RESUMO
PURPOSE: This study aimed to describe and assess the regional experience of a pediatric hematology/oncology fellowship program based in Guatemala. METHODS: The Unidad Nacional de Oncología Pediátrica (UNOP) in Guatemala City, Guatemala, is the only hospital in Central America dedicated exclusively to childhood and adolescent cancer. To address the regional need for specialists, a fellowship program in pediatric hematology/oncology was launched in 2003. The UNOP fellowship program comprises 3 years of training. Although the program is based at UNOP, it also includes rotations locally and internationally to enhance clinical exposure. The curriculum is based on international standards to cover clinical expertise, research, professionalism, communication, and health advocacy. Trainees are selected according to country or facility-level need for pediatric hematologists/oncologists, with a plan for them to be hired immediately after completing their training. RESULTS: Forty physicians from 10 countries in Latin America have completed training. In addition, there are currently 13 fellows from five countries in training. Of the graduates, 39 (98%) are now practicing in pediatric hematology/oncology in Latin America. Moreover, many of them have leadership positions within their institutions and participate in research, advocacy, and policy making. Graduates from the UNOP program contribute to institutions by providing care for an increasing number of patients with pediatric cancer. The UNOP program is the first pediatric hematology/oncology fellowship program in the world to be accredited by Accreditation Council for Graduate Medical Education-International, an international body accrediting clinical training programs. CONCLUSION: The UNOP program has trained specialists to increase the available care for children with cancer in Latin America. This regional approach to specialist training can maximize resources and serve as a model for other programs and regions.
Assuntos
Bolsas de Estudo , Hematologia , Oncologia , Pediatria , Humanos , Guatemala , Hematologia/educação , Bolsas de Estudo/organização & administração , Oncologia/educação , Pediatria/educação , Criança , Adolescente , Neoplasias , FemininoRESUMO
ABSTRACT: Objective: To explore patient experience for non-surgical periodontal therapy using phenomenography. Methods: This qualitative study was performed in a postgraduate specialist training program in periodontics. Patients reported their experiences through in-depth interviews in order to recognize the impact of non-surgical periodontal therapy on their quality of life and their satisfaction. A homogeneous sampling procedure was used, establishing redundancy after the fifteenth interview. Interviews were audio recorded, transcribed and analyzed by three researchers who codified the answers into categories to determine the emerging topics. Results: The core emerging themes were: (i) lack of information about periodontal disease; (ii) experience during treatment; (iii) treatment implications; and (iv) clinician-patient relationship. Conclusions: Patients seem to have limited knowledge about periodontal diseases. Reasons for attendance mainly include bleeding gums, tooth mobility, and aesthetic problems. Therapy can generate pain, fear, and is considered invasive, whereas dentine hypersensitivity may occur post-operatively. Despite this, patients would be willing to undergo treatment again and were generally satisfied with the level of care and treatment received.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Doenças Periodontais , Periodontia , Periodontite/terapia , Educação de Pós-Graduação em OdontologiaRESUMO
Introducción: La Organización Internacional para las Migraciones (OIM), reportó en 2018 244 millones de migrantes en el mundo, el 3,3 por ciento de la población mundial. De ellos, México es el segundo país expulsor con 13 000 000. El fenómeno migratorio y la salud guardan estrecha relación, debido a diversos factores de riesgo que influyen en lo personal y familiar. Objetivo: Identificar los factores de riesgo relacionados con la salud de las personas migrantes durante el proceso migratorio. Métodos: Estudio de investigación transversal, prospectivo, no comparativo. Se desarrolló de marzo de 2017 a diciembre de 2018, en la ciudad de Tijuana, Baja California, en seis instituciones de apoyo al migrante. El instrumento contó con 62 ítems. La muestra fue de 392 migrantes mexicanos de ambos sexos, mayores de 18 años, que migraron y vivieron en Estados Unidos y regresaron a México. Resultados: De los 392 migrantes, resultaron 96,3 por ciento hombres y 3,8 por ciento mujeres, el principal factor de migración fue el económico (76,3 por ciento); 92 por ciento salió sano de México; 31,4 por ciento adquirió una nueva adicción, principalmente cristal (9,4 por ciento) y marihuana (6,6 por ciento). El 11,2 por ciento regresó con alguna enfermedad crónica: 4,1 por ciento con hipertensión; 3,1 por ciento con diabetes mellitus tipo 2 y 1,8 por ciento con epilepsia. Conclusiones: Las etapas del proceso migratorio de tránsito y vivir en los Estados Unidos fueron las que generaron mayores riesgos a la salud, la primera por los accidentes y agresiones de terceras personas y la segunda vinculada a la adquisición de nuevas adicciones a sustancias ilegales(AU)
