The role of social movements in strengthening health systems: The experience of the National Health Forum in El Salvador (2009–2018)

From Crossref via Jisc Publications RouterNicole Vidal - ORCID 0000-0001-6159-2757 https://orcid.org/0000-0001-6159-2757Pol de Vos - ORCID 0000-0002-1672-6469 https://orcid.org/0000-0002-1672-6469In 2009, the newly elected FMLN government of El Salvador launched a comprehensive health reform, which gave the National Health Forum (NHF) a key role in developing community participation. This study aims to examine and analyze the content and impact of this social movement during the study period 2009–2018. The context was analyzed through relevant documents, which helped identify key stakeholders. Semi-structured interviews took place at 3 levels of decision making: the political level, the health professionals, and the community. Data were analyzed using a qualitative methodology. Participation is carried by a structure created by the Ministry of Health, the National Health Forum. The NHF developed 3 strategies: (1) leadership building in the communities through the strengthening of social, political, and economic skills, where they developed social accountability mechanisms at all decision-making levels of the health system; (2) the strategy carried by the sectoral working groups, where they responded to prioritized needs identified by the community; and (3) advocacy for human rights-based policies. The NHF, and its role in the strengthening of the National Public Health System, provides strong evidence of community participation strategies and co-governance with the health system within the social determinants of health scope.Funder: Health Services and Delivery Research Programme; FundRef: 10.13039/501100002001; Grant(s): 16/136/10050pubpub

Community and health staff perceptions on non-communicable disease management in El Salvador’s health system: A qualitative study

From Springer Nature via Jisc Publications RouterHistory: received 2019-10-01, accepted 2020-04-23, registration 2020-04-23, online 2020-05-27, epub 2020-05-27, collection 2020-12Funder: Public Health Research Programme; doi: http://dx.doi.org/10.13039/501100001921; Grant(s): Programme 16/136/100Dataset available in eData: https://eresearch.qmu.ac.uk/handle/20.500.12289/9699Background: Non-communicable Diseases (NCDs) are the leading cause of global mortality and disability with a rising burden in low- and middle-income countries. Their multifactorial aetiology, and their requirement of long-term care, implies the need for comprehensive approaches. From 2009, the Ministry of Health (MoH) in El Salvador has developed a national public health system based on comprehensive primary health care. This study aims to describe the different stakeholders’ perceptions about the management of NCDs along the pathways of care in this health system. Methods: During three fieldwork periods in 2018, three complementary qualitative data collection methods were deployed and conducted in settings with high prevalence of NCDs within El Salvador. First, illness narrative methodology was used to document the life histories of people living with a chronic disease and being treated in second and third level health facilities. Second, through social mapping, support resources that NCD patients used throughout the process of their illness within the same settings were analysed. Third, semi-structured interviews were conducted in the same locations, with both chronic patients and health personnel working at different levels of the primary health care setting. Participants were recruited through purposive and snowball sampling, and a deductive approach was implemented for coding during the analysis phase. After grouping codes into potential themes, a thematic framework was developed using a reflexive approach and following triangulation of the data. Results: This innovative approach of combining three well-defined qualitative methods identified key implications for the implementation of a comprehensive approach to NCD management in resource-poor settings. The following elements are identified: 1) social risk factors and barriers to care; 2) patient pathways to NCD care; 3) available resources identified through social connections mapping; 4) trust in social connections; and 5) community health promotion and NCD prevention management. Conclusions: The Salvadoran public health system has been able to strengthen its comprehensive approach to NCDs, combining a clinical approach – including long-term follow-up – with a preventive community-based strategy. The structural collaboration between the health system and the (self-) organised community has been essential for identifying failings, discuss tensions and work out adapted solutions.This study was supported by the NIHR Research Unit on Health in Situations of Fragility (RUHF), through the NIHR Global Health Research Programme 16/136/10020pubpu

Comprehensive primary health care and non-communicable diseases management: A case study of El Salvador

