National Action Plan for the Prevention and Control of Noncommunicable Diseases 2015-2020

NCDs are the main cause of mortality and morbidity in Suriname, as is the case in most of the countries in the world. At the UN High Level Meeting in September 2011, Suriname endorsed the UN resolution on NCDs, immediately after which the government assigned a special budget to the MOH to support prevention and control activities in the area of NCDs. This illustrates that the government takes up its own responsibility in the fight against the epidemic of NCDs. One of the first priorities has been the development of this National Action Plan for the Prevention and Control of NCDs which provides a framework for a coordinated and integrated approach during the coming years in the fight against NCDs in our country. The elements of the NCD plan focus on public awareness of the NCD burden, healthy lifestyle promotion, health systems strengthening, strengthening of the legal framework, strengthening of surveillance and operational research and the strengthening of monitoring and evaluation systems. For the coming years the priority NCDs namely cancer, diabetes, and cardiovascular disease which account for 60% of mortality nationwide will be targeted. Another priority health area which also will be included is mental health and substance abuse. The fight against NCDs cannot be successful without a strong intersectoral collaboration which is crucial for healthy lifestyle promotion and risk factor reduction. This plan calls for a collective effort through the establishment of structured intersectoral cooperation with other ministries, private sector and civil society. Periodic evaluations are an essential part of the fight of all diseases and specifically of NCDs which require more complex interventions than the communicable diseases. This NCD plan is a dynamic document which will be periodically revised in order to enable us to keep on track towards the goals set. As health sector and as a nation we have to join hands, be accountable and share responsibility to be able to really tackle the burden of NCDs. We owe it to the next generation.

Estilos de vida en pobladores del municipio de Santiago de Cuba / Lifestyles in residents from Santiago de Cuba municipality: en

Introducción: Las enfermedades no transmisibles representan uno de los mayores desafíos en el desarrollo de las naciones en el siglo XXI. Objetivo: Caracterizar a una población del municipio de Santiago de Cuba según estilos de vida. Métodos: Se realizó un estudio observacional, descriptivo y transversal, durante el año 2020, de 1265 individuos residentes en el municipio de Santiago de Cuba, seleccionados a partir de un diseño muestral aleatorizado, proporcional y estratificado, en quienes se aplicó una encuesta que incluía aspectos sociodemográficos y de estilos de vida. La información obtenida fue procesada empleando medidas de resumen para variables cualitativas y cuantitativas. Resultados: En la serie se determinó que 24,3 % de la población santiaguera consumía tabaco, con primacía en los hombres (57,7 %), y que 38,8 % estaban expuestos en el hogar al humo de tabaco ajeno. Asimismo, la ingestión de alcohol figuró en 46,8 %, la actividad física que mayormente se efectuaba era caminar para desplazarse en 43,2 %, y el sobrepeso y la obesidad prevalecieron en 59,3 %. Conclusiones: En el municipio de Santiago de Cuba se identificó el consumo de tabaco, los hábitos dietéticos inadecuados, la baja actividad física, el sobrepeso y la obesidad como estilos de vida no saludables que incrementan el riesgo de padecer enfermedades no transmisibles.

Introduction: Noncommunicable diseases represent one of the greatest challenges in the development of nations in the 21st century. Objective: To characterize a population from Santiago de Cuba municipality according to lifestyles. Methods: An observational, descriptive and cross-sectional study was carried out during the year 2020, of 1265 residents in Santiago de Cuba municipality selected from a randomized, proportional and stratified sample design, whom a survey that included sociodemographic and lifestyle aspects was applied. The information obtained was processed by using summary measures for qualitative and quantitative variables. Results: In the series, it was determined that 24.3% of Santiago population used tobacco, predominantly in men (57.7%), and that 38.8% were exposed to other people's tobacco smoke at home. Likewise, alcohol use appeared in 46.8%, walking to get around was the physical activity mostly carried out in 43.2%, and overweight and obesity prevailed in 59.3%. Conclusions: In Santiago de Cuba municipality, tobacco consumption, inadequate dietary habits, low physical activity, overweight and obesity were identified as unhealthy lifestyles that increase the risk of suffering from noncommunicable diseases.

Lectura, interpretación y uso del etiquetado nutricional en la decisión de compra de adultos de un barrio de Asunción / Reading, interpretation and use of nutritional labeling in adultsin a neighborhood of Asunción

Introducción.El etiquetado nutricional informa al consumidor acerca del tipo y contenido de nutrientes,favoreciendola selección apropiada según sus necesidades o condiciones de salud. Objetivo.Evaluar la lectura, interpretación y uso del etiquetado nutricional de alimentos en la decisión de compra de adultos del Barrio Villa Morra de Asunción consultados en junio de 2018. Materiales y métodos.Estudio descriptivo transversal, con aplicación de cuestionario estructurado mediante entrevista, con preguntas sobre datos sociodemográficos, frecuencia de lectura, motivos de la lectura o no, uso del etiquetado nutricional, contenidos revisados por el consumidor, interpretación de los términos porción y Porcentaje de Valor Diario (%VD) y acuerdo con la implementación del etiquetado frontal. Resultados.De 100 entrevistados, 73% refirió lectura (siempre y a veces) del etiquetado nutricional, 48% de estos lo emplea para la selección y compra de alimentos y 75 % desconoce o no interpreta los términos de porción y %VD. Los motivos asociados a la lectura fueron "preocupación por la salud de su familia" (36%), "estar a dieta" (33%), y "curiosidad" (23%); la no lectura fue "por falta de tiempo" (61,7%) y "porque no se visibiliza bien, es muy pequeño" (28%); al 91% le parece necesaria laimplementación del etiquetado frontal de alimentos como método de alerta. Conclusión.La lectura del etiquetado nutricional es frecuente, no así su correcta interpretación yuso,por lo que urge establecer campañas educativas dirigidas a la población yestrategias como el etiquetado frontal que faciliten y agilicen la lectura e interpretación. Palabras clave: enfermedades no transmisibles; alimentos; alimentos industriales; etiquetado nutricional.

Introduction.Nutritional labeling informs the consumer about the type and content of nutrients, favoring the appropriate selection according to their needs or health conditions. Objective.Evaluate the reading, interpretation and use of nutritional food labeling in the purchase decision of adults from the Villa Morra neighborhood of Asunción consulted in June 2018. Materials and methods.Cross-sectional descriptive study, with the application of a structured questionnaire through an interview, with questions about sociodemographic data, reading frequency, reasons for reading or not, use of nutritional labeling, content reviewed by the consumer, interpretation of the terms contribution and Percentage of Daily Value (%DV) and agreement with the implementation of front labeling. Results.Of 100 interviewees, 73% reported reading (always and sometimes) the nutritional labeling, 48% of theseuse it for the selection and purchase of food and 75% ofthe general population you do not know or do not interpret the terms of portion and %DV. The reasons associated with reading were "concern about the health of their family" (36%), "being on a diet" (33%), and "curiosity" (23%); not reading was referred tofor reasons such as "due to lack of time" (61.7%) and "because it is not well visible, it is very small" (28%); 91% think implementation ofthe front labeling of foodas an alert methodis necessary. Conclusion.The reading of nutritional labeling is frequent, but its correct interpretation and use is not, which is why it is urgent to establish educational campaigns aimed at the population and implement front labelingto facilitate and speed up reading and interpretation.Key words:non-communicable diseases; food; industrialized food; nutritional labeling.

