.7) and 40 years or older (OR, 6.5; 95% CI, 5.1-8.2). COVID-19 death was also associated with being male (OR, 1.4; 95% CI, 1.1-1.7), age 40 years or older (OR, 17.9; 95% CI, 11.6-27.7), and in the Western versus South East Health Region (OR 1.7; 95% CI, 1.2-2.3). Conclusions: The findings of this cross-sectional analysis indicate that confirmed cases of COVID-19 in Jamaica were more likely to be female and younger individuals, whereas COVID-19 deaths occurred more frequently in males and older individuals. There is increased risk of poor COVID-19 outcomes beginning at age 40, with males disproportionately affected. COVID-19 death also varied by geographic region. This evidence could be useful to other countries with similar settings and to policymakers charged with managing outbreaks and health.

RESUMO

INTRODUCTION: The COVID-19 pandemic had significant repercussions for the everyday life and public health of society. Healthcare professionals were particularly vulnerable. Here, we interviewed medical residents about their lived experiences during the pandemic to offer a phenomenological analysis. To this end, we discuss their pandemic experiences considering Jaspers' "limit situation" concept - that is, a radical shift from their everyday experiences, to one causing them to question the basis of their very existence. METHODS: We interviewed 33 medical residents from psychiatry and other specialties from the Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HCFMUSP) who either (a) worked directly with COVID-19 patients or (b) provided psychiatric care to other healthcare professionals. Semi-structured interviews were developed using the Inductive Process to Analyze the Structure of lived Experience (IPSE). RESULTS: The descriptions of the lived experiences of medical residents during the pandemic were organized into four content themes: (a) existential defense, (b) limit situations during the COVID-19 pandemic, (c) changes in lived experience, and (d) new world meanings through lived experience. CONCLUSION: During the COVID-19 pandemic, medical residents experienced what can be thought of as a "limit situation," as they encountered the healthcare delivery challenges coupled with the social isolation imposed by the COVID-19 pandemic. These challenges included fear of infection and potential death, uncertainty about the future, and the emotional overload caused by the sharp increase in patient deaths. That said, after facing such a limit situation, residents reported feeling strengthened by this experience. This is consistent with the notion that when confronted with limit situations, we draw on our resources to overcome adversity and, in turn, reap existential gains. Health care providers might use these experiences to energize their own professional approach.

Assuntos

RESUMO

Resumo Objetivou-se identificar através da revisão integrativa a abordagem sobre a maternidade e maternagem em situação de rua. Trata-se de uma revisão integrativa realizada nas bases de dados PubMed, BIREME, Medline, e portal de buscas SciELO, em português, inglês e espanhol. A pesquisa foi realizada entre os meses de outubro a dezembro de 2021, seguindo às recomendações do fluxograma Prisma e suporte do software Mendeley, submetidos à análise de conteúdo de Minayo. Foram selecionados 18 artigos. A partir da leitura foi possível identificar duas categorias temáticas: "Maternidade e maternagem nas ruas" e "Principais desafios vivenciados na maternidade e maternagem em situação de rua". Abordar sobre a maternidade e maternagem enquanto um campo de produção de saberes cria-se um tensionamento das construções sociais que não possuem efetivação de direitos por falta de programas e políticas intersetoriais contundentes. Além da estigmatização por uso de substâncias psicoativas como também a estrutura patriarcal atribuída à maternidade. A responsabilidade pelo cuidado acarreta diversas questões que atravessam a maternidade e maternagem nas ruas, são elas: preocupação com a saúde dos filhos, a criação da prole, bem como, o temor pela perda da custódia de seus entes.

Abstract The objective was to identify through integrative review the approach on maternity and motherhood in street situation. This is an integrative review performed in the databases PubMed, BIREME, Medline, and SciELO search portal, in Portuguese, English and Spanish. The survey was conducted between October and December 2021, following the recommendations of the Prisma flowchart and support of the Mendeley software, submitted to content analysis by Minayo. Eighteen articles were selected. The reading allowed the identification of two thematic categories: "Maternity and mothering in the streets" and "Main challenges experienced in maternity and mothering in street situation". Address about motherhood and mothering as a field of knowledge production creates a tension of the social constructions that do not have effecting rights for lack of programs and forceful intersectoral policies. In addition to the stigmatization for use of psychoactive substances, as well as the patriarchal structure attributed to motherhood. The responsibility for care entails several issues that cross the motherhood and mothering in the streets, namely: concern with the health of children, the fear of losing custody of their loved ones.

RESUMO

Introducción: El análisis de la situación de salud es una investigación primordial que se realiza en el sistema de salud cubano, en el que se estudia la salud, los elementos que la determinan y las formas de mejorarla. Objetivo: Evaluar la propuesta de diseño de un esquema que contribuya a la mejora del aprendizaje del análisis de la situación de salud de la comunidad para los residentes de la especialidad Medicina General Integral, pertenecientes a la Universidad de Ciencias Médicas de Guantánamo. Método: Se realizó una investigación pedagógica de tipo descriptiva en la antes mencionada institución durante el período marzo-julio de 2022. De un universo de 67 profesores que aceptaron participar, se seleccionaron 26 por muestreo intencional. Para obtener los datos primarios fueron aplicados tres cuestionarios tipo Likert para evaluar el esquema, en consideración con la estructura, la funcionalidad y el aporte en el aprendizaje. Dichos cuestionarios incluyeron las respuestas: Totalmente en desacuerdo, En desacuerdo, Ni de acuerdo ni en desacuerdo, De acuerdo y Totalmente de acuerdo. Los datos se resumieron en números absolutos y porcentajes. Se presentaron en tablas de distribución de frecuencias. Resultados: Los subtotales de respuestas Totalmente de acuerdo y De acuerdo sobre la evaluación estructural y funcional, así como la influencia que se espera de este para mejorar el aprendizaje del análisis de situación de salud, se consideraron adecuados al superar el estándar. Conclusiones: El esquema propuesto es evaluado como adecuado en estructura y funcionalidad. Se considera positiva la influencia que se espera de este para mejorar el aprendizaje del análisis de situación de salud de la comunidad.(AU)

