Producción científica sobre depresión en poblaciones quechua hablantes: Una revisión narrativa / Scientific production on depression in Quechua-speaking populations: A narrative review

Resumen: Antecedentes: Las poblaciones quechua hablantes se extienden por siete países latinoamericanos y por sus características requieren de atención diferenciada sobre la depresión. Objetivo: Describir la atención y producción científica sobre depresión en poblaciones quechua hablantes. Método: Revisión narrativa realizada con búsqueda en PUBMED, WEB OF SCIENCE y SCOPUS, incluyendo estudios en inglés y/o español, la estrategia de búsqueda se desarrolló con descriptores para depresión y población quechua hablante, la búsqueda fue realizada por dos revisores, quienes organizaron los resultados de la búsqueda en Microsoft Excel. Se incluyeron estudios que consideraron a la depresión y que se haya estudiado en poblaciones quechua hablantes de cualquier variante del quechua. Resultados: Se encontró 7 estudios, la prevalencia de la depresión en quechua hablantes fue de 38.9 % en Ayacucho Perú y (4 de 7 estudios) emplearon instrumentos psicométricos para evaluar la depresión. Existen escasas investigaciones sobre depresión en poblaciones quechua hablantes, principalmente son de tipo transversal y el instrumento utilizado es válida solo para una variante del quechua. Conclusiones: Se encontraron escasas investigaciones en poblaciones quechua hablantes, las publicaciones son principalmente estudios transversales, aún no se tienen instrumentos adaptados y validados a todas las variantes del quechua. Los síntomas depresivos parecen ser mayores especialmente en las mujeres. Por otro lado, el acceso a los servicios de atención en salud es limitada por las dificultades de aculturación, dominio del idioma por parte del profesional de salud; así como por el estigma y desconocimiento de la depresión por esta población.

Abstract: Background: Quechua-speaking populations span seven Latin American countries and, due to their characteristics, require differentiated attention to depression. Objective: Describe the attention and scientific production on depression in Quechua-speaking populations. Method: Narrative review carried out with a search in PUBMED, WEB OF SCIENCE and SCOPUS, including studies in English and / or Spanish, the search strategy was developed with descriptors for depression and Quechua-speaking population, the search was carried out by two reviewers, who organized the search results in Microsoft Excel. Studies that considered depression and that have been studied in Quechua populations speaking any variant of Quechua were included. Results: 7 studies were found, the prevalence of depression in Quechua speakers was 38.9% in Ayacucho Peru and (4 of 7 studies) used psychometric instruments to evaluate depression. There is little research on depression in Quechua-speaking populations, they are mainly cross-sectional and the instrument used is valid only for a variant of Quechua. Conclusions: Little research was found in Quechua-speaking populations, the publications are mainly cross-sectional studies, and there are still no instruments adapted and validated for all variants of Quechua. Depressive symptoms seem to be greater especially in women. On the other hand, access to health care services is limited by the difficulties of acculturation, command of the language on the part of the health professional; as well as the stigma and ignorance of depression by this population.

Uma contribuição da metodologia Peir para o estudo de uma pequena cidade na Amazônia: Ponta de Pedras, Pará / A contribution from the DPSIR methodology to the study of a small town in the Amazon: Ponta de Pedras, Pará, Brazil

Resumo Este artigo objetivou analisar a contribuição da metodologia Peir para estudo de uma pequena cidade da Amazônia a partir da análise do modo de vida da população. Como procedimento metodológico procurou-se entender a relação entre aspectos de urbanização conectados à globalização e saúde da população dessa cidade. Foram obtidos dados em campo, os quais permitiram analisar a situação de saúde em dois setores urbanos. A metodologia Pressão-Estado-Impacto-Resposta (Peir), desenvolvida pelo Programa das Nações Unidas para o Meio Ambiente (Pnuma) e adaptada pela Organização para a Cooperação e Desenvolvimento Econômico (OCDE), servirá de suporte para a compreensão dos impactos na saúde da população a partir do acesso a infraestruturas disponíveis, entre elas o abastecimento de água. O local de estudo é cidade de Ponta de Pedras, situada na Ilha do Marajó, estado do Pará, Brasil. Como resultado nota-se a necessidade de intervenções imediatas por parte do poder público para minimizar os impactos das condições de vulnerabilidade sobre as populações.

