Ghost of Medical Gaslighting

Medical gaslighting is when the actual symptoms of patients are dismissed or downplayed by medical professionals. It occurs frequently among patients suffering from chronic illnesses for which medical science gives no authoritative diagnostic protocol or effective treatment and those from populations underrepresented in clinical trials such as the female gender, specific races and ethnicity, third gender and patients with disability. Gaps in scientific knowledge and missing empathy have been cited as possible reasons. Respecting patient symptoms, accepting epistemic humility and investing in research may be possible solutions for this disharmony.

Estilos de vida de estudiantes de la Escuela Universitaria de Enfermería de la Universidad Nacional de Tucumán, Argentina

Fundamento: el estilo de vida saludable se erige como un factor protector contra el desarrollo de diversas enfermedades crónicas, y en el caso del estudiante de enfermería, su adopción incide en la eficacia de su futura práctica profesional como educador en salud, también sobre la calidad de la atención prestada. Objetivo: describir los comportamientos asociados a los estilos de vida de los estudiantes de la Escuela Universitaria de Enfermería de la Universidad Nacional de Tucumán en Argentina. Métodos: se realizó un estudio descriptivo, transversal y cuantitativo. Se encuestaron a 406 estudiantes con el cuestionario Health Promoting Life Profile II bajo el modelo de Nola Pender. El instrumento obtuvo un alfa de Cronbach de 0,93 (alta fiabilidad) en la población estudiada. Resultados: la media de edad fue de 28,63 años. Predominaron las mujeres, solteras y estudiantes de primer año. El crecimiento espiritual y el manejo del estrés fueron las dimensiones con el mayor y menor puntaje, respectivamente. La media del estilo de vida fue de 117,17 (DE: 20,10; IC 95 %: 115,21-119,14) con una caracterización de regular. Conclusión: el 3,94 % de los encuestados obtuvieron un estilo de vida evaluado como saludable, y las variables que incidieron fueron: la edad, el sexo, el estado civil y el año del plan de estudios en el que se encuentran inscritos. Se requiere del diseño e implementación de acciones que favorezcan la adopción de estilos de vida que promuevan un estado saludable en los estudiantes de enfermería para disminuir el riesgo de padecer enfermedades crónicas no transmisibles y contribuyan a formarlos como promotores de salud.

Background: the healthy lifestyle is established as a shielding factor against the development of diverse chronic illnesses, and in the case of the infirmary student, its adoption impacts in the effectiveness of its future professional practice as educator in health, also about the quality of the borrowed attention. Objective: to describe the behaviors associated to the lifestyles of the students of the University School of Infirmary of the National University of Tucumán in Argentina. Methods: a descriptive, traverse and quantitative study was carried out. 406 students were interviewed with the questionnaire Health Promoting Life Profile II under the Nola Pender pattern. The instrument obtained an alpha of Cronbach of 0,93 (high reliability) in the studied population. Results: the typical age was of 28,63 years. The feminine sex, single and students of the first year. Spiritual growth and manage of the stress were the dimensions with the adult and smaller punctuation, respectively. The average of the lifestyle was of 117,17 (OF: 20,10; IC 95 %: 115,21-119,14) with a characterization of regulating. Conclusion: 3,94 % of those interviewed obtained a lifestyle evaluated as healthy, and the variables that impacted were the age, the sex, the civil state and the year of the plan of studies in which they are inscribed. Its required of the design and implementation of actions them to favor the adoption of healthy lifestyles in the infirmary students to diminish the risk of suffering chronic not transmissible illnesses and contributes to his education on health education.

Impact of COVID-19 pandemic on non-communicable chronic lifestyle diseases in population of India: A systematic review

Background: Diabetes, chronic respiratory diseases, heart diseases, and cancers are diseases of public health importance in India. People with pre-existing non communicable diseases (NCDs) are vulnerable to COVID and associated complications. Risk factors for NCDs were found to have increased due to pandemic. Aims and Objectives: The aim of the study was to study the impact of the COVID 19 on chronic NCDs and life style diseases. Materials and Methods: Articles from India published between March 2019 and May 2022 were searched from database such as PubMed, Scopus, Google scholar using MeSH and keywords such as “COVID 19” OR “Coronavirus” OR “SARS-2 CoVirus” AND Lifestyle diseases,” “COVID-19” OR “Coronavirus” OR “SARS-2 CoVirus” AND “Diabetes” OR “HYPERTENSION.” Summary of 18 articles was presented after inclusion and exclusion criterion and removing of duplicates. Results: Risk of COVID 19 in people with pre-existing non-communicable diseases is high, prognosis is poor, and complications are higher. COVID 19 and lockdown measures resulted in restrictions of movements, dietary and sleep pattern changes, psycho social impacts, non-availability or difficulty in procuring medicines, accessibility to health-care facilities, burden on health-care facilities, difficulties in (using or lack of awareness) about tele-consultations facilities, and thus burden of NCDs is expected to rise in future. Conclusions: COVID 19 pandemic had direct and indirect impact on screening, diagnosis and management of patients with NCDs. Burden of NCDs may rise thereby putting extra burden on health-care facilities which warrants preparedness.

