Community-Based Knowledge Translation Strategies for Maternal, Neonatal, and Perinatal Outcomes: A Systematic Review of Quantitative and Qualitative Data.

Objective: To identify and assess the effect of community-based Knowledge Translation Strategies (KTS) on maternal, neonatal, and perinatal outcomes. Methods: We conducted systematic searches in Medline, Embase, CENTRAL, CINAHL, PsycInfo, LILACS, Wholis, Web of Science, ERIC, Jstor, and Epistemonikos. We assessed the certainty of the evidence of the studies using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework. Results: We identified seven quantitative and seven qualitative studies. Quantitative findings suggest that there is a possible effect on reducing maternal mortality (RR 0.65; 95% CI, 0.48-0.87; moderate evidence certainty); neonatal mortality (RR 0.79; 95% CI 0.70-0.90; moderate evidence certainty); and perinatal mortality (RR 0.84; 95% CI 0.77-0.91; moderate evidence certainty) in women exposed to KTS compared to those who received conventional interventions or no intervention at all. Analysis of qualitative studies identified elements that allowed to generate benefit effects in improving maternal, neonatal, and perinatal outcomes. Conclusion: The KTS in maternal, neonatal, and perinatal outcomes might encourage the autonomy of communities despite that the certainty of evidence was moderate.

Métodos de investigación empleados para el análisis del acceso a los servicios de salud en contextos rurales / Research methods used for the analysis of access to health services in rural contexts

Introducción: La ruralidad y los sistemas de salud a nivel global constituyen un campo de fuerzas marcado por la pervivencia de la ruralidad y las condiciones de inequidad y desigualdad en el acceso a los servicios de salud. Objetivo: Identificar los métodos de investigación utilizados en el contexto internacional para analizar los servicios de salud en poblaciones rurales. Métodos: Se realizó un estudio de revisión sistemática que incluyó los reportes de investigación relacionados con el tema, publicados hasta diciembre de 2014. El proceso de selección de los estudios se realizó en cuatro etapas: identificación, cribado, elegibilidad e inclusión. Se recuperaron 253 referencias que muestran la diversidad metodológica de aproximación al acceso a servicios de salud en poblaciones rurales. Conclusiones: Se necesita una mirada diferenciada a la ruralidad para elaborar políticas públicas eficientes, que estén en concordancia con los contextos y necesidades de las comunidades que demandan los servicios de salud(AU)

Introduction: Rurality and health systems represent globally a field of forces marked by the survival of rurality and the inequity and inequality conditions in the access to health services. Objective: Identify the research methods used in the international context to analyze health services in rural populations. Methods: It was carried out an study of systematic review that included research reports related with the topic published until December, 2014. The selection process of the studies was conducted in four stages: identification, sieving, elegibility and inclusion. 253 references were recovered and those show the methodological diversity of approaches in the access to health services in rural populations. Conclusions: It is needed a different view to rurality for creating efficient public policies that are in accordance with the contexts and needs of communities that demand health services(AU)

Immunomodulatory, trypanocide, and antioxidant properties of essential oil fractions of Lippia alba (Verbenaceae).

BACKGROUND: Parasite persistence, exacerbated and sustained immune response, and continuous oxidative stress have been described to contribute to the development of the cardiac manifestations in Chronic Chagas Disease. Nevertheless, there are no efficient therapies to resolve the Trypanosoma cruzi infection and prevent the disease progression. Interestingly, trypanocide, antioxidant, and immunodulatory properties have been reported separately for some major terpenes, as citral (neral plus geranial), limonene, and caryophyllene oxide, presents in essential oils (EO) extracted from two chemotypes (Citral and Carvone) of Lippia alba. The aim of this study was to obtain L. alba essential oil fractions enriched with the aforementioned bioactive terpenes and to evaluate the impact of these therapies on trypanocide, oxidative stress, mitochondrial bioenergetics, genotoxicity, and inflammatory markers on T. cruzi-infected macrophages. METHODS: T. cruzi-infected J774A.1 macrophage were treated with limonene-enriched (ACT1) and citral/caryophyllene oxide-enriched (ACT2) essential oils fractions derived from Carvone and Citral-L. alba chemotypes, respectively. RESULTS: ACT1 (IC50 = 45 ± 1.7 µg/mL) and ACT2 (IC50 = 80 ± 1.9 µg/mL) exhibit similar trypanocidal effects to Benznidazole (BZN) (IC50 = 48 ± 2.5 µg/mL), against amastigotes. Synergistic antiparasitic activity was observed when ACT1 was combined with BZN (∑FIC = 0.52 ± 0.13 µg/mL) or ACT2 (∑FIC = 0.46 ± 1.7 µg/mL). ACT1 also decreased the oxidative stress, mitochondrial metabolism, and genotoxicity of the therapies. The ACT1 + ACT2 and ACT1 + BZN experimental treatments reduced the pro-inflammatory cytokines (IFN-γ, IL-2, and TNF-α) and increased the anti-inflammatory cytokines (IL-4 and IL-10). CONCLUSION: Due to its highly trypanocidal and immunomodulatory properties, ACT1 (whether alone or in combination with BZN or ACT2) represents a promising L. alba essential oil fraction for further studies in drug development towards the Chagas disease control.