Introduction: The analysis of the health situation is a fundamental investigation carried out in the Cuban health system, in which health is studied, the elements that determine it and the ways to improve it. Objective: To evaluate the design proposal of a scheme that contributes to the improvement of learning of the analysis of the health situation of the community for the residents of the Comprehensive General Medicine specialty, belonging to the Universidad de Ciencias Médicas de Guantánamo. Method: A descriptive pedagogical research was carried out in the aforementioned institution during the period March-July 2022. From a universe of 67 teachers who agreed to participate, 26 were selected by intentional sampling. To obtain primary data, three Likert-type questionnaires were applied to evaluate the scheme, taking into consideration the structure, functionality and contribution to learning. These questionnaires included the responses: Totally disagree, Disagree, Neither agree nor disagree, Agree and Totally agree. Data were summarized in absolute numbers and percentages. They were presented in frequency distribution tables. Results: The subtotals of Completely Agree and Agree responses on the structural and functional evaluation, as well as the expected influence of this to improve the learning of health situation analysis, were considered adequate when exceeding the standard. Conclusions: The proposed scheme is evaluated as adequate in structure and functionality. The influence expected from this to improve learning about the analysis of the community's health situation is considered positive.(AU)

Introdução: A análise da situação sanitária é uma investigação fundamental realizada no sistema de saúde cubano, no qual se estuda a saúde, os elementos que a determinam e as formas de melhorá-la. Objetivo: Avaliar a proposta de desenho de um esquema que contribua para a melhoria da aprendizagem da análise da situação de saúde da comunidade para os residentes da especialidade Medicina Geral Integral, pertencente à Universidad de Ciencias Médicas de Guantánamo. Método: Foi realizada uma pesquisa pedagógica descritiva na referida instituição durante o período de março a julho de 2022. De um universo de 67 professores que aceitaram participar, 26 foram selecionados por amostragem intencional. Para obtenção dos dados primários, foram aplicados três questionários do tipo Likert para avaliação do esquema, levando em consideração a estrutura, funcionalidade e contribuição para a aprendizagem. Esses questionários incluíram as respostas: Discordo totalmente, Discordo, Nem concordo nem discordo, Concordo e Concordo totalmente. Os dados foram resumidos em números absolutos e porcentagens. Eles foram apresentados em tabelas de distribuição de frequência. Resultados: Os subtotais das respostas Concordo Totalmente e Concordo na avaliação estrutural e funcional, bem como a influência esperada desta para melhorar a aprendizagem da análise da situação de saúde, foram considerados adequados quando excedem o padrão. Conclusões: O esquema proposto é avaliado como adequado em estrutura e funcionalidade.A influência que se espera disto para melhorar a aprendizagem sobre a análise da situação de saúde da comunidade é considerada positiva.(AU)

RESUMO

ABSTRACT Objectives. To describe the characteristics and outcomes of COVID-19 cases in Jamaica and to explore the risk factors associated with severe COVID-19 from 9 March to 31 December 2020. Methods. A cross-sectional analysis of national surveillance data was conducted using confirmed COVID-19 cases in Jamaica. Definitions of a confirmed case, disease severity, and death were based on World Health Organization guidelines. Chi-square and Fisher exact tests were used to determine association with outcomes. Logistic regression models were used to determine predictors of severe COVID-19. Results. This analysis included 12 169 cases of COVID-19 (median age, 36 years; 6 744 females [ 55.4%]) of which 512 cases (4.2%) presented with severe disease, and of those, 318 patients (62.1%) died (median age at death, 71.5 years). Severe disease was associated with being male (OR 1.4; 95% CI, 1.2-1.7) and 40 years or older (OR, 6.5; 95% CI, 5.1-8.2). COVID-19 death was also associated with being male (OR, 1.4; 95% CI, 1.1-1.7), age 40 years or older (OR, 17.9; 95% CI, 11.6-27.7), and in the Western versus South East Health Region (OR 1.7; 95% CI, 1.2-2.3). Conclusions. The findings of this cross-sectional analysis indicate that confirmed cases of COVID-19 in Jamaica were more likely to be female and younger individuals, whereas COVID-19 deaths occurred more frequently in males and older individuals. There is increased risk of poor COVID-19 outcomes beginning at age 40, with males disproportionately affected. COVID-19 death also varied by geographic region. This evidence could be useful to other countries with similar settings and to policymakers charged with managing outbreaks and health.

RESUMEN Objetivos. Describir las características y los resultados de los casos de COVID-19 en Jamaica y explorar los factores de riesgo asociados a la COVID-19 grave desde el 9 de marzo hasta el 31 de diciembre del 2020. Métodos. Se realizó un análisis transversal de datos nacionales de vigilancia a partir de los casos confirmados de COVID-19 en Jamaica. Las definiciones de caso confirmado, gravedad de la enfermedad y muerte se basaron en las directrices de la Organización Mundial de la Salud. Para determinar la asociación con los criterios de valoración se utilizó la prueba de χ2 y la prueba exacta de Fisher. Se usaron modelos de regresión logística para determinar los factores predictivos de la COVID-19 grave. Resultados. Se incluyeron en el análisis 12 169 casos de COVID-19 (mediana de edad, 36 años; 6 744 mujeres [55,4%]), de los que 512 (4,2%) fueron de enfermedad grave. De estos pacientes, 318 (62,1%) fallecieron (mediana de edad al morir, 71,5 años). Se observó una asociación de la enfermedad grave con el sexo masculino (OR de 1,4; IC del 95 %, 1,2-1,7) y con la edad igual o superior a 40 años (OR de 6,5; IC del 95 %, 5,1-8,2). La muerte por COVID-19 también mostró una asociación con el sexo masculino (OR de 1,4; IC del 95%, 1,1-1,7), con la edad igual o superior a 40 años (OR de 17,9; IC del 95%, 11,6-27,7) y con la Región de Atención de Salud Occidental en comparación con la Sudoriental (OR de 1,7; IC del 95%, 1,2-2,3). Conclusiones. Los resultados de este análisis transversal indican que los casos confirmados de COVID-19 en Jamaica correspondieron una mayor probabilidad a mujeres y personas más jóvenes, mientras que las muertes por COVID-19 fueron más frecuentes en varones y personas de mayor edad. Hay un mayor riesgo de evolución desfavorable de la COVID-19 a partir de los 40 años, que afecta de manera desproporcionada a los varones. Las muertes por COVID-19 también variaron según la región geográfica. Esta evidencia podría ser de utilidad para otros países con entornos similares y para los responsables de la formulación de políticas en materia de gestión de brotes y salud.