Prevención de enfermedades profesionales y superación profesional, valoraciones desde los estudios sobre Ciencia, tecnología y sociedad

El proceso de actualización del modelo económico-social cubano de desarrollo socialista, genera importantes transformaciones asociadas a la actividad de trabajo; aspecto que refuerza la significación médico-social de la prevención de enfermedades profesionales. El presente trabajo tiene el objetivo de valorar la significación de la prevención de enfermedades profesionales para la superación del médico de familia, a partir de los estudios ciencia, tecnología y sociedad. Entre los métodos empleados figuran el histórico-lógico, el analítico-sintético y la sistematización; aplicados esencialmente en la valoración de las direcciones principales y referentes ubicados en el campo de los estudios ciencia, tecnología y sociedad. También se empleó la revisión de documentos para examinar instrumentos programáticos y disposiciones jurídicas. Los resultados incluyen valoraciones sobre los referentes vinculados al tema, la determinación de nexos con el desarrollo socioeconómico del país y el establecimiento de relaciones teórico-conceptuales desde un enfoque interdisciplinario, humanista, activo y transformador.

The process of bring up to date of the pattern socio-economic Cuban of development socialist, generates important transformations associated to the work activity; aspect that reinforces the doctor-social significance of the prevention of professional illnesses. The present work has the objective of valuing the significance of the prevention of professional illnesses for the family doctor's self-improvement, starting from the studies science, technology and society. Among the used methods they figure the historical-logical one, the analytic-synthetic one and the systematizing; applied essentially in the valuation of the main and relating addresses located in the field of the studies science, technology and society. The revision of documents was also used to examine programmatic instruments and juridical dispositions. The results include valuations on the relating ones linked to the topic, the determination of nexuses with the socioeconomic development of the country and the establishment of theoretical-conceptual relationships from an interdisciplinary, humanist focus, I activate and transformer.

Major cardiovascular risk factors and serious mental disorders, a double-edged sword: literature review

Background. The burden of mental disorders continues to grow with significant impacts on health. Their prevalence is higher in patients presenting cardiovascular risk factors.This review takes stock of the frequency, the mechanisms, and the implications of major cardiovascular risk factors in patients with serious mental disorders. Methods. A literature search was done in PubMed from 1980 to 2021 using various combinations of Mesh termslike tobacco, diabetes mellitus, hypertension, dyslipidemia, major depressive disorder, bipolar disorder, schizophrenia. Results. People with serious mental disordershave a greater prevalence of major cardiovascular risk factors compared to the general population. Conversely, people with cardiovascular diseases more frequently suffer from serious mental disorders. More specifically, we note that 45 to 88% of patients suffering from schizophrenia are tobacco users, Depression is reported to be 3 times higher in hypertensives than in non-hypertensives while around 19% of type 2 diabetic patients suffer from major depressive disorderwhich is 3 times greater than in the general population, and the prevalence of dyslipidemia among persons with severe and persistent mental illness is higher than the prevalence in the general population and ranges from 25% to 70%. The concomitant presence of these different pathologies can be explained either by their intertwined pathophysiological mechanisms, or by the side effects of the various medications taken in the context of these chronic diseases. Conclusion. The predisposing factors for the coexistence of mental illnesses and cardiovascular diseases are often entangled. It would be interesting to carry out more studies to elucidate precisely the different pathophysiological mechanisms of these diseases.

Contexte. La prévalence des maladies mentales est plus élevée chez les patients présentant des facteurs de risque cardiovasculaire. Cette revue fait le point sur la fréquence, les mécanismes et les implications des facteurs de risque cardiovasculaire majeurs chez les patients atteints de pathologies psychiatriques graves. Méthodologie. Une recherche documentaire a été effectuée dans PubMed de 1980 à 2021 en utilisant diverses combinaisons de termes MeSH comme tabac, diabète, hypertension, dyslipidémie, trouble dépressif majeur, trouble bipolaire, schizophrénie. Résultats. Les personnes atteintes de maladie mentales graves ont une plus grande prévalence de facteurs de risque cardiovasculaire majeurs comparé à la population générale. A l'inverse, les personnes atteintes de maladies cardiovasculaires souffrent plus fréquemment de troubles mentaux graves. Plus précisément, on note que 45 à 88% des patients souffrant de schizophrénie consomment du tabac. La dépression serait 3 fois plus élevée chez les hypertendus que chez les non hypertendus. Par ailleurs, environ 19% des patients diabétiques de type 2 souffrent d'un trouble dépressif majeur ce qui est 3 fois plus élevée que dans la population générale. La prévalence des dyslipidémies chez les personnes atteintes d'une maladie mentale grave est supérieure à la prévalence dans la population générale et varie de 25 % à 70 %. La présence concomitante de ces différentes pathologies s'explique soit par leurs mécanismes physiopathologiques imbriqués, soit par les effets secondaires des différents médicaments pris dans le cadre de ces maladies chroniques. Conclusion. Les facteurs prédisposant à la coexistence des maladies mentales et des maladies cardiovasculaires sont souvent intriqués. Il serait intéressant de mener plus d'études pour élucider précisément les différents mécanismes physiopathologiques de ces maladies.

