Salud Publica

Objective. To examine the prevalence of metabolic syndrome (MS) and its associated risk factors in Mexican adults aged 20 years or older, using data derived from the National Health and Nutrition Survey 2006 (ENSANUT 2006). Material and Methods. The ENSANUT 2006 was conducted between October 2005 and May 2006. Questionnaires were administered to 45 446 adult subjects aged 20 years or older who were residents from urban and rural areas. Anthropometric and blood pressure measurements were obtained from all subjects and fasting blood specimens were provided by 30% of participants. We randomly selected a sub-sample of 6 613 from which laboratory measurements were carried out for glucose, insulin, triglycerides, total cholesterol and HDL-cholesterol. For this analysis, we included only results from eight or more hours of fasting samples (n=6 021). We used individual weighted factors in the statistical analysis and considered the survey's complex sampling design to obtain variances and confidence intervals. All analyses were done

Gorbanev I & Agudelo-Londoño S, et al. (2018) Medical Education Online, 23:1, 1438718, ABSTRACT Introduction: The literature shows an optimistic landscape for the effectiveness of games in medical education. Nevertheless, games are not considered mainstream material in medical teaching. Two research questions that arise are the following: What pedagogical strategies do developers use when creating games for medical education? And what is the quality of the evidence on the effectiveness of games? Methods: A systematic review was made by a multidisciplinary team of researchers following the Cochrane Collaboration Guidelines. We included peer-reviewed journal articles which described or assessed the use of serious games or gamified apps in medical education. We used the Medical Education Research Study Quality Instrument (MERSQI) to assess the quality of evidence in the use of games. We also evaluated the pedagogical perspectives of such articles. Results: Even though game developers claim that games are useful pedagogical tools, the evidence on their effectiveness is moderate, as assessed by the MERSQI score. Behaviourism and cognitivism continue to be the predominant pedagogical strategies, and games are complementary devices that do not replace traditional medical teaching tools. Medical educators prefer simulations and quizzes focused on knowledge retention and skill development through repetition and do not demand the use of sophisticated games in their classrooms. Moreover, public access to medical games is limited. Discussion: Our aim was to put the pedagogical strategy into dialogue with the evidence on the effectiveness of the use of medical games. This makes sense since the practical use of games depends on the quality of the evidence about their effectiveness. Moreover, recognition of said pedagogical strategy would allow game developers to design more robust games which would greatly contribute to the learning process.

Resumen | El presente artículo analiza los programas y acciones que desarrollaron las empresas asociadas a la gran industria chilena para mejorar la condición nutricional de la población trabajadora, con el objetivo de enfrentar las enfermedades profesionales y mejorar los rendimientos productivos de los trabajadores. Es de especial interés conocer el papel que tuvo la familia y la mujer en su calidad de madre y esposa para transmitir los valores asociados a la correcta alimentación. Las fuentes disponibles para el estudio son los escritos de médicos que abordaron la temática de la alimentación, en especial en el ámbito laboral, las encuestas de nutrición desarrolladas entre fines de la década de 1920 y comienzos de los años de 1940, y las publicaciones de los Departamentos de Bienestar Social de las distintas empresas estudiadas.

Abstract | This article analyzes the programs and actions developed by large-scale industrial plants to improve the nutritional conditions of the working class, with the aim of tackling occupational diseases and improving the productive performance of workers. Special interest is taken on knowing the role played by the family and women in their role as mothers and wives in transmitting the values associated with proper nutrition. The sources available for the study are the writings of physicians who addressed the issue of nutrition, especially in the workplace, the nutrition surveys developed between the late
1920s and the early 1940s, and the publications of the Social Welfare Departments of the different companies studied.

Resumo | Este artigo analisa os programas e ações desenvolvidos pelas empresas associadas à grande indústria chilena para melhorar o estado nutricional da população trabalhadora, com o objetivo de combater as doenças ocupacionais e melhorar o desempenho produtivo dos trabalhadores. Interesse especial é saber o papel desempenhado pela família e pela mulher como mãe e esposa para transmitir os valores associados à nutrição adequada. As fontes disponíveis para o estudo são os escritos de médicos que abordaram a questão da
nutrição, especialmente no local de trabalho, as pesquisas de nutrição desenvolvidas entre o final da década de 1920 e início dos anos 1940, e as publicações dos Departamentos de Assistência Social das diferentes empresas estudadas.