RESUMO Objetivos. Descrever as características e os desfechos dos casos de COVID-19 na Jamaica e explorar os fatores de risco associados à COVID-19 grave de 9 de março a 31 de dezembro de 2020. Métodos. Análise transversal de dados de vigilância nacional usando casos confirmados de COVID-19 na Jamaica. As definições de caso confirmado, gravidade da doença e morte foram baseadas nas recomendações da Organização Mundial da Saúde. Foram usados testes de qui-quadrado e exato de Fisher para determinar a associação com os desfechos. Modelos de regressão logística foram usados para determinar os preditores de COVID-19 grave. Resultados. Esta análise incluiu 12.169 casos de COVID-19 (idade mediana: 36 anos; 6 744 do sexo feminino [55,4%]), dos quais 512 casos (4,2%) apresentaram doença grave; desses, 318 pacientes (62,1%) morreram (idade mediana ao morrer: 71,5 anos). A doença grave estava associada a ser do sexo masculino (razão de chances [RC]: 1,4; intervalo de confiança de 95% [IC 95%]: 1,2-1,7) e ter 40 anos ou mais de idade (RC: 6,5; IC 95%: 5,1-8,2). A morte por COVID-19 também estava associada a ser sexo masculino (RC: 1,4; IC 95%: 1,1-1,7), ter 40 anos ou mais (RC: 17,9; IC 95%: 11,6-27,7) e estar na Região Sanitária Oeste em comparação com a Região Sanitária Sudeste (RC: 1,7; IC 95%: 1,2-2,3). Conclusões. Os achados desta análise transversal indicam que a probabilidade de casos confirmados de COVID-19 na Jamaica era maior em indivíduos do sexo feminino e mais jovens, ao passo que as mortes por COVID-19 ocorreram com mais frequência em indivíduos do sexo masculino e mais velhos. Há um risco maior de resultados desfavoráveis em relação à COVID-19 a partir dos 40 anos, e indivíduos do sexo masculino são desproporcionalmente mais afetados. A morte por COVID-19 também variou de acordo com a região geográfica. Essas evidências podem ser úteis para outros países com cenários semelhantes e para os formuladores de políticas encarregados de manejar surtos e gerenciar a saúde.

RESUMO

This situation-specific theory was developed by linking concepts from Orem's Self-Care Deficit Nursing Theory and standardized nursing languages with the purpose of explaining and describing the health management of outpatients with heart failure. This theory suggests that the health management of these patients is influenced by basic conditioning factors, which may affect individuals' health management capability and may interfere with the ability to present health management behaviors. Knowing the ability of these patients to manage their health will allow nurses to plan their interventions, which will reflect directly on a patient's quality of life, and reduce the chances of hospitalization and health costs.

Assuntos

RESUMO

Introducción: la carrera de Estomatología emplea las Tecnologías de la Información y las Comunicaciones en el proceso docente educativo, muestra de lo cual es la inserción de manera creciente y progresiva de los softwares educativos. Objetivo: desarrollar un objeto de aprendizaje de tipo multimedia sobre Análisis de la Situación de Salud: Componente dental. Métodos: se realizó un estudio de tipo innovación tecnológica en el período de febrero a julio de 2018 en la Universidad de Ciencias Médicas de Sancti Spíritus. Se emplearon para el diseño y desarrollo del objeto de aprendizaje programas como MatchWare Mediator 9.0, HotPotatoes 6, Adobe Photoshop CS versión 8.0.1. El objeto de aprendizaje se validó por especialistas y por los estudiantes. Resultados: El 97,4 % de los estudiantes refirieron que el producto tenía la calidad y atracción necesaria para contribuir a su aprendizaje, el 100 % refirió su utilidad, lo cual se corroboró en el resultado de las calificaciones obtenidas que fueron buenas en el 97,4 % de los estudiantes. Conclusiones: la multimedia constituye un recurso educacional flexible, dinámico, claro, objetivo y de fácil comprensión; aborda una temática relevante para la Estomatología y cumple con el objetivo para el que fue concebido.

Introduction: the Stomatology career uses Information and Communication Technologies in the educational teaching process, an example of which is the increasing and progressive insertion of educational software. Objective: to develop a multimedia learning object on Analysis of the Health Situation: Dental Component. Methods: a technological innovation study was carried out in the period from February to July 2018 at the University of Medical Sciences of Sancti Spíritus. Programs such as MatchWare Mediator 9.0, HotPotatoes 6, Microsoft Office 2010, Adobe Photoshop CS version 8.0.1, were used for the design and development of the multimedia learning object. Specialists and students validated the obtained product. Results: the multimedia product was created. In addition, 97,4 % of the students reported that the product had the necessary quality and attraction to contribute to their learning and 100 % reported its usefulness, which was corroborated in the result of the grades obtained, being good in 97,4 % thereof. Conclusions: multimedia is a flexible, dynamic, clear, objective and easy to understand educational resource; addressing a relevant topic for Stomatology, fulfilling the objective for which it was conceived.