From PubMed via Jisc Publications RouterOne of today's greatest challenges in public health worldwide - and especially its key management from Primary Health Care (PHC) - is the growing burden of non-communicable diseases (NCDs). In El Salvador, since 2009 the Minister of Health (MoH) has scaled up a national public health system based on a comprehensive PHC approach. A national multi-sectorial strategic plan for a comprehensive approach to NCDs has also been developed. This analysis explores stakeholders' perceptions related to the management of NCDs in PHC and, in particular, the role of social participation. A case-study was developed consisting of semi structured interviews and official document reviews. Semi-structured interviews were developed with chronic patients (14) and PHC professionals working in different levels within PHC (12). Purposive sampling was used to recruit participants. A non-pure, deductive approach was implemented for coding. After grouping codes into potential themes, a thematic framework was elaborated through a reflexive approach and the triangulation of the data. The research was conducted between March and August of 2018 in three different departments of El Salvador. The structure and the functioning of the Salvadoran PHC system and its intersectoral approach is firstly described. The interdisciplinary PHC-team brings holistic health care closer to the communities in which health promoters play a key role. The findings reflect the generally positive perception of the PHC system in terms of accessibility, quality and continuity of care by chronic patients. Community engagement and the National Health Forum are ensuring accountability through social controllership mechanisms. However, certain challenges were also noted during the interviews related to the shortage of medication and workforce; coordination between the levels of care and the importance of prevention and health promotion programmes for NCDs. The Salvadoran PHC and its comprehensive approach to NCDs with an emphasis on intersectoral participation has been positively perceived by the range of stakeholders interviewed. Social engagement and the NHF works as a driving force to ensure accountability as well as in the promotion of a preventive culture. The challenges identified provide keys to amplify knowledge for addressing inequalities in health by strengthening PHC and its NCDs management.19pubpu

eWOM en redes sociales en relación a la intención de compra en la categoría de jeans urbano femenino en el nivel socioeconómico A y B de los distritos de la zona 8 de Lima Metropolitana (Surquillo, Barranco, Chorrillos y San Juan de Miraflores)

En el Perú, el eWOM, está en crecimiento, ya que muchas empresas la están aplicando en sus estrategias de marketing, pues se da la posibilidad que el eWOM negativo pueda influenciar en la intención de compra de moda urbana femenina. Por ello, el estudio tendrá la finalidad de determinar la relación del eWOM en redes sociales y si esta influye en la intención de compra en la categoría de ropa urbana femenina. El eWOM ha ido evolucionando y con el surgimiento de nuevas herramientas y plataformas digitales el nivel de influencia del eWOM es cada vez más relevante. Si bien es cierto, existe eWOM positivo y negativo a nivel internacional el que predomina es el positivo en relación a la intención de compra. Sin embargo, en el Perú es posible que el eWOM negativo tenga la misma relevancia o mayor que el positivo, ya que hemos podido observar opiniones de este tipo.In Peru, eWOM is growing, since many companies are applying it in their marketing strategies, since it is possible that the negative eWOM may influence the intention to buy women's urban fashion. For this reason, the study will aim to determine the relationship of eWOM on social networks and whether it influences the intention to buy in the category of women's urban clothing. The eWOM has evolved and with the emergence of new tools and digital platforms the level of influence of the eWOM is increasingly relevant. Although it is true, there is a positive and negative eWOM at the international level, the predominant one is the positive one in relation to the purchase intention. However, in Peru it is possible that the negative eWOM has the same relevance or greater than the positive, since we have been able to observe opinions of this type.Trabajo de investigació

Co-creating FabLab La Campana: Empowering a marginalised community in the North of Mexico

FabLabs are a celebrated approach to formal and informal learning through making with digital fabrication tools. This paper discusses the co-creation of a FabLab with a marginalised community in Monterrey, Mexico. One of the main challenges in establishing these Makerspaces is in sustaining the activities and community engagement on an ongoing basis. In responding to this challenge, this process focused on the empowerment of community members to make the changes they desire, either for themselves or their community. Beyond skills for making and playful engagement in STEAM learning, makerspaces also facilitate the building of networks and partnerships, and the development of social competencies and soft skills, that are often overlooked in the process of empowerment and social mobility. Primary insights from the co-creation process of the La Campana FabLab are reported here. A Mexican higher education institution with a strong social responsibility agenda facilitated the process, securing funds and connecting project partners, locally and globally. Framing the co-creation of the FabLab with the partners was and is an ongoing process. Key factors included the donation of a safe space and tools for the community to host and run the FabLab. Establishing the role of the FabLab in the community from the participants’ point-of-view and committing to regular ongoing educational dialogue was important in forming an equitable partnership between institutions and community. Beyond the physical space, equipment and educational activities, a community architecture intervention demonstrated the large-scale impact digital fabrication could have in creating spaces shaped by and for the community

Strengthening collaborative food waste prevention in Peru: towards responsible consumption and production

Inefficient management and handling of organic waste generated by the food service sector is a big global challenge. In addition to the negative environmental impacts of food waste, the effect of the amount of food that is wasted when it is not handled properly is even more alarming. This is particularly when we witness the millions of people who suffer from lack of food and malnutrition. The objective of this research is to examine the situation of organic waste management in food services in the cities of Lima and Tacna in Peru. Using a quantitative methodological approach to waste management, a questionnaire was administered to a sample of 67 restaurants in both cities. The survey results suggest that the restaurants do not carry out the separation or reuse of organic waste. Furthermore, the main methods of disposal include providing surpluses to the staff and sending organic waste to the sanitary landfill and slaughterhouses. There is also a lack of awareness and training about the importance of organic waste management. From the restaurants interviewed, although around 60% claimed to segregate them, only 28% measured organic waste using a manual control and 18% indicated that they weighed the waste for management purposes. As a corrective measure for this deficiency, the production of an awareness video was created to improve decision-making and support change

