Descifrando narrativas contemporáneas sobre la salud y la enfermedad: el proyecto Madrasa / Deciphering Contemporary Narratives on Health and Disease: The Madrasa Project

OBJETIVO: describir el desarrollo del proyecto Madrasa y sus resultados tras dos años de implementación. METODOLOGÍA: proyecto de innovación docente llevado a cabo con metodología de Investigación-Acción Participativa y la participación de alumnos de los grados de Enfermería, Medicina y Antropología Social y Cultural de la Universidad de Granada. Resultados principales: se realizaron 10 círculos narrativos, 2 elucidarios y 2 visitas dialogadas, contando con 19 expertos invitados. Se registraron 1203 participantes (785 alumnos) en las actividades presenciales y los círculos narrativos experimentaron 8.400 visitas desde las plataformas digitales, con una satisfacción media del 84 %. Conclusión principal: el proyecto Madrasa ha logrado instaurar una pedagogía innovadora, apoyada en la transformación digital, con enfoque multidisciplinar, que contribuye a incorporar a la enseñanza reglada de los futuros profesionales de la salud y la antropología, de una forma transversal, competencias para el desarrollo del pensamiento crítico en el análisis de la diversidad de narrativas que se producen en torno a la salud y la enfermedad en el mundo contemporáneo

OBJECTIVE: to describe the development of the Madrasa project and its results after two years of implementation. METHODOLOGY: teaching innovation project carried out with Participatory Action Research methodology and the participation of students from the Nursing, Medicine and Social and Cultural Anthropology degrees at the University of Granada. MAIN RESULTS: 10 narrative circles, 2 elucidations and 2 dialogued visits were carried out, with 19 invited experts. 1203 participants (785 students) were registered in the face-to-face activities and the narrative circles experienced 8,400 visits from digital platforms, with an average satisfaction of 84%. Main conclusion: the Madrasa project has managed to establish an innovative pedagogy, supported by digital transformation, with a multidisciplinary approach, which contributes to incorporating into the regulated education of future health and anthropology professionals, in a transversal way, competences for the development of critical thinking in the analysis of the diversity of narratives that occur around health and disease in the contemporary world

Typhoid and the Military in the Early 20th Century.

BACKGROUND: In the decades following the discovery of the bacillus causing typhoid, in 1880, understanding of the disease formerly known as enteric fever was transformed, offering new possibilities for prevention. Gradually, measures that aimed to prevent infection from human carriers were developed, as were inoculations designed to confer immunity against typhoid and paratyphoid fevers. These were initially introduced in European armies that were regularly ravaged by typhoid, especially garrisons stationed in the colonies. This article reviews the research undertaken in the armed forces and the measures that they implemented in the years up to and during the First World War. METHODS: The article is based on an analytical review of scientific literature from the early 19th century, focusing on the United Kingdom, Germany, and France. RESULTS: The armies of the United Kingdom, Germany, and France undertook important work on the transmission of typhoid in the years between 1890 and 1918. Many preventive measures were introduced to deal with the spread of typhoid but these varied between the 3 countries, depending largely on their political traditions. Inoculation was particularly successful in preventing typhoid and greatly reduced the number of casualties from this disease during the First World War. Despite this, it proved difficult to prevent paratyphoid infection, and debates continued over which vaccines to use and whether or not immunization should be voluntary. CONCLUSIONS: By the end of the First World War, the value of inoculation in preventing the spread of typhoid had been proven. Its successful implementation demonstrates the importance of vaccination as a public health intervention during times of conflict and social upheaval.

Implementation of the risk and harm reduction strategy against unsafe abortion in Uruguay: From a university hospital to the entire country.

The history of the creation of the risk and harm reduction model applied to unsafe abortion is reviewed, from its initial implementation by a small group of gynecologists at the Pereira Rossell Hospital Center in Uruguay to its spread to the rest of the country. Its ethical rationale, its successful application in the hospital, the decision to disseminate it with the cooperation of the International Federation of Gynecology and Obstetrics (FIGO), and the intervention procedures are explained. It was evaluated from the epidemiological and anthropological viewpoints, from the changes in professionals' and users' perception of the care offered and its impact on complications and maternal deaths. A very favorable change was seen in the number and quality of the services, the providers' attitude, and maternal morbidity and mortality were reduced. It also brought visibility to women with unplanned and unwanted pregnancies and an improved understanding of their problems, which contributed to the legislative changes that were made subsequently.

Sostenibilidad y excelencia del sistema sanitario catalán. Nuevos paradigmas, retos y respuestas / Sustainability and excellence of the Catalan health system. New paradigms, challenges and responses

El objetivo de un sistema de salud y la prioridad de un gobierno es la de anticiparse a los problemas, dar respuestas innovadoras a las nuevas necesidades y modelos de atención, mejorar la accesibilidad de los ciudadanos y pacientes al sistema sanitario, atender especialmente a los colectivos más vulnerables, mejorar los resultados de salud y hacer las reformas estructurales necesarias para mantener viable y hacer sostenible una sanidad pública de calidad para todos. En el contexto actual, los sistemas de salud se enfrentan a nuevos paradigmas en ámbitos como el económico, demográfico, asistencial, social, tecnológico y político, a los que las políticas de salud deben dar respuesta. Frente a estos retos, los sistemas de salud, y en el caso de Cataluña en concreto, tienen el reto de tomar decisiones sobre cómo orientar las reformas estructurales que posibiliten la sostenibilidad económica y presupuestaria necesarias al servicio de unas nuevas políticas de salud innovadoras y centradas en la persona en un sistema marcado por la excelencia y la equidad (AU)