RESUMO

In response to the need to manage Antimicrobial Resistance (AMR), countries have produced National Action Plans (NAPs), which require detailed information of the AMR situation in all sectors. Considering the limited information that is publicly available for an analysis of the AMR situation in animal production, the FAO Regional Office for Latin America and the Caribbean (FAO RLC) developed the "FAO tool for a situation analysis of AMR risks in the food and agriculture sectors." The objective of this paper is to present the methodology developed for a qualitative evaluation of the risk factors of AMR toward animal and human health, based on terrestrial and aquatic production systems and their associated national public and private mitigation measures. The tool was developed reflecting the AMR epidemiological model and the guidelines to conduct a risk analysis of AMR from the Codex Alimentarius and WOAH. Applied in four stages of progressive development, the objective of the tool is to provide a qualitative and systematic assessment of the risks of AMR from animal production systems, to animal and human health, and to identify gaps in cross cutting factors in AMR management. The tool consists of three instruments: (i) a survey to collect data for a situation analysis of AMR risks; (ii) a methodological procedure for the analysis of the information obtained; (iii) instructions for the preparation of a national roadmap for the containment of AMR at a national level. Based on the results from the information analysis, a roadmap is prepared by guiding and prioritizing the needs and sectoral actions for the containment of AMR under an intersectoral, multidisciplinary and collaborative approach, and according to country priorities and resources. The tool helps to determine, visualize and prioritize the risk factors and challenges that contribute to AMR from the animal production sector and that need to be addressed to manage AMR.

RESUMO

Introdução: Políticas públicas intersetoriais em saúde são intervenções populacionais (e de cunho ecológico) muito utilizadas para a redução da carga global de doença e otimização de recursos tanto financeiros quanto humanos. Objetivo: O objetivo deste estudo foi analisar a situação de saúde de usuários idosos de uma política municipal de atividades físicas. Métodos: Trata-se de um estudo transversal com amostragem baseada em centros comunitários (N dispositivos comunitários=11), que disponibilizam práticas de movimentos corporais e outros, subsidiados pela Secretaria Municipal de Desenvolvimento Social e Esporte (SMDSE), Prefeitura Municipal de Porto Alegre (RS). A amostragem de usuários foi ponderada para o total de usuários atendidos por centro, adotando seleção aleatória simples. A coleta de dados ocorreu entre abril de 2018 e fevereiro de 2019, em que a equipe de coleta se deslocou ao território adscrito dos usuários para a condução de inquérito de saúde autoaplicado e a avaliação funcional; de forma contrária, os usuários compareceram a um centro de coleta para a série laboratorial (sem jejum). Resultados: Foram incluídos e analisados 351 usuários (média±desvio padrão, 70±6 anos). Para fatores de risco cardiovasculares, a prevalência de hipercolesterolemia foi de 54,2% e de 49,3% para hipertensão arterial sistêmica ­ as mais elevadas. O transtorno de sono foi prevalente em 55,3% da amostra. Entre as doenças autorrelatadas, os participantes listaram as cardiovasculares (14,3%), câncer prévio (14,6%), diabetes (13,2%), artrite reumatoide/ reumatismo (29,6%) e depressão (sem discriminador de depressão maior/ menor) (18,6%). A capacidade funcional, estimada pelo teste de caminhada em 6 minutos e a força de preensão manual, preditores de mortalidade cardiovascular e agravos, tiveram valores médios encontrados de 498,05±78,96 m e 27,08±8,14 kg, respectivamente. Conclusão: Os achados do presente estudo permitem contrastar prevalências estimadas em idosos participantes de um programa público de atividades físicas com outras estimativas em grupos de comparação, possibilitando a análise de situação de saúde com base em diferentes comportamentos e fatores de risco. Por fim, o trabalho viabilizou a monitorização de intervenções públicas para idosos em nível comunitário, sendo um ponto de base para acompanhamento futuro.

Introduction: Intersectoral public policies on health are population (and ecological) interventions widely used to reduce the global burden of disease and optimize both financial and human resources. Objective: The objective of this study was to analyze the health status of older adults users of a municipal policy on physical activities. Methods: This is a cross-sectional study with a sample based on community centers (N community centers=11), which provide body movement practices and others, funded by the Municipal Department of Social Development and Sports (SMDSE), City Hall of Porto Alegre (state of Rio Grande do Sul ­ RS, Brazil). The users' sample was weighted by the number of users of each center, by simple random sampling. Data collection took place between April 2018 and February 2019, in which the collection team went to the users' assigned territory to conduct a self-administered health survey and functional assessment; conversely, the users attended a collection center for laboratory tests (without fasting). Results: A total of 351 users (mean±SD, 70±6 years old) were included. For cardiovascular risk factors, the prevalence of hypercholesterolemia was 54.2% and 49.3% for systemic arterial hypertension ­ the highest levels. Sleep disorder was prevalent in 55.3% of the sample. Among the self-reported diseases, participants listed cardiovascular (14.3%), previous cancer (14.6%), diabetes (13.2%), rheumatoid arthritis/rheumatism (29.6%), and depression (without major/minor depression discrimination) (18.6%). Functional capacity, estimated by the six-minute walk test, and handgrip strength, predictors of cardiovascular mortality and injuries, had mean values of 498.05±78.96 m and 27.08±8.14 kg, respectively. Conclusions: The findings of this study allow contrasting prevalence rates estimated in older adults participants of a public physical activity program with other estimates in comparison groups, enabling the analysis of health status based on different behaviors and risk factors. All in all, our study enabled to monitor public interventions for older adults at the community level, serving as a baseline for future monitoring.

