Atención de emergencias obstétricas en Chiapas, México. Caminando hacia la conformación de redes

Responses to the systemic limitations of health care in Mexico have included public policies for universal access implemented through inter-institutional agreements. Those focused on emergency obstetric care are a vivid example of these efforts. Based on a case study, this article describes a general picture of the ways in which health-service networks operate in the state of Chiapas. We review their infrastructure and analyze their capacity to respond to obstetric emergencies. We also assess the current condition of these networks in terms of being able to function as a collaborative network. Our findings demonstrate that public institutions in the Mexican health sector have made little or no use of the benefits offered by inter-institutional agreements, and identify the strengths and obstacles in their utilization. The results of our research can help optimize obstetric care for women in Chiapas.Como respuesta a las limitaciones del Sistema de Salud en México por su fragmentación y segmentación, se han puesto en marcha políticas públicas de acceso universal que operan a través de convenios y acuerdos interinstitucionales, como las dirigidas a la atención de emergencias obstétricas. A través de un estudio de caso, se ofrece un panorama de las redes de servicios de salud en Chiapas dando cuenta de su infraestructura para determinar la resolutividad real de los establecimientos ante emergencias obstétricas y su condición para operar como red colaborativa. Se muestra que las instituciones públicas del sector salud dan un uso limitado o nulo a los acuerdos y convenios interinstitucionales. Se identifican las fortalezas y obstáculos en su utilización y se efectúan recomendaciones para optimizar los mecanismos de la atención obstétrica para las mujeres en Chiapas

Challenges of health services related to the population displaced by violence in Mexico

OBJECTIVE: To analyze the impacts of the care to the population displaced by violence on the health system and the challenges that this entails. METHODS: This is a narrative review of the national and international literature in PubMed, SciELO, WHO/PAHO, and Bireme. Inclusion criteria were date of publication ( from 2000), relation with the subject, and language (Spanish or English). We found 292 documents, of which 91 met the inclusion criteria. RESULTS: The main challenges are the intersectoral, participatory, and integral approach (with emphasis on mental health and sexual and reproductive health), ensured accessibility to health services, the need for a reliable registration and information system of the population displaced by violence and its characteristics, and the addressing of the biopsychosocial problems of the different groups, especially women, persons with disabilities or infectious diseases, adolescents, children, ethnic minorities, older adults and the lesbian, gay, bisexual, transsexual, and intersexual population. CONCLUSIONS: The lack of political will to accept and see the internal displacement by violence and its importance as a humanitarian and public health problem is an obstacle to the adequate and timely care of the population displaced by violence in Mexico

Prevalence and factors associated with violence and abuse of older adults in Mexico’s 2012 National Health and Nutrition Survey

Background: Factors associated with violence and the abuse of older adults are understudied and its prevalence in Mexico has not been reported. The aim of this study was to identify the prevalence and factors associated with violence and abuse of older adults in Mexico. Methods: We used Mexico’s 2012 National Health and Nutrition Survey, which included a sample of 8,894 individuals who are 60 years or older and who self-reported a negative health event related to robbery, aggression or violence in the previous 12 months. We used chi-squared test and Fisher’s exact test to analyze the variables related to violence. Adjusted estimates were completed with multiple logistic regression models for complex surveys. Results: The prevalence of violence was 1.7 % for both men and women. In 95 % of the cases, the aggression was from an unknown party. Verbal aggressions were the most prevalent (60 %). Among men, physical aggression was more common. Violence frequently occurred in the home (37.6 %); however, men were primarily assaulted in public places (42.4 %), in comparison to women (30.7 %). There were also differences in the risk factors for violence. Among men, risk was associated with younger age (60–64 years), higher education (secondary school or above) and higher socioeconomic status. Among women, risk was associated with depression, not being the head of the family, and region of the country. Conclusions: Violence against older adults presents differently for men and women, which means it is necessary to increase knowledge about the dynamics of the social determinants of violence, particularly in regards to the role of education among men. The relatively low prevalence found in this study may reflect the difficulty and fear of discussing the topic of violence. This may occur because of cultural factors, as well as by the perception of helplessness perpetuated by the scarce access to social programs that ensure protection and problem solving with regards to the complex social determinants of individual and family violence that this population group endures.publishedVersio