Rurality as an analytic category: implications for public health / Ruralidad como una categoría analítica: implicaciones para la salud pública

ABSTRACT Rurality as a concept was originated within the framework of the migration phenomena of the nineteenth century. During the post-war period, a dichotomic approach was established for this concept, along with the emerging notion of growth, which influenced the economic models of multiple countries worldwide. However, during the last 50 years, the rurality concept acquired a polysemic nature. Thus, the main objective of this article is analyzing several definitions of rurality from the perspective of some subdisciplines of the social sciences and their lines of thought to evaluate their implications for public health within different contexts.

RESUMEN El concepto de ruralidad surgió en el marco de los fenómenos migratorios ocurridos durante el siglo XIX. Para el periodo posguerra, con la emergente noción de desarrollo, se configuró una aproximación dicotómica al concepto, que influyó en los modelos económicos de distintos países del mundo. No obstante, durante los últimos 50 años la ruralidad adquirió un carácter polisémico. En consecuencia, el objetivo del artículo es analizar las definiciones de ruralidad desde algunas disciplinas de las ciencias sociales y sus corrientes de pensamiento, con el fin de inferir sus implicaciones para la salud pública en distintos contextos.

Rurality as an analytic category: implications for public health.

Rurality as a concept was originated within the framework of the migration phenomena of the nineteenth century. During the post-war period, a dichotomic approach was established for this concept, along with the emerging notion of growth, which influenced the economic models of multiple countries worldwide. However, during the last 50 years, the rurality concept acquired a polysemic nature. Thus, the main objective of this article is analyzing several definitions of rurality from the perspective of some subdisciplines of the social sciences and their lines of thought to evaluate their implications for public health within different contexts.

Evidencias para la prevención y control de lesiones en motociclistas / Evidence for the prevention and control of injuries in motorcyclists

Los accidentes del tránsito representan una de las principales causas de mortalidad, lesiones y discapacidad en personas a nivel mundial. Este fenómeno no es ajeno al contexto colombiano, con la particularidad del aumento del parque automotor durante las últimas dos décadas con mayor número de motocicletas, que representan más del 50 por ciento de las lesiones y muertes en los accidentes de tránsito. El trabajo fue autorizado por el comité de ética e investigación, su propósito es identificar las estrategias más efectivas que contribuyan a la prevención y control de las lesiones causadas por el tránsito de motocicletas. Se realizó una revisión sistemática de la literatura que incluyó estudios observacionales, investigación cualitativa y estudios econométricos. Se recopilaron 30 artículos publicados entre el 2002 y el 2013. Estos estudios muestran la implementación del uso del casco, de medidas de visibilidad, control de comportamientos de riesgo y la aplicación de leyes donde se restringe la ingesta de alcohol, como las principales prácticas orientadas a la prevención de accidentes en los motociclistas. El presente estudio resalta la robustez del uso del casco como la principal medida para la prevención y control de estos accidentes, reconoce la complejidad del fenómeno y la necesidad en consecuencia de la sinergia entre métodos cualitativos y cuantitativos para darleuna mayor explicación; supone una base conceptual sólida para la generación de políticas públicas pertinentes que busquen la disminución de la morbilidad, mortalidad y discapacidad asociada a este tipo de siniestros viales(AU).

Traffic accidents represent one of the main causes of mortality, injuries and disabilities worldwide. This phenomenon is also present in the Colombian setting where its main feature is related to the significant increase of the car fleet over the past two decades, with greater number of motorcycles, accounting for more than 50 percent of the lesions and deaths from road traffic accidents. The ethics and research committee authorized the presentation of this paper. Its objective was to identify the more effective strategies that will contribute to the prevention and control of injures from motorcycle traffic accidents. A systematic literature review including observational, qualitative and econometric studies was made. Thirty studies published from 2002 to 2013 were gathered. These studies showed the implementation of the use of helmet provisions, visibility measures, control of risky behaviors and application of laws on alcohol consumption as the main practices aimed at the prevention of motorcycle accidents. The present study underlined the soundness of the helmet use as the main measure for the prevention and control of accidents. It also recognized the complexity of this phenomenon and the need of synergy between qualitative and quantitative methods to provide broader explanation. This paper represents a sound conceptual basis for the generation of relevant public policies in search of the reduction of morbidity, mortality and disability associated to this type of road disasters(AU).

Impacto y repercusión de 37 revistas de Enfermería del Espacio Científico Iberoamericano. Año 2008 / Impact Index of 37 journals of Nursing Science Space Iberoamericano. Year 2008

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