ABSTRACT
Resumen América Latina se ha convertido en uno de los epicentros de la pandemia de Covid-19, con una crisis sanitaria y humanitaria. El objetivo del artículo es analizar las medidas para enfrentar la pandemia en países de la Región y el rol de la Atención Primaria de Salud, discutiendo obstáculos y potencialidades. Son analizados los casos de Bolivia, Brasil, Chile, Colombia, Cuba, Uruguay y Venezuela. Los siete países adoptaran medidas de aislamiento social de diferentes alcances, con grados distintos de sostenibilidad. El énfasis de las respuestas estuvo más en la atención hospitalaria que en la vigilancia de la salud, identificación de casos y contactos y disposición de condiciones adecuadas para el confinamiento. En casi todos los países, se subestimó la capacidad de los servicios de atención primária en el territorio. No obstante, iniciativas de enfoque territorial y comunitario buscaron integrar la vigilancia de la salud con actividades de promoción, prevención y cuidado, aunque con alcance parcial. En este contexto la Atención Primaria Integral e integrada toma nuevo sentido y reclama desarrollos que contribuyan a recobrar el equilibrio entre sociedad y medio ambiente. Es necesario repensar los sistemas de salud y la importancia de la atención primaria de salud integrada e integral.
Abstract Latin America has become one of the epicenters of the COVID-19 pandemic, with a health and humanitarian crisis. The objective of the article is to analyze the strategies implemented by countries in the Region to face the pandemic and the role of Primary Health Care, considering obstacles and potential. The cases of Bolivia, Brazil, Chile, Colombia, Cuba, Uruguay and Venezuela were analyzed. The seven countries have adopted diverse social distancing strategies with varying degrees of sustainability. The responses emphasized hospital care more than surveillance, case identification, contact tracking, and enabling adequate conditions for isolation. In almost all cases studied, the capacity of primary care services in the territory was underestimated. Even so, primary care initiatives with a territorial and community focus sought to integrate health surveillance with promotion, prevention and care, despite partial implementation. In this context, comprehensive and integrated primary care takes on new meaning and requires new developments in order to contribute to the recovery of the balance between society and the environment. The pandemic showed the need to rethink health care systems and the importance of primary care for comprehensive and integrated health.
Resumo A América Latina tornou-se um dos epicentros da pandemia de Covid-19, com uma crise sanitária e humanitária. O objetivo do artigo é analisar as estratégias implementadas por países da Região para enfrentar a pandemia e o papel da Atenção Primária à Saúde, ponderando obstáculos e potencialidades. Foram analisados os casos de Bolívia, Brasil, Chile, Colômbia, Cuba, Uruguai e Venezuela. Os sete países adotaram estratégias de distanciamento social diversas com diferentes graus de sustentabilidade. As respostas enfatizaram mais a assistência hospitalar do que a vigilância, a identificação de casos, o rastreamento dos contatos e a viabilização de condições adequadas para isolamento. Em quase todos os casos estudados, foi subestimada a capacidade dos serviços de atenção primária no território. Ainda assim, iniciativas de atenção primária com enfoque territorial e comunitário buscaram integrar a vigilância à saúde com a promoção, prevenção e cuidado, apesar de implantação parcial. Nesse contexto, uma atenção primária integral e integrada adquire novo significado e requisita novos desenvolvimentos de forma a contribuir para a recuperação do equilíbrio entre a sociedade e o meio ambiente. A pandemia mostrou a necessidade de repensar os sistemas de atenção à saúde e a importância da atenção primária à saúde integral e integrada.
Subject(s)
Humans , Primary Health Care , Health Systems , Coronavirus Infections , Public Health SurveillanceABSTRACT
Tras la muerte de un organismo vivo, la actividad de los insectos es el principal mecanismo por el que la materia orgánica en descomposición se reintegra en la cadena alimenticia. No obstante, hay que tener en cuenta que dicha actividad puede implicar modificaciones de gran interés tafonómico y forense. Si no se conoce bien su magnitud, pueden inducir al error en el posterior análisis del patólogo forense. En este artículo, damos una clasificación organizada de los diferentes fenómenos tafonómicos inducidos por insectos (adición, eliminación y modificación del cadáver) y enunciamos los caracteres diferenciales que permiten separarlos de procesos patológicos similares, centrando nuestra atención en los órdenes Coleoptera, Diptera y Lepidoptera como principales causantes de estas modificaciones...