La intensificación de la producción agrícola en los países del cono sur de Latinoamérica ha implicado un incremento en la utilización de agroquímicos. La producción científica disponible en salud se ha concentrado en los aspectos epidemiológicos, y son escasos los estudios que contemplan las dimensiones sociales de la exposición a estas sustancias. Esta revisión bibliográfica tuvo el objetivo de relevar las publicaciones científicas que estudian la producción subjetiva de colectivos expuestos a agroquímicos. Para eso se revisaron artículos en las bases SCOPUS, PubMed, BVS, Scielo y DOAJ, que fueron publicados entre 1991 y 2016. A su vez, como estrategia adicional se revisaron las referencias bibliográficas de los artículos seleccionados. Entre los resultados obtenidos se destaca que lo subjetivo adquiere distintas denominaciones, donde los estudios de percepción de riesgo y de creencias en salud son los dominantes. En cuanto a la explicación-comprensión de los procesos subjetivos, una serie de artículos únicamente contemplan los estilos de vida individuales, y otra porción incorpora los modos de vida colectivos. Lo diverso de los resultados indica que se trata de un campo de estudios en disputa, donde convergen enfoques positivistas y funcionalistas, con estudios situados históricamente y de perspectiva crítica.

Courts play a key role in deciding on public health controversies, but the legitimacy of judicial intervention remains highly controversial. In this article I suggest that we need to carefully distinguish between different reasons for persistent disagreement in the domain of public health. Adjudicating between public health controversies rooted in factual disagreements allows us to investigate more closely the epistemic capacities of the judicial process. While the critics typically point out the lack of appropriate expertise of judges—in particular with respect to health and public health—we should not move too fast in inferring from this a generalized competence problem. This article offers four reasons for vindicating the importance of judicial intervention in factual disagreements: the relative independence of judges from the political establishment, the judicial commitment to evidence, the specific nature of judicial reasoning and an additional voice for the people in the policy-making process.

In Peru, the climate pattern El Niño-Southern Oscillation was linked to a resurgence of cholera in 1998.  While previous studies found a temperature connection, El Niño’s impact on cholera in Peru has not been fully explored.  In this study, climate associations with cholera incidence during the 1997-98 El Niño are examined at a district-level in Piura, a coastal area located in northern Peru.  Piura is important to study because it was one of the most affected areas by cholera and El Niño in 1998.  The approach taken in this study is a “multiple pathways” perspective, which highlights various dimensions of ENSO to explain cholera linkages.  Associations were estimated at various temporal lags using bivariate regression and then mapped in ArcGIS.  The results show significant cholera associations with SST in the central equatorial Pacific and on the coast (0-1 month lag), rainfall (1 month lag), and mean and maximum temperatures (5 month lags).  Overall, the strongest consistent impact was rainfall, which supports the notion that flooding was a pathway for cholera exposure in Piura.  Local sea and air temperature associations also suggest that exposure was potentially linked to vibrio proliferation, which increased the probability of cholera risk.  Furthermore, this study shows that climate impacts on cholera were unevenly distributed across Piura, indicating that some districts were more vulnerable than others, possibly related to infrastructure deprivation.  In conclusion, the study provides a basis for future investigations, which may be useful for epidemic preparedness during future El Niños and other extreme climate events.

Resumen: En el presente artículo nos proponemos analizar la trayectoria profesional del médico argentino Francisco José Martone (1909-1998) y explorar las contribuciones de este a una medicina preventiva y social. El trabajo ha sido realizado desde una metodología cualitativa de análisis documental y desde un enfoque biográfico en diálogo con una corriente de investigaciones que vienen analizando las carreras profesionales de ciertos médicos argentinos y latinoamericanos. Para cumplir nuestros objetivos apelamos a distintos tipos de fuentes: libros y artículos publicados por Martone, documentación oficial, su legajo administrativo en la Universidad y otro tipo de materiales. De acuerdo con estas fuentes, pudimos reconstruir la trayectoria universitaria y profesional de Martone, su paso por distintas comisiones legislativas en el Congreso Nacional, su participación en la gestión peronista y su producción teórica relativa a la fundamentación de la medicina social y la profesionalización de la enfermería. Estos aportes, así como su biografía, nos permiten un acercamiento íntimo a los avatares del campo de la salud pública argentina en el período que va desde los años treinta hasta los ochenta del siglo XX.

