117 research outputs found
¿Los trabajadores independientes y los pensionados que suscriben contratos de prestación de servicios, deben aportar a la Seguridad Social?
Prevención selectiva del consumo problemático de alcohol en la escuela
Con base en fundamentos teóricos y empíricos, se diseña una estrategia de formación a orientadores
escolares, con el objetivo de fomentar en ellos las competencias requeridas para implementar en sus
instituciones dos programas de prevención de corte motivacional, uno de ellos centrado en el fomento del
sentido de vida y otro orientado al fomento de la abstención y la moderación en el consumo de alcohol
Representaciones sociales de líderes comunitarios sobre el consumo de sustancias psicoactivas en un sector marginal de la ciudad de Cali
Introduction: Social representations are a kind of common sense knowledge by means of which individuals and communities convert a physical reality into perceptible constructions of what surrounds them, converting the strange into familiar. The main objective of this study was to understand the social representations of the leaders of community-based organizations on the consumption of psychoactive substances in a neighborhood sector of commune 18 in the city of Cali. Method: A study was developed under a qualitative research approach and its design was assumed as a study of social representations, which subscribes to the interpretive-constructivist paradigm. Results: The community leaders defined the two-dimensional phenomenon, on the one hand; a health problem, evidencing a series of scientific knowledge in the participants, which influences the constitution of the Social Representation of psychoactive substance consumption as a disease, and on the other hand, a social problem given that it is associated with social determinants and of policies that are outside the scope of consumption itself. Conclusion: The Social Representations that leaders and community-based organizations attribute to the use of psychoactive substances in the sector of the commune 18 are characterized by being made up of meanings that are woven between a scientific knowledge about the consumption of substances, an institutional discourse and the moral assessment system established in the context of the community. Introducción: Las representaciones sociales son un tipo de conocimiento de sentido común por medio del cual los individuos y las comunidades convierten una realidad física en construcciones perceptibles de aquello que les rodea, convirtiendo lo extraño en familiar. El objetivo primordial de este estudio fue comprender las representaciones sociales de los líderes de organizaciones de base comunitaria sobre el consumo de sustancias psicoactivas en un sector barrial de la comuna 18 en la ciudad de Cali. Método: Se desarrolló un estudio bajo un enfoque investigativo cualitativo y su diseño se asumió como un estudio de representaciones sociales, el cual se suscribe al paradigma interpretativo-constructivista. Resultados: Los líderes comunitarios definieron el fenómeno de manera bidimensional; por un lado, como un problema de salud, evidenciando una serie de saberes científicos en los participantes que influyen en la constitución de la representación social de consumo de sustancias psicoactivas como una enfermedad, y por otro lado, como un problema social asociado a determinantes sociales y políticas que están fuera del alcance del consumo en tanto fenómeno. Conclusión: Las representaciones sociales que los líderes y organizaciones de base comunitaria le atribuyen al uso de sustancias psicoactivas en el sector de la Comuna 18; están caracterizadas por significados que se tejen entre un saber científico sobre el consumo de sustancias, un discurso institucional y el sistema de valoración moral establecido en el contexto de la comunidad
Development of a food frequency questionnaire for assessing dietary intake in children and adolescents in South America
ABSTRACT: This study aimed to describe the development of a food frequency questionnaire (FFQ) to assess dietary intake in South American children and adolescents. Methods: A total of 345 children (aged 3-10 years) and 357 adolescents (aged 11-17 years) were included for analysis. The FFQ was designed to be self-administered and to assess dietary intake over the past 3 months. It was developed in Spanish and translated into Portuguese. Multiple approaches were considered to compile the food list, and 11 food groups were included. A food photo booklet was produced as supporting material. Results: The FFQ items maintained a common core list among centers (47 items) and country-specific foods. The FFQ for Buenos Aires and Lima had a total of 63 items; there were 55 items for the FFQ in Medelin, 60 items for Montevideo, 58 items for Santiago, 67 items for Sao Paulo, and 68 items for Teresina. Alcohol was also incorporated in the adolescents’ FFQ. Conclusions: We developed a semiquantitative, culturally adapted FFQ to assess dietary intake in children and adolescents in South America. It has an optimal size allowing its completion in a high proportion of the population; therefore, it can be used in epidemiological studies with South American children and adolescents
How universal is coverage and access to diagnosis and treatment for Chagas disease in Colombia? A health systems analysis
