Barriers to the care of febrile patients in a malaria endemic area : El Bagre (Antioquia, Colombia) 2016.

Objetivo: Identificar limitaciones de los pacientes con síndrome febril agudo para acceder a los servicios de atención institucional, con énfasis en la identificación de barreras de comunicación.Método: Estudio descriptivo que involucra técnicas de investigación cualitativa con pacientes de los servicios de atención de la malaria y con personal asistencial y administrativo del municipio de El Bagre Antioquia, Colombia en el 2016. Se aplicaron encuestas semiestructuradas individuales, entrevistas y grupos focales. Los usuarios señalaron dificultades con el transporte, insuficiente número de citas y falta de personal para acceder a la atención. Resultados: Las dificultades de comunicación se relacionaron con la información suministrada sobre trámites y documentación para asistir a los puestos de salud, poca información sobre el diagnóstico, control y adherencia al tratamiento antimalárico y el no uso de algunos pacientes del español para comunicarse en forma verbal o escrita. Conclusiones: Esto exige crear modelos de salud basados en transformaciones estructurales que abarquen las necesidades de los actores del sistema de salud y las comunidades, permitiendo establecer las bases para un proyecto multicultural de sociedad.Objective: identify constraints of patients with acute febrile syndrome to institutional care services access, emphasizing the identification of communication barriers. Method: this is a descriptive study that involves qualitative research techniques including malaria care service patients as well as assistance and administrative personnel of El Bagre town in Antioquia, Colombia in 2016. Semi-structured individual surveys, interviews and focus groups were used. Results: users listed difficulties including transportation, insufficient number of appointments and absence of personnel to access healthcare. Communication difficulties were related to the information provided in the paperwork and documents filled out to attend healthcare facilities, scarce information about diagnostic, control, and adherence to antimalarial treatment; additionally some patients did not use Spanish to communicate in oral or write form. Conclusion: the creation of health models based on structural transformations that encompass the needs of Healthcare System actors and communities is a must, which allows the establishment of foundations for a multicultural society Project

Comparative Study of Lifestyle: Eating Habits, Sedentary Lifestyle and Anthropometric Development in Spanish 5- To 15-yr-Olds

Background: The infant-juvenile period is one of high vulnerability during the lifestyles chosen become determining factors for future health status. This study aimed to evaluate lifestyle, specifically eating habits and physical activity, in 5-15-year-olds in Spain and their health status (anthropometry). Methods: This cross-sectional population study with two time points (2006 and 2013) was conducted by compiling data from the Spanish National Health Survey. We used the minor survey, specifically the data from the Health De-terminants module, which included 5-15-year-olds. Compiled information was obtained from parents or guardians. Results: The overall overweight and obesity prevalence in Spain (2013) in 5- to 15-year-olds is 24.3%. A drop of 8.2% in meat consumption was found, while overall intake was high. Daily intake of plant-based food (fruit, vegetables, pulses) was low, especially vegetables (32.9%). Increased sedentary lifestyle was observed, probably because the use of communication technologies has increased in recent years (P<0.001). Moreover, watching TV rose to 19.3% for 1 hour/day watching TV on weekdays and to 23.5% at weekends. Conclusion: When comparing the two time points (2006 and 2013), we observed that lifestyle, eating habits and phys-ical activity strongly associated with the Spanish infant-juvenile population¿s anthropometry. Mediterranean diet pat-terns seem to be abandoned and physical activity is practiced less, which will have a negative impact on future quality of life

Assessment of the microbiological quality of groundwater in three regions of the Valencian community (Spain)

Urban groundwater development was traditionally constrained by concerns about its quality. This study was conducted in the regions of La Ribera Alta and Ribera Baja and La Plana de Requena-Utiel of the Valencian Community (Valencia, Spain) where population density, demand for drinking water and agricultural activities are high. Groundwater bodies (GWBs) are regarded as management areas within each territory, and were used to establish protection policies. This study analyzed eleven GWBs. We used two databases with microbiological measurements from 154 wells over a 7-year period (2004-2011), risk factors and groundwater information. Wells were grouped according to frequency of microbiological contamination using E. coli measurements, category <1, or wells with low-frequency microbiological contamination and high-frequency wells or category 1-100, according to World Health Organization (WHO) quality criteria of drinking water. Of all wells, 18.12% showed high-frequency microbiological contamination with a majority distribution in the Ribera Alta region (26.98%, p < 0.001). No significant differences were found between the two risk categories for flow, static level, well depth and distance from population centres. This paper reveals that the vulnerability classes established by the Geological and Mining Institute of Spain (IGME) do not match the microbiological results, and that only eight wells with high-frequency contamination coincide with the high vulnerability areas