Estresse como fator de risco para cronicidade: abordagem quantitativa / Stress as a risk factor for chronicity: quantitative approach

OBJETIVO: Investigar a influência do estresse enquanto fator de risco no adoecimento por doenças crônicas, mediante avaliação do nível de estresse percebido, e caracterizar a população portadora dessas condições. MÉTODO: Estudo exploratório, transversal, com abordagem quantitativa, realizado a partir da Escala de Estresse Percebido (Perceived Stress Scale -14), utilizando a técnica "bola de neve" de forma online. RESULTADOS: Participaram do estudo 147 pessoas predominantemente do sexo feminino (73,46%), com diagnóstico de bronquite, entre 18 e 29 anos (32,65%), casadas (42,8%), católicas (59,18%), graduadas (43,54%), empregadas (39,45%), com renda familiar superior a cinco salários mínimos (36,05%), três dependentes dessa renda (24,50%) e com média percepção de estresse (82,31%). O perfil que conferiu aumento do estresse foi: sexo feminino, 18 a 29 anos, solteiros, religião umbanda, diagnóstico de câncer, graduados, serviço de casa como ocupação, renda familiar inferior a um salário mínimo e cinco ou mais dependentes da renda. CONCLUSÃO: O estresse percebido em pessoas com condições crônicas de saúde é multifatorial e relaciona-se a variáveis socioeconômicas.

OBJECTIVE: To investigate the influence of stress as a risk factor in illness by chronic diseases by evaluating the perceived stress level and characterizing the population carrier of these conditions. METHOD: An exploratory, cross-sectional study with a quantitative approach, carried out from the Perceived Stress Scale - 14 Stress Scale - 14), using the technique "snowball" online. RESULTS: The study included 147 predominantly female (73.46%), with diagnosis of bronchitis, between 18 and 29 years (32.65%), married (42.8%), catholic (59.18%), graduated (43.54%), employed (39.45%), with family income greater than five minimum wages (36.05%), three dependents on this income (24.50%) and with average perception of stress (82.31%).The profile that gave rise to stress was: female, 18 to 29 years, single, umbanda religion, cancer diagnosis, graduates, home service as occupation, family incomeless than a minimum wage, and five or more dependents of income. CONCLUSION: The perceived stress in people with chronic health conditions is multifactorial and is related to socioeconomic variables.

Disposição de enfermeiros para o uso do telemonitoramento em usuários com condições crônicas: estudo transversal / Nurses' willingness to resort to telemonitoring in users with chronic conditions: a cross-sectional study

OBJETIVO: Verificar a disposição de enfermeiros da Atenção Primária em utilizar o telemonitoramento no acompanhamento de usuários com hipertensão arterial e/ou diabetes mellitus. MÉTODO: Estudo transversal realizado com enfermeiros atuantes nos municípios da 15ª Regional de Saúde do Paraná. Dos 289 convidados, 65 responderam ao questionário online disponibilizado em maio e junho de 2021 no Google Forms. Foram incluídos os enfermeiros que atuavam nas unidades de saúde da 15ª Regional de Saúde e que responderam ao questionário enviado. Não foi adotado nenhum critério de exclusão, mesmo quando o enfermeiro deixava alguma questão em branco. Na análise, foram utilizados os testes Qui-quadrado, Exato de Fisher e Razão de Prevalência. RESULTADOS: Entre as variáveis analisadas, observou-se associação entre ter menos idade e menor tempo de formado e a percepção de que o telemonitoramento sem atendimento presencial é insuficiente para acompanhar os usuários, e das variáveis "telemonitoramento favorece a comunicação com o paciente" e "é possível" com "otimiza o trabalho da equipe". E também maior disposição para uso foi observada entre os que receberam capacitação. CONCLUSÃO: Ausência de capacitações e insuficiência de equipamentos e recursos humanos são fatores que afetam e podem inviabilizar o uso do telemonitoramento.

OBJECTIVE: To verify Primary Care nurses' willingness to resort to Telemonitoring in the follow-up of users with arterial hypertension and/or diabetes mellitus. METHOD: A cross-sectional study conducted with nurses working in the municipalities from the 15th Health Region of Paraná. Of all the 289 individuals invited, 65 answered the online questionnaire made available in May and June 2021 via Google Forms. The nurses included were those working in the health units from the 15th Health Region and who answered the questionnaire sent. No exclusion criteria were adopted, even when a nurse left some questions unanswered. Chi-square, Fisher's Exact and Prevalence Ratio tests were used in the analysis. RESULTS: An association was observed between less time since graduation and the perception that Telemonitoring without in-person assistance is insufficient to follow up the users; in addition, it was noticed that the Telemonitoring variables favor communication with the patients and can streamline the work performed by the team. More willingness to use Telemonitoring was perceived among those who underwent training. CONCLUSION: The absence of training sessions and the insufficiency of devices and human resources affect and may preclude Telemonitoring.

Multimorbidade em idosos: prevalência, padrões de ocorrência e utilização de serviços de saúde na cidade de São Paulo, Brasil / Multimorbidity in the elderly: prevalence, patterns of occurrence, and use of health services in São Paulo, Brazil

O objetivo deste estudo foi analisar a multimorbidade em idosos em função de sua prevalência, padrões de ocorrência e utilização de serviços de saúde. Foi realizada uma pesquisa transversal, aninhada ao ISA-Capital, na cidade de São Paulo, com 1019 idosos com 60 anos ou mais. Os dados foram analisados com auxílio do Software Stata e os resultados apresentados em três artigos científicos. A prevalência de multimorbidade foi de 40% (IC95% 36,6 - 43,8), sendo maior nas mulheres (aRP= 1,95 [comparado com homens]; IC95% 1,58 - 2,40), nos indivíduos com 75 anos ou mais (aRP=1,25 [comparado com indivíduos de 60 a 64 anos]; IC95% 1,01 - 1,60), nos pretos (aRP= 1,28 [comparado com brancos]; IC95% 1,04 -1,59), nas pessoas de alta renda (aRP=1,27 [comparado com baixa renda]; IC95% 1,09 - 1,50) e nos exfumantes (aRP=1,30 [comparado com quem nunca fumou]; IC95% 1,05 - 1,60), e menor nos que se declararam fumantes (aRP=0,72 [comparado com quem nunca fumou]; IC95% 1,09 - 1,50). Os padrões mais comuns de ocorrência da multimorbidade foram as díades hipertensão arterial sistêmica /diabetes mellitus tipo 2 (18,3%; IC95% 15,9 - 20,7; p<0,001), hipertensão arterial sistêmica/ artrite e reumatismo (15,4%; IC95% 13,1 - 17,6; p=0,008), hipertensão arterial sistêmica/ osteoporose (9,2%; IC95% 7,4 - 10,9; p=0,258); e, artrite e reumatismo/osteoporose (7,8%; IC95% 6,1 - 9,5; p<0,001). Sobre utilização de serviços, a taxa de idosos multimórbidos aumentou em todos os recortes considerados, a patamares de 35% naqueles que foram a um serviço de saúde uma ou mais vezes nos últimos 30 dias (aRP= 1,35 [comparado nenhuma vez]; IC95% 1,15 - 1,59), 28% em indivíduos com histórico de hospitalização em uma ou mais oportunidades em 12 meses (aRP=1,28 [comparado ausência de histórico de hospitalização]; IC95% 1,05 - 1,58), 20% em quem reportou cobertura por algum plano de saúde (aRP=1,20 [comparado com não coberto]; IC95% 1,02 - 1,42) e 24% em quem informou ter um equipamento de saúde como referência para atendimento (aRP=1,24 [comparado com quem não possui]; IC95% 1,01 - 1,53). Em conclusão, a prevalência de multimorbidade foi inferior a reportada na maioria dos estudos revisados, mas houve consistência sobre a sua associação com sexo, idade, cor da pele, tabagismo e nível socioeconômico. Ademais, embora com agrupamentos em torno de afecções cardiovasculares, metabólicas e músculo-esqueléticas, tal como a literatura revisada, os padrões mais comuns de ocorrência foram substancialmente diferentes dos já reportados. A maior frequência de utilização de serviços de saúde, assim como as maiores taxas de hospitalização, em indivíduos multimórbidos, foram achados consistentes com outras pesquisas, apontando para grandes desafios para os sistemas de saúde, sobretudo no que se refere a integralidade da atenção e a coordenação do cuidado com base em serviços de atenção primária.