Abstract: In this article we propose to analyze the professional career of the Argentine physician Francisco José Martone (1909-1998) in order to explore its contributions to preventive and social medicine. The work has been carried out from a qualitative methodology of documentary analysis and from a biographical approach, in dialogue with a stream of research that has been analyzing the professional careers of certain Argentine and Latin American physicians. To meet our objectives we resort to different types of sources: books and articles published by Martone, official documentation, his administrative file at the university and other types of unpublished materials. According to these sources, we were able to reconstruct Martone’s university and professional trajectory, his belonging to different legislative committees in the National Congress, his participation in the Peronist administration and his theoretical production relative to the foundations of social medicine and the professionalization of nursing. These contributions, as well as his biography, allow us an intimate approach to the avatars of the field of public health in Argentina in the period from the thirties to the eighties.

Resumen: con la irrupción de la pandemia por el SARS-CoV-2 y su devastador avance se implementaron diferentes formas de confinamiento que en Latinoamérica transformaron radical y rápidamente los abordajes de salud pública. El objetivo de este trabajo consiste en delimitar preliminarmente el problema de las acusaciones y denuncias de persona a persona en contextos de proximidad bajo el régimen del confinamiento en el área metropolitana de Buenos Aires (AMBA).  En este trabajo se examinan tres cuestiones: 1) las perspectivas antropológicas sobre la judicialización; 2) las amplias consecuencias y efectos paradojales que las acusaciones, denuncias y judicializaciones han demostrado tener para el bienestar, la salud y la supervivencia de las personas y conjuntos sociales afectados; y 3) las particularidades que asume el trabajo antropológico en contextos altamente normatizados, sancionados y criminalizados. Este artículo se estructura respecto del caso del AMBA, para cuyo análisis se ensamblan materiales heterogéneos: antecedentes históricos, argumentos antropológicos, resultados de investigaciones, información de medios de comunicación, normativas, etc. Específicamente, el texto focaliza en aquellas prácticas desarrolladas durante los meses del período inicial de confinamiento en el AMBA, desde el 20 de marzo hasta el 9 de noviembre 2020. El análisis expuesto en este artículo arroja luz sobre los modos en que las acusaciones y denuncias en contextos de proximidad no solo fragilizan las tramas sociales, profundizan las desigualdades y acentúan la incertidumbre sobre las respuestas sociales frente a la posible infección y muerte, sino que también comprometen y distorsionan las estrategias epidemiológicas preventivas y de cuidado. Si bien acciones legales del mismo tipo han tenido lugar para otras dolencias y epidemias, las acusaciones y denuncias en contextos de proximidad, en este caso, son entendidas como estrategias habilitadas y legitimadas que expresan y traducen a la microescala del aislamiento profundas transformaciones de los vínculos entre salud pública, legislación y fuerzas de seguridad en los regímenes del confinamiento social.

Palabras clave: antropología de la salud, formaciones jurídico-sanitarias, judicialización, lógica de acusaciones, pandemia por el SARS-CoV-2.

The Multiplication of Penalties: Preliminary Issues in Dealing with Proximity Accusations and Allegations in Times of Pandemic