Approach to Development Cooperation 3.0: From the Statutes to the Praxis in a NGDO

The progress of development cooperation has been carried out in the world originally focusing to reduce poverty and to increase the economic growth. Subsequently, the application of Information and Communication Technologies (ICTs) resulted in the appearance of the term development cooperation 2.0. However, the use of scientific focus applied in this area is giving rise a new concept called development cooperation 3.0. In this article, we have explained in a practical contribution in a non-governmental development organization (NGDO) starting by its statutes to examples conducted in three countries

Efectos de la alteración endocrina durante la gestación: una revisión sistemática

Los alteradores endocrinos son contaminantes ambientales, naturales y sintéticos, ubicuos, que pueden mimetizar, bloquear o alterar funciones hormonales. La exposición ambiental a estos contaminantes es prácticamente imposible de evitar debido a que están presentes en el aire, en el agua, en los suelos, en los alimentos, y en muchos de los materiales con los que estamos en contacto diariamente, como los plásticos. La gestación supone una etapa de vulnerabilidad para el feto porque su organismo está en proceso de desarrollo y cualquier alteración puede afectar su salud a corto o largo plazo. Hay cierta evidencia de que estas sustancias alteran procesos de crecimiento y diferenciación de tejidos, producen malformaciones y afectan la duración del embarazo. Hasta el momento se conoce algo de sus efectos en la etiología de la criptorquidia, hipospadias y micropene, abortos espontáneos, partos prematuros y el bajo peso al nacimiento, efectos que serán revisados en este documento que quiere aportar una actualización del conocimiento, concentrándose en la epidemiología ambiental y la literatura relacionada. La dificultad para estudiar este tema por la cantidad de factores que intervienen hace que los resultados existentes no sean concluyentes o incluso contradictorios, por lo que es necesario que se siga investigando Abstract.Endocrine disruptors are ubiquitous natural and synthetic environmental pollutants that can mimic, block or disturb normal hormonal function. Environmental exposure to these pollutants is almost impossible to prevent due to their presence in the air,water, soil, food and in many other materials with which we come in contact daily, such as plastics. Foetuses are vulnerable during pregnancy because their organism is in a developmental stage, and any disruption may affect their health in the short and/or long term. There is some evidence that these substances disrupt tissue differentiation and growth processes, cause birth defects and affect the length of pregnancy. In this review we will focus on environmental epidemiology and related literature in order to update current knowledge based on the actual evidence of the effects of these substances on the aetiology of preterm delivery, miscarriages, low birth weight, malformations, cryptorchidism, hypospadias and micropenis. The difficulty in studying this topic is due to the high number of involved factors, which makes the available results inconclusive or even contradictory. Consequently,further research is necessary

Exposición a factores ambientales y riesgo de tumores en el sistema nervioso central en niños: revisión sistemática y metaanálisis

Se analiza el riesgo de tumores en el sistema nervioso central en niños en relación con la exposición a factores ambientales como radiaciones (ionizantes, no ionizantes), sustancias químicas (pesticidas, productos de belleza, contaminantes atmosféricos) y alimentos. Se realizó una revisión sistemática y un metaanálisis con estudios identificados en la búsqueda de PubMed (1987-2013). Los resultados obtenidos a partir de los valores de OR muestran que el riesgo de tumores en el sistema nervioso central en niños se asocia significativamente con la exposición de los padres y que el periodo prenatal es una ventana crítica para varios de los factores ambientales considerados. Aunque la fracción de riesgo atribuible a cada factor aún se desconoce, el análisis estadístico permitió determinar asociaciones significativas para factores químicos como pesticidas (OR: 1,93; IC 95 % 1,51-2,47), contaminantes atmosféricos (OR: 1,45; IC 95 % 1,17-1,80) y alimentos con compuestos N-nitroso (OR: 1,96; IC 95 % 1,40-2,73) especialmente durante la exposición prenatal. Abstract. We analyzed the risk of tumors in the central nervous system of children in relation to exposure to environmental factors such as radiation (ionizing, non-ionizing), chemicals (pesticides, cosmetics, air pollutants) and foods. We performed a systematic review and meta-analysis of studies identified through a PubMed search (1987-2013). The results obtained from OR values show that the risk of tumors in the central nervous system of children is significantly associated with parental exposure and that the prenatal period is a critical window for several of the environmental factors considered. Although the risk fraction attributable to each factor is still unknown, a statistical analysis allowed to determine significant relations for chemical factors such as pesticides (OR:1.93; 95% IC 1.51-2.47), air pollutants (OR: 1.45; 95% IC 1.17-1.80) and foods with N-nitrous compounds (OR: 1.96; 95% IC 1.40-2.73) especially for prenatal exposur