This study aimed to analyze multimorbidity in the elderly according to its prevalence, patterns of occurrence, and use of health services. A cross-sectional study was conducted, nested at ISA-Capital, in the city of São Paulo, with 1019 elderly people aged 60 years or more. The data were analyzed using the Stata Software and the results were presented in three scientific articles. The prevalence of multimorbidity was 40% (95%CI 36.6 - 43.8), being higher in women (PRa= 1.95 [compared to men]; 95%CI 1.58 - 2.40), in individuals aged 75 years or more (PRa = 1.25 [compared to individuals aged 60 to 64]; 95%CI 1.01 - 1.60.60), in blacks (PRa = 1.28 [compared to whites]; 95%CI 1.04 - 1.59), in high-income people (PRa =1.27 [compared to low income]; 95%CI 1.09 - 1.50) and in former smokers (Arp=1.30 [compared to those who never smoked]; 95%CI 1.05 - 1.60), and less in those who declared themselves smokers (PRa =0.72 [compared to those who never smoked]; 95%CI 1.09 - 1.50). The most common patterns of occurrence of multimorbidity were systemic hypertension /diabetes mellitus type 2 (18.3%; 95%CI 15.9 - 20.7; p<0.001), systemic arterial hypertension/ arthritis, and rheumatism (15.4%; 95%CI 13.1 - 17.6; p=0.008), systemic arterial hypertension/ osteoporosis (9.2%; 95%CI 7.4 - 10.9; p=0.258); and, arthritis and rheumatism/osteoporosis (7.8%; 95%CI 6.1 - 9.5; p<0.001). Concerning the use of services, the rate of multimorbid elderly increased in all scenarios considered, at levels of 35% in those who went to a health service once or more in the last 30 days (PRa = 1.35 [compared not once]; 95%CI 1.15 - 1.59), 28% in individuals with a history of hospitalization at one or more opportunities in 12 months (PRa =1.28 [compared to no history of hospitalization]; 95%CI 1.05 - 1.58), 20% in those who reported coverage by a healthplan (PRa =1.20 [compared to not covered]; 95%CI 1.02 - 1.42) and 24% in those who reported having health equipment as a reference for care (PRa =1.24 [compared to those who do not have it]; 95%CI 1.01 - 1.53). In conclusion, the prevalence of multimorbidity was lower than that reported in most of the reviewed studies, but there was consistency in its association with sex, age, skin color, smoking, and socioeconomic status. In addition, although there were clusters around cardiovascular, metabolic, and musculoskeletal disorders, as in the reviewed literature, the most common patterns of occurrence were substantially different from those already reported. The higher frequency of use of health services, as well as the higher hospitalization rates in multimorphic individuals, were found to be consistent with other studies, pointing to major challenges for health systems, attention, and coordination of care based on primary care services.

Mortalidade de idosos por diabetes mellitus no Brasil: 1996 a 2021 / Mortality of elderly due to diabetes mellitus in Brazil: 1996 to 2021 / Mortalidad de ancianos por diabetes mellitus en Brasil: 1996 a 2021

Objetivo: Analisar a frequência de registros de óbito de idosos por diabetes mellitus (DM) no Brasil, nos anos de 1996 a 2021. Método: Estudo exploratório, comparativo, descritivo e de abordagem quantitativa. Os dados foram extraídos no Serviço de Informação sobre Mortalidade do Ministério da Saúde (SIM/MS). Resultados: Foi identificado o universo de "1.020.672" registros de óbitos por DM, com média e desvio padrão (39.256,6±12.953). As maiores preponderâncias foram de 41,9% (n=427.586) da região Sudeste (SE), 19,4% (n=197.995) do estado de São Paulo (SP), 85,1% (n=868.576) dos óbitos foram por DM não especificada (CID10: E14), 36,2% (n=369.855) possuíam de 70 a 79 anos, 51,3% (n=523.101) eram de cor/raça "branca", 23,2% (n=237.279) não possuíam "nenhuma" escolarização, 37,9% (n=387.194) eram casadas(os), 68,2% (n=696.158) tiveram registro de óbito no hospital. Conclusão: Foi verificado aumento na frequência de registros de óbito de idosos por DM no recorte geográfico e histórico analisados.

Objective: Analyzing the frequency of death records of elderly individuals due to diabetes mellitus (DM) in Brazil, from 1996 to 2021. Method: Exploratory, comparative, descriptive, and quantitative study. Data were extracted from the Mortality Information System of the Ministry of Health (SIM/MS). Results: A universe of "1,020,672" death records due to DM was identified, with a mean and standard deviation of (39,256.6±12,953). The highest prevalences were 41.9% (n=427,586) in the Southeast region (SE), 19.4% (n=197,995) in the state of São Paulo (SP), 85.1% (n=868,576) of deaths were due to unspecified DM (ICD-10: E14), 36.2% (n=369,855) were aged 70 to 79, 51.3% (n=523,101) were of "white" race/color, 23.2% (n=237,279) had "no" education, 37.9% (n=387,194) were married, and 68.2% (n=696,158) had a hospital death record. Conclusion: An increase in the frequency of death records of elderly individuals due to DM was observed in the analyzed geographical and historical context