Abstract: With the outbreak and devastating spread of the SARS-CoV-2 pandemic, different forms of containment methods have been implemented across Latin America that have radically and rapidly transformed public health approaches. The purpose of this paper is to provide a preliminary delimitation of the problem of person-to-person accusations and complaints in proximity contexts under the confinement regime in the metropolitan area of Buenos Aires (AMBA).  This paper examines three issues: 1) anthropological perspectives on judicialization; 2) the broad-ranging consequences and paradoxical effects that accusations, denunciations, and judicializations have been proven to cause for the well-being, health, and survival of affected individuals and social groups; and 3) the particularities that anthropological work assumes in highly normatized, sanctioned, and criminalized contexts. This article addresses heterogeneous materials: historical background, anthropological arguments, research results, media information, regulations, etc., to analyze the case of the AMBA. Specifically, the text focuses on the practices employed during the months of the initial period of confinement in AMBA, from March 20 to November 9, 2020. This analysis sheds light on the ways in which proximity accusations and allegations lead to the fragmentation of social fabrics, deepen inequalities, and accentuate uncertainty about social responses to possible infection and death. They also compromise and distort epidemiological, preventive, and care strategies. While legal actions of the same type have taken place for other ailments and epidemics, proximity accusations and allegations, in this case, are understood as enabled and legitimized strategies that express and translate deep transformations —at the micro-scale of isolation— of the links between public health, legislation and security forces in social confinement regimes.

Keywords: Anthropology of health, judicialization, legal and public health formations, logic of accusation, SARS-CoV-2 pandemic.

A multiplicação das penas: questões preliminares para a abordagem de acusações e denúncias de proximidade em tempos de pandemia

Resumo: com a irrupção e o devastador avanço da pandemia ocasionada pelo Sars-CoV-2, foram implementadas diferentes formas de confinamento que, na América Latina, transformaram radical e rapidamente as abordagens de saúde pública. O objetivo deste trabalho é delimitar preliminarmente o problema das acusações e das denúncias de pessoa a pessoa em contextos de aproximação sob o regime do confinamento na região metropolitana de Buenos Aires (RMBA). Neste trabalho, foram examinadas três questões: 1) as perspectivas antropológicas sobre a judicialização; 2) as amplas consequências e os efeitos paradoxos que as acusações, as denúncias e as judicializações vêm demonstrando ter para o bem-estar, a saúde e a sobrevivência das pessoas e dos conjuntos sociais afetados; 3) as particularidades que o trabalho antropológico assume em contextos altamente normatizados, sancionados e criminalizados. Este artigo trata do caso da RMBA, no qual a análise é estruturada a partir de materiais heterogêneos: antecedentes históricos, argumentos antropológicos, resultados de pesquisas, informação de meios de comunicação, leis etc. especificamente, no texto, foca-se naquelas práticas desenvolvidas durante os meses do período inicial de confinamento na RMBA, desde 20 de março até 9 de novembro de 2020. A análise exposta no artigo esclarece acerca dos modos pelos quais as acusações as denúncias em contextos de aproximação não somente fragilizam as relações sociais, aprofundam as desigualdades e acentuam as incertezas sobre as respostas sociais diante da possível infecção e morte, mas também comprometem e distorcem as estratégias epidemiológicas, preventivas e de cuidado. Embora as ações legais do mesmo tipo venham tendo lugar para outras doenças e epidemias, as acusações e as denúncias em contextos de aproximação, nesse caso, são entendidas como estratégias habilitadas e legitimadas que expressam e traduzem à microescala do isolamento profundas transformações dos vínculos entre saúde pública, legislação e forças de segurança nos regimes do confinamento social.

Palavras-chave: antropologia da saúde, formações jurídico-sanitárias, judicialização, lógica de acusações, pandemia pelo Sars-CoV-2.

A pesar de haber alcanzado una esperanza de vida promedio de 75 años, similar a la de países más desarrollados, México ingresó al siglo XXI con un sistema de salud marcado por su incapacidad para ofrecer protección financiera en salud a más de la mitad de su población. Esto es ...

To quantify fruit and vegetable (FV) dietary intake in the Mexican population and compliance with international recommendations. FV dietary intake (FV-DI) and compliance with international recommendations were obtained in a representative sample of a Mexican population ages 1-59 years old using dietary data from the Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006). Average FV-DI for different age groups range from 61 to 72 g for fruits and 26 to 56 g for vegetables. Average total FV intakes were 88.7 g in preschool-age, 103.1 g in school-aged children, 116.3 g in adolescents and 122.6 g in adults. The lowest intakes were observed in the northern region and among the population with the lowest wellbeing levels. Less than 30% of the Mexican population had adequate intakes of FV. Developing and implementing strategies aimed at increasing intake of these food groups is a national priority.