Historia de la viña y el vino de Uruguay : el vino uruguayo y sus espacios, imagen y consumo (1870-1930). Tomo 3

La vitivinicultura uruguaya es una de las actividades productivas en la que Uruguay ha conquistado un lugar destacado en mercados altamente exigentes y su «estrella» —el vino uruguayo— ha merecido numerosas premiaciones en los certámenes internacionales más importantes. Esta constatación interpela el perfil de su empresariado, tanto en su recorrido histórico como en sus desempeños actuales, sus capacidades para innovar y su voluntad de liderazgo. No deja de llamar la atención que el sector vitivinícola figure en los dos fines de siglo (XIX y XX) como una de las banderas de las «modernizaciones» que sus elites dirigentes se propusieron para el país. Por una parte, el desarrollo de la vitivinicultura se asocia con la diversificación productiva en el agro, la constitución de una fracción de agricultores con cierta capacidad de acumulación, la expansión del mercado interno y el Estado de bienestar. Por otra parte, el viñedo y el vino han incidido en modificar el paisaje ganadero, han propiciado instancias de innovación, y un cierto nivel de cualificación de sus trabajadores. Más recientemente, se ha reparado en su capacidad para acrecer los valores de «patrimonio», conformar espacios productivo-cultural-paisajísticos (terroir) y fomentar el turismo (enoturismo). No puede ignorarse su proyección sobre el diseño y la publicidad, así como en la generación de una cultura un tanto sofisticada que asocia el placer de los sentidos con el conocimiento y el consumo de vinos finos. A su vez, sustenta una red especializada de servicios (revistas para consumidores, catas, asociaciones de enófilos, cursos de degustación), proyectándose con fuerza sobre la gastronomía. Consiguientemente, el tema es relevante socialmente, a nivel de la producción, el intercambio y la culturaPresentación de la Colección Biblioteca Plural, Roberto Markarian. -- Prólogo / Jean-Marie Aurand. -- Prefacio / José María Lez Zecchi. -- Presentación / Alcides Beretta Curi. -- Capítulo 1. Buscando la uva para el vino uruguayo (1): La experiencia del catalán Francesc Vidiella / Alcides Beretta Curi. Anexo: Inventario de la biblioteca técnica de Francesc Vidiella. -- Capítulo 2. Buscando la uva para el vino uruguayo (2): La experiencia del vasco Pascual Harriague / Daniele Bonfanti. -- Capítulo 3. Las bodegas y su equipamiento, fines del siglo XIX y principios del XX (elementos involucrados en la industria derivada e inducida del vino) / Nicol de León. -- Capítulo 4. Los vinos del 900 / Estela de Frutos. -- Capítulo 5. Marco Jurídico / Yanel Gómez Recuero. Anexo: Ley 2.856. -- Capítulo 6. Entre el impulso, la protección y el desinterés un examen de la legislación vitivinícola (1870-1930) / Daniele Bonfanti. -- Capítulo 7. Cartografía de la ingesta de alcoholes / Daniela Bouret Vespa. -- Capítulo 8. El vino en la boca / Daniela Bouret Vespa. -- Capítulo 9. Apuntes para integrar el uso de las imágenes / Daniela Bouret, Fernando Miranda y Gonzalo Vicci. -- Capítulo 10. Paisaje y arquitectura en las primitivas bodegas del Uruguay a fines del siglo XIX / Carlos Altezor. -- Capítulo 11. Bebidas espirituosas de papel (Alcohol, gringos y criollos en la narrativa y la poesía rural, 1890-1950) / Pablo Rocca. -- Fuentes. -- Bibliografía

First record of Callipodium rubens (Anthozoa: Octocorallia) in a lagoon system in Mexico