Characteristics of Paediatric Death Cases at a Malaysian University Hospital

@#Introduction: Auditing of paediatric deaths has rarely been evaluated in hospitals especially in low and middle-income countries. The aim of the study is to describe the characteristics of paediatric death in hospitalised children and determine the predictors of death location in Hospital Universiti Sains Malaysia (USM). Method: Paediatric mortality cases for children aged between 29 days and 18 years old at the time of death were analyzed. These were documented cases between the year 2013 and 2020 at Hospital USM. Case notes were reviewed, and data were captured retrospectively. Multiple Logistic Regression was used to assess predictors of the location of death especially in the ward setting.Results: Out of 841 paediatric deaths identified during the period of the study, 544 cases were enrolled. The male gender has a higher proportion (1.4:1). The median age was 56 months, with infancy being the predominant age group. The median length of hospital stay was 10.5 days. More than half of the cases (58.3%) had underlying life-limiting illnesses. The majority of the patients had “Do Not Resuscitate” orders. A longer length of stay (prevalence odds ratio (POR 0.99, 95% CI 0.98, 0.99), being on ventilator (POR 3.42,95% CI 1.95, 6.01), being terminally ill (POR 0.40,95% CI 0.23, 0.70) and having underlying life limiting illness (POR 0.50, 95% CI 0.33, 0.75) were the significant predictors for the ward death. Conclusion: Understanding the characteristics of child death and the factors associated with death location is critical for improving paediatric care and treatment.

Evaluación del cumplimiento de las Buenas Prácticas de Manufactura (BPM) en fundaciones sociales de la Región Metropolitana de Chile

RESUMEN Las Enfermedades Transmitidas por Alimentos (ETA) son causadas por el consumo de alimentos o agua contaminada, debido a las malas prácticas en el manejo causando daño a la salud de las personas. El objetivo de este estudio fue determinar el porcentaje de cumplimiento de las Buenas Prácticas de Manufacturas (BPM) basado en el Reglamento Sanitario de los Alimentos de Chile, de diferentes fundaciones sociales pertenecientes de la Región Metropolitana de Chile. El diseño de estudio fue descriptivo, en una muestra intencionada y no probabilística de 12 fundaciones sociales de la Región Metropolitana de Chile. Se aplicó in situ la lista de chequeo de las BPM versión 04, código 834 - PR02- INS2. De acuerdo al porcentaje de cumplimiento de 4 factores críticos de las BPM de las 12 fundaciones sociales de la Región Metropolitana, se observó que sólo 3 de las fundaciones cumplen con el 100% de los 4 factores críticos. En relación al porcentaje de cumplimiento general de las BPM, se examinó que el 50% de ellas cumplió con el 70% o más de acuerdo al requerimiento del Ministerio de Salud de Chile. Existe un bajo cumplimiento de las Buenas Prácticas Manufacturas en las 12 fundaciones evaluadas de la Región Metropolitana de Chile, principalmente en la higiene personal y en capacitación además de solo cumplir con el factor crítico Nº1. Por lo tanto, se debe capacitar a las fundaciones y establecer procedimientos escritos para así disminuir y evitar enfermedades transmitidas por los alimentos y garantizar la inocuidad alimentaria.

ABSTRACT Foodborne Diseases (FBD) are caused by the consumption of contaminated food or water, due to poor practices in food handling, causing damage to people's health. The objective of this study was to determine the percentage of compliance with Good Manufacturing Practices (GMP) according to the Food Sanitary Regulations of Chile, of different social foundations belonging to the Metropolitan Region of Chile. The study design was descriptive, in an intentional and non-probabilistic sample of 12 social foundations in the Metropolitan Region of Chile. The GMP checklist version 04, code 834 - PR02-INS2, was applied in situ. According to the percentage of compliance with the 4 critical factors of the GMP of the 12 social foundations of the Metropolitan Region, it was observed that only 3 of the foundations comply with 100% of the 4 critical factors. In relation to the percentage of general compliance with the GMP, it was examined that 50% of them complied with 70% or more in accordance with the requirements of the Ministry of Health of Chile. There was low compliance with Good Manufacturing Practices in the 12 foundations evaluated in the Metropolitan Region of Chile, mainly in personal hygiene and training, in addition to only complying with critical factor Nº1. Therefore, foundations should be trained and written procedures must be established in order to reduce and prevent foodborne illnesses and guarantee food safety.