Purpose -While Argentina has significantly improved access to HIV care and antiretroviral therapy (ART) for both the general population and prisoners, the prevalence of alcohol use disorders (AUDs) among HIV-infected prisoners and their relationship to accessing ART in Argentina is currently unknown. This study aims to characterize the substance abuse patterns of HIV-infected prisoners in Argentina and to assess the independent correlates of receipt of pre-incarceration ART.

In 1914, while Spain was making agreements to modernize its scientific and sanitary structure, Venezuela started to structure a sanitation authority following international models, in line with Pan Americanism and the controls for the opening of the Panama Canal, for which is received sponsorship from the Rockefeller Foundation as of 1913. In 1931, the Second Spanish Republic sent ever greater numbers of scholars to study in the United States and established a public health system along the lines of the administrative models for sanitation and technical units for investigation and control as proposed by the Foundation. The Spanish Civil War interrupted this process and Venezuela seized the moment to hire the exiled doctors and nurses and incorporate them into its new Ministry for Sanitation and Social Welfare, created in 1936.

Objective. To explore the degree of usage of therapeutic medical plants among the patients, physicans and health workers in a local Family Mediccal Care Unit of the Mexi- can Institute of Social Security (IMSS)). Material and methods. A transversal descriptive study was performed. A questionnaire focusing on two variables was designed and validated. It was applied to 60 family physicians,

Este estudio tiene como propósito describir aspectos éticos relacionados con la atención de enfermería en personas con discapacidad, población considerada socialmente vulnerable y reconocida en condiciones de desigualdad. Corresponde a una primera fase de estudio primario realizado en la región de Atacama, Chile, que utilizó metodología cualitativa y análisis de contenido. Se realizan entrevistas a profesionales de enfermería respetando los criterios éticos de Ezekiel Emanuel. Los principales hallazgos dan cuenta de las categorías ontológicas: razonamiento moral, sistema de valores, modelo de relación enfermera-paciente, consecuencias de la acción ética de enfermería, estrategias para superar conflictos morales y barreras en el cuidado. Se concluye que cuidar personas con discapacidad es fuente de dilema y angustia moral para los profesionales de enfermería, especialmente cuando se trata de sujetos con discapacidad sensitiva o cognitiva. El modelo médico paternalista predomina en el...

Objective. To determine the association between physical activity and overweight/obesity in Mexican adults. Material and Methods. Cross-sectional design. Adults 20 to 69 years of age were included in the Mexican National Health and Nutrition Survey 2006 (ENSANUT 2006). The dependent variable was overweight/obesity and the independent variable was recalled physical activity. Analysis was by logistic regression, adjusting for sex, age, residence area, region, socioeconomic status, indigenous ethnicity, smoking, schooling, work activity, alcohol consumption and sitting time. Results. Data from 15 901 adults were analyzed. The prevalence of overweight/obesity had an inverse association with physical activity among men but not among women. Conclusions. The practice of physical activity was negatively associated with the prevalence of overweight/obesity only in adult men. These results underscore the importance of promoting physical activity to prevent and control overweight/obesity. Gómez LM, Hernández-Prado B, Morales MC, Shamah-Levy T. Actividad física y sobrepeso/obesidad en población adulta mexicana. Encuesta Nacional de Salud y Nutrición 2006. Salud Publica Mex 2009;51 supl 4:S621-S629.

Identificar las conductas y hábitos de la población es fundamental para establecer las estrategias y herramientas pertinentes para promover el cambio de las prácticas inadecuadas. El objetivo de este estudio es elaborar una herramienta confiable que permita cuantificar y determinar
los hábitos alimentarios tanto individuales como poblacionales. En base a la encuesta validada por Pardo (2004), un grupo de estudiantes de 3º año de Nutrición y Dietética elaboró una encuesta de 48 ítems, la cual se aplicó a una muestra de 402 personas de todos los grupos etarios (220 mujeres y 180 varones), cuya edad promedio fue de 30,24 ± 24,75 años. El cuestionario revela una confiabilidad aceptable (α-cronbach=0,792), estableciéndose 11 dimensiones con 38 preguntas. Las mujeres presentaron un puntaje total promedio significativamente superior en comparación a los varones (p<0,001). En conclusión, la aplicación y validación del cuestionario nos permite contribuir con una herramienta de bajo costo que permita conocer aspectos más íntimos de las
conductas alimentarias que forman parte de los hábitos de personas que asisten a centros de salud públicos.

