Rapid health evaluation in migrant peoples in transit through Darien, Panama: protocol for a multimethod qualitative and quantitative study.

BACKGROUND: The world is currently unprepared to deal with the drastic increase in global migration. There is an urgent need to develop programs to protect the well-being and health of migrant peoples. Increased population movement is already evident throughout the Americas as exemplified by the rising number of migrant peoples who pass through the Darien neotropical moist broadleaf forest along the border region between Panama and Colombia. The transit of migrant peoples through this area has an increase in the last years. In 2021, an average of 9400 people entered the region per month compared with 2000-3500 people monthly in 2019. Along this trail, there is no access to health care, food provision, potable water, or housing. To date, much of what is known about health needs and barriers to health care within this population is based on journalistic reports and anecdotes. There is a need for a comprehensive approach to assess the health care needs of migrant peoples in transit. This study aims to describe demographic characteristics, mental and physical health status and needs, and experiences of host communities, and to identify opportunities to improve health care provision to migrant peoples in transit in Panama. STUDY DESIGN AND METHODS: This multimethod study will include qualitative (n = 70) and quantitative (n = 520) components. The qualitative component includes interviews with migrant peoples in transit, national and international nongovernmental organizations and agencies based in Panama. The quantitative component is a rapid epidemiological study which includes a questionnaire and four clinical screenings: mental health, sexual and reproductive health, general and tropical medicine, and nutrition. CONCLUSION: This study will contribute to a better understanding of the health status and needs of migrant peoples in transit through the region. Findings will be used to allocate resources and provide targeted health care interventions for migrant peoples in transit through Darien, Panama

Metodología para un proceso apreciativo, dinámico y colaborativo: III Plan de Salud de Canarias

Resumen: La necesidad de nuevos enfoques de planificación estratégica con la incorporación de la visión de profesionales y ciudadanos ha orientado un nuevo modelo para el III Plan de Salud de Canarias (IIIPSC). Se propone un proceso participativo con soporte de metodología cualitativa en dos etapas: 1) fase local: estudio cuantitativo-cualitativo a través de una acción formativa y de investigación-acción-participación, y 2) fase insular: conferencias de salud, con debate sobre resultados en sesiones presenciales en cada área de salud (isla) y propuestas de acción. El proceso define una priorización de problemas y un plan de acción específico para cada isla mediante operaciones consideradas viables, agrupadas por temas y ponderadas según el potencial impacto sobre los problemas priorizados. Este proceso de interacción puede contribuir a orientar los cambios de modelo de planificación y la toma de decisiones en política sanitaria, y se encuentra recogido en el Proyecto del IIIPSC para su tramitación parlamentaria. Abstract: The need for new approaches to strategic planning by incorporating the perspectives of professionals and inhabitants has led to a new model for the 3rd Canary Islands (Spain) Health Plan (IIIPSC). A dual-phase participatory process using qualitative techniques is proposed: 1) local phase: a quantitative and qualitative study based on training and a research-action-participation initiative; and 2) insular phase: health conferences with face-to-face discussion of results in each health area (island) and proposals for action. The process prioritises problems and establishes a specific action plan for each island through initiatives that are considered to be viable, grouped by themes and weighted according to the potential impact on priority problems. This process of interaction may help to guide planning model changes and health policy decision-making, and was included in the IIIPSC Project for its parliamentary procedure. Palabras clave: Implementación plan de salud, Planificación sanitaria, Investigación en servicios sanitarios, Educación a distancia, Diálogo apreciativo, Investigación-acción, Keywords: Health plan implementation, Health planning, Health services research, Distance learning, Appreciative inquiry, Action researc

Anuario del Centro de Estudios Martianos (Vol. 26 2003)

El Anuario del Centro de Estudios Martianos es la publicación insignia de esta institución y heredera directa del Anuario Martiano de la Biblioteca Nacional José Martí, que se publicó entre 1969 y 1977, bajo la dirección del poeta y ensayista Cintio Vitier. Desde que salió a la luz su primera entrega, en 1978, se han publicado treinta y cinco números, en los que aparecen artículos y ensayos de importantes estudiosos de la vida y obra del Apóstol, en Cuba y el resto del mundo. En sus secciones fijas (Otros textos de José Martí, Documentos, Estudios y aproximaciones, Vigencias, Publicaciones, Bibliografía, Constante) y los apartados especiales, los lectores pueden conocer disímiles temas del quehacer martiano internacional, en el año que termina además de mantenerse al tanto de las últimas contribuciones de los promotores e investigadores de la obra martiana en el orbe

Pneumonia treated in the internal medicine department: Focus on healthcare-associated pneumonia

Patients with pneumonia treated in the internal medicine department (IMD) are often at risk of healthcare-associated pneumonia (HCAP). The importance of HCAP is controversial. We invited physicians from 72 IMDs to report on all patients with pneumonia hospitalized in their department during 2weeks (one each in January and June 2010) to compare HCAP with community-acquired pneumonia (CAP) and hospital-acquired pneumonia (HAP). We analysed 1002 episodes of pneumonia: 58.9% were CAP, 30.6% were HCAP and 10.4% were HAP. A comparison between CAP, HCAP and HAP showed that HCAP patients were older (77, 83 and 80.5years; p<0.001), had poorer functional status (Barthel 100, 30 and 65; p<0.001) and had more risk factors for aspiration pneumonia (18, 50 and 34%; p<0.001). The frequency of testing to establish an aetiological diagnosis was lower among HCAP patients (87, 72 and 79; p<0.001), as was adherence to the therapeutic recommendations of guidelines (70, 23 and 56%; p<0.001). In-hospital mortality increased progressively between CAP, HCAP and HAP (8, 19 and 27%; p<0.001). Streptococcus pneumoniae was the main pathogen in CAP and HCAP. Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA) caused 17 and 12.3% of HCAP. In patients with a confirmed aetiological diagnosis, the independent risk factors for pneumonia due do difficult-to-treat microorganisms (Enterobacteriaceae, P. aeruginosa or MRSA) were HCAP, chronic obstructive pulmonary diseases and higher Port Severity Index. Our data confirm the importance of maintaining high awareness of HCAP among patients treated in IMDs, because of the different aetiologies, therapy requirements and prognosis of this population. © 2011 The Authors. Clinical Microbiology and Infection © 2011 European Society of Clinical Microbiology and Infectious Diseases