Introduction: The International Organization for Migration (IOM) reported, in 2018, 244 million migrants worldwide, 3.3 percent of the world population. Of these, Mexico is the second country of origin, accounting for 13 000 000. The migration phenomenon and health are closely related, due to various risk factors that influence the personal and familial aspects. Objective: To identify risk factors related to the health of migrants during the migration process. Methods: Cross-sectional, prospective and noncomparative research study carried out from March 2017 to December 2018, in the city of Tijuana, Baja California, at six institutions that support migrants. The instrument had 62 items. The sample consisted of 392 Mexican migrants of both sexes, over 18 years of age, who migrated to and lived in the United States, and returned to Mexico. Results: Of the 392 migrants, 96.3 percent were men and 3.8 percent were women. The main migration factor was the economic (76.3 percent). 92 percent left Mexico healthy, while 31.4 percent acquired a new addiction, mainly crystal meth[amphetamine] (9.4 percent) and marijuana (6.6 percent). 11.2 percent returned with any chronic disease: 4.1 percent, with hypertension; 3.1 percent, with type 2 diabetes mellitus; and 1.8 percent, with epilepsy. Conclusions: The stages of the immigration process of transit and living in the United States were those that generated the greatest health risks; the first, due to accidents and assaults by third parties and the second in association with the uptake of new addictions to illegal substances(AU)
Assuntos
Humanos , Masculino , Feminino , Nível de Saúde , Fatores de Risco , Emigração e Imigração , Epidemiologia Descritiva , Estudos Transversais , Estudos Prospectivos , MéxicoRESUMO
Introducción: La Organización Mundial de la Salud considera a la planificación familiar posparto como la principal intervención que salva la vida de madres e hijos, porque al favorecer periodos intergenésicos de dos o más años, reduce en 10 y 30 por ciento la mortalidad infantil y materna, respectivamente. Objetivo: Determinar los factores que influyen en el uso de métodos anticonceptivos post evento obstétrico. Métodos: Estudio descriptivo, observacional y transversal. Se estudiaron mujeres en edad reproductiva durante los meses de mayo y junio de 2018, en un centro de salud en la Ciudad de México. Participaron 136 mujeres quienes tenían hasta un máximo de once meses y 29 días posterior a evento obstétrico. Se elaboró un cuestionario de autoaplicación, anónimo, integrado por 21 preguntas. La información fue integrada en el programa SPSS V25, y analizada a través de estadística descriptiva e inferencial. Resultados: Se encontró correlación significativa entre el uso de métodos anticonceptivos post evento obstétrico y las variables: conocimiento de la pareja en el uso de método anticonceptivo (p < 0,000); escolaridad de la paciente (p < 0,020); área del centro de salud en la que recibió la consejería (p < 0,032) y número de relaciones sexuales mensuales (p < 0,038). Conclusiones: El estudio logró determinar cuatro factores que influyen en el uso de métodos anticonceptivos post evento obstétrico, los cuales, están relacionados directamente con el éxito o fracaso en la consejería para planificación familiar prenatal(AU)
Introduction: The World Health Organization considers postpartum family planning as the main intervention that saves the lives of mothers and children, because, by favoring intergenetic periods of two or more years, it reduces infant and maternal mortality by 10% and 30 percent, respectively. Objective: To determine the factors that influence the use of contraceptive methods after an obstetric event. Methods: Descriptive, observational and cross-sectional study. Women of reproductive age were studied during the months of May and June of 2018, at a health center in Mexico City. 136 women participated who had up to a maximum of eleven months and 29 days after an obstetric event. An anonymous self-application questionnaire was prepared, consisting of 21 questions. The information was integrated into the program SPSS version 25, and analyzed through descriptive and inferential statistics. Results: A significant correlation was found between the use of contraceptive methods after an obstetric event and the variables knowledge of the couple regarding the use of the contraceptive method (P<0.000), schooling of the patient (P<0.020), area of the health center in which counseling was received (P<0.032), and number of monthly sexual relations (P<0.038). Conclusions: The study permitted to determine four factors that influence the use of contraceptive methods after an obstetric event, which are directly related to the success or failure of prenatal family planning counseling(AU)
