Salud y calidad de vida autopercibida de los adultos mayores en un municipio del caribe colombiano

Objetivo: Determinar la relación entre calidad de vida y salud autopercibida en adultos mayores atendidos en las instituciones prestadoras de servicios de salud en un municipio del Caribe colombiano. Metodología: Se realizó un estudio descriptivo de tipo transversal con diseño observacional y con una fase correlacional, en una muestra de 365 adultos mayores seleccionados probabilisticamente que asisten al programa del Adulto mayor en las diferentes Instituciones prestadoras de servicios de salud en un municipio del Caribe colombiano. Se aplicó una encuesta sociodemográfica, el Índice multicultural de calidad de vida y la inclusión de dos preguntas para medir la salud autopercibida. Se usó la estadistica descriptiva y un modelo de regresión logistica multivariada. Se mantuvo la confidencialidad de la información, el anonimato de los participantes y se diligenció el consentimiento informado. Resultados: La percepción global de la calidad de vida en un 54 % fue deficiente, como regular en un 56 % autoperciben su salud como positiva; y un 44 % (161) como negativa. Las dimensiones con mayores puntuaciones fueron Bienestar psicosocial (55 %), autocuidado y funcionamiento (52 %), funcionamiento interpersonal (52 %), satisfacción espiritual (60%) y con menor puntuación: bienestar fisico (51 %), apoyo social (50) y satisfacción personal (51 %). Conclusión: Se encontró relación en las variables de calidad de vida y de salud autopercibida: en cuanto mayor autonomia, hay buena percepción de la salud, pero a mayor deterioro fisico, insatisfacción interpersonal y deficiente apoyo social, los adultos mayores tienen baja percepción global de su calidad de vida y de su salud.

Objective: To determine the relationship between quality of life and self-perceived health of the elderly treated in Health Services facilities of the elderly from a Colombian municipally Caribbean 2019. Method: A descriptive, cross-sectional study was carried out with an obervational design and a correlational pase, in a sample of 365 probabilistically selected older adults, who older adult program in the different health service providers from a Colombian municipally Caribbean. A sociodemographic survey, multicultural quality of life index and self-perceived health questionnaire were applied. Descriptive statistics and a multivariate logistic regression model were used. The confidentiality of the information, the anonymity of the participants, and the informed consent were filled out. Results: The overall perception of quality of life was 54%deficient as a regular, 56 % self-perceive their health as positive; and 44 % (161) as negative. The dimensions with the highest scores were Psychosocial Welfare (55%), Self-Care and Functioning (52 %), Interpersonal Functioning (52 %), Spiritual Satisfaction (60 %) and with lower score: physical well-being (51 %), social support (50) and personal satisfaction (51 %). Conclution: Tere was a relationship in the variables of quality of life and self-perceived health in terms of greater autonomy there is a good perception of health, but to greater physical deterioration, interpersonal dissatisfaction, poor social support older adults have low overall perception of their quality of life and health.

The path towards herd immunity: Predicting COVID-19 vaccination uptake through results from a stated choice study across six continents.

Despite unprecedented progress in developing COVID-19 vaccines, global vaccination levels needed to reach herd immunity remain a distant target, while new variants keep emerging. Obtaining near universal vaccine uptake relies on understanding and addressing vaccine resistance. Simple questions about vaccine acceptance however ignore that the vaccines being offered vary across countries and even population subgroups, and differ in terms of efficacy and side effects. By using advanced discrete choice models estimated on stated choice data collected in 18 countries/territories across six continents, we show a substantial influence of vaccine characteristics. Uptake increases if more efficacious vaccines (95% vs 60%) are offered (mean across study areas = 3.9%, range of 0.6%-8.1%) or if vaccines offer at least 12 months of protection (mean across study areas = 2.4%, range of 0.2%-5.8%), while an increase in severe side effects (from 0.001% to 0.01%) leads to reduced uptake (mean = -1.3%, range of -0.2% to -3.9%). Additionally, a large share of individuals (mean = 55.2%, range of 28%-75.8%) would delay vaccination by 3 months to obtain a more efficacious (95% vs 60%) vaccine, where this increases further if the low efficacy vaccine has a higher risk (0.01% instead of 0.001%) of severe side effects (mean = 65.9%, range of 41.4%-86.5%). Our work highlights that careful consideration of which vaccines to offer can be beneficial. In support of this, we provide an interactive tool to predict uptake in a country as a function of the vaccines being deployed, and also depending on the levels of infectiousness and severity of circulating variants of COVID-19.

Capturing and analysing heterogeneity in residential greywater reuse preferences using a latent class model.