Abstract This article aimed to analyze DPSIR approach's contribution in an Amazonian small town, according to the local people's lives. As methodological procedure, we sought to understand the relation between urbanization aspects connected to globalization and the population health of said small town. For this research, data were obtained in field, which allowed an analysis of the health situation in two urban sectors. The DPSIR methodology - Driving force-Pressure-State-Impact-Response, developed by United Nations Environment (UNE) and adapted by the Organization for Economic Cooperation and Development (OECD), will serve as support for the understanding of impacts on the population's health, analyzing issues as access to available infrastructure, including water supply. As a result, Ponta de Pedras town, located in Marajó Island (PA), Brazil - where the research was performed -, requires an immediate intervention from the public authorities to minimize impacts of population's exposure to vulnerable conditions.

Aggregation of health industry factors and policy innovation attempts based on the practice of ;Healthy Towns in Tonglu / 中华医院管理杂志

Authors of the paper analyzed the motivation of building the healthy town,and interrelated the scientific aspects of such a town. It was found that this town of diversified resources and advantages had become small but beautiful,special and strong clustering and convergent by means of collecting high-end factors, selecting of essential health businesses and constructing an ecosystem of health industry clusters. Based on a definition of the government role,the paper described the innovation of health policy in view of policy supply.

Participação dos municípios de pequeno porte no Projeto Mais Médicos para o Brasil na macrorregião norte do Paraná / Participation of small municipalities in the Mais Médicos para o Brasil (More Doctors to Brazil) Program in the macro-region of Northern Paraná

Resumo Resumo Em municípios de pequeno porte, que em geral são situados em áreas geográficas mais isoladas, combinado com situações de maior vulnerabilidade social e econômica, a escassez de médicos é um problema constante. O objetivo deste estudo foi identificar a participação e as características dos municípios de pequeno porte da macrorregião norte do estado do Paraná que aderiram ao Projeto Mais Médico para o Brasil (PMMB). Trata-se de um estudo quantitativo realizado em 82 municípios que utilizou dados primários e secundários. Os resultados revelaram que eram poucos os municípios que possuíam algum critério de adesão (6,1%), mas isso não representou um impedimento para que os demais aderissem ao projeto (75,6%). Os municípios que possuíam menores índices de desenvolvimento humano, que tinham população de mais de cinco mil habitantes, algum critério de adesão e que eram mais afastados, seja da sede da região, seja do município de médio/grande porte mais próximo foram os que mais aderiram ao PMMB. Não se pode negar que o PMMB reduziu de forma significativa a distribuição desigual de médicos no Brasil e na região de estudo. Contudo, a sustentabilidade dessa política precisa estar atrelada ao enfrentamento de outros desafios que ainda persistem no SUS.

Abstract Doctor shortage is a constant problem in smaller cities and towns, which tend to be more vulnerable from a social and economic point of view, and located in geographically isolated areas. The goal of this study was to establish the share and characteristics of the small cities and towns in the macro-region of northern Paraná that subscribed to the Mais Médicos para o Brasil (PMMB) program. This is a quantitative study of 82 cities and towns using primary and secondary data. Results show that only a few of them (6.1%) had any adherence criteria, which was not an impediment for other cities and towns (75%) to adhere to the project. Cities and towns with over five thousand inhabitants, lower municipal HDI (Human Development Index), some adherence criteria and more geographically isolated, either from the main city in the region or the closest large or mid-sized city, tended to adhere to the PMMB. It is undeniable that the PMMB significantly reduced the uneven distribution of doctors in Brazil and the study region. However, the sustainability of this policy is linked to addressing other remaining challenges in the SUS system.