Assuntos
Humanos , Anticoncepção/métodos , Sexualidade , Período Pós-Parto , Saúde Reprodutiva/educação , Epidemiologia Descritiva , Estudos Transversais , Planejamento Familiar , Estudo ObservacionalRESUMO
BACKGROUND: Peru has a public health problem because of asbestos imports. We analyzed the mortality trends for mesothelioma in Peru and its provinces from 2005 to 2014 and estimated their relationship with the amount of asbestos imported previously. METHODS: We computed age-standardized mortality rates (ASMRs) per 100,000 population (direct method and SEGI world standard population reference), and the standardized mortality ratio (SMR). The relationship between the amount of asbestos imported annually along the period 1965-2010 and the number of mesothelioma deaths per year from 2005 to 2014 was estimated by log-linear Poisson regression models and Pearson correlation calculations. RESULTS: After correcting the number of deaths, Peru registered 428 cases (or 430 when corrected cases are rounded by sex) between 2005 and 2014. The highest ASMRs were in Arequipa and Callao (range: 0.40-0.41/100,000 population), followed by Huancavelica (0.36/100,000 population). This translates into approximately one death per each 68-111 of asbestos tons imported. The latency period for the higher level of positive correlation found was 8 years (râ¯=â¯0.8). Male female sex ratio was lower in provinces such as Junin and Hunacavelica with geological asbestos risk. CONCLUSIONS: Two patterns of mesothelioma risk have been detected, occupational and environmental. During the 2002-2006 years, Peru increased the asbestos use. If crocidolite imports were also increased, this could be behind the 8 years latency period detected. Peru should boost strategies towards the total ban of all forms of asbestos.
Assuntos
Amianto/efeitos adversos , Carcinógenos/toxicidade , Mesotelioma/mortalidade , Exposição Ocupacional/efeitos adversos , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Geografia , Humanos , Lactente , Recém-Nascido , Masculino , Mesotelioma/epidemiologia , Mesotelioma/etiologia , Pessoa de Meia-Idade , Peru/epidemiologia , Prognóstico , Taxa de Sobrevida , Adulto JovemRESUMO
En el contexto la VII Cumbre Iberoamericana de Medicina Familiar, efectuada en Cali, Colombia el 13 y 14 de Marzo de 2018, el grupo de investigación y la Red Iberoamericana de Medicina Familiar (IBIMEFA) con el objetivo de Identificar las percepciones de médicos familiares graduados y en proceso de formación de Iberoamérica, sobre las condiciones que tienen para desarrollar investigación aplicada al territorio, realizaron un estudio exploratorio, descriptivo, de corte transversal en los países miembros de la Confederación Iberoamericana de Medicina Familiar (CIMF). Para la recolección de información, se diseñó una encuesta con 51 items, cuyo contenido fue validado por el grupo de trabajo. El instrumento se almacenó en Google Drive y su divulgación se efectuó a través de medios virtuales. Se obtuvo respuesta de 277 personas, representantes de 16 países de Iberoamérica en los que se encontró que existe interés y potencial dentro del grupo de la Red IBIMEFA, para realizar estudios con el enfoque de investigación aplicada al territorio, aunque se deben superar dificultades de tiempo y financiación para lograrlo, así como encontrar estratégias que permitan hacer un trabajo cooperativo que consolide la Red.
In the context of the pre-summit and the VII Ibero-American Family Medicine Summit, held in Cali, Colombia on March 13 and 14, 2018, the research group and the Ibero-American Family Medicine Network (IBIMEFA) with the objective of identifying the perceptions of family doctors graduated and in process of formation of Ibero-America, on the conditions they have to develop applied research to the territory, carried out an exploratory, descriptive, cross-sectional study in the member countries of the Ibero-American Confederation of Family Medicine (CIMF)). For the collection of information, a survey was designed with 51 items, whose content was validated by the working group. The instrument was stored in Google Drive and its dissemination through virtual media. A response was obtained from 277 people, representatives from 16 countries of Ibero-America in which it was found that there is interest and potential within the group of the IBIMEFA Network, to carry out studies with the research focus applied to the territory, although time difficulties must be overcome and funding to achieve it, as well as finding strategies that allow cooperative work to consolidate the Network.