To legally permit greywater reuse as a management strategy, it is necessary to establish allowed uses, as well as guarantee legitimacy, safety and maintain public trust. Cities with previous experience in greywater reuse have reconfigured their regulations according to their own evidence with decentralized water reuse systems. This has allowed them to encourage or restrict certain indoor uses of treated greywater. However, cities starting to use these residential schemes lack the experience to reconfigure their water and sanitation regulation, and thus need "blindly" decide on the type of greywater uses to allow in order to achieve a balance between users' acceptability and avoiding public health problems. In this research, we analyse hypothetical situations of greywater reuse based on real evidence related to decentralized water systems. The main objective of this study is to evaluate the heterogeneity of individuals' preferences regarding residential greywater reuse for six intended indoor uses, using stated choice experiments and a latent class model. Hence, we obtain preliminary evidence about the direction that the regulation or pilot tests should take. We use the context of Santiago (Chile) as a reference, where although allowed, greywater reuse is not taking place widely. Our results show that survey respondents can be classified into four classes (enthusiasts, greywater sceptics, appearance conscious and water expenditure conscious), according to the preferences for the different types of indoor greywater reuse and the appearance of the treated greywater. From a policy perspective, our results show differences across classes as a function of socioeconomic characteristics and previous greywater reuse knowledge, as well as wider household characteristics, including the presence of sensitive individuals (under 15 and over 74 years old), number of residents, number of sanitary devices, and location and type of garden.

Understanding the preferences for different types of urban greywater uses and the impact of qualitative attributes.

Greywater reuse can allow substantial improvements in the efficiency of potable water systems. However, widespread uptake of greywater reuse depends on its acceptability by the population. Previous studies have assessed the implementation costs of greywater reuse technology, and considered its acceptability in principle. Although cost is clearly very important in terms of adopting/installing the technology, the actual perception of greywater reuse is crucial in driving the acceptability of use and the long-term success of the technology. This study uses discrete choice models to quantify, for the first time, the preferences of different socio-economic groups for greywater of different quality (colour, odour) and for different uses inside homes. A stated choice survey that removed the influence of installation costs was developed, and implemented in Santiago, Chile. Although legislation allows greywater use in Santiago, it does not take place at any meaningful scale. Results show that, in decreasing order of preference, there is an overall acceptance for using high quality treated greywater for toilet flushing, laundry, garden irrigation, hand washing and, shower/bathtub use, but not for drinking. When the quality of appearance in terms of colour and odour gets worse, monetary incentives could be needed even for those uses that do not involve human contact. Gender, age, educational level, water expenditure level, and in particular previous knowledge about greywater reuse, are important determinants of acceptability and thus willingness to pay for greywater use; however, their importance varies according to the type of use. Our results provide important insights for understanding the conditions that would precipitate rapid and wide uptake of greywater reuse in cities, and thereby make better use of limited water resources.

Calidad del cuidado de Enfermería brindado por profesionales en una ciudad colombiana / Quality of nursing care, provided by professionals, in a Colombian city / Qualidade do cuidado de enfermagem prestado por profissionais de uma cidade colombian

Objetivo: Evaluar la calidad del cuidado de Enfermería brindado por profesionales en instituciones de salud de Sincelejo (Colombia), mediante la aplicación del Care Q. Materiales y métodos: Estudio descriptivo y transversal. La población se conformó por 515 pacientes, se estimó un cálculo de muestra inicial de 212 pacientes quienes respondieron al instrumento; tras eliminación por filtro a través de la pregunta control quedaron finalmente 123 pacientes que fueron captados mediante el tipo de muestreo no probabilístico de acuerdo con las condiciones de la investigación. La calidad fue valorada a través del instrumento Care Q que evalúa las siguientes dimensiones: ac-cesibilidad, explica, facilita, conforta, se anticipa, mantiene relaciones de confianza, monitorea y hace seguimiento. Se utilizaron: el análisis de frecuencias, porcentajes con su intervalo de confianza y alfa de Cronbach para la comprobación de fiabilidad del instrumento "Care Q" al contexto. Resultados: Se pudo hallar una calidad total alcanzada en un 62%. La dimensión con más alta calidad fue "monitorea y hace se-guimiento" (73,2%) y la más baja "se anticipa" (56,1%). 42% de los pacientes dijeron no haber sido atendidos y no reconocen a la Enfermera (o) del servicio. Conclusión: la calidad global del cuidado de Enfermería percibido por el usuario en las IPS es-tudiadas es regular (62%), con amplias oportunidades de mejora, lo que merece una revisión desde las instituciones de salud, las Enfermeras (os) y la academia