Medical services for sports injuries and illnesses in the Beijing 2022 Olympic Winter Games / 世界急诊医学杂志（英文）

BACKGROUND: Beijing 2022 Olympic Winter Games was the second Games held amid the COVID-19 pandemic. To a certain extent, it has altered the way sporting activities operate. There is a lack of knowledge on injury risk and illness occurrence in elite winter sport athletes amid the COVID-19 pandemic. This study aimed to describe the incidence of injuries and illnesses sustained during the XXIV Olympic Winter Games in Beijing from February 4 to 20, 2022. METHODS: We recorded the daily number of injuries and illnesses among athletes reported by Beijing 2022 medical staff in the polyclinic, medical venues, and ambulance. We calculated injury and illness incidence as the number of injuries or illnesses occurring during competition or training, respectively, with incidence presented as injuries/illnesses per 100 athlete-days. RESULTS: In total, 2,897 athletes from 91 nations experienced injury or illness. Beijing 2022 medical staff reported 326 injuries and 80 illnesses, equaling 11.3 injuries and 2.8 illnesses per 100 athletes over the 17-day period. Altogether, 11％ of the athletes incurred at least one injury and nearly 3％ incurred at least one illness. The number of injured athletes was highest in the skating sports (n=104), followed by alpine skiing (n=53), ice track (n=37), freestyle skiing (n=36), and ice hockey (n=35), and was the lowest in the Nordic skiing disciplines (n=20). Of the 326 injuries, 14 (4.3％) led to an estimated absence from training or competition of more than 1 week. A total of 52 injured athletes were transferred to hospitals for further care. The number of athletes with illness (n=80) was the highest for skating (n=33) and Nordic skiing (n=22). A total of 50 illnesses (62.5％) were admitted to the department of dentistry/ophthalmology/otolaryngology, and the most common cause of illness was other causes, including preexisting illness and medicine (n=52, 65％). CONCLUSION: Overall, 11％ of athletes incurred at least one injury during the Games, which is similar to the findings during the Olympic Winter Games in 2014 and 2018. Regarding illness, 2％ of athletes were affected, which is approximately one-third of the number affected in the 2018 Olympic Winter Games.

Clasificación de pacientes especiales según sus requerimientos en la atención estomatológica / Classification of specials patients according their dentist attention requirements

Introducción: El paciente de riesgo quirúrgico es aquel susceptible a un posible daño que amenaza al individuo que será sometido a una intervención quirúrgica. Este tipo de paciente es llamado"paciente especial", o que presenta deficiencias y existen además otros conceptos donde pudiera estar implícito. Este paciente no es claramente identificado y esto hace más complicado unificar criterios que permitan llevar a cabo un el tratamiento estomatológico sin causar daños colaterales. Objetivo: Elaborar una clasificación de pacientes especiales según sus requerimientos en la atención estomatológica. Métodos: Investigación cualitativa. Se realizó revisión bibliográfica y se tomaron en consideración investigaciones previas de la autora principal para la confección de la propuesta de clasificación. Para evaluar la misma se utilizó el método Delphi, lo cual permitió llegar a opiniones de consenso de los expertos, quienes valoraron la propuesta como: inadecuada, poco adecuada, adecuada, bastante adecuada y muy adecuada. Resultados: Se expone la clasificación de pacientes especiales según requerimientos durante la atención estomatológica. Incluyó a cinco grupos. El grupo I, nombrado de riesgo quirúrgico, se subdividió en cinco subgrupos. Los expertos consideraron la clasificación propuesta como Bastante Adecuada(2) y Muy Adecuada (12). Conclusiones: La clasificación propuesta facilita al estomatólogo una atención diferenciada al paciente especial, donde se hace adecuaciones en el paciente de riesgo quirúrgico teniendo en cuenta las características más importantes de las enfermedades de base. La clasificación propuesta fue catalogada como aceptada(AU)

Introduction: Numerous definitions exist where the patient of surgical risk can be incorporate keeping in mind her definition that is possible damage that she threatens the individual that will be subjected to a surgical intervention, such as patient special, with deficiencies among other but it has not been find a classification of patient of risk surgery. It cannot allow indentify those and it is difficult the dentist treatment without systemic complication. Objective: To elaborate a classification proposal of specials patients according dentist attention requirements. Methods: it was qualitative research. It was carried out exhaustive bibliographical revision and it took in consideration previous investigations carried out by the main author, with this consideration the classification proposal was made. To evaluate the proposal it used the method Delphi, which allowed arriving to opinions of the experts' consent. It took into consideration different variables: Inadequate, Not Appropriate, Appropriate, Quite Appropriate and Very Appropriate. Results: The classification is exposed of patient special according dentist attention requirements, it included to five groups and the group I was subdivided, called surgical risk, in five subgroups. 100 percent experts considered the classification like Quite Appropriate and Very Appropriate 2 in the first categories and 12 in the second one. Conclusions: The proposed classification facilitates to the dentist an attention to the differentiated special patient with emphasis in surgical risk patients keeping in mind the most important characteristics in the base illnesses. The proposed classification was classified as having accepted(AU)

Importancia del buen dormir en nuestros pacientes / Importance of good sleep in our patients