Six Collective Challenges for Sustainability of Almería Greenhouse Horticulture

Globally, current food consumption and trade are placing unprecedented demand on agricultural systems and increasing pressure on natural resources, requiring tradeoffs between food security and environmental impacts especially given the tension between market-driven agriculture and agro-ecological goals. In order to illustrate the wicked social, economic and environmental challenges and processes to find transformative solutions, we focus on the largest concentration of greenhouses in the world located in the semi-arid coastal plain of South-east Spain. Almería family farming, predominantly cooperative, greenhouse intensive production, commenced after the 1960s and has resulted in very significant social and economic benefits for the region, while also having important negative environmental and biodiversity impacts, as well as creating new social challenges. The system currently finds itself in a crisis of diminishing economic benefits and increasing environmental and social dilemmas. Here, we present the outcomes of multi-actor, transdisciplinary research to review and provide collective insights for solutions-oriented research on the sustainability of Almeria’s agricultural sector. The multi-actor, transdisciplinary process implemented collectively, and supported by scientific literature, identified six fundamental challenges to transitioning to an agricultural model that aims to ameliorate risks and avoid a systemic collapse, whilst balancing a concern for profitability with sustainability: (1) Governance based on a culture of shared responsibility for sustainability, (2) Sustainable and efficient use of water, (3) Biodiversity conservation, (4) Implementing a circular economy plan, (5) Technology and knowledge transfer, and (6) Image and identity. We conclude that the multi-actor transdisciplinary approach successfully facilitated the creation of a culture of shared responsibility among public, private, academic, and civil society actors. Notwithstanding plural values, challenges and solutions identified by consensus point to a nascent acknowledgement of the strategic necessity to locate agricultural economic activity within social and environmental spheres.This paper demonstrates the need to establish transdisciplinary multi-actor work-schemes to continue collaboration and research for the transition to an agro-ecological model as a means to remain competitive and to create value

Early transcontinental import of SARS-CoV-2 variant of concern 202012/01 (B.1.1.7) from Europe to Uruguay

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant B.1.1.7 causes a more transmissible and apparently more severe disease. We report its early introduction from Europe to South America from a traveler who arrived in Uruguay from the United Kingdom, even before B.1.1.7 was recognized as a variant of concern. This highlights the risk of introduction of SARS-CoV-2 variants despite strict contingency protocols and underscores the need of improving real-time surveillance worldwide.ANII: POS_NAC_2018_1_15149

SITUACIÓN ACTUAL DE PROGRAMAS DE PROMOCIÓN DE LA SALUD EN PLANES DE ESTUDIOS DE LICENCIATURAS EN EL ÁREA DE LA SALUD

La Promoción de la Salud (PS) es un eje central en los modelos de salud. Se le define en la carta de Ottawa como una estrategia para proporcionar los medios necesarios para mejorar la salud de la población y ejercer un mayor control sobre la misma. El propósito de este estudio fue realizar una revisión documental de los planes de estudios con el fin de identificar asignaturas relacionadas con PS en los currículos de diversas licenciaturas del área de la salud en Mexico, el cual fue un estudio descriptivo. Se revisaron planes de estudio de Universidades incorporadas a la Asociación Nacional de Universidades e Instituciones de Educación Superior (ANUIES) en sus sitios de internet, entre diciembre de 2013 y enero de 2014, y que contaran con alguna de las siguientes licenciaturas: medicina, odontología, enfermería, cultura física y deporte, nutrición, veterinaria, psicología de la salud, salud pública, administración de los servicios de salud. Se encontró una baja cantidad de programas de PS en las diversas universidades, por lo que es necesario reforzar y ampliar dichos programas

Seminario semipresencial sobre “Metodología Cualitativa” a través de la plataforma Studium

Memoria ID12-0213. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2012-2013

Cellular Integrin α5β1 and Exosomal ADAM17 Mediate the Binding and Uptake of Exosomes Produced by Colorectal Carcinoma Cells

Approximately 25% of colorectal cancer (CRC) patients develop peritoneal metastasis, a condition associated with a bleak prognosis. The CRC peritoneal dissemination cascade involves the shedding of cancer cells from the primary tumor, their transport through the peritoneal cavity, their adhesion to the peritoneal mesothelial cells (PMCs) that line all peritoneal organs, and invasion of cancer cells through this mesothelial cell barrier and underlying stroma to establish new metastatic foci. Exosomes produced by cancer cells have been shown to influence many processes related to cancer progression and metastasis. In epithelial ovarian cancer these extracellular vesicles (EVs) have been shown to favor different steps of the peritoneal dissemination cascade by changing the functional phenotype of cancer cells and PMCs. Little is currently known, however, about the roles played by exosomes in the pathogenesis and peritoneal metastasis cascade of CRC and especially about the molecules that mediate their interaction and uptake by target PMCs and tumor cells. We isolated exosomes by size−exclusion chromatography from CRC cells and performed cell-adhesion assays to immobilized exosomes in the presence of blocking antibodies against surface proteins and measured the uptake of fluorescently-labelled exosomes. We report here that the interaction between integrin α5β1 on CRC cells (and PMCs) and its ligand ADAM17 on exosomes mediated the binding and uptake of CRC-derived exosomes. Furthermore, this process was negatively regulated by the expression of tetraspanin CD9 on exosomes

Una experiencia educativa con la tableta digital en el aula

Memoria ID-0076. Ayudas de la Universidad de Salamanca para la innovación docente, curso 2014-2015.[ES]La aparición de las tabletas digitales supone un punto de inflexión en el desarrollo educativo, la forma que podemos acceder a Internet, en la portabilidad, en la conectividad sencilla, en la multifuncionalidad, en la consulta y en la generación de contenidos. Dadas sus peculiaridades, la tableta digital puede ser un elemento interesante de cara a su utilización educativa. Eso es lo que pretende averiguar el proyecto DEDOS: una experiencia educativa con la tableta digita