No contexto da pré-cúpula e da VII Cúpula Ibero-Americana de Medicina de Família, realizada em Cali, Colômbia, em 13 e 14 de março de 2018, o grupo de pesquisa e a Rede Ibero-Americana de Medicina Familiar (IBIMEFA) com o objetivo de identificar as percepções de médicos de família formados e em processo de formação da Ibero-América, sobre as condições que têm para desenvolver pesquisa aplicada ao território, realizaram um estudo corte-transversal, descritivo, e exploratório, nos países membros da Confederação Iberoamericana da Medicina Famíliar (CIMF)). Para a coleta de informações, foi elaborada um questionario com 51 itens, cujo conteúdo foi validado pelo grupo de trabalho. O instrumento foi armazenado no Google Drive e sua divulgação foi feita através de mídia virtual. Foi obtida resposta de 277 pessoas, representantes de 16 países da Ibero-América e se verificou que há interesse e potencial dentro do grupo da Rede IBIMEFA, para realizar estudos com o foco de pesquisa aplicada ao território, ainda que se deva superar dificuldades relacionadas ao tempo e ao financiamento para conseguir realiza-la, bem como encontrar estratégias que permitam o trabalho cooperativo para consolidar a Rede.
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Pesquisa , Medicina de Família e Comunidade , Determinantes Sociais da SaúdeRESUMO
Estudio exploratorio, transversal, descriptivo y cuali-cuantitativo, con el objetivo de determinar las condiciones de acceso y cobertura de los servicios de salud de Medicina Familiar y Atención Primaria para la población migrante en Iberoamérica. Se preparó un cuestionario con 22 preguntas relacionadas con el fenómeno de la migración y la prestación de servicios de salud en medicina familiar y atención primaria, el cual fue validado en apariencia y contenido por profesores de las Universidades de México, Colombia y Ecuador. Posteriormente fue respondida y documentada cada pregunta por los docentes e investigadores de 13 países de la región. Las conclusiones y recomendaciones propuestas por el Grupo de Trabajo sobre Migración y Salud de la VII Cumbre Iberoamericana de Medicina Familiar, fueron: a) reconocer el derecho a la salud de las personas migrantes y sus familias; b) incorporar en los programas de pregrado, posgrado y formación continua, las competencias necesarias para la atención integral de la población migrante y de sus familias y c) la creación de un observatorio de salud de los migrantes.
This is an exploratory, transverse, Qualitative-Quantitative descriptive research, whose objective is to determine the Primary Access and Family Medicine Healthcare conditions for the migrant population in Ibero-America. With the support of University Professors from the Mexico, Colombia and Ecuador Universities, a validated 22 question questionnaire was prepared with items related to the migration phenomenon and healthcare services in Primary Care access and Family Medicine. Subsequently it was responded by the involved researchers of the 13 countries in the region. The conclusions and proposed recommendations from the Work Group on Migration and Healthcare of the VII Iberoamerican Family Medicine Summit were: a) It is necessary to recognize the migrants and their family rights to proper healthcare b) Include in the undergraduate, postgraduate and continuous educational programs the needed capabilities and skills towards an integral healthcare of the migrant populations and their families and c) create a Migrant Health Observatory entity.
Estudo exploratório, transversal, descritivo e quali-quantitativo, com o objetivo de determinar as condições de acesso e cobertura dos serviços de saúde de Medicina de Família e Atenção Primária para a população migrante na América Latina. Foi elaborado um questionário com 22 perguntas relacionadas ao fenômeno da migração e da prestação de serviços de saúde em medicina de família e cuidados de saúde primários, que foi validado na forma e conteúdo por professores de universidades no México, Colômbia e Equador. Posteriormente, foi respondida e documentada cada pergunta por professores e pesquisadores de 13 países da região. As conclusões e recomendações propostas pelo Grupo de Trabalho sobre Migração e Saúde da VII Cúpula Ibero-Americana de Medicina de Família, foram: a) reconhecer o direito à saúde dos migrantes e suas famílias; b) incorporar em cursos de graduação, pós-graduação e educação continuada, as competências necessárias para o atendimento integral dos migrantes e suas famílias e c) a criação de um observatório da saúde dos migrantes.