Cidades, corpos medicalizados e o biocapital: o mercado da saúde / Cities, bodies medicalized and the biocapital: the market health

Resumo Este artigo tem o objetivo de colocar em interrogação as práticas de medicalização das cidades e dos corpos por meio do governo da vida, em uma sociedade neoliberal que tornou as populações capitais e os espaços das cidades lugares de empreendimento. Pretende pensar os processos de subjetivação fazendo uma crítica ao investimento das cidades e dos corpos enquanto biocapitais, assegurados por um mercado crescente, em nome da saúde e segurança. Com os estudos de Michel Foucault e algumas de suas ferramentas, efetuou-se uma história breve da medicalização das cidades e dos corpos bem como dos seus efeitos na produção de subjetividades, no contemporâneo (AU).

Abstract This article aims to put in question the medicalization practices of cities and bodies through the government of life in a neoliberal society that became the capital populations and areas of the city enterprise spaces. Want to think the subjectivity processes making a critical investment of cities and bodies as biocapitais rely on a growing market, in the name of health and safety. With the studies of Michel Foucault and some of its tools made a brief history of the medicalization of cities and bodies. Also well as their effects on the production of subjectivities, in the contemporary.(AU)

Demands and Countermeasures of TCM Continuing Education of Doctors in Health Clinics in Towns and Townships of Hunan Province / 中国中医药信息杂志

Objective To investigate the awareness rate of TCM knowledge, the application, and demand situation of Chinese appropriate techniques in health clinics in towns and townships of Hunan Province;To put forward the countermeasures of TCM continuing education. Methods 50%of the training doctors were adopted randomly from 4 training courses in health clinics in towns and townships in Hunan Province. The student number of each course was 49, 51, 53, 53, respectively. Self-designed questionaires were used to investigate 206 training doctors. Results 168 (81.55%) doctors’ degrees were technical secondary school degree and college degree;186 (90.29%) doctors’ professional titles were physician assistant and physician;The awareness rate of TCM knowledge was 63.83%;Different study backgrounds of doctors had different effects on the rate of TCM knowledge (χ2=42.42, P=0.01). The using rates of TCM appropriate techniques were all lower than 30%. 96.60%of doctors in health clinics in towns and townships hope to learn one or more TCM appropriate techniques to help diagnose and treat disease. Conclusion The degree, professional title, mastery of TCM knowledge, and TCM appropriate techniques were not optimistic. The doctors in health clinics in towns and townships showed strong desire for TCM appropriate techniques. The health department should combine the actual situation of doctors in health clinics in towns and townships and develop targeted TCM continuing education.

Avaliação da satisfação do usuário do Programa de Saúde da Família na zona rural de dois pequenos municípios do Rio Grande do Norte / Evaluation of user's satisfaction with the Family Health Program in the rural area of two smalls cities in Rio Grande do Norte State, Brazil

Este estudo objetiva avaliar a satisfação do usuário quanto ao cuidado do Programa de Saúde da Família (PSF) de dois pequenos municípios do Rio Grande do Norte. Foi realizado um Estudo de Caso entre outubro e dezembro de 2007 utilizando 4 grupos focais com 60 usuários. O método de análise foi o de conteúdo, com as seguintes categorias: concepções sobre necessidades de saúde e PSF; integralidade do cuidado (acolhimento, vínculo, visita domiciliar), ações de promoção da saúde, facilidades e dificuldades em relação aos atendimentos, e participação social. Os resultados mostraram: percepção das necessidades de saúde como assistência; desconhecimento do programa; satisfação pela ampliação do acesso; melhoria da qualidade; vínculo; acolhimento; e visita domiciliar. O motivo de insatisfação foi a presença descontínua das equipes e a falta de centros de saúdes. Ações de promoção e controle social eram praticamente inexistentes, direcionando as reivindicações aos políticos locais. Concluiu-se que não houve conversão, e sim reprodução de um modelo de atenção simplificada, não articulado nem com promoção nem com saúde como direito social.