After death of a living organism, the activity of insects is the main mechanism by which decomposing organic matter returns to the nutritional chain. However, it is necessary to consider that this activity can imply modifications of great taphonomic and forensic interest. If its magnitude is not known well, it can induce to error in the later analysis of the forensic pathologist. In this article, we give an organized classification of the different taphonomic phenomena induced by insects (addition, elimination and modification of the corpse) and enunciate the differential features that allow to separate them from similar pathological processes, focusing our attention on the orders Coleoptera, Diptera and Lepidoptera as the main responsibles of these modifications...
Subject(s)
Humans , Arthropods , Lepidoptera , Postmortem ChangesABSTRACT
This paper outlines the evolution of the concept of continuing medical professional development in Uruguay, as that professional development has progressed from independent and varied efforts that were not coordinated or evaluated to a plan that is aimed at improving the quality of educational activities and programs and making them accessible to all the physicians in the country. In contrast to countries where scientific societies and medical associations preside over continuing professional development, in Uruguay the Graduate School of the School of Medicine of the University of the Republic has taken on managing and developing this process. The key objective of this process is for the Graduate School to work in conjunction with other leading players in professional development to create a national system of continuing medical professional development. This system should be interinstitutional and include both public and private entities. By having the key public institutions (the Graduate School and the Ministry of Public Health) working with private entities (medical associations, scientific societies, and health care institutions), there should be an adequate balance of interests. The national professional development system should work in the most decentralized manner possible and should be based on a network of units distributed around the entire country, but with centralized coordination. The system's interinstitutional character should ensure high technical and ethical standards as well as a balance among the governmental, commercial, professional, and university components. This system should serve as the basis for extending this activity to all health personnel in Uruguay. While the national system is still being finalized, the Graduate School has implemented a process of accrediting institutions that are involved in continuing professional medical development. The aim of this accreditation process is to improve the educational offerings for physicians and to generate practical experience that will serve the future system
Subject(s)
Humans , Education, Medical, Continuing/organization & administration , UruguayABSTRACT
El propósito de este trabajo fue identificar y evaluar los factores psicosociales productores de estrés organizacional en trabajadores de la planta de envasado de industria cervecera, y determinar la influencia del ruido industrial en la ocurrencia del estrés laboral. Se aplicó el Cuestionario de Estrés Organizacional de la OIT/OMS en 163 trabajadores para evaluar factores psicosociales en el trabajo, y se exploraron las características socio-demográficas a escala individual. Se determinó el nivel de ruido continuo equivalente (Leq) y las bandas de octava con un sonómetro, según metodología descrita en la Norma COVENIN. El estrés total resultó en una ocurrencia del 33,74 por ciento (55 trabajadores), de éstos, 25,76 por ciento (42 trabajadores) estuvieron en el nivel intermedio, y 7,98 por ciento (13 trabajadores) en el nivel de estrés (p<0,0001). La ocurrencia de estrés ponderado fue del 100 por ciento, representadas por: influencia del líder (14,00 ñ 7,27;87.7 por ciento), estructura organizacional (12,36 ñ 5,14;93,3 por ciento) y clima organizacional (11,83 ñ 5,09; 95,1 por ciento). Las medias de estrés total y ponderado mostraron una tendencia ascendente a medida que aumenta la edad y la antiguedad laboral (p<0,05). El Leq se encuentra en un rango de 87,9-100 dB(A), el cual supera el valos límite umbral. No hubo asociación entre los niveles de ruido y los niveles de estrés. El estrés total es similar a lo descrito en otros estudios. El estrés ponderado es una variable con alta sensibilidad para determinar cuales factores psicosociales producen estrés. Esto puede ser utilizado para implementar medidas de prevención y control del estrés organizacional