Limited access to Chagas disease diagnosis and treatment is a major obstacle to reaching the 2020 World Health Organization milestones of delivering care to all infected and ill patients. Colombia has been identified as a health system in transition, reporting one of the highest levels of health insurance coverage in Latin America. We explore if and how this high level of coverage extends to those with Chagas disease, a traditionally marginalised population. Using a mixed methods approach, we calculate coverage for screening, diagnosis and treatment of Chagas. We then identify supply-side constraints both quantitatively and qualitatively. A review of official registries of tests and treatments for Chagas disease delivered between 2008 and 2014 is compared to estimates of infected people. Using the Flagship Framework, we explore barriers limiting access to care. Screening coverage is estimated at 1.2% of the population at risk. Aetiological treatment with either benznidazol or nifurtimox covered 0.3-0.4% of the infected population. Barriers to accessing screening, diagnosis and treatment are identified for each of the Flagship Framework's five dimensions of interest: financing, payment, regulation, organization and persuasion. The main challenges identified were: a lack of clarity in terms of financial responsibilities in a segmented health system, claims of limited resources for undertaking activities particularly in primary care, non-inclusion of confirmatory test(s) in the basic package of diagnosis and care, poor logistics in the distribution and supply chain of medicines, and lack of awareness of medical personnel. Very low screening coverage emerges as a key obstacle hindering access to care for Chagas disease. Findings suggest serious shortcomings in this health system for Chagas disease, despite the success of universal health insurance scale-up in Colombia. Whether these shortcomings exist in relation to other neglected tropical diseases needs investigating. We identify opportunities for improvement that can inform additional planned health reforms. (C) 2017 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license
Abdominal obesity and low physical activity are associated with insulin resistance in overweight adolescents: a cross-sectional study
ABSTRACT: Background: Previous studies have assessed the metabolic changes and lifestyles associated with overweight adolescents. However, these associations are unclear amongst overweight adolescents who have already developed insulin resistance. This study assessed the associations between insulin resistance and anthropometric, metabolic, inflammatory, food consumption, and physical activity variables amongst overweight adolescents. Methods: This cross-sectional study divided adolescents (n = 120) between 10 and 18 years old into 3 groups: an overweight group with insulin resistance (O + IR), an overweight group without insulin resistance (O-IR), and a normal-weight control group (NW). Adolescents were matched across groups based on age, sex, pubertal maturation, and socioeconomic strata. Anthropometric, biochemical, physical activity, and food consumption variables were assessed. Insulin resistance was assessed using homeostatic model assessment (HOMA Calculator Version 2.2.2 from ©Diabetes Trials Unit, University of Oxford), and overweight status was assessed using body mass index according to World Health Organization (2007) references. A chi-square test was used to compare categorical variables. ANOVAs or Kruskal-Wallis tests were used for continuous variables. Multiple linear regression models were used to calculate the probability of the occurrence of insulin resistance based on the independent variables. Results: The risk of insulin resistance amongst overweight adolescents increases significantly when they reach a waist circumference > p95 (OR = 1.9, CIs = 1.3-2.7, p = 0.013) and watch 3 or more hours/day of television (OR = 1.7, CIs = 0.98-2.8, p = 0.033). Overweight status and insulin resistance were associated with higher levels of inflammation (hsCRP ≥1 mg/L) and cardiovascular risk according to arterial indices. With each cm increase in waist circumference, the HOMA index increased by 0.082; with each metabolic equivalent (MET) unit increase in physical activity, the HOMA index decreased by 0.026. Conclusions: Sedentary behaviour and a waist circumference > p90 amongst overweight adolescents were associated with insulin resistance, lipid profile alterations, and higher inflammatory states. A screening that includes body mass index, in waist circumference, and physical activity evaluations of adolescents might enable the early detection of these alterations
The gut microbiota of Colombians differs from that of Americans, Europeans and Asians
ABSTRACT: The composition of the gut microbiota has recently been associated with health and disease, particularly with obesity. Some studies suggested a higher proportion of Firmicutes and a lower proportion of Bacteroidetes in obese compared to lean people; others found discordant patterns. Most studies, however, focused on Americans or Europeans, giving a limited picture of the gut microbiome. To determine the generality of previous observations and expand our knowledge of the human gut microbiota, it is important to replicate studies in overlooked populations. Thus, we describe here, for the first time, the gut microbiota of Colombian adults via the pyrosequencing of the 16S ribosomal DNA (rDNA), comparing it with results obtained in Americans, Europeans, Japanese and South Koreans, and testing the generality of previous observations concerning changes in Firmicutes and Bacteroidetes with increasing body mass index (BMI). Results: We found that the composition of the gut microbiota of Colombians was significantly different from that of Americans, Europeans and Asians. The geographic origin of the population explained more variance in the composition of this bacterial community than BMI or gender. Concerning changes in Firmicutes and Bacteroidetes with obesity, in Colombians we found a tendency in Firmicutes to diminish with increasing BMI, whereas no change was observed in Bacteroidetes. A similar result was found in Americans. A more detailed inspection of the Colombian dataset revealed that five fiber-degrading bacteria, including Akkermansia, Dialister, Oscillospira, Ruminococcaceae and Clostridiales, became less abundant in obese subjects. Conclusion: We contributed data from unstudied Colombians that showed that the geographic origin of the studied population had a greater impact on the composition of the gut microbiota than BMI or gender. Any strategy aiming to modulate or control obesity via manipulation of this bacterial community should consider this effect
- …