Assuntos
Atenção Primária à Saúde , Saúde , Medicina de Família e Comunidade , Migração Humana , Serviços de SaúdeRESUMO
Introducción: la reprobación es una de las principales manifestaciones de fracaso escolar, generalmente suele ser relacionada con factores de origen personal, económico, social, cultural, docente o institucional. En otros términos, la reprobación debe ser analizada en un contexto multivariado para identificar sus causas y efectos. Objetivos: identificar los factores que se asocian y predicen la reprobación en alumnos de la carrera de Medicina en 2014. Métodos: estudio exploratorio, transversal, retrospectivo, comparativo. Se analizó un universo de 388 alumnos en servicio social de enero de 2014. Se formaron dos grupos de estudio: Grupo 1 (alumnos que no reprobaron materias durante la carrera) y Grupo 2 (alumnos que sí reprobaron materias durante la carrera). Se elaboró y validó un cuestionario con 58 items relacionadas con: factores sociodemográficos, educativos, de satisfacción de los alumnos y desarrollo de servicio social. De estas, fueron seleccionadas 21 items que pudieran tener relación con la reprobación. Se realizó análisis multivariado, mediante la técnica de análisis discriminante.Resultados: el análisis multivariado reportó que sólo siete de ellas fueron discriminantes significativas asociadas a la reprobación, en orden de importancia son: la edad, ser seleccionado a la residencia, ingreso familiar, sexo, repetición de años durante la primaria o secundaria, años que tardó en ingresar a la carrera y el tipo de actividad realizada durante el servicio social. Conclusiones: la predicción de que un alumno repruebe o no materias en la licenciatura de medicina se debe a la sinergia que se produce entre las siete características mencionadas, no se deben "aislar las variables" para considerarlas predictivas por sí mismas(AU)
Introduction: Academic failure is one of the main school manifestations, usually associated with factors of personal, economic, social, cultural, educational or institutional origin. In other words, Academic failure must be analyzed in a diverse and varied context to identify its causes and effects. Objectives: To identify associated factors and predict failure in students of the medical major in 2014. Methods: Exploratory, cross-sectional, retrospective, comparative study. A universe of 388 students in social service was analyzed in January 2014. Two study groups were formed: group 1 (students who did not fail any subjects during the course) and group 2 (students who failed subjects during the course). A questionnaire was elaborated and validated, containing 58 items related to: sociodemographic and educational factors, student satisfaction and social service performance. 21 of these items were chosen as they could be associated with academic failure. A multivariate analysis was performed, using the discriminant analysis technique. Results: The multivariate analysis reported that only seven were significant discriminants associated with academic failure, arranged by importance are: age, being chosen for the residence, family income, sex, retake of academic years in primary or secondary levels, years to enter the major and the type of activity carried out during the social service. Conclusions: The prediction that a student may fail or may not fail subjects in the medical major depends on the synergy between the seven characteristics that were mentioned; the variables should not be isolated to consider them predictive by themselves(AU)
Assuntos
Humanos , Estudantes de Medicina , Universidades , Fracasso Acadêmico , MéxicoRESUMO
Se presentan los resultados del diagnóstico situacional de 16 países de América Latina, en cuanto a sus Sistemas de Referencia y Contrarreferencia de pacientes entre los tres niveles de atención médica. Los resultados de la investigación fueron analizados por representantes de los países miembros de WONCA Iberoamérica CIMF, en el marco de la VI Cumbre Iberoamericana de Medicina Familiar en San José de Costa Rica en abril de 2016.
The results of the Situational Analysis among their various levels of healthcare of 16 countries in Latin America related to their Referral and Counter-Referral Patient Management Systems are presented in this document. The research results were analyzed by WONCA Latin America country member representatives at the VI Ibero-American Family Medicine Summit in San Jose, Costa Rica in April 2016.
São apresentados os resultados do diagnostico situacional de 16 países da América Latina em relação aos seus Sistemas de Referência e Contra-Referencia de pacientes entre os três níveis de atenção médica. Os resultados da pesquisa foram analisados por representantes dos países membros da WONCA Ibero-Americana CIMF no âmbito da VI Cúpula Ibero-Americana de Medicina Familiar em San Jose, Costa Rica em abril 2016.