El sueño es una necesidad biológica. Regula las funciones inmunitarias. Las funciones inmunológicas dependen de los ritmos circadianos y del sueño regular. Según estudios previos a la pandemia, la corta duración del sueño o privación de sueño, en la semana cercana a la vacunación, se asocia con respuestas más bajas de anticuerpos. La privación de sueño da como resultado una función inmunológica más deficiente (es decir, actividad reducida de las células natural killer, producción de IL-2 suprimida) así como un aumento de los niveles circulantes de marcadores inflamatorios (IL-6, TNF-α [factor de necrosis tumoral] y proteína C reactiva). Los médicos deben ser conscientes de que muchas enfermedades que mencionamos en esta resumida actualización son comórbidas con alteraciones del sueño, y es importante, por ello, enseñar a los pacientes a mejorar su comportamiento con respecto al sueño y fomentar la educación sobre higiene del sueño. Destacamos que, en el interrogatorio de cualquier especialidad médica, deben incorporarse preguntas sobre el "dormir", dado que el sueño de buena calidad es fundamental en la prevención y el tratamiento de diversas enfermedades. (AU)

Sleep is a biological necessity. Regulates immune functions. Immune functions depend on circadian rhythms and regular sleep. According to studies prior to the pandemic, short duration of sleep or sleep deprivation, in the week leading up to vaccination, is associated with lower antibody responses to vaccination. Sleep deprivation results in poorer immune function (i.e., reduced natural killer cell activity, suppressed IL-2 production) as well as increased circulating levels of inflammatory markers (IL-6, factor of tumor necrosis, C-reactive protein). Clinicians should be aware that many illnesses, which we mention in this brief update, are comorbid with sleep disturbances and it is therefore important to teach patients to improve their sleep behavior and should encourage sleep hygiene education . We emphasize that in the questioning of any medical specialty, questions about "sleep" should be incorporated, given that good quality sleep is essential in the prevention and treatment of various diseases. (AU)

Research progress in mechanism and protection of high temperature environment influencing the body function / 中华创伤杂志

The thermal environment increases the risk of thermal injury for persons under high temperature environment. A full understanding of the effects and hazards of the thermal environment on the human body is of great significance to improve the awareness of persons under high temperature environment and reduce occupational heat damage during work. The authors mainly review the thermal environment from aspects of the definition, mechanism of its influence on main functional systems of the human body, influencing factors of heat stress and progress of protection, so as to provide references for the identification and protection of heat-induced diseases for workers under high temperature environment.

Producción de aceite de palma en Colombia: ¿trabajo decente y saludable? / Palm Oil Production in Colombia: Decent and Healthy Work? / Produção de óleo de palma na Colombia: trabalho decente e saudável?

Resumen Introducción: este artículo analiza la relación entre el proceso productivo del aceite de palma en Colombia y sus efectos en la salud de los trabajadores del sector. Método: entre marzo y septiembre de 2017, se llevaron a cabo un taller piloto con directivos sindicales y ocho grupos focales en los que participaron 165 trabajadores de diversas áreas y empresas del sector y un taller de revisión y retroalimentación con la participación de diez dirigentes sindicales. Igualmente, se efectuaron visitas a algunas empresas para observar los procesos productivos, tanto en las plantaciones como en las plantas extractoras. La Encuesta de Morbilidad Sentida, sobre la información suministrada por los trabajadores (percepciones e interpretaciones acerca de su estado de salud en vínculo con su trabajo), fue la base para identificar los factores de riesgo del sector, el desgaste, la fatiga y las condiciones de salud-enfermedad asociadas a los oficios del cultivo de la palma en campo y al proceso industrial en la planta de extracción del aceite. Conclusión: la morbilidad sentida sugiere que las cargas laborales, los patrones de desgaste asociados a la producción, la exposición a altas temperaturas y agrotóxicos, además de la intensificación productiva derivada de la forma de organización del trabajo afectan significativamente la salud de los trabajadores de la agroindustria de palma. Basados en estos resultados, sugerimos que los trabajadores del sector deberían ser cobijados por un régimen especial de pensión conjugado con políticas de prevención en salud y seguridad en el trabajo y cobertura de protección social.

Abstract Introduction: This article presents the examination of the relation between the production process of palm oil in Colombia and its impact on the health of workers. Method: Between March and September of 2017, one pilot workshop with union leaders was performed along with eight focus groups in which 165 workers from diverse work areas and palm oil firms participated and one workshop dedicated to the revision and feedback from ten union leaders. Additionally, visits were conducted to some palm oil firms as a means of observing the production process (in plantations and processing mills). Conclusion: The workers' reports of their health and working conditions or their 'felt morbidity' was the basis for identifying the risk factors in this sector, the experiences of health and illness, the patterns of wear-and-tear associated with the production, the exposure to high temperatures and pesticides, and the intensification of production due to the way in which the work process is organized, all of which significantly affect the health of palm oil workers.