Considering that in the Mexican coastal of Gulf of Mexico, the octocoral reports have been made exclusively in marine ecosystems, the present investigation provides the unusual presence of Callipodium rubens in a lagoon system of Veracruz, for the first time. In the Tampamacho lagoon, nine, two and 13 specimens (respectively) were recorder during 2015, 2016 and 2018. They were fixed on immerged roots of Rhizophora mangle. Callipodium rubens was recorded occupying the lower horizons (near the bottom) of mangrove roots, spaces that are usually occupied by other sessile epibionts such as bivalves and barnacles. Because the records have been made in different locations and years in Tampamachoo lagoon, a detailed study is necessary to explain the ecological role that C. rubens performs, as a part of epibiont community in red mangrove roots.Considerando que en las costas mexicanas del golfo de México los reportes de octocorales se han hecho exclusivamente en ecosistemas marinos, la presente investigación aporta por primera vez la presencia inusual de Callipodium rubens en un sistema lagunar de Veracruz. En la laguna de Tampamachoco durante los años 2015, 2016 y 2018 se registraron nueve, dos y 13 ejemplares (respectivamente) fijados en raíces sumergidas de Rhizophora mangle. Callipodium rubens fue registrado ocupando los horizontes inferiores (cercanos al fondo) de las raíces de mangle, espacios que suelen ser ocupados por otros epibiontes sésiles como bivalvos y balanos. Dado que los registros se han realizado en diferentes localidades y años en la laguna de Tampamachoco, es necesario un estudio detallado para explicar el papel ecológico que desempeña C. rubens como parte de la comunidad epibionte en raíces del mangle rojo

Characterization of deep-sea benthic invertebrate megafauna of the Galapagos Islands

© The Author(s), 2020. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Salinas-de-León, P., Martí-Puig, P., Buglass, S., Arnés-Urgellés, C., Rastoin-Laplane, E., Creemers, M., Cairns, S., Fisher, C., O'Hara, T., Ott, B., Raineault, N. A., Reiswig, H., Rouse, G., Rowley, S., Shank, T. M., Suarez, J., Watling, L., Wicksten, M. K., & Marsh, L. Characterization of deep-sea benthic invertebrate megafauna of the Galapagos Islands. Scientific Reports, 10(1), (2020): 13894, doi:10.1038/s41598-020-70744-1.The deep sea represents the largest and least explored biome on the planet. Despite the iconic status of the Galapagos Islands and being considered one of the most pristine locations on earth, the deep-sea benthic ecosystems of the archipelago are virtually unexplored in comparison to their shallow-water counterparts. In 2015, we embarked on a multi-disciplinary scientific expedition to conduct the first systematic characterization of deep-sea benthic invertebrate communities of the Galapagos, across a range of habitats. We explored seven sites to depths of over 3,300 m using a two-part Remotely Operated Vehicle (ROV) system aboard the E/V Nautilus, and collected 90 biological specimens that were preserved and sent to experts around the world for analysis. Of those, 30 taxa were determined to be undescribed and new to science, including members of five new genera (2 sponges and 3 cnidarians). We also systematically analysed image frame grabs from over 85 h of ROV footage to investigate patterns of species diversity and document the presence of a range of underwater communities between depths of 290 and 3,373 m, including cold-water coral communities, extensive glass sponge and octocoral gardens, and soft-sediment faunal communities. This characterization of Galapagos deep-sea benthic invertebrate megafauna across a range of ecosystems represents a first step to study future changes that may result from anthropogenic impacts to the planet’s climate and oceans, and informed the creation of fully protected deep-water areas in the Galapagos Marine Reserve that may help preserve these unique communities in our changing planet.We are thankful to the Ocean Exploration Trust as well as the pilots and crew aboard the E/V Nautilus during cruise NA064 for their assistance in sample collection and exploration using the Hercules ROV. Thank you to the NOAA Office of Exploration and Research for funding the E/V Nautilus Exploration Program (NA15OAR0110220). Further acknowledgements and thanks go out to the Charles Darwin Foundation and the Galapagos National Park Directorate for their collaboration and assistance in the exploration of the Galapagos Platform conducted under research permits PC-26–15 & PC-45-15. We also gratefully recognize the Government of Ecuador via the Ecuadorian Navy for permission to operate in their territorial waters. This research was supported by a grant from the Helmsley Charitable Trust and the Gordon and Betty Moore Foundation. This publication is contribution number 2354 of the Charles Darwin Foundation for the Galapagos Islands

Hyperlocal Learning Network ‘La Campana-Altamira’: Using low-cost technologies to support maker education during lockdown times

The Covid-19 pandemic worsened access to education and socio-economic development opportunities for marginalized communities around the globe. ‘Hyperlocal Learning Network La Campana-Altamira’ has used low-cost technologies to target this challenge in a city in the Northeast region of Mexico. With the collaboration of academics from Mexico and the United Kingdom, the project in progress has aimed to build hyperlocal and creative learning networks under a socio-constructivist and grounded approach that could empower individuals (children, parents and general community) and nurture makerspace characteristics at home during lockdown. The project established a hyperlocal learning network in La Campana-Altamira with 11 families, using a combination of craft kits and low-cost digital networks to enable making, reflecting, and sharing in the neighbourhood while schools and makerspaces were closed. This paper presents initial findings of the research process and seeks to open a debate on innovative methods and transnational collaboration during pandemics