Estudio de la obesidad y del sobrepeso como factores de riesgo de la prevalencia y severidad del asma en niños de Valencia

[email protected]; [email protected]; [email protected]: La obesidad y el sobrepeso se han descrito como factores de riesgo asociados a la prevalencia y severidad del asma en niños y adolescentes. El objetivo del estudio ha sido el valorar el papel de la obesidad en el asma infantil. Ámbito de estudio y sujetos:Estudio realizado en niños y adolescentes entre 8 y 15 años, elegidos por un muestreo aleatorio tipo cluster entre los niños que estudiaban en 80 colegios, el cual representa el 30% de los colegios de la ciudad de Valencia. Material y métodos:El análisis de los datos se organizó en dos grupos, obesos (aquellos niños en un percentil superior al 85 del Índice de Masa Corporal (kg/m2), tomando como referencia la población española) y no obesos, cuando no cumplian esta condición. Se calcularon la prevalencia de los diferentes parámetros con un intervalo de confianza al 95%, y el riesgo relativo (RR) de los síntomas compatibles con asma entre niños obesos comparándolos con los no obesos. Resultados: No se obtuvo un riesgo relativo significativo para la obesidad con respecto al asma en aquellos niños por encima del percentil 85. Por otra parte, un incremento en el riesgo en relación con la severidad del asma se observó con la obesidad, principalmente en el percentil 85 (RR = 1,51 de sufrir entre 4-12 ataques de pitos y RR = 1,86 de sufrir más de 12 ataques en niños obesos frente a los no obesos) Conclusiónes: En este estudio, no identificamos un riesgo más alto de asma entre niños obesos frente a los no obesos, aunque encontramos que hubiera un riesgo más alto de severidad de síntomas asmáticos. En relación con la severidad del asma, observamos un riesgo más alto de ataques de pitos y sibilancias entre los niños obesos en los percentiles 85 y 95 del Indice de Masa Corporal.Background: Obesity and overweight have been described as factors associated with asthma. Our aim was to evaluate the role obesity plays on asthma in children. Scope and subjects: A study carried out on children and teenagers between 8 and 15 years of age, chosen for a cluster-type random sampling from children who studied in 80 schools, which represents 30% of the schools in the city of Valencia. Material and Methods: The analysed data was organized into two groups, obese (from the Body Mass Index (Kg/m2)), showing children with a percentile over 85% of the measuring reference for the Spanish population) and non obese, when they did not fulfil this condition. The prevalence of the different parameters studied was calculated by an Interval of Confidence of 95%. The risk was calculated (Relative Risk) from those symptoms compatible with asthma among obese children compared to non obese children. Results: No significant relative risk (RR) was seen for obesity with regards to asthma in those percentiles of obesity over 85. Otherwise, an increase in the relative risk (RR) regarding the severity of asthma was seen in relation to obesity, mainly in the 85th percentile (RR = 1.51 of suffering between 4-12 wheezing attacks and RR = 1.86 of suffering more than 12 attacks in obese children as opposed to non obese children). Conclusions: In this study, we did not identify a higher risk of asthma among obese children than among non obese children, although we did find there was a higher risk of severity of asthmatic symptoms. As far as the severity of the asthma is concerned, we saw a higher risk of wheezing and whistling attacks among obese children with the 85th and the 95th percentiles according to the Body Mass [email protected]; [email protected]; [email protected]

Evaluación de resultados en el tratamiento quirúrgico de las fracturas aisladas de cabeza de radio en el adulto