Objective: Evaluate the nursing care quality provided by professionals in health ins-titutions in Sincelejo (Colombia), through the application of Care Q. Materials and methods; Descriptive and cross-sectional study. The population consisted of 515 pa-tients, an estimated initial sample of 212 patients who responded to the instrument was calculated; after elimination by filter through a control question, 123 patients participated using a non-probability sample according to the conditions of the research. The quality was evaluated through the Care Q instrument, which evaluates the following dimensions: accessibili-ty, explains, facilitates, comforts, anticipates, maintains trusting relationships, monitors and follows up. Frequency analysis, percentages with their confidence interval and the Cronbach's alpha were used to verify the reliability of the instrument "Care Q" to the context. Results: The reached quality found was 62%. The dimension with the highest quality was "monitoring and follow up" (73.2%) and the lowest "anticipates" (56.1%). 42% of the patients said they were unattended and do not recognize the nurse. Conclusion: The global quality of nursing care perceived by the users in the studied IPS (Healthcare Provider) is regular (62%), with ample opportunities of improving, which merits a review from the health institutions, nurses and the academy

Objetivo: Avaliar a qualidade dos cuidados de enfermagem oferecido por profissionais em insti-tuições hospitalares de Sincelejo (Colômbia), mediante a aplicação do Care Q. Materiais e mé-todos: Estudo descritivo transversal. A população foi de 515 pacientes e estimou-se uma amostra inicial de 212 que responderam a escala. Após a realização do filtro utilizando-se uma pergunta con-trole, foram analisados 123 questionários mediante amostragem não probabilística de acordo com as condições da pesquisa. O Care Q avalia a qualidade as dimensões: acessibilidade, explicação, facilidade, conforto, antecipação, relacionamento de confiança, monitoramento e acompanhamento. Utilizou-se a análise de frequência, percentagens com intervalos de confiança e alfa de Cronbach para a comprobação de fiabilidade da escala Care Q para o contexto. Resultados: Encontrou-se uma qualidade total de 62%. A dimensão com maior qualidade foi "monitoramento e acompanhamento" (73.2%) e a menor qualidade observou-se na antecipação (56.1%). 42% dos participantes referiram não ter recebido atendimento e não reconheceram a enfermeira (o) do serviço. Conclusão: A qua-lidade global dos cuidados de enfermagem percebidos pelos usuários das instituições hospitalares estudadas é moderada (62%), com amplias oportunidades de melhoramento, o que merece atenção pelas instituições de saúde, as enfermeiras (os) e as escolas de enfermagem.

[Educational intervention for the control of dengue in family environments in a community in Colombia]. / Intervención educativa para el control del dengue en entornos familiares en una comunidad de Colombia.

OBJECTIVES: To evaluate the effectiveness of an educational intervention to induce changes in behavior to eliminate breeding places for the dengue vector in families from a community in the Municipality of Sincelejo, Colombia. MATERIALS AND METHODS: An educational intervention type was performed before and after, with a group of 54 families selected by convenience sampling. An educational program designed with the results of a knowledge test, a semi-structured interview, observation guide and the main concepts of the Communication for Behavioural Impact (COMBI) toolkit was applied. The impact was measured by proportion changes and the McNemar test. RESULTS: Post-intervention changes were made in the levels of inadequate knowledge about dengue and behavior of the vector from 14.8% to 3.7% (p=0.109), in their inadequate beliefs from 20.4% to 5.6% (p=0.008) and in adequate practices from 24 to 87% (p=0.001). At the end of the process with each of the participant groups, 64.8% were classified in the action stage. There was a reduction of the number of intradomiciliary Aedes breeding places from 92.6% to 35.2% (p=0.001). CONCLUSIONS: The intervention lead participants to adhere to the behavior changes that were promoted. It was useful to subdivide the population into those who apply preventive measures and those who only have the intention of making them, because this enables the health personnel to adopt actions according to the characteristics of each group.

Intervención educativa para el control del dengue en entornos familiares en una comunidad de Colombia / Educational intervention for the control of dengue in family environments in a community in Colombia

Objetivos. Evaluar la eficacia de una intervención educativa para inducir cambios en la conducta de eliminar los criaderos del vector del dengue en familias de una comuna del Municipio de Sincelejo en Colombia. Materiales y métodos. Se realizó un estudio de una intervención educativa tipo antes y después, con un solo grupo a 54 familias seleccionadas por conveniencia. Se aplicó un programa educativo diseñado con los resultados de un test de conocimiento, una entrevista semiestructurada, guía de observación y los referentes del modelo de adopción de precauciones y aspectos de la teoría de comunicación para impactar en conducta (COMBI). El impacto fue medido mediante proporción de cambios y la prueba de McNemar. Resultados. Posintervención se lograron cambios en los niveles de conocimientos inadecuados sobre el dengue y comportamiento del vector de un 14,8% a un 3,7% (p=0,109), en sus creencias inadecuadas de un 20,4% a un 5,6% (p=0,008) y en la practicas adecuadas del 24 al 87% (p=0,001). Se logró que al final del proceso concada uno de los grupos participantes clasificados el 64,8% se ubicaran en la etapa de acción. Se redujo el número de criaderos intradomiciliarios de Aedes, de un 92,6% a un 35,2% (p=0,001). Conclusiones. La intervención permitió conducir a los participantes a la adherencia de la conducta promovida. Fue útil subdividir a la población, en los que aplican las medidas preventivas y los que solo tienen la intención de realizarlas, porque permite al personal de salud adoptar las acciones de acuerdo a las características de cada grupo.