This study aims to evaluate the user's satisfaction with the Family Health Program in two small municipalities in Rio Grande do Norte. A case-study was conducted from October to December 2007, using four focus groups with 60 users. The method was the content analysis, with the following categories: conceptions of health needs and PSF; comprehensive care (welcoming, bond, home visits), health promotion activities, facilities and difficulties in relation to care, and social participation. The results show perception of health needs such as care; unfamiliarity with the program; satisfaction with broad accesses; improvement of quality; bond; welcoming, home visits. The reason for dissatisfaction was the lack of continuous teams and lack of central health clinics. Actions to promote better quality and social control hardly existed, directing the claims to local politicians. We concluded that there was no conversion, but a reproduction of a simplified model of attention, disarticulated both with health promotion and with health itself as a social right.

La estrategia de municipios saludables como política pública, Antioquia, Colombia, 2007 / Healthy cities strategy as public policy, Antioquia, Colombia, 2007

Objetivo: evaluar el proceso de formulación e implementación de la estrategia de municipios saludables como política pública en Antioquia, Colombia, en el periodo 2001-2005. Métodos: la investigación se realizó en dos componentes: uno cualitativo, para el cual se realizaron entrevistas semiestructuradas y grupos focales con los actores claves departamentales, subregionales y locales comprometidos en el proceso de formulación e implementación de la política; el componente cuantitativo incluyó una encuesta a los responsables institucionales municipales de la política y la revisión de los planes de desarrollo municipal del periodo 2004-2007. Resultados: la decisión política manifestada por las autoridades departamentales y locales acerca de la política de municipios saludables no fue suficiente para el desarrollo de la misma, la intención gubernamental no tuvo viabilidad en sus diferentes dimensiones y los planes de desarrollo municipal tampoco consideraron la viabilidad y sostenibilidad de la estrategia de municipios saludables como política pública. Conclusiones: el proceso de formulación de la política pública no fue deliberado, argumentado ni negociado; tampoco tuvo en cuenta el contexto político, económico, social ni el desarrollo institucional municipal. La decisión departamental no fue el resultado de un proceso incluyente para asegurar el desarrollo de la política.

Objective: to evaluate the formulation and implementation processes of the Healthy Cities Strategy as public policy in Antioquia, Colombia, from 2001 to 2005. Methods: the research was carried out in two sections. A qualitative component was conducted through semistructured interviews and focus groups with the actors involved in the formulation and implementation process of the public policy at the departmental, subregional and local level. The quantitative component is a cross-sectional study in a sample of towns that implanted the public policy. A survey was applied to local health directors of each town selected. Municipality development plans were also reviewed during the period 2004-2007. Results: politic decision taken for the departmental and local authorities about the policy was not enough to assure its development, the governmental intention did not go along viability in different dimensions, and Municipal Development Plans did not guarantee viability or sustentability of the healthy cities strategy as public policy. Conclusions: public policy formulation process was not deliberated, discussed or negotiated, nor political, economic, social or institutional context was taken into consideration. Departamental decision was not the result of an inclusive process intended to assure policy achievement.

Nosocomial Infections in Clinical Laboratory of Hospital Attached to Health Center of Small Towns:Hidden Danger and Administration Strategy / 中华医院感染学杂志

OBJECTIVE To prevent and control nosocomial infection in clinical laboratory of health center in small towns.METHODS Hidden danger of nosocomial infection was investigated and analyzed to formulate the strategy of precaution and control.RESULTS Management status in laboratory was not standardized and occurred several administration shortages such as supervising system,precaution consciousness,operating instruction,contamination zonation,medical garbage disposal,etc.CONCLUSIONS Adopting comprehensive management,establishing relevant rules and carrying on standardized administration are essential for prevention and control of nosocomial infections in laboratory of health center in small towns.