Introducción: Las políticas de salud pública intersectoriales tienen el potencial de destacar la reducción de la carga global de enfermedad y la optimización de los recursos financieros y humanos. Objetivo: El objetivo de este estudio fue analizar la situación de salud de los usuarios, ancianos, de una política municipal de actividades físicas. Métodos: Se trata de un estudio transversal con muestreo a partir de centros comunitarios (N dispositivos comunitarios=11), que brindan prácticas de movimiento corporal y otras, subsidiadas por la Secretaria Municipal de Desenvolvimento Social e Esporte (SMDSE), Prefeitura Municipal de Porto Alegre (RS). El muestreo de usuarios fue ponderado por el total de usuarios atendidos por centro, adoptando selección aleatoria simple. La recolección de datos ocurrió entre abril/2018 y febrero/2019, cuando el equipo de recolección viajó al territorio asignado de los usuarios para realizar una encuesta de salud auto aplicada y evaluación funcional; por el contrario, los usuarios acudían a un centro de recogida de series de laboratorio (sin ayuno). Resultados: Se incluyeron y analizaron 351 usuarios (media±DP, 70±6 años). Para los factores de riesgo cardiovascular, la prevalencia de hipercolesterolemia fue de 54,2% y de hipertensión arterial sistémica de 49,3%, la más alta. El trastorno del sueño fue prevalente en el 55,3% de la muestra. Entre las enfermedades auto informadas, los participantes enumeraron enfermedades cardiovasculares (14,3%), cáncer previo (14,6%), diabetes (13,2%), artritis reumatoide/reumatismo (29,6%) y depresión (sin discriminación de depresión mayor/menor) (18,6%). La capacidad funcional, estimada por la prueba de la marcha de 6 minutos, y la fuerza de prensión manual, predictores de mortalidad y lesiones cardiovasculares, tuvieron valores medios de 498,05±78,96 m y 27,08±8,14 kg, respectivamente. Conclusiones: Los hallazgos de este estudio permiten contrastar las prevalencias estimadas en participantes ancianos de un programa público de actividades físicas con otras estimaciones en grupos de comparación, lo que permite el análisis de la situación de salud basado en diferentes comportamientos y factores de riesgo. Por último, el trabajo ha facilitado la monitorización de intervenciones públicas para personas mayores a nivel comunitario, sirviendo como punto de partida para un seguimiento futuro.

RESUMO

OBJECTIVE: To measure the prevalence of suicidal ideation and attempts as well as suicide attempts' associated factors among street-involved youth in southern Brazil. PARTICIPANTS AND SETTING: Cross-sectional study was conducted with street-involved adolescents and children from Porto Alegre and Rio Grande, Brazil. METHODS: A respondent-driven sampling strategy was used to access this hard-to-reach population quickly and efficiently. Descriptive, bivariate, and multivariate analyses were conducted, with the latter being binary logistic regression. RESULTS: The prevalence of suicide attempts was 16.3%, while the frequency of suicidal ideation was 30.9%. Most participants were male, aged between 16 and 18 years, with no ties to school and family. Almost half of the sample had been in a street situation for five years or more, and two-thirds reported spending more than seven hours a day on the streets. Variables independently associated with suicide attempts were aged 19-21 years old, with reduced ties with school and family, having had an experience of sexual abuse, and lifetime use of crack. CONCLUSIONS: Public policies targeting the strengthening ties of street-involved children, adolescents, and youth with school and family might reduce their vulnerability to threats, such as sexual abuse and use of crack, and hence focus on decreasing suicide attempts.

Assuntos

RESUMO

En Ecuador la mayoría de los delitos de robo disminuyeron constantemente entre el 2009 y el 2015. La tasa de homicidios aumentó de 1999 al 2009, pero disminuyó un 65% entre el 2010 (18,74) y el 2017 (5,78). Fue el único caso en las Américas para ese momento. En este artículo se propone entender este fenómeno desde la noción de proximidad y situación. Metodológicamente se estudian las políticas criminales mediante el sistema before/after policiales. Para ello, se utilizó el efecto del modelo policial en un radio euclidiano alrededor de la productividad de paz en los cuarteles policiales desconcentrados, contrastando grupos de control e identificando el rol de las políticas que incluyeron abordajes de la situación delictiva en microterritorios. Se concluyó que la proximidad policial y las estrategias situacionales están visiblemente relacionadas con la disminución del crimen. Para el caso de homicidios el análisis también se confirma, aunque podrían estar involucrados otros factores no estudiados.

In Ecuador, most robbery crimes decreased steadily between 2009 and 2015. The homicide rate increased from 1999 to 2009, but decreased by 65% between 2010 (18.74) and 2017 (5.78). It was the only case in the Americas at that time. This article proposes to understand this pheno-menon from the notion of proximity and situation. Methodologically, criminal policies are studied through the before/after policing system. To do so, we used the effect of the police model in a Euclidean radius around peace productivity in deconcentrated police headquarters, contrasting control groups and identifying the role of policies that included approaches to the criminal situation in micro-territories. It was concluded that police proximity and situational strategies are visibly related to crime reduction. For homicides the analysis is also confirmed, although other factors not studied could be involved.

No Equador, a maioria dos crimes de roubo diminuiu de forma constante entre 2009 e 2015. A taxa de homicídios aumentou de 1999 a 2009, mas diminuiu em 65% entre 2010 (18,74) e 2017 (5,78). Era o único caso nas Américas naquela época. Este artigo propõe entender este fenômeno a partir da noção de proximidade e situação. Metodologicamente, as políticas criminais são estudadas através do sistema antes/depois do policiamento. Para isso, usamos o efeito do modelo policial em um raio euclidiano em torno da produtividade da paz na sede desconcentrada da polícia, contrastando grupos de controle e identificando o papel das políticas que incluíam abordagens da situação criminal em micro-territórios. Concluiu-se que a proximidade policial e as estratégias situacionais estão visivelmente relacionadas à redução da criminalidade. Para os homicídios, a análise também é confirmada, embora outros fatores não estudados possam estar envolvidos.

Assuntos

RESUMO

ABSTRACT Objective: To describe the patterns of overall mortality and mortality from external causes and the temporal evolution in the municipalities of the Paraopeba River Basin, before the socio-environmental disaster of the Brumadinho dam and, additionally, to investigate the correlation between mortality and socioeconomic deprivation in these municipalities. Methods: Global Burden of Disease Study mortality estimates for 26 municipalities in the state of Minas Gerais, Brazil, were analyzed. Rates of overall mortality and mortality from external causes were estimated in the triennia (T) T1 (2000 to 2002), T2 (2009 to 2011), and T3 (2016 to 2018). Pearson's correlation coefficient measured the association between mortality rates and socioeconomic deprivation, according to the Brazilian Deprivation Index (IBP). Results: There was a decrease in overall mortality in the Paraopeba River Basin from 717.7/100 thousand to 572.6/100 thousand inhabitants, and in most municipalities between T1-T3. Mortality from external causes increased from 73.3/100 thousand to 82.1/100 thousand, and it was higher in these municipalities compared with the mean for Brazil and Minas Gerais. Deaths from suicide and interpersonal violence increased from 29.6/100 thousand to 43.2/100 thousand in most of the 26 municipalities. Death rates due to unintentional injuries decreased during the period, and those due to transport injuries, increased. There was a positive correlation between socioeconomic deprivation and the percent change in mortality rates. Conclusion: Despite the strong presence of mining activity in the region, such did not reflect in the improvement of the sanitary situation. Death rates due to external causes increased in the period, associated with inequalities, which must be considered in the planning for the recovery of the disaster areas.