Resumo Introdução: este artigo analisa a relação entre a forma em que se realiza o processo produtivo do óleo de palma na Colombia e seus impactos sobre a saúde dos trabalhadores do setor. Método: realizaram-se, entre marco e setembro de 2017, um workshop piloto com diretivos sindicais e 8 grupos focais nos que participaram 165 trabalhadores de diversas áreas de trabalho e empresas do setor e um workshop de revisão e retroalimentação com a participação de 10 dirigentes sindicais. Igualmente, efetuaram-se visitas a algumas empresas para observar os processos produtivos, tanto nas plantações quanto nas plantas extratoras. O inquérito de "morbilidade sentida", que se refere á informação subministrada pelos trabalhadores, desde suas percepções e interpretações, acerca de seu estado de saúde em vínculo com seu trabalho, foi a base para identificar os fatores de risco do setor, o desgaste, a fatiga e as condições de saúde-doença associadas aos ofícios de cultivo da palma em campo e ao processo industrial na planta de extração do óleo. Conclusão: a morbilidade sentida sugere que as cargas laborais, os padrões de desgaste associados á produção, a exposição a altas temperaturas e agrotóxicos, além da intensificação produtiva derivada da forma de organização do trabalho afetam significativamente a saúde dos trabalhadores da agroindústria de palma.

El proceso de atención al Adulto Mayor en Cienfuegos: ¿salud o bienestar? / The process of care to the elderly in Cienfuegos: Health or well-being?

RESUMEN Este artículo surge de la necesidad de facilitarles a los profesionales de la Cultura Física de un programa con los elementos necesarios para la atención de los adultos mayores. El objetivo de la investigación es proponer un Programa de Ejercicios Físicos para el tratamiento de la hipertensión arterial en el Adulto Mayor. Esta situación hace necesario el desarrollo de la atención integral de los ancianos que se realiza esencialmente a través de los Círculos de Abuelos constituidos a lo largo de todo el país, atendidos por profesionales del Ministerio de Salud Pública y el Instituto de Cultura Física, Deportes y Recreación.

ABSTRACT This article arises of the necessity of facilitating to the professionals of the Physical Culture of a program with the necessary elements for the attention of the biggest adults. The objective of the investigation is to propose a Program of Physical Exercises for the treatment of the arterial hypertension in the biggest Adult. This situation makes necessary the development of the integral attention of the old men that is carried out essentially through the Circles of Grandparents constituted along the whole country, assisted by professionals of the Ministry of Public Health and the Institute of Physical Culture, Sports and Recreation.

Calidad de vida relacionada con la salud: exclusión de la subjetividad / Health-related quality of life: Exclusion of subjectivity

Resumo La Calidad de Vida es un concepto utilizado cada vez con más frecuencia para evaluar la afectación de las enfermedades crónicas y la efectividad de los tratamientos médicos. Su abordaje en el campo de la salud suele realizarse a través de cuestionarios autodiligenciados, dada la alta instrumentalización actual del ejercicio clínico. Esos instrumentos tienen utilidad para los profesionales de la salud, al permitirles analizar el efecto de sus intervenciones. Igualmente, son relevantes para la salud pública, en tanto informan acerca de las condiciones de quienes presentan enfermedades cuya prevalencia va en aumento. Sin embargo, en este artículo se plantea que el abordaje de la calidad de vida es limitado cuando se realiza con instrumentos estructurados. En particular se reflexiona acerca de cómo estos excluyen la subjetividad, pese a que son autodiligenciados por los pacientes. También se analizan las limitaciones concernientes a la cuantificación y a la transversalidad que se presenta al evaluar la calidad de vida con estas escalas. Como alternativa para superar estas falencias, se propone el abordaje narrativo, el cual permite dar cuenta de los cambios que se experimentan en la subjetividad con el transcurrir de la enfermedad.

Abstract Quality of life is a concept increasingly being used to assess the impact of chronic illnesses and the effectiveness of medical treatment options. The approach in the field of health is usually conducted using self-administered surveys, given the current high cost of instrumentalization of clinical practice. These instruments are useful for health professionals enabling them to analyze the effect of their interventions. Likewise, they are also relevant to public health, as they report on conditions of those with illnesses whose prevalence is increasing. Nevertheless, in this article, it is proposed that the quality of life approach is limited when it is carried out with structured instruments. It particularly reflects on how these instruments lack subjectivity, despite the fact that they are self-administered by patients. The limitations relating to quantification and transversality that arise when evaluating quality of life with these parameters are also analyzed. As an alternative to overcome these shortcomings, the narrative approach is proposed, as it makes it possible to report on changes experienced in subjectivity with the ongoing progress of the illness.

Pre-existing chronic medical illnesses and follow up status among active pulmonary tuberculosis cases in a district population