Presentamos una serie de 35 pacientes intervenidos en nuestro servicio por fractura aislada de cabeza de radio. El objetivo ha sido evaluar el resultado funcional del tratamiento quirúrgico de estas fracturas en el adulto, la correlación de los diferentes sistemas de evaluación de resultados y determinar los factores pronóstico. Las fracturas se clasificaron según Mason evaluando los resultados utilizando la escala de valoración del hospital par cirugía especial (HSSA) de Inglis y Pellici, el índice de clasificación funcional de Broberg y Morrey y la escala de evaluación funcional del codo de la Clínica Mayo. En más del 80% de los casos se obtuvieron resultados buenos ó excelentes, con una flexión media de 139% y un déficit de extensión de 10º. Los tres métodos de valoración mostraron un índice de concordancia estadísticamente significativo resultado por tanto ser equiparables. El retraso en la cirugía resultó ser un factor pronóstico en el resultado final (p<0.05) mientras que el tipo de fractura y de cirugía muestran tendencia a influir en el resultado final.Functional outcome after surgery for isolated radial head fractures in adults was assessed using three different outcome assessment approaches and favourable prognostic factors were determined. Thirty-five patients with radial head fractures were operated. Fractures were grouped according to the Mason classification, and the results obtained were assessed by means of the hospital for special surgery assessment (HSSA) system. Broberg and Morrey functional classification index and the Mayor Clinic elbow functional in over 80% of cases, with an average flexion of 139 degrees and an extension defect of 10 degrees. All three assessment system yielded statistically significant concordant scores, and was thus considered to be equivalent. Surgical delay proved to be a significant prognostic factor of the end result (p<0.05), while the type of fracture and surgery employed tended to influence outcome

Risk factors for non-melanoma skin cancer in kidney transplant patients in a Spanish population in the Mediterranean region

Non-melanoma skin cancer (NMSC) is the most frequent malignancy in organ transplant recipients. The aetiology of NMSC after transplant is multifactorial. The aim of this study was to determine the clinical and environmental factors involved in the development of NMSC in a Spanish kidney transplant population from the Mediterranean region. A total of 289 patients who had received a kidney transplant during the period January 1996 to December 2010 were included in the study. Both prospective and retrospective data were used. All patients underwent a structured interview and a complete examination of the skin. After a median follow-up of 72 months (range 12-180 months), 73 of the 289 patients (25.2%) developed 162 tumours. The ratio of basal cell carcinoma to squamous cell carcinoma was 2.21:1. The cumulative incidence of NMSC increased with the duration of immunosuppression, from 20.78% at 5 years, to 37.35% at 10 years to 53.08% at 15 years after transplantation. Age at the time of transplant, phototype and occupational sun exposure were associated with a higher risk of NMSC. NMSC is a significant clinical problem in kidney transplant recipients. This has implications for the development of prevention and surveillance strategies. Clinical and environmental factors may be used to identify those patients who are at risk for NMSC

Anthropometric Status and Nutritional Intake in Children (6-9 Years) in Valencia (Spain): The ANIVA Study

The aim of our study was to assess nutritional intake and anthropometric statuses in schoolchildren to subsequently determine nutritional adequacy with Spanish Dietary ReferenceIntake (DRIs). The ANIVA study, a descriptive cross-sectional study, was conducted in 710 schoolchildren (6-9 years) in 2013-2014 in Valencia (Spain). Children's dietary intake was measured using 3-day food records, completed by parents. Anthropometric measures (weight and height) were measured according to international standards, and BMI-for-age was calculated and converted into z-scores by WHO-Anthro for age and sex. Nutrient adequacy was assessed using DRI based on estimated average requirement (EAR) or adequate intake (AI). Pearson's chi-square and Student's t-test were employed. Of our study group (47.61% boys, 52.39% girls),53.1% were normoweight and the weight of 46.9% was inadequate; of these, 38.6% had excess body weight (19.6% overweight and 19.0% obesity). We found intakes were lower for biotin, fiber, fluoride, vitamin D (p < 0.016), zinc, iodine, vitamin E, folic acid, calcium and iron (p < 0.017),and higher for lipids, proteins and cholesterol. Our results identify better nutritional adequacy to Spanish recommendations in overweight children. Our findings suggest that nutritional intervention and educational strategies are needed to promote healthy eating in these children and nutritional adequacies