Objetivo: Analizar la frecuencia de los registros de muerte de ancianos por diabetes mellitus (DM) en Brasil, de 1996 a 2021. Método: Estudio exploratorio, comparativo, descriptivo con abordaje cuantitativo. Los datos fueron extraídos del Servicio de Información de Mortalidad del Ministerio de Salud (SIM/MS). Resultados: Se identificó un universo de "1.020.672" actas de defunción por DM, con media y desviación estándar (39.256,6±12.953). Las mayores prevalencias fueron 41,9% (n= 427.586) en la región Sudeste (SE), 19,4% (n=197.995) en el estado de São Paulo (SP), 85,1% (n=868.576) de las muertes fueron por DM no especificada (CID-10: E14), 36,2% (n=369.855) tenían entre 70 y 79 años, 51,3% (n= 523.101) eran de color/raza "blanca", 23,2% (n=237.279) tenían "ninguna" escolaridad, El 37,9 % (n=387.194) estaban casados, el 68,2% (n=696.158) tenían registro de defunción en el hospital. Conclusión: Hubo un aumento en la frecuencia de registros de muerte de ancianos por DM en el área geográfica e histórica analizada

Comportamentos alimentares de portadores de DCNT que frequentam uma clínica integrada no extremo sul catarinense / Dietary behaviors of patients with NCDs who are attending an integrated clinic in southern Santa Catarina / Comportamientos alimentarios de pacientes con ENT que asisten a una clínica integrada en el extremo sur de Santa Catarina

Objetivo: verificar os comportamentos alimentares de indivíduos com doenças crônicas não transmissíveis. Método: Estudo descritivo, transversal, quantitativo com coleta de dados primários. Resultados: Sobre os comportamentos alimentares 48,6% (36) relataram realizar refeições em frente às telas, a maioria executa café da manhã, almoço e jantar e grande parte do grupo expôs consumir alimentos protetores e ultraprocessados. Conclusão: Os comportamentos alimentares encontrados entres os indivíduos com DCNT foram em geral desfavoráveis, mesmo com uma divisão adequada e inclusão de alguns bons alimentos, houve prevalência no consumo de biscoitos recheados, doces e bebidas adoçadas, além do péssimo hábito de se alimentar em frente a televisão.

Objective: to assess the dietary behaviors of individuals with chronic non-communicable diseases. Method: The study followed a descriptive, cross-sectional, quantitative approach with primary data collection. Results: The results revealed that 48.6% (36) reported having meals in front of screens, and the majority of the participants had breakfast, lunch, and dinner. A significant portion of the group reported consuming both protective foods and ultra-processed foods. Conclusion: In conclusion, the dietary behaviors observed among individuals with NCDs were generally unfavorable. Despite proper meal distribution and the inclusion of some healthy foods, there was a prevalence of consumption of filled cookies, sweets, and sugary beverages, along with the detrimental habit of eating in front of the television.

Objetivo: verificar los comportamientos alimentarios de individuos con enfermedades crónicas no transmisibles que asisten a una clínica integrada en el extremo sur de Santa Catarina. Método: Se llevó a cabo un estudio descriptivo, transversal y cuantitativo con recolección de datos primarios. Resultados: En cuanto a los comportamientos alimentarios, el 48,6% (36) informó realizar comidas frente a las pantallas, y la mayoría de los participantes desayunaban, almorzaban y cenaban. Además, una parte significativa del grupo declaró consumir alimentos protectores y ultraprocesados. Conclusión: Los comportamientos alimentarios encontrados entre los individuos con enfermedades crónicas no transmisibles fueron generalmente desfavorables. A pesar de una adecuada distribución de las comidas e inclusión de algunos alimentos saludables, hubo una prevalencia en el consumo de galletas rellenas, dulces y bebidas azucaradas, además del mal hábito de comer frente al televisor.

Sedentariness and overweight in relation to mortality in Sub-Saharan Africa. A Mediation analysis based on the WHO-Global Health Observatory Data Repository

Aims: The aim of the study was to investigate the complex mediation analysis between physical inactivity and overweight in relation to mortality. Methods: The study is based on public data collected by the Global Health Observatory (GHO) of the World Health Organisation. Results: We showed that the median early mortality attributable to NCDs during the period 2016 - 2019 in both men and women all together was 23.2% (5th to 95th range = 17.2, 35.6) while that in men alone was 25.1% (16.5, 45.7) and that of women was 22.0% (17.0, 27.9). When considering regional early NCDs mortality for both men and women, a systematically high median was observed in Southern Africa (28.7% (22.2, 43.8)) and a low median in Eastern Africa (21.1% (17.15, 27.3)). The analysis of the overall relation between physical inactivity, overweight and early mortality due to NCDs revealed a statistical significance of the direct association between physical inactivity and early mortality due to NCDs. Conclusion: Our findings revealed three main epidemiological and public health concerns. First, an early mortality attributable to NCDs in a range of about 20% to 30% across the SSA regions for both sexes were observed. Second, there was a direct effect between physical inactivity and early NCDs mortality as well as for the indirect effect mediated by overweight. Finally, a percentage point decrease of physical inactivity prevalence and overweight could effectively generate a reduction of mortality due to NCDs. Future studies are needed to confirm the scientific evidence observed in this study. Such studies should be based on observation of individual subjects, adopt a longitudinal design, and collect information that evaluate the complex relation between physical inactivity and early NCDs mortality, along with the role of overweight as a possible mediator.

Maladies non transmissibles et comorbidités chez les séniors dans le service de medécine interne du CHU de Bouaké / Non-Communicable Diseases and Comorbidities in Seniors in the Internal Medicine Department of the University Hospital of Bouake

. Les maladies non transmissibles chez le sujet âgé sont négligées en Afrique car l'espérance de vie n'était aussi élevée qu'aujourd'hui. Quel en était donc le panorama, il y a 10 ans ? Objectif : Améliorer les connaissances des maladies non transmissibles et des comorbidités chez les sujets âgés. Méthodes. Il s'agissait d'une étude transversale, rétrospective à visée descriptive du 1er janvier 2009 au 31 décembre 2013 dans le service de Médecine Interne du Centre Hospitalier Universitaire de Bouaké (CHU). Elle portait sur 151 patients hypertendus âgés de 65 ans et plus. Résultats. L'âge moyen était de 75 ans avec des extrêmes de 65 ans et 93 ans. Le sex-ratio était de 1,07. Les comorbidités étaient marquées principalement par le diabète (47%). Les motifs d'hospitalisation étaient dominés par les signes neurologiques (70%). L'hypertension artérielle (HTA) systolique isolée représentait 48% et l'HTA de grade III 23%. Ses principales complications étaient les accidents vasculaires cérébraux (AVC) (62%) et les cardiopathies (32%). Ces AVC étaient surtout ischémiques (78%). L'HTA était associée à d'autres facteurs de risque cardiovasculaire (78%) notamment la pression pulsée (52%) et le diabète (47%). Les Inhibiteurs de l'enzyme de conversion (IEC) étaient les plus prescrits (64%). La mortalité était de 23%. Conclusion. Les facteurs de risque cardiovasculaire constituent depuis plus de 10 ans à Bouaké, la morbidité mais surtout la mortalité des séniors, du fait de la gravité de leurs complications.