@#Introduction: The knowledge of pre-existing medical illnesses and their follow up status among active pulmonary tuberculosis (PTB) subjects can help in tuberculosis (TB) control programme. The aims of our study were to examine: the prevalence of pre-existing chronic medical illnesses, the follow up status of known pre-existing co-morbid and to distinguish between diagnosed and undiagnosed preexisting tuberculosis related chronic medical illnesses among our active PTB subjects. Methods: We conducted a retrospective review of demographic and clinical data of active PTB subjects that were diagnosed between January 2015 and June 2017 in the district of Manjung, Perak, Malaysia. Among the 302 TB clinical notes reviewed, 253 patients were included. Subjects below the age of 18 years and whose follow up centres for their medical illnesses that were located outside of Manjung were excluded. Demographic and clinical data were collected using pre-tested data collection form by trained investigators. The data was analysed using SPSS Version 20.0. Results: We identified diabetes mellitus as the most prevalent pre-existing co-morbid (77 cases) and almost 90% (68 cases) of these diabetic subjects were diagnosed prior to active PTB diagnosis. This was followed by Human Immunodeficiency Virus and Hepatitis C infection which accounted for 12.0% (30 cases) of the study populations. Among 132 subjects who had pre-existing chronic medical illnesses, only 74 subjects (29%) were under regular follow up at healthcare facilities in Manjung prior to PTB diagnosis. Conclusion: Overall, our research provides evidence on the existence of wide variation of clinical background among active PTB subjects.

Intersectorialidad en el manejo de las afecciones reumáticas / Intersectoriality in the managment of rheumatic disceaces

La centralización de la atención sanitaria y social en el paciente es una cuestión de primer orden en la percepción de la calidad, la salud, la calidad asistencial y la satisfacción del abordaje de las enfermedades reumáticas. En la actualidad, para alcanzar metas superiores en salud pública y mejorar la calidad de su práctica, se trabaja en el perfeccionamiento de la intersectorialidad como tecnología imprescindible para preservar y generar la salud en la población. En esta comunicación se relacionan ejemplos donde se evidencia la intersectorialidad, en función de facilitar la promoción y el logro de los objetivos comunes en varias áreas. Dada las particularidades de las patologías reumáticas, los profesionales de la salud enfrentan verdaderos retos en su manejo; de esta manera se mantienen en constante relación cada vez más intersectorial y profundamente con los otros actores, como los productores de tecnologías, los laboratorios y la industria farmacéutica(AU)

The centralization of the sanitary and social attention in the patient is a question of first order in the perception of the quality, the health, the assistance quality and the satisfaction of the boarding of the rheumatic diseases. Actually, to reach superior goals in public health and to improve the quality of their practice, one works in the improvement of the intersectoriality like indispensable technology to promote the health in the population. In this communication there were related examples where the intersectoriality is evidenced, in function of facilitating the promotion and the achievement of the common objectives in several areas. Based in the particularities of the rheumatic pathology, the health care professionals face true challenges in their handling; this way they stay in constant more and more intersector relationship and deeply with the other actors, as those producing of technologies, the laboratories and the pharmaceutical industry(AU)

Study of health care seeking behaviour for illnesses among malnourished children of age 06-59 months in rural and urban areas of Jabalpur district, Madhya Pradesh

Background: Even though appropriate medical care seeking could prevent a significant number of child deaths, significant numbers of children die without ever reaching a health facility or due to delays in seeking care.1 This study aimed to compare health seeking behaviour among malnourished children in rural and urban areas.Methods: Cross sectional study carried out in rural and urban areas of Jabalpur district among 1237 children of age group 06-59 months in randomly selected in eight wards and two blocks of Jabalpur District. Where 720 children were from urban wards and 517 from rural villages. Multistage random sampling technique was used for the selection of study subjects. Predesigned questionnaire used to collect data.Results: Out of 720 children of urban area, percentage of acute malnutrition (low weight-for-height) was 136 (18.8%) while in rural area, out of 517 children percentage of acute malnutrition (low weight-for-height) was 102 (19.7%). Out of 136 malnourished children in urban, 32 (23.5%) were having illness while in rural out of 102, 43 (42.1%) were having illness. In rural areas, the mother or primary care giver of the study subjects preferred nearby government hospital (21.9%) the most during illness. While in urban, registered private practitioner (47%) were mostly preferred for consulting during sickness. Still 16.3% of the caregiver in rural area preferred quacks.Conclusions: This shows that the approach of health seeking behaviour is better in urban areas as compared to rural as people still prefer quacks in rural areas.

Seasonal variations among admitted paediatric patients at tertiary care hospital, Gadap Town, Karachi, Pakistan

Background: In pediatrics, the season is one of the elements contributing to the etiological factors of community based diseases. Awareness of this variation can help the physicians for prevention and counseling of the patients. A cross-sectional observational study was designed with non-probability convenient sampling technique to determine the frequency of patients admitted to the paediatric ward of the hospital in a whole calendar year and to ascertain which disease presentation is most common. Methods: Study conducted at paediatric ward of Al-Tibri Medical College and Hospital Karachi, Pakistan having patients admitted during May 2018 to April 2019. After ethical approval and informed consent from their parents/ guardian, a total of 734 paediatric patients that were admitted from paediatric OPD/ emergency were selected for the study. Paediatric patients that were referred, in emergency/ ICU and surgical paediatric patients were excluded from the study. Chi-square test was applied to evaluate the statistical variation among the patients.Results: From the 734 patients, 357 (48.6%) patients were of acute gastroenteritis, 104 (14.2%) of respiratory illness, 86 (11.7%) of viral fever, 67 (9.1%) of urinary tract infection, 36 (4.9%) of neurological illness, 29 (4.0%) of protein calorie malnutrition, 25 (3.4%) of enteric fever, 20 (2.7%) of haematological illness and 10 (1.4%) patients were admitted due to sepsis.Conclusion: Our study concluded that majority of the patients admitted were of acute gastroenteritis / admitted due to gastric issues, therefore further studies in the vicinity would help to better understand the issues and help plan a strategy to combat the diseases.