RESUMO: Objetivo: Descrever os padrões de mortalidade geral e por causas externas e a evolução temporal nos municípios da Bacia Hidrográfica do Rio Paraopeba previamente ao desastre socioambiental de Brumadinho e, adicionalmente, investigar a correlação entre a mortalidade e a privação socioeconômica nesses municípios. Métodos: Foram analisadas estimativas de mortalidade do Estudo Carga Global de Doenças referentes a 26 municípios de Minas Gerais. Calcularam-se taxas de mortalidade geral e por causas externas nos triênios (T) T1 (2000 a 2002), T2 (2009 a 2011) e T3 (2016 a 2018). O coeficiente de correlação de Pearson mediu associação entre as taxas de mortalidade e a privação socioeconômica, segundo Índice Brasileiro de Privação. Resultados: Houve declínio da mortalidade geral na Bacia Hidrográfica do Rio Paraopeba de 717,7/100.000 para 572,6/100.000 hab. e na maioria dos municípios entre T1-T3. A mortalidade por causas externas aumentou de 73,3/100.000 para 82,1/100.000 e foi mais elevada nesses municípios comparando-se com a média do Brasil e de Minas Gerais. As mortes por suicídio e violência interpessoal aumentaram de 29,6/100.000 para 43,2/100.000 na maioria dos 26 municípios. Os acidentes não intencionais reduziram-se no período, e as taxas por acidente de transporte aumentaram. Houve correlação positiva entre a privação socioeconômica e a variação percentual das taxas de mortalidade. Conclusão: Apesar da forte presença da atividade mineradora na região, isso não refletiu na melhoria do quadro sanitário, as causas externas aumentaram no período, associadas às desigualdades, o que deve ser considerado no planejamento para a recuperação das áreas do desastre.

RESUMO

RESUMEN Se realizó una investigación cualitativa en el campo de la Educación Médica, con revisión bibliográfica y documental de nueve programas del Plan de estudio D Perfeccionado de Estomatología, con el objetivo de analizar cómo se comporta el proceso de enseñanza-aprendizaje de los contenidos de asignaturas de la Disciplina Estomatología Integral en relación con los determinantes sociales de la salud. Al analizar el vínculo de los contenidos de las asignaturas en estudio con los determinantes sociales de la salud, se constató que al inicio de la carrera se imparten sus fundamentos y las herramientas de su identificación, pero se requiere mayor atención de los riesgos sociales en relación a enfermedades y problemas de salud, así como, en la sistematicidad y control de la metodología para aplicarlo en los Análisis de Situación de Salud en el transcurso de la carrera.

ABSTRACT A qualitative research was carried out in the field of Medical Education, with a bibliographic and documentary review of nine programs of the Dentistry's Study plan D Perfected, with the aim of analyze how the teaching-learning process of the contents of subjects of the Comprehensive. Dentistry Discipline in relation to the social determinants of health. By analyzing the link of the contents of the subjects under study with the social determinants of health, it was found that at the beginning of the career are taught its fundamentals and the tools of its identification, but greater attention to the risks is required in relation to diseases and health problems, as well as, in the systematicity and control of the methodology to apply it in the Health Situation Analysis during the course of the carreer.

RESUMO

RESUMO Relato de experiência sobre o processo de construção do Plano Municipal de Saúde sob perspectiva distrital de residentes em Planejamento e Gestão. O processo de elaboração do Plano Municipal de Saúde de Salvador (2022-2025), com a mobilização dos Distritos Sanitários (DS) para elaboração da Análise de Situação de Saúde (Asis), teve início em abril/2021. Três residentes em Planejamento e Gestão, sob supervisão docente e acompanhamento da preceptoria, vivenciaram todo o processo, uma vez que estavam envolvidas no contexto de um dos doze DS do município. Por meio do levantamento e do acesso aos sistemas de informação em saúde e de contatos com gestores e técnicos, foi elaborada a Asis do DS do período de 2010-2020. Reuniões para compartilhamento e mobilização da situação distrital foram realizadas com diversos atores, anteriormente à oficina distrital, para priorização dos problemas de saúde que tiveram como produto final o relatório distrital. O processo de elaboração da Asis distrital possibilitou a compreensão da importância do planejamento em saúde e sua aplicabilidade, contribuindo para o processo formativo das residentes, no desenvolvimento de competências e habilidades, considerando a realidade sanitária e epidemiológica.

ABSTRACT Experience report on the construction process of the Municipal Health Plan from the district perspective of residents in Planning and Management. The elaboration process of the Municipal Health Plan of Salvador (2022-2025), with the mobilization of Health Districts (DS) for the elaboration of the Health Situation Analysis (ASIS), began in April/2021. Three residents in Planning and Management, under the supervision of teachers and monitoring of the preceptorship, experienced the whole process, since they were involved in the context of one of the twelve health districts of the municipality. Through the survey and access to health information systems and contacts with managers and technicians, the ASIS of the DS for the period 2010-2020 was prepared. Meetings for sharing and mobilizing the district situation were held with various actors, prior to the district workshop, to prioritize health problems, which resulted in the district report. The process of elaborating the district ASIS made it possible to understand the importance of health planning and its applicability, contributing to the training process of residents, in the development of skills and abilities, considering the health and epidemiological reality.