Mortalidade prematura por doenças crônicas não-transmissíveis / Premature mortality from non-communicable chronic diseases

As Doenças Crônicas Não Transmissíveis (DCNTs) têm origem não infecciosa e são compostas pelas doenças respiratórias crônicas (DRC), neoplasias malignas ou cânceres (CA), diabetes mellitus (DM) e doenças do aprelho respiratório (DAC). Em todo o mundo, essas doenças são responsáveis por 63% das mortes, correspondendo a 36 milhões de óbitos anualmente e dentre essas, 15 milhôes ocorrem prematuramente em indivíduos com menos de 70 anos de idade. Diante desse cenário, e na perspectiva de enfrentamento das DCNTs, foi instituído em 2011 o Plano de Ações Estratégicas (2011-2022) com meta a reduzir, anualmente, 2% da taxa de mortalidade prematura. Sendo assim, essa revisão traz uma análise dos indicadores estratégicos, comparando dados que comprovem se as metas foram alcançadas e as tendências futuras das DCNTs que compõe o indicador Taxa de mortalidade prematura

Chronic Noncommunicable Diseases (NCDs) have a non-infectious origin and are composed of chronic respiratory diseases (CKD), malignant neoplasms or cancers (CA), diabetes mellitus (DM) and diseases of the respiratory system (CAD). Worldwide, these diseases are responsible for 63% of deaths, corresponding to 36 million deaths annually and of these, 15 million occur prematurely in individuals under 70 years of age. Given this scenario, and with a view to tackling NCDs, the Strategic Action Plan (2011-2022) was established in 2011 with the goal of reducing the premature mortality rate by 2% annually. Therefore, this review provides an analysis of strategic indicators, comparing data that prove whether the goals were achieved and future trends in NCDs that make up the indicator Premature mortality rate

Declaración de Punta Cana, de la Asociación Latinoamericana de Pediatría para la prevención de enfermedades no transmisibles / Punta Cana declaration, of the Latin American Association of Pediatrics for the prevention of non-comunicable diseases

Las Enfermedades No Transmisibles (ENT) constituyen la mayor causa de morbilidad y mortalidad en las Américas y que la salud de las generaciones futuras comienza a forjarse desde antes de la concepción declara que los presidentes de las filiales se comprometen a trabajar en la prevención de Enfermedades No Transmisibles promoviendo: - Hábitos saludables de las mujeres y sus parejas antes, durante y después del embarazo. - Una adecuada atención prenatal y perinatal, procurando el acceso de la madre y el recién nacido a instituciones categorizadas por nivel de complejidad y riesgo. - Lactancia materna exclusiva durante el primer semestre y LM continuada hasta los 2 años o más, con la incorporación de una alimentación complementaria saludable y adecuada a partir de los 6 meses y reforzado la importancia del vínculo afectivo madre-hijo, - El crecimiento y desarrollo saludable de la niñez, reforzando el conocimiento de las herramientas para la detección precoz de sus alteraciones, -La difusión del concepto del origen fetal y de las etapas tempranas del desarro-llo del niño en la enfermedad del adulto, en el equipo de salud del primer nivel de atención, de manera de fundamentar las actividades de prevención en el cuidado de la salud de las mujeres y niños. -La implementación de programas de educación comunitaria brindando a la población conocimientos para proteger la salud materno infantil y preservar el ambiente. - Ambientes saludables, evitando las exposiciones tóxicas y reforzando la importancia de garantizar a la embarazada y el niño una buena calidad de aire, agua y alimentos. -La inclusión de temas relacionados con los riesgos de enfermedades del adulto a partir de exposiciones prenatales o de la infancia en los ejes de capacitación y las actividades científicas. - Investigaciones para lograr diagnósticos locales y regionales de estos temas. -La abogacía por el cumplimiento del Código de comercialización de sucedáneos de la leche materna. -La creación de medidas eficaces en políticas públicas en resguardo de la salud de las generaciones presentes y futuras. Sabemos que la mejor manera de avanzar en la prosecución de estos objetivos es actuar en forma interdisciplinaria e intersectorial, con la articulación e integración entre los profesionales y distintos actores sociales interesados en el cui-dado de la madre y el niño, según las posibilidades y la idiosincrasia de cada país. Como Sociedades Científicas comprometemos nuestros esfuerzos en la prevención de ENT, ratificando nuestra responsabilidad de velar por el bienestar de la niñez y adolescencia en nuestra región y por una mejor salud para las futuras ge-neraciones.

Noncommunicable diseases (NCDs) constitute the most significant cause of morbidity and mortality in the Americas, and the health of future generations begins to be forged before conception declares the following, the presidents of the affiliates commit to working on the prevention of noncommunicable diseases by promoting the following: - Healthy habits of women and their partners before, during, and after pregnancy. - Adequate prenatal and perinatal care, ensuring access for the mother and the newborn to institutions categorized by level of complexity and risk. - exclusive breastfeeding during the first semester and continued breastfeeding for up to 2 years or more, with the incorporation of a healthy and adequate complementary diet from 6 months and reinforcing the importance of the mother-child affective bond, - The growth and healthy development of childhood, reinforcing the knowledge of the tools for the early detection of its alterations, -Dissemination of the concept of fetal origin and the early stages of child development in adult disease in the health team at the first level of care to base prevention activities on women's health care. Women and children- -The implementation of community education programs providing the population with the knowledge to protect maternal and child health and preserve the environment. - Healthy environments, avoiding toxic exposures and reinforcing the importance of guaranteeing good air, water, and food quality for pregnant women and children. -The inclusion of issues related to the risks of adult diseases from prenatal or childhood exposures in the training axes and scientific activities. - Research to achieve local and regional diagnoses of these issues. -Advocacy for compliance with the Code for the Marketing of Breast Milk Substitutes. -The creation of effective measures in public policies to safeguard the health of present and future generations. We know that the best way to advance in pursuing these objectives is to act in an interdisciplinary and intersectoral manner, with the articulation and integration between professionals and different social actors interested in the care of mothers and children, according to the possibilities and idiosyncrasies of each country. As Scientific Societies, we commit our efforts to prevent NCDs, confirming our responsibility to ensure the well-being of children and adolescents in our region and for better health for future generations.

Conocimientos, actitudes y prácticas sobre el consumo de sal en la población peruana: Estudio transversal / Knowledge, attitudes and practices about salt consumption in the Peruvian population: A crosssectional study

Introducción: La reducción del consumo de sal se ha identificado como una de las intervenciones prioritarias para prevenir las enfermedades no transmisibles a nivel mundial. Por ello, se recomienda que uno de los tres pilares para reducir su ingesta es reconocer el nivel de conocimientos, actitudes y prácticas relacionadas con el consumo de sal (CAP-sal). Objetivo: Determinar el nivel de CAP-sal y los factores asociados a estos en la población peruana. Materiales y métodos: Estudio transversal analítico realizado mediante encuesta virtual en población adulta peruana. Resultados: Se trabajó con una muestra de 918 sujetos. La proporción de participantes con conocimiento, actitudes y prácticas suficientes, fue del 54,58 %; 50,22 % y 40,31 %, respectivamente. Las variables que aumentan la probabilidad de tener un nivel suficiente de CAP-sal fueron el sexo femenino, la presencia de obesidad e HTA. Mientras que los antecedentes familiares y área de residencia lo fueron únicamente para conocimientos, el grado de instrucción para conocimientos y prácticas, y la actividad física tanto para actitudes como prácticas. Conclusiones: Tanto el nivel de conocimiento y actitudes fueron suficientes en la mitad de la muestra, pero las prácticas se encuentran por debajo de esta. Existen brechas que varían según las características sociodemográficas, como la edad, sexo, antecedentes de HTA, obesidad y realización de actividad física. Resultados que podrían apoyar la inclusión de la promoción de una nutrición saludable en la población peruana(AU)