Objectives. To evaluate the effectiveness of an educational intervention to induce changes in behavior to eliminate breeding places for the dengue vector in families from a community in the Municipality of Sincelejo, Colombia. Materials and methods. An educational intervention type was performed before and after, with a group of 54 families selected by convenience sampling. An educational program designed with the results of a knowledge test, a semi-structured interview, observation guide and the main concepts of the Communication for Behavioural Impact (COMBI) toolkit was applied. The impact was measured by proportion changes and the McNemar test. Results. Post-intervention changes were made in the levels of inadequate knowledge about dengue and behavior of the vector from 14.8% to 3.7% (p=0.109), in their inadequate beliefs from 20.4% to 5.6% (p=0.008) and in adequate practices from 24 to 87% (p=0.001). At the end of the process with each of the participant groups, 64.8% were classified in the action stage. There was a reduction of the number of intradomiciliary Aedes breeding places from 92.6% to 35.2% (p=0.001). Conclusions. The intervention lead participants to adhere to the behavior changes that were promoted. It was useful to subdivide the population into those who apply preventive measures and those who only have the intention of making them, because this enables the health personnel to adopt actions according to the characteristics of each group.

Condición sociofamiliar, asistencial y de funcionalidad del adulto mayor de 65 años en dos comunas de Sincelejo (Colombia) / Social and family, health care and functional conditions of elderly people over 65 year old in two neighborhoods of Sincelejo (Colombia)

Objetivo: Determinar las condiciones sociofamiliares, asistenciales, funcionales y factores asociados en adultos mayores de 65 años en dos comunas de Sincelejo (Sucre, Colombia). Materiales y métodos: Estudio descriptivo, correlacional, de corte transversal y de contactos múltiples en una muestra de 275 adultos mayores de 65 años, residentes en 18 barrios que conforman las comunas 9 y 6 de la ciudad de Sincelejo. Mediante encuesta se indagaron las características sociodemográficas, hábitos higiénicos, problemas de salud. Se emplearon la Escala de Valoración Sociofamiliar de Gijón, Escala de Lawton y Brody, Índice de Katz para la valoración funcional y la Escala Minimental para la evaluación cognitiva. Resultados: El 61% de los adultos mayores son de sexo femenino y la media de edad de 75,4 años. Con criterios diagnósticos de hipertensión arterial (75.2%), cardiopatías isquémicas (70.5%) y osteoarticulares (68.3%), los cuales se incrementan con la edad, y en el sexo femenino, el 51% presenta pluripatología. La comorbilidad se relacionó con polimedicación (76%), problemas bucodentales (70.1%), dolores en miembros inferiores y depresión (68 y 54.1% respectivamente). El test de Gijón determinó que el 67.7% de los adultos mayores tenía riesgo y problema social, siendo más representativo en las mujeres (p < 0,05). La valoración funcional se deterioró con la edad (p < 0,05). Conclusión: Los adultos mayores se encuentran en vulnerabilidad y riesgo social, tienen buena capacidad funcional, la cual se deteriora con el incremento de la edad, y presentan una elevada comorbilidad.

Objective: To determine social, family, health care and functional conditions and risk factors of elderly people over 65 year old in two neighborhoods of Sincelejo (Colombia). Materials and methods: A descriptive, correlational and cross-sectional study was conducted. Multiple contacts were made with 275 elderly people over 65 years old who living in 18 different neighborhoods of Sincelejo. Through survey, socio demographic characteristics, habits and health problems were determined. We used the Gijón Social-Familiar Scale, Lawton and Brody Scale, and the Katz index to assess productivity and the Mini- mental Scale, to avaluate the cognitive state. Results: 61% of the elderly people studied are females and the average age is 75, 4 years old. 75.2% of the studied population aged 65 or older was diagnosed with hypertension, 70.5% of them with ischemic heart disease, and 68.3% with ostearticular heart disease and 51% with comorbidity, which was associated with multiple medication (76%), oral health (70.1%), lower body pains (68%) and depression (54.1%). Gijón test found that 67.7% of elderly were at high risk and have social problems, specially woman (p<0,05). Functional assessment gets worse with the aging process (p<0,05). Conclusion: The study found an elderly population at risk for social vulnerability; they have a good functional capacity that gets worse along with aging process and a high comorbidity.