RESUMO

Este artigo é desdobramento de uma pesquisa sobre população em situação de rua e violações de direitos. Debateremos, aqui, um aspecto do referido estudo por nós considerado fulcral, a saber: os processos de resistências e os modos de enfrentamentos (est)ético-políticos produzidos por pessoas em situação de rua, frente às violações de seus direitos. Epistemologicamente, orientamo-nos principalmente pela teorização relativa às relações de poder desenvolvidas por Michel Foucault, articulando-a sucintamente à problemática da necropolítica, proposta por Achille Mbembe. A produção da matéria empírica da pesquisa ocorreu por meio de observações, conversas informais, registros em diário de campo e quatro interlocuções; com pessoas que estavam ou já estiveram em situação de rua há mais de três meses, e que viviam na região central de Florianópolis/SC. A perspectiva da análise de práticas discursivas e produção de sentidos foi a estratégia teórico-metodológica utilizada para a discussão da empiria. Buscou-se, por fim, lançar questionamentos e ampliar discussões acerca da população em situação de rua, suas resistências e enfrentamentos (est)éticos frente às violações de direitos, bem como problematizar as relações de poder que atravessam a vida na rua e, quiçá, romper com lógicas hegemônicas e universais acerca das possibilidades de existência dessas populações.

This article is an unfolding of a research on population in street situation and rights' violations. Here we discuss an aspect of the study that we consider to be pivotal, namely: processes of resistance and aesthetical-ethical-political modes of confrontation produced by people in street situation, in the face of their rights' violations. Epistemologically, we are mainly guided by the theorization concerning power relations developed by Michel Foucault, articulating it briefly to the problem of necropolitics, proposed by Achille Mbembe. The production of the empirical material of the research occurred through observations, informal conversations, field diary records and four interlocutions with people who were or had been in a street situation for more than three months, and who lived in the central region of Florianópolis/SC. The perspective of discursive practice analysis and sense production was the theoretical-methodological strategy used for empiric discussion. Finally, we sought to question and expand discussions about the population in a street situation, their resistance, and aesthetical-ethical confrontations in the face of rights' violations, as well as to problematize power relations that go throughout life on the street and, perhaps, to break with hegemonic and universal logics about the possibilities of existence of these populations.

RESUMO

Introducción: En Cuba antes de registrarse casos de la Covid-19 se elaboró un Plan de Prevención y Control y se conformó un Grupo de Trabajo para asesorar al Gobierno en el enfrentamiento a la pandemia con una participación crucial y cohesionada de la comunidad, los trabajadores de la salud y la comunidad científica del país. Objetivo: Explorar la percepción de riesgo y las actitudes de personas residentes en La Habana en el cumplimiento de las medidas de protección durante la Covid-19. Material y Métodos: Entre los meses de mayo-julio de 2021 se realizó un estudio descriptivo trasversal para lo cual se aplicó una encuesta online en Google Forms que se mantuvo en línea durante tres meses; la misma fue respondida de forma voluntaria por 2 012 residentes en todos los municipios de La Habana, integrantes de grupos poblacionales de interés en Telegram®, WhatsApp y otras redes sociales. Resultados: Se evidenció baja percepción de riesgo e incumplimiento de las medidas de protección entre los encuestados. Conclusiones: La baja percepción de riesgo poblacional y el incumplimiento de las medidas de protección contribuyen a elevar la gravedad de la situación epidemiológica de La Habana y la expansión de la pandemia.

Introduction: Before cases of Covid-19 were registered in Cuba, a prevention and control plan was developed and a working group was formed to advise the Government on the confrontation of the pandemic with a crucial and cohesive participation of the community, the health workers, and the scientific community of the country. Objective: to explore the risk perception and attitudes of people residing in Havana in compliance with protection measures during Covid-19. Material and Methods: A cross-sectional descriptive study was carried out between May and July 2021 applying an online survey in Google Forms that remained online for three months and was answered voluntarily by 2 012 residents in all the municipalities of Havana that were members of population groups of interest on Telegram®, WhatsApp, and other social networks. Results: Low risk perception and non-compliance with protection measures were evidenced among the respondents. Conclusions: The low perception of population risk and non-compliance with protection measures contribute to increasing the severity of the epidemiological situation in Havana and the spread of the pandemic.

Assuntos

RESUMO

Introducción: Las condiciones de vida son las condiciones objetivas en las que los hombres reproducen su existencia social e individual. La adolescencia es una etapa importante del curso de la vida. Objetivo: Describir las condiciones de vida de adolescentes en cuatro consultorios del médico y la enfermera de la familia. Material y Métodos: Estudio descriptivo de corte transversal. Se estudiaron 377 adolescentes. Se utilizaron estadísticas descriptivas y correlación de Pearson. Resultados: Predominó el rango de edad de 15-18 (233 para 61,8 por ciento). El nivel de escolaridad más alto terminado por las madres de los adolescentes fue el preuniversitario (143 para 37,9 por ciento). El índice académico del adolescente en el curso anterior que predominó fue el de 90-94 (121 para 32,1 por ciento). Existió una correlación significativa entre el nivel educacional más alto terminado por la madre del adolescente y el índice académico de este en el curso anterior. Predominaron las familias medianas y nucleares. La percepción de la situación económica tanto para el adolescente como para la madre o tutor fue regular. En relación con los equipos electrodomésticos, la gran mayoría refiere tener cinco de los seis equipos de primera necesidad; en los de segunda necesidad, existe déficit de aire acondicionado en las viviendas, horno micro-onda, olla reina, computadora, video, freezer, calentador de agua, teléfono y cocina eléctrica. Conclusiones: Las condiciones de vida expresan diferencias según el nivel de escolaridad más alto terminado por la madre del adolescente y la percepción de la situación económica(AU)

Introduction: Living conditions are the objective conditions in which the individuals reproduce their social and individual existence. Adolescence is an important stage in the course of life. Objective: To describe the living conditions of adolescents in four family doctor-and-nurse offices. Material and Methods: A descriptive cross-sectional study was conducted in 377 adolescents. Descriptive statistics and Pearson's correlation were used. Results: The predominant age group was 15-18 years, 233 adolescents (61,8 percent). Pre-university was the highest educational level completed by the adolescents' mothers, 143 mothers (37,9 percent). The prevailing academic index among adolescents in the previous year was 90-94, 121 adolescents (32,1 percent). There was a significant correlation between the highest educational level completed by the adolescent's mother and the adolescent´s academic index in the previous year. Medium-sized and nuclear families predominated. The perception of the economic situation for both the adolescent and the mother or guardian was regular. In relation to household electrical equipment, the vast majority referred to this as having five of the six basic necessities; regarding those of second most important need at home, there was a deficit of air conditioning, microwave oven, queen pot, computer, video, freezer, water heater, telephone, and electric stove. Conclusions: There are differences in living conditions concerning the highest level of education completed by the adolescent's mother and the perception of the economic situation(AU)