Los ahogamientos representan una de las principales causas de mortalidad externa a nivel mundial. El objetivo fue conocer las características del proceso de ahogamiento y su conexión con las condiciones de seguridad de las piscinas de uso colectivo. Método: Se realizó un estudio observacional descriptivo utilizando datos de fuentes judiciales con emplazamiento en la población española durante 2000-2015. Se investigaron datos sociodemográficos, tipos de instalaciones, actividad previa que realizaba la víctima, factores de riesgo y la causa principal del suceso lesivo. Resultados: Se registraron un total de 56 ahogamientos en piscinas, de los que 49 fallecieron. Un 76,8% eran varones, 71,4% menores de edad y el grupo más vulnerable (32,4%) fue el de 5-10 años. El 37,5% de las víctimas no sabía nadar y el 60,7% no estaban solas. Los sucesos se localizaron más habitualmente en piscinas municipales (46,4%). Entre las causas más frecuentes de ahogamiento destacaron la culpa in vigilando del socorrista (19,64%), deficiente supervisión del niño por un adulto (17,86%) y la conducta imprudente de la víctima (14,29%). Se identificaron factores de riesgo relacionados con deficiencias o ausencia de medidas pasivas: barrera de protección del vaso (7,1%), equipamiento de salvamento acuático (7,1%), visibilidad de zona de baño (3,6%) y toma de aspiración de agua desprotegida (1,8%). Conclusiones: Los ahogamientos continúan siendo una importante causa de mortalidad en piscinas de uso colectivo. Para reducir las tasas de ahogamiento y evitar una devaluación de las condiciones de seguridad que malogren los objetivos preventivos es preciso cumplir rigurosamente las normas reglamentarias de piscinas y diseñar estrategias de intervención específicas.
Abstract: Drownings represent one of the main external causes of mortality worldwide. Our objective was to determine the characteristics of the process of drowning and its connection to the safety conditions of collective use swimming pools. Method: A descriptive observational study using data from judicial sources was conducted with setting in spanish population during the period of 2000-2015. Socio-demographic data, types of facilities, previous activity held by the victim, risk factors and the main cause of the injurious event were investigated. Results: A total of 56 drowning in swimming pools, of which 49 died, were recorded. There were 76.8% males, 71.4% underage and children 5-10 years were the most vulnerable group (32.4%). 37.5% of victims didn’t know how to swim and 60.7% were not alone. Critical events were commonly found in municipal swimming pools (46.4%). Among the most frequently causes of drowning were included: faults in lifeguards’ vigilance (19.64%), poor adult supervision for children (17.86%) and the reckless behavior of the
victim (14.29%). There were identified risk factors related to deficiencies or absence of passive measures: pool fencing (7.1%), equipment of aquatic rescue (7.1%), visibility of bathing area (3.6%) and unprotected water drain suction (1.8%). Conclusions: The drownings remain an important cause of death in swimming pools for public use. To reduce drowning rates and to avoid a downgrading of safety standards that have a negative effect on preventive aims, the swimming pools code must be rigorously complied as well as to design specific intervention strategies.

Objective: In Ecuador, the reported maternal death rate was 45.71 per 100,000 live births in 2013. This may be partly due to a lack of maternal knowledge of obstetric warning signs during pregnancy, delivery and the post-partum period. This study sought to evaluate awareness of obstetric warning signs among pregnant women in relation to individual
demographic and area-level socio-economic indicators.
Study design: We conducted a cross-sectional analysis of data collected by Ecuador's Ministry of Health at the conclusion of a national maternal health campaign (2014e2015). A nationally representative sample of 3435 pregnant women from the nine administrative zones completed surveys regarding basic demographics and their awareness of obstetric
warning signs.
Methods: We defined eight obstetrical warning signs according to the literature and Ecuadorian practice that could occur during pregnancy, delivery and the post-partum period (severe headache, strong abdominal ache, bleeding or presence of malodorous secretion, rupture of the amniotic sac, high fever, abnormal presentation of the baby, decrease in
baby's movements and delayed labour). A woman was considered ‘aware’ if she recognised at least four of the eight warning signs and stated she would seek immediate healthcare at their presentation. For each administrative zone, four socio-economic indicators (poverty,
illiteracy, unemployment and subemployment) were obtained from the National Institute of Statistics and Census. Correlates of awareness of the obstetric warning signs were evaluated using hierarchical logistic models clustered by the administrative zone.