Introduction: Reducing salt intake has been identified as one of the priority interventions to prevent non-communicable diseases worldwide. For this reason, it is recommended that one of the three pillars to reduce its intake is to recognize the level of Knowledge, Attitudes and Practices related to salt consumption (CAP-salt, in Spanish). Objective: To determine the level of CAP-salt and the factors associated with these in the Peruvian population. Materials and Methods: Cross-sectional analytical study carried out through a virtual survey of the Peruvian population. Results: We studied 918 subjects. The proportion of patients with sufficient knowledge, attitudes and practices was 54.58 %; 50.22 % and 40.31 %, respectively. The factors that increase the probability of having sufficient CAPsalt were female sex, the presence of obesity and hypertension. While family history and area of residence were only for knowledge, the degree of education for knowledge and practices, and physical activity for both attitudes and practices. Conclusions: The level of knowledge and sufficient attitudes are present in half of the population, but the practices are below this. In turn, several gaps vary according to sociodemographic characteristics, such as age, sex, history of hypertension, obesity, and physical activity, which could be the target of the new population awareness goals(AU)

Configuração da rede de cuidados às doenças crônicas não transmissíveis na perspectiva da integração / Configuration of the care network for chronic non-communicable diseases from the perspective of integration / Configuración de la red de atención de enfermedades crónicas no transmisibles desde la perspectiva de la integración

Objetivo: Descrever a configuração da Rede de Cuidados às Doenças Crônicas não Transmissíveis em um Distrito Sanitário na perspectiva da integração. Métodos: Trata-se de estudo qualitativo desenvolvido em um Distrito Sanitário, no qual foram realizadas entrevistas com 34 participantes (coordenadores e enfermeiros assistenciais) com experiência na gestão e no cuidado. Resultados: Os resultados evidenciaram, em termos gerais, que é possível descrever a Rede de Cuidados a partir de uma inter-relação entre as dimensões da integração, destacando-se as interações profissionais, a organização do cuidado e processos logísticos relacionados aos fluxos assistenciais com facilitadores e impeditivos para a atenção às pessoas com Doenças Crônicas não Transmissíveis. Conclusão: Destaca-se como um facilitador na configuração da Rede a capacidade gerencial dos coordenadores em integrar as unidades de saúde e os profissionais na organização do cuidado; e, dentre os percalços para a conformação da Rede o não apontamento teórico dos princípios e diretrizes do SUS, choque nas relações profissionais, falhas operacionais na logística de fluxos assistenciais, sistema de informação não totalmente interligado, fragilidade quanto ao sistema de financiamento e falta de parcerias ou opiniões ambíguas referentes aos processos de trabalho adotados em cada unidade. (AU)

Objective: To describe the configuration of the Care Network for Chronic Non Communicable Diseases in a Health District from the perspective of integration. Methods: This is a qualitative study developed in a Health District, in which interviews were conducted with 34 participants (coordinators and clinical nurses) with experience in management and care. Results: The results showed, in general terms, that it is possible to describe the Care Network from an interrelationship between the dimensions of integration, highlighting professional interactions, the organization of care and logistical processes related to care flows with facilitators and impediments to care for people with Chronic Non-Communicable Diseases. Conclusion: The managerial capacity of coordinators to integrate health units and professionals in the organization of care stands out as a facilitator in the configuration of the Network; and, among the setbacks for the conformation of the Network, the theoretical failure to point out the principles and guidelines of the SUS, a shock in professional relationships, operational failures in the logistics of assistance flows, an information system not fully interconnected, weakness in the financing system and lack of partnerships or ambiguous opinions regarding the work processes adopted in each unit. (AU)

Objetivo: Describir la configuración de la Red de Atención a Enfermedades Crónicas No Transmisibles en un Distrito de Salud desde la perspectiva de la integración. Métodos: Se trata de un estudio cualitativo desarrollado en un Distrito de Salud, en el que se realizaron entrevistas a 34 participantes (coordinadores y enfermeras clínicas) con experiencia en gestión y atención. Resultados: Los resultados mostraron, en términos generales, que es posible describir la Red de Cuidado a partir de una interrelación entre las dimensiones de la integración, destacando las interacciones profesionales, la organización del cuidado y los procesos logísticos relacionados con los flujos de cuidado con facilitadores e impedimentos para el cuidado. Personas con Enfermedades crónicas no transmisibles. Conclusión: La capacidad gerencial de los coordinadores para integrar unidades y profesionales de salud en la organización de la atención se destaca como facilitador en la configuración de la Red; y, entre los retrocesos para la conformación de la Red, el teórico fracaso en señalar los principios y lineamientos del SUS, un choque en las relaciones profesionales, fallas operativas en la logística de los flujos de asistencia, un sistema de información n plenamente interconectado, debilidad en el sistema de financiamiento y la falta de alianzas o opiniones ambiguas sobre los procesos de trabajo adoptados en cada unidad. (AU)

Llamado a la implementación de la Ley 2120 de 2021 contra la comida chatarra en los tiempos del COVID-19 en Colombia / A call for implementation of the Law 2120 against junk food during pandemic times in Colombia

Durante dos años y medio, tanto en Colombia como en el resto del mundo, hemos enfrentado la pandemia generada por el SARS-CoV-2, agudizando los múltiples problemas de salud pública que venían cursando a manera de sindemias. Tal es el caso de las enfermedades crónicas no transmisibles asociadas, entre otros factores, a los malos hábitos alimenticios, especialmente por el gran consumo de alimentos ultraprocesados y bebidas azucaradas. En julio del 2021, se aprobó la Ley 2120, por medio de la cual se adoptaron medidas para fomentar entornos alimentarios saludables. Entre estas medidas, también se promueve que los alimentos empacados, procesados y que afectan negativamente la salud humana, tengan un sello que identifique sus componentes y valor nutricional para informar a los consumidores sobre el producto que están comprando o consumiendo. Entre las enfermedades más prevalentes en Colombia que afectan la salud bucal, se encuentran las caries y las periodontitis, ambas con factores de riesgo comunes con las enfermedades crónicas no transmisibles. Dados sus costos y prevalencia, dichas enfermedades crónicas no transmisibles resultan primordiales desde un enfoque de gestión del riesgo en salud pública, siendo, quizá, su gravedad mayor durante la pandemia generada por el SARS CoV-2. Asimismo, se especula que la población confinada pudo llegar a consumir más comida chatarra durante la pandemia del COVID-19 en comparación con otros períodos, además, porque en aquellos con enfermedades crónicas no transmisibles, el confinamiento obligado se asocia con mayor sedentarismo y con un menor número de controles médicos regulares, asuntos que se han reportado previamente. La promulgación de la ley de comida chatarra no va a cambiar los hábitos de alimentación de los colombianos "de la noche a la mañana" y, por esto, se necesita con urgencia implementar procesos de educación y sensibilización frente a los efectos adversos de los alimentos procesados y ultraprocesados en la salud.