The aim of a health system and the priority of any government is to anticipate problems before they appear, provide an innovative response to these new needs and healthcare models, improve access of the general public and patients to health care, especially care for the most vulnerable groups, improve healthcare results and implement the structural reforms necessary to maintain a viable and sustainable quality public healthcare system for everyone. In the current environment, health systems are facing new economic, demographic, care, social, technological and political paradigms to which health policy must respond. Faced with these challenges, health systems, especially in the case of Catalonia, are challenged to take decisions on how best to approach the implementation of structural reform designed to facilitate the necessary economic and fiscal sustainability in the service of fresh and innovative health policies and patient-centred care within a system marked by excellence and equity (AU)

Going for gold: blood planning for the London 2012 Olympic Games.

The Olympics is one of the largest sporting events in the world. Major events may be complicated by disruption of normal activity and major incidents. Health care and transfusion planners should be prepared for both. Previously, transfusion contingency planning has focused on seasonal blood shortages and pandemic influenzas. This article is the first published account of transfusion contingency planning for a major event. We describe the issues encountered and the lessons identified during transfusion planning for the London 2012 Olympics. Planning was started 18 months in advance and was led by a project team reporting to the Executive. Planning was based on three periods of Gamestime. The requirements were planned with key stakeholders using normal processes enhanced by service developments. Demand planning was based on literature review together with computer modelling. The aim was blood-stock sufficiency complimented by a high readiness donor panel to minimise waste. Plans were widely communicated and table-top exercised. Full transfusion services were maintained during both Games with all demands met. The new service improvements and high readiness donors worked well. Emergency command and control have been upgraded. Red cell concentrate (RCC) stock aged but wastage was not significantly increased. The key to success was: early planning, stakeholder engagement, service developments, integration of transfusion service planning within the wider health care community and conduct within an assurance framework.

Attempts to undermine tobacco control: tobacco industry "youth smoking prevention" programs to undermine meaningful tobacco control in Latin America.

We sought to understand how the tobacco industry uses "youth smoking prevention" programs in Latin America. We analyzed tobacco industry documents, so-called "social reports," media reports, and material provided by Latin American public health advocates. Since the early 1990s, multinational tobacco companies have promoted "youth smoking prevention" programs as part of their "Corporate Social Responsibility" campaigns. The companies also partnered with third-party allies in Latin America, most notably nonprofit educational organizations and education and health ministries. Even though there is no evidence that these programs reduce smoking among youths, they have met the industry's goal of portraying the companies as concerned corporate citizens and undermining effective tobacco control interventions that are required by the World Health Organization Framework Convention on Tobacco Control.

Segunda presentación del documento: "Plan de Salud, Atención Primaria y Medicina Social". Santiago de Chile 1964. (Candidatura presidencial del Dr. Salvador Allende) / Second presentation of the document: health plan of primary care and social medicine

El programa de salud de 1964 del candidato Salvador Allende es un documento con una riqueza político técnica incalculable. Daré algunas razones para argumentar esta aseveración. Pero antes, quisiera recordar algunos elementos de contextualización histórica en relación a la protección social en salud hasta los sesenta. En aquella época existía como antecedente importante una evolución de la sanidad chilena desde la creación del Seguro Obrero Obligatorio en 1924, seguida de otros hitos relevantes tales como la promulgación de la ley de medicina preventiva en 1938, el envío del proyecto de creación del sistema nacional de salud por el Ministerio de Salud Salvador Allende en 1941, la creación en 1942 de Protinfa, la fundación del Colegio Médico en el 48, la promulgación del estatuto del médico funcionario en 1951, y el año siguiente la creación del SNS y el SSS, y finalmente la aparición de las mutualidades de seguridad en 1958, que verán en 1968 respaldada sus funciones en la protección de los trabajadores a través de la ley respectiva

The last Senior Medical Inspector of Factories and his place in the history of occupational health.

BACKGROUND: Apart from a few industrialists with senses of enlightened self-interest and of ethics, 19th century Occupational Health (OH) in the United Kingdom was essentially in the care of Her Majesty's Factory Inspectorate (HMFI). Two World Wars drew attention to the special health and efficiency needs of workers in the armaments industry, but it required the climate of a Welfare State after the Second for more general provision to be considered. A number of committees made recommendations for enhancing OH that were not implemented, and it was not until 1972 that a political will developed to enhance the State's provision. As a result of a far-sighted senior civil servant, a remarkable Senior Medical Inspector was in post, ready and willing to assist in bringing about change. METHODS: Published official materials have been reviewed in the light of the author's observation of events and persons from 1967 onwards. RESULTS: For a few years, as a consequence of a political will, academic, corporate, and governmental OH burgeoned in Britain, but with a decline in the economy and political change favoring deregulation, it underwent regression. CONCLUSIONS: Any number of committees may meet to discuss OH provision but their reports will moulder until there is a will for implementing their recommendations, at which the requisite funds and persons materialize to establish institutions. When the political climate changes, it will not be difficult to find persons who for a consideration will assist in their demolition.