Petroleum Pollution and Decrease Neuroplasticity in Brain Development of the Ogoni Children in Rivers State, Nigeria

Background:Health and mental related illnesses has emerged as a new challenge in the rural and undeveloped areas in Ogonilandwhere petroleum exploration activities have devastated the entire ecosystem. Many of the school children are no longer zealous about their academic activities, as their performances in school are always very poor. It has been reported that the children’s poor performance in school is closely linked withseveral health and mental challenges suffered by these children in the highly polluted areas. Methods:The study comprises of 383 primary school teachers selected from 8 rural communities in the four (4) Ogoni Local Government Areas (Gokana, Tai, Eleme and Khana) in Rivers Statewhere massive environmental pollution has been reported. Structured questionnaires were used to collect the data from the teachers on the children’s exposure to oil pollution; self-rated mental illnesses and behavioural symptoms among the school children, perception to petroleum pollution and mental illnesses. Results:The results revealed that the signs of mental illnesses like anxiety disorder, attention-deficit disorder, autism spectrum disorder, mood disorder, schizophrenia and eating disorder were noticeable among the school children. The children also exhibited behavioural challenges such as extreme fear, difficulty in concentrating, self-imposed injuries, aggressive behaviour,avoiding other classmates and poor academic performances. The field survey further revealed that mental illnesses and behavioural challenges were common in areas of massive petroleum pollution of the environment. Other causes of these illnesses were revealed to be poverty and psychoactive substance use. Conclusion:It was concluded that constant exposures of the children to environmental pollution is associated with decreasing neuroplasticity of the brain.

Caracterización de las enfermedades valvulares congénitas en la edad pediátrica / Characterization the pediatric patients with diagnostic of illnesses congenital valvulares

Introducción: Las valvulopatías congénitas son un grupo de entidades en las cuales la principal alteración anatomofuncional está en las válvulas cardiacas. Objetivo: Caracterizar los pacientes pediátricos nacidos vivos con diagnósticos de valvulopatías congénitas. Métodos: Se realizó una investigación descriptiva retrospectiva a partir de los registros de valvulopatías congénitas del Servicio de Cardiología del Hospital Pediátrico Universitario José Luis Miranda en Santa Clara, Cuba, en el periodo de 2005 a 2016. La población estuvo conformada por los 147 niños nacidos vivos con diagnóstico de valvulopatías congénitas. Se empleó un muestreo no probabilístico intencional por criterios y la muestra quedó conformada por 143. La recogida de la información se realizó a través de la revisión documental de las historias clínicas. Resultados: La tasa de incidencia de la valvulopatías congénitas fue de 1,5 x 1 000 nacidos vivos, predominó la estenosis pulmonar que agrupó el 70,6 por ciento de los diagnosticados. Se encontró predominio del sexo masculino con 50,3 por ciento, se determinó que 45,5 por ciento de los casos se diagnosticaron antes de los 29 días de nacido, período que incluye un diagnóstico prenatal. Conclusiones: El desarrollo del diagnóstico prenatal de las cardiopatías congénitas ha posibilitado la disminución de la incidencia de las malformaciones más complejas. El conocimiento de las enfermedades congénitas del corazón contribuye a operar de forma segura y con resolución anatómica completa a muchos de estos niños en el período prenatal o cuando son lactantes pequeños, para evitar el deterioro global de estos cuando la cardiopatía no está resuelta(AU)

Introduction: The congenital valvulopatías is a group of entities in which the main alteration anatomofuncional is in the heart valves. Objective: To characterize the pediatric patients with diagnostic of born congenital valvulopatías. Methods: He/she was carried out a retrospective descriptive investigation starting from the registrations of congenital valvulopatías of the service of Cardiology of the Hospital Pediatric University student José Luis Miranda in the period of 2005 at the 2016. The population was conformed by the 147 alive born children with diagnostic of congenital valvulopatías, a sampling was not used intentional probabilístico by approaches, being conformed the sample by 143. The collection of the information was carried out through the documental revision of the clinical histories. Results: The rate of incidence of the congenital valvulopatías was of 1,5 x 1000 born alive, the lung estenosis prevailed containing to 70,6 percent of those diagnosed he/she was prevalence of the masculine sex in 50,3 percent, it was determined that 45,5 percent of the cases was diagnosed before the 29 days where a prenatal diagnosis is included. Conclusions: The development of the prenatal diagnosis of the congenital cardiopatías has facilitated the decrease of the incidence of the most complex malformations. The knowledge of the congenital illnesses of the heart contributes to operate in a sure way and with complete anatomical resolution to many of these children in the prenatal period or when they are small nurslings, to avoid the global deterioration of these when the cardiopatía is not resolved(AU)