RESUMO:

Este artigo discute as necessidades e demandas de saúde de homens trans, tema pouco estudado que, com frequência, interpela a construção de práticas de cuidado em saúde para esta população. Foi realizada uma pesquisa qualitativa composta de observação participante e entrevistas semiestruturadas com dez homens trans residentes em Salvador, Bahia, Brasil, em sua maioria negros, heterossexuais e com idades entre 20 e 43 anos. A análise foi baseada na antropologia interpretativa, articulada às críticas do pressuposto da interseccionalidade e da perspectiva decolonial. As necessidades e demandas de saúde dos homens trans são organizadas em três aspectos: a despatologização, a modificação corporal e os atendimentos ambulatoriais. Esses não são universais entre todos os homens trans e podem ser decorrentes de situações que assinalam conflitos e pressões grupais. A ausência do processo transexualizador no estado e as barreiras no acesso à rede de atenção à saúde intensificam o processo de mercantilização das suas demandas de saúde, em especial, as modificações corporais. Conclui-se que a transfobia estrutural faz disparar uma série de questões de saúde, ao mesmo tempo em que limita as possibilidades de obtenção de cuidado. A despatologização das vivências trans constitui o eixo central com base no qual o cuidado deve ser pensado, relacionando-a a mudanças culturais, políticas e sociais que impliquem a construção de uma sociedade não transfóbica e incidam no bem-estar e reconhecimento dos homens trans.

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ABSTRACT:
This article discusses the health needs and demands of trans men, a topic that has received little attention and frequently calls for the development of specific health care practices for this population. A qualitative study was performed, consisting of participant observation and semi-structured interviews with trans men residing in Salvador, Bahia State, Brazil, the majority of whom were black, heterosexual, and 20 to 43 years of age. The analysis was based on interpretative anthropology, linked to critique of the assumption of intersectionality and the decolonial perspective. The health needs and demands of trans men are organized in three aspects: de-pathologization, body modification, and outpatient care. These aspects are not universal among trans men and may result from situations that indicate group conflicts and pressures. The absence of transsexualization process in the state of Bahia and barriers to accessing the health care network intensify the commodification of trans men’s health demands and especially body modifications. The study concludes that structural transphobia triggers a series of health issues, while limiting the possibilities for obtaining care. The de-pathologization of trans experiences constitutes the central basis for conceiving care, relating it to cultural, political, and social changes that involve the construction of a non-transphobic society and foster the well-being and recognition of trans men.

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RESUMEN:
Este artículo discute las necesidades y demandas de salud de hombres transexuales, tema poco estudiado que, con frecuencia, requiere la construcción de prácticas de cuidado de salud para esta población. Se realizó una investigación cualitativa, compuesta de diez hombres transexuales residentes en Salvador, Bahia, Brasil, en su mayoría negros, heterosexuales y con edades entre 20 y 43 años. El análisis se basó en la antropología interpretativa, vinculada a críticas del presupuesto de la interseccionalidad y desde una perspectiva decolonial. Las necesidades y demandas de salud de los hombres transexuales se organizan en torno a tres aspectos: despatologización, modificación corporal y atención ambulatoria. Estos no son universales entre todos los hombres transexuales y pueden derivarse de situaciones que indican conflictos y presiones grupales. La ausencia del proceso transexualizador en el estado y las barreras en el acceso a la red de atención de la salud intensifican el proceso de mercantilización de sus demandas de salud, en especial, las modificaciones corporales. Se concluye que la transfobia estructural dispara una serie de cuestiones de salud, al mismo tiempo que limita las posibilidades de obtención de cuidado. La despatologización de las vivencias trans constituye el eje central, en base al cual se debe pensar el cuidado, relacionándolo con cambios culturales y políticas sociales que impliquen la construcción de una sociedad no transfóbica e incidan en el bienestar y reconocimiento de los hombres transexuales.