For more than one year and a half, Colombia and the world have been facing the effects caused by the pandemics of SARS CoV-2 with concomitant and aggravating deterioration of multiple public health problems such as noncommunicable diseases. Noncommunicable diseases are frequently associated with poor eating habits and regular consumption of processed and ultra-processed foods, among other important risk factors related to culture, genetics, and sedentarism. In July, 2021, Colombia ratified the Law 2120 that promotes healthy food habits and recreational environments, by forcing food producers to include nutritional advertisement seals on processed food packages, with explanatory guidelines for consumers about calories and nutritional value. This editorial note highlights the importance in Odontology of promoting and implementing this Law through education and sensitization of populations, in order to cope with some of the adverse risk factors of the hypercaloric diet.

Estrategias de apropiación social del conocimiento en salud: revisión sistemática / A Systematic Review of Strategies for the Social Appropriation of Health Knowledge / Estratégias para a apropriação social do conhecimento em saúde: uma revisão sistemática

Las enfermedades no transmisibles son un problema de salud pública que afecta los siste-mas de salud y carga las economías y la sociedad. Existen estrategias para la prevención de estas enfer-medades, como la apropiación social del conocimiento, por medio del empoderamiento de las comu-nidades y la mejora de sus indicadores en salud. El objetivo del artículo es describir las metodologías empleadas en el diseño de estrategias de apropiación social del conocimiento en salud en la prevención de enfermedades no transmisibles en adultos en el mundo. Materiales y métodos: revisión sistemática de artículos de estrategia de apropiación social del conocimiento en salud, buscados en las bases de datos Google Scholar, ovid, Biblioteca Virtual en Salud, Medline, ebsco y SciELO. Los criterios de inclusión fue-ron publicaciones en revistas indexadas entre 2016 y 2021, en idioma inglés, portugués y español, con temáticas de intervenciones en salud. Resultados: se revisaron 39 artículos, 36 con diseño cualitativo, dos mixtos y uno transversal. El enfoque metodológico utilizado para el diseño de las estrategias fue la metodología de investigación participativa basada en la comunidad o community-based participatory research. Se establecieron cuatro fases comunes, tituladas diagnóstico comunitario, diseño de la inter-vención, implementación y evaluación. Conclusiones: la metodología indicada ha sido la más utilizada en población de alto riesgo social, económico y de salud. La tendencia investigativa permitió identificar la importancia del diagnóstico comunitario como puerta de entrada en el diseño, implementación y evaluación de las estrategias creadas conjuntamente.

Noncommunicable diseases are a public health issue that burdens health systems, econo-mies, and society. These diseases can be prevented by using several methods, such as the social appro-priation of knowledge, empowerment of communities, and improvement of their health indicators. This review seeks to describe the methodologies used in designing strategies for the social appropriation of health knowledge in the prevention of noncommunicable diseases in adults worldwide. Materials and methods: A systematic review of articles containing social appropriation of health knowledge strategy was made searching the following databases Google Scholar, ovid, Virtual Health Library, Medline, ebsco, and SciELO. With the following criteria: publications in journals indexed between 2016 and 2021; writ-ten in English, Portuguese, and Spanish; and addressing health intervention topics. Results: A total of 39 articles were reviewed, of which 36 were qualitative, 2 mixed, and 1 cross-sectional. The methodological approach used to develop the strategies was community-based participatory research (cbpr). Based on the characteristics shared by the various phases of the studies, four common characteristics were identi-fied: community diagnosis, intervention design, implementation, and evaluation. Conclusions: cbpr is the most widely used method for the social appropriation of health knowledge for the adult population, par-ticularly in populations at high social, economic, and health risks. The research trend made it possible to recognize the significance of community diagnosis as a stepping stone to the design, implementation, and evaluation of jointly developed strategies.

as doenças não transmissíveis são um problema de saúde pública que afeta os sistemas de saúde e sobrecarrega as economias e a sociedade. Existem estratégias para a prevenção dessas doenças como a apropriação social do conhecimento, por meio do empoderamento das comunidades e melhoria de seus indicadores de saúde. O objetivo é descrever as metodologias utilizadas no desenho de estraté-gias de apropriação social do conhecimento em saúde na prevenção de doenças não transmissíveis em adultos em todo o mundo. Materiais e métodos: revisão sistemática de artigos sobre a estratégia de apro-priação social do conhecimento em saúde. A busca foi realizada nas bases de dados Google acadêmico, ovid, Biblioteca Virtual em Saúde, Medline, ebsco e SciELO. Os critérios de inclusão foram os seguintes: publicações em periódicos indexados entre 2016 e 2021, idioma inglês, português e espanhol e temas de intervenções em saúde. Resultados: foram revisados 39 artigos, 36 com delineamento qualitativo, 2 mistos e 1 transversal. A abordagem metodológica utilizada para desenhar as estratégias foi a metodo-logia de pesquisa participativa de base comunitária ou community-based participatory research (cbpr). Foram estabelecidas quatro fases comuns, intituladas diagnóstico comunitário, desenho de intervenção, implementação e avaliação. Conclusões: a metodologia cbpr tem sido a mais utilizada em uma população de alto risco social, econômico e de saúde. A tendência investigativa permitiu identificar a importância do diagnóstico comunitário como porta de entrada para o desenho, implementação e avaliação de estra-tégias criadas em conjunto.

La dispensarización de pacientes hipertensos en el Policlínico Rafael Echezarreta / The classification of hypertensive patients at Rafael Echezarreta Polyclinic

Introducción: Uno de los principales problemas de salud que afectan a la población de Cuba y del mundo es la hipertensión arterial. En San José de Las Lajas aparece dispensarizada como hipertensa el 14 por ciento de su población, pero se observan múltiples deficiencias en su dispensarización. Objetivo: Determinar la situación de la dispensarización de las personas que padecen hipertensión arterial en los consultorios del médico y la enfermera de la familia del policlínico Rafael Echezarreta del municipio San José. Métodos: Se realizó una investigación descriptiva rápida de corte transversal, en enero de 2020. Se revisaron las historias clínicas individuales de una muestra de 379 pacientes hipertensos, que representaron el 11 por ciento de los 3446 hipertensos registrados en el policlínico. Resultados: Solo cerca del 20 por ciento de los hipertensos estaba dispensarizados. A excepción de los grupos de edades extremas, en el resto predominó el sexo femenino. Con el aumento de la edad aumentó la proporción de pacientes hipertensos. Ninguno de los pacientes tenía evidencia registrada en su historia clínica de haber sido atendido en los últimos cuatro meses y casi el 68 por ciento del total no había sido visto hacía más de un año. Conclusiones: La dispensarización mantiene insuficiencias que no garantizan atención médica integral a la población, no se cumple la frecuencia mínima de evaluación establecida para cada grupo dispensarial y el método clínico presenta fallas en su aplicación. Por lo que se puede afirmar que existe un número potencial de pacientes hipertensos aún sin controlar(AU)