Assuntos

RESUMO

ABSTRACT BACKGROUND: Stroke is one of the main causes of death worldwide. Educational interventions on stroke are potentially effective in reducing the period between the onset of symptoms and the initial emergency medical assistance. OBJECTIVES: To assess high school students' knowledge of stroke. DESIGN AND SETTING: Cross-sectional study conducted in high schools in northeastern Brazil. METHODS: A self-structured questionnaire survey regarding stroke awareness was applied among high school students in northeastern Brazil. Data were collected between 2018 and 2019. The chi-square test and other descriptive statistics were used. Univariate and multivariate analyses were performed using logistic regression. RESULTS: A total of 1,788 students were analyzed. Eighty percent (n = 1430) of them did not have the minimum knowledge on how to act in a stroke situation. Only 10% (n = 179) presented the ideal knowledge on how to act. Males presented lower levels of knowledge on risk factors (odds ratio, OR: 0.62%; 95% confidence interval, CI: 0.49-0.79) and signs and symptoms of stroke (OR: 0.63%; 95% CI: 0.52-0.77). Students with ≥ 10 years of schooling (OR: 1.64%; 95% CI: 1.30-2.07) demonstrated greater knowledge of signs and symptoms of stroke. Students aged 18 years (OR: 1.70%; 95% CI: 1.14-2.52) demonstrated greater knowledge than other ages regarding the telephone number of the emergency medical services. CONCLUSIONS: There was a knowledge deficit with regard to recognizing stroke and activating the emergency medical services. The findings apply to the sample investigated and suggest that there is a need for stroke educational interventions, starting in high school.

RESUMO

Diets based on meals that provide a large amount of energy and consumed frequently often increase the rate of growth of the body mass index (overweight or obesity) and, in turn, the risk of suffering from non-communicable diseases. In order to make a food choice, it is necessary to search for foods in the environment, taking into account physical and social variables (contextual variables) which, together with individual variables, delimit the situation of food selection. The objective of this study was to evaluate the effect of social facilitation, portion size, salience of food, and food preference or rejection on the selection of energy-dense foods by young college students. To do so, we performed a factorial experiment in which unaccompanied and accompanied participants (levels of social facilitation) as they went through the process of choosing from different options of main dishes, beverages, and desserts then noted the reasons for their selection (preference or rejection of the food). Results showed significant differences between the group of accompanied participants and salience of food in the selection of the energy-dense main dishes and desserts (pizza, spaghetti, and chocolate cake). A significant relationship was also identified between accompanied participants, hedonistic/sensory reasons (food preference or rejection category), and salience of food in the selection of the energy-dense main dishes. In conclusion, key findings of the variables that constitute the situation that predicts the selection of energy-dense foods have emerged from this study, when participants and the given level of social facilitation (in this case, being accompanied) were faced with the conditions of the food salience of the meals of their preference regarding its taste and appearance.

RESUMO

Resumen En este trabajo los mamíferos mayores que habitan en los bosques montanos del departamento de Huánuco son estudiados para determinar la diversidad de especies y el estado actual de sus poblaciones. Se realizaron censos por transecto lineal y entrevistas entre los años 2014 y 2015, en seis sitios de muestreo correspondientes a cinco provincias. De los censos y exploraciones nocturnas se obtuvieron 439 registros pertenecientes a 37 especies; de estas, 4 son endémicas de Perú y 9 se encuentran en alguna categoría de conservación de la Legislación peruana. Los órdenes más representativos correspondieron a los carnívoros y primates con 11 y 10 especies, respectivamente, mientras que los avistamientos más frecuentes fueron de Tremarctos ornatus (43 registros), Nasua nasua (34 registros) y Cuniculus paca (32 registros). Los Índices de diversidad de Shannon-Wiener y de Simpson indican a Miraflores como el sitio de muestreo con más alta diversidad (H'=3.11, 1-D=0.95). La principal amenaza para los mamíferos mayores y otros componentes de la fauna mayor es la deforestación; no obstante, la presencia de especies indicadoras de la comunidad primaria de fauna como Tremarctos ornatus, Lagothrix flavicauda y otros primates, nos indican que todavía existen fragmentos de bosque primario relativamente extensos, en particular entre los ríos Chontayacu y Crisnejas en la provincia de Marañón y entre los ríos Oso mayo y Blanco en la provincia de Puerto Inca, por lo que deben ser tomados en cuenta para su conservación.

Abstract In this work, the larger mammals that inhabit the montane forests of the department of Huánuco are studied to determine the diversity of species and the status of their populations. Linear transect censuses and interviews were conducted between 2014 and 2015 on six sampling sites corresponding to five provinces. 439 records belonging to 37 species were obtained from the censuses and nocturnal explorations. Of these species, 4 are endemic to Peru and 9 are in some conservation category of Peruvian legislation. The most representative orders corresponded to carnivores and primates with 11 and 10 species, respectively, while the most frequent sightings were of Tremarctos ornatus (43 records), Nasua nasua (34 records) and Cuniculus paca (32 records). The Shannon-Wiener and Simpson Diversity Indices indicate Miraflores as the sampling site with the highest diversity (H'=3.11, 1-D=0.95). The main threat to larger mammals and other components of the larger fauna is deforestation; however, the presence of indicator species of the primary fauna community such as Tremarctos ornatus, Lagothrix flavicauda and others primates, indicate that there are still relatively extensive fragments of primary forest, particularly between the Chontayacu and Crisnejas rivers in the province of Marañón and between the Oso mayo and Blanco rivers in the province of Puerto Inca, so they must be taken into account for their conservation.