Objetivos. Este artículo analiza las diversas estrategias que despliegan mujeres migrantes originarias de Bolivia y del noroeste argentino, para afrontar las barreras de accesibilidad al sistema de salud durante sus
recorridos migratorios vinculados con el trabajo agrícola en Argentina. Exponemos parte de los resultados de una investigación sobre experiencias de salud, enfermedad y cuidados de mujeres migrantes que trabajan en la agricultura. El enfoque teórico del estudio vincula herramientas conceptuales feministas y de la medicina social latinoamericana. Metodología. Planteamos un diseño cualitativo flexible, de carácter etnográfico, que prioriza la técnica de relatos de vida y la observación participativa. El trabajo de campo se desarrolló entre 2014 y 2018 en la localidad de Ugarteche, un territorio agrícola ubicado en el oasis norte de la provincia de Mendoza (Argentina). Conclusiones. Ante contextos restrictivos de acceso a la atención médica y a la discriminación sufrida en los servicios de salud, las mujeres migrantes interponen prácticas de gestión y cuidado que les permiten preservar su salud y la de sus grupos. Constituyen estrategias creativas orientadas a aprender saberes de la biomedicina, recuperar conocimientos de sus comunidades de origen y enfrentarse al maltrato institucional, mediante las cuales sortean barreras de acceso a la atención y lidian con contextos atemorizantes y expulsivos. Originalidad. Este artículo contribuye a un área poco explorada de los estudios de migraciones y salud, en cuanto aborda tanto las dificultades que las mujeres migrantes enfrentan en el acceso a la atención médica, como las estrategias que
despliegan para sortear esas barreras y sus aportes a las sociedades de acogida mediante las labores cotidianas de cuidado.

Este artículo reflexiona sobre los supuestos de la investigación en salud basada en las artes (Art-Based Health Research) a partir de la experiencia del Proyecto Arte y Salud en el organismo público Madrid Salud del Ayuntamiento de Madrid. Las investigaciones en el ámbito del arte y la salud tienen una amplia trayectoria que permite un análisis crítico de los aportes y también una reflexión sobre su trascendencia e impacto. El artículo recoge aspectos de la investigación en salud basada en las artes, que se sustenta en la investigación basada en las artes y que plantean cuestiones y conflictos teóricos, metodológicos y éticos. El trabajo desarrollado en Madrid Salud desde en 2011 permite una revisión desde la práctica de estas cuestiones y un amplio campo de experimentación para reflexionar sobre los retos de este enfoque de investigación.

Objective. To determine the prevalence of tobacco consumption among the active insured population of the Mexican Social Security Institute. Material and methods. A cross-sectional study in which the active insured population from the 36 political delegations was interviewed by means of a structured and self-applicable questionnaire on tobacco consumption, age of initiation, amount of cigarettes consumed and suspension. Results. The sample consisted of 45 117 subjects, of which approximately half were men and half women. Smoking prevalence in men was 40% and in women, 17.6%. Prevalence was highest in the north of the country. There is an effect of age on tobacco consumption and more than half started smoking during adolescence. Conclusions. Smoking prevalence was found to be high, however, the average number of cigarettes is low. Suspension index is low. Public health measures are necessary to diminish this addiction.

Idioma: Español Referencias bibliográficas: 34 Paginas: 134-144 Archivo PDF: 116.52 Kb. ... Objetivo. Determinar la actitud del personal de salud en la identificación y la referencia de las víctimas de violencia de género (VG), así como los factores relacionados con dicha ...

This article analyzes the process of interaction between the Instituto de la Salud Juan Lazarte research team and the Buenos Aires Public Health Insurance (PHI) management team during the design and development of the study titled "PHI Institutional Capability Analysis and Performance Evaluation", currently underway. From a cross-disciplinary perspective, examining different areas of interaction between the SPS management team and the research team, the relationship is characterized as an application of the "interaction model". This approach promotes the construction of interfaces that allow the development of negotiation and collaboration between the scientific and political "communities". Application of this model has produced changes in the conceptual and methodological framework and in substantive issues during implementation of the SPSMI.