Introduction: One of the main health problems that affect Cuban and worldwide population is high blood pressure. In San José de Las Lajas municipality, 14 percent of its population appears to be hypertensive, but there are multiple deficiencies in its classification. Objective: To determine the situation of the classification of people suffering from arterial hypertension in the Family Doctor´s Offices belonging to Rafael Echezarreta polyclinic, San José municipality. Methods: A rapid cross-sectional descriptive research was conducted in January 2020. The individual medical records (HCIs) of a sample of 379 hypertensive patients were reviewed, representing 11 percent of the 3446 hypertensive patients registered in the polyclinic. Results: Only about 20 percent of hypertensive patients were classified. With the exception of the extreme age groups, the female sex predominated in the rest. With increasing age, the proportion of hypertensive patients increased. None of the patients had evidence recorded in their medical records of having been attended in the last four months and almost 68 percent of the total had not been attended more than a year ago. Conclusions: The classification has insufficiencies that do not guarantee comprehensive medical care to the population, the minimum frequency of evaluation established for each classification group is not met and the clinical method presents failures in its application. So it can be said that there is a potential number of hypertensive patients still uncontrolled(AU)

Expectativas en salud de las personas mayores que acuden a la atención primaria / Health expectations of older people attending primary care

INTRODUCCIÓN: Desde la última década se ha evidenciado el aumento de la población de personas mayores en Chile. Muchos de ellos son usuarios regulares del sistema público de salud el cual se caracteriza por entregar una atención de tipo integral. En este sentido, resulta relevante conocer los requerimientos en salud desde la perspectiva de las experiencias de las personas mayores con respecto al uso de este servicio. OBJETIDO: El objetivo de este estudio fue identificar las expectativas de las personas mayores que asisten a los centros de APS. MATERIAL Y MÉTODOS: Este es un estudio cualitativo, descriptivo, donde la muestra fue de 13 personas mayores de 65 años y más, autovalentes, de tres centros APS, los cuales fueron entrevistados mediante instrumento semiestructurado, con análisis cualitativo de datos método que incluyó codificación abierta y focalizada. RESULTADOS: Las expectativas de las personas mayores fueron categorizadas como requerimiento de una atención profesional integral, oportunidad de atención, accesibilidad de la atención, promoción de salud sobre el autocuidado, explicación de cambios en el envejecimiento con enfoque biológico y alfabetización en salud. CONCLUSIONES: Las expectativas de las personas mayores en este estudio dan cuenta de una atención profesional integral poco efectiva, además de la necesidad de un trato especializado al grupo poblacional específico, no sólo de los profesionales, sino también del personal administrativo de los centros de APS, considerándolos una barrera en la calidad de la atención.

INTRODUCTION: Since the last decade there has been evidence of an increase in the population of older people in Chile. Many of them are regular users of the public health system (PHS) which is characterized by providing comprehensive care. In this sense, it is relevant to know the health requirements from the perspective of the experiences of the older people regarding the use of this health service. OBJECTIVE: The objective of this study was to identify the needs and expectations of older people attending PHS centers. MATERIAL AND METHODS: It were a qualitative and descriptive study. The sample was compounded by 13 people over 65 years and over, self-sufficient, from three PHS centers. It was used a semi-structured instrument. RESULTS: The main needs of the elderly were categorized as a requirement for comprehensive professional care, the opportunity for care, accessibility of care, health promotion on self-care, explanation of changes in aging with a biological focus and health literacy. CONCLUSIONS: The needs and expectations of the older people in this study account for an ineffective comprehensive professional care, in addition to the need for specialized treatment of the specific population group, not only of professionals but also of the administrative staff of the centers of PHS, considering them a barrier in the quality of care.

Estrategia educativa para elevar el conocimiento sobre hipertensión arterial en la población, de 20 años en adelante / Educational strategy to raise knowledge about arterial hypertension in the population aged 20 and over

En el mundo las enfermedades cardiovasculares son responsables de casi un tercio del total de las muertes por año. Cada vez son más las personas que padecen hipertensión arterial (HTA), desconociendo muchos su condición. Objetivo: Diseñar una estrategia educativa para elevar el conocimiento sobre hipertensión arterial en la población de 20 años y más en el consultorio 2 de Medicina Familiar y Comunitaria; Centro de Salud Luchadores del Norte, año 2021.Materiales métodos: Se realizó una investigación descriptiva, observacional, prospectiva y transversal con la población de adultos del Centro de Salud Luchadores Norte, para elaborar el diseño de una estrategia educativa que eleve el conocimiento sobre esta enfermedad; se midieron variables sociodemográficas, de estilos de vida y de conocimiento. Resultados: El grupo de edad más frecuente de 50 a 59 años 26,2%; sexo masculino 66,4%; escolaridad nivel básico 41,1%; estado civil unión libre 52,3%; etnia mestizo 58,9% y ocupación empleado privado 29,0%; no realizan actividad física 65,4%; consumo excesivo de sal 67,3%; grasa 58,9%; gaseosas y energizantes 52,8%; no conocen de la enfermedad 62,6%; técnica charla 39,3%; frecuencia una vez cada 15 días 43,9%; horario de mañana 57,0%; duración 30 minutos 52,3%; lugar centro de salud 50,5% y tamaño del grupo de 6 a 10 (42,1%). Conclusión: La bibliografía concuerda mayoritariamente con los resultados de la investigación, en consumo de sal elevado, grasas, gaseosas y bebidas energizantes; el conocimiento sobre la enfermedad es escaso en los hipertensos, concordando con las citas de referencia; concluyendo, que coexisten estilos de vida no saludables con desconocimiento; favoreciendo las complicaciones de la enfermedad, una intervención educativa elevaría conocimiento y cambia actitudes evitando consecuencias y daños irreversibles(AU)

In the world, cardiovascular diseases are responsible for almost a third of all deaths per year. More and more people suffer from high blood pressure (HBP), many unaware of their condition. Objective: To design an educational strategy to raise awareness about arterial hypertension in the population aged 20 and over in Family and Community Medicine office 2; Luchadores del Norte Health Center, year 2021. Materials and methods: A descriptive, observational, prospective and cross-sectional investigation was carried out with the adult population of the Luchadores Norte Health Center, to develop the design of an educational strategy that raises knowledge about this illness; sociodemographic, lifestyle and knowledge variables were measured. Results: The most frequent age group was 50 to 59 years old, 26.2%; male sex 66.4%; basic level schooling 41.1%; marital status free union 52.3%; mestizo ethnic group 58.9% and occupation private employee 29.0%; do not perform physical activity 65.4%; excessive consumption of salt 67.3%; fat 58.9%; soft drinks and energy drinks 52.8%; 62.6% do not know about the disease; talk technique 39.3%; frequency once every 15 days 43.9%; morning hours 57.0%; duration 30 minutes 52.3%; health center location 50.5% and group size from 6 to 10 (42.1%). Conclusion: The bibliography mostly agrees with the results of the investigation, in consumption of high salt, fat, soft drinks and energy drinks; knowledge about the disease is scarce in hypertensive patients, in agreement with the reference citations; concluding that unhealthy lifestyles coexist with ignorance; favoring the complications of the disease, an educational intervention would increase knowledge and change attitudes, avoiding consequences and irreversible damage(AU)