Search

Objectives: To assess hypertension prevalence and the extent and associated factors of hypertension diagnosis, follow‐up, treatment and control gaps in low‐income urban Medellin, Colombia. Methods: We randomly sampled 1873 adults aged 35 or older. Unaware hypertensive individuals were defined as those without previous diagnosis whose average blood pressure was equal to or above 140/90 mmHg. For aware hypertensive patients, control was delimited as average blood pressure below 140/90 if under 59 years old or diabetic, and as less than 150/90 otherwise. We used logistic regression to identify care gap‐associated factors. Results: Hypertension prevalence was 43.5% (95% CI 41.2–45.7). We found 28.2% aware and 15.3% unaware hypertensive individuals, which corresponds to a 35.1% (95% CI 31.9–38.5) underdiagnosis. This gap was determined by age, sex, education and lifestyle factors. 14.4% (95% CI 11.6–17.6) of aware hypertensive patients presented a follow‐up gap, 93.4% (95% CI 90.9–95.2) were prescribed antihypertensive drugs, but 38.9% (95% CI 34.7–43.3) were not compliant. The latter was strongly associated with follow‐up. The hypertension control gap in aware hypertensive patients, 39.0% (95% CI: 34.9–43.2), was associated with being older, having diabetes, weakly adhering to pharmacological treatment and receiving poor non‐pharmacological advice. Overall, 60.4% (95% CI 57.0–63.8) of aware and unaware hypertensive participants had either diagnosed but uncontrolled or undiagnosed hypertension. Conclusions: We found high hypertension prevalence coupled with, from an international perspective, encouraging awareness and control figures. Still, there remains ample room for improvement. Our findings can assist in designing integrated primary healthcare measures that further strengthen equitable and effective access to hypertension care and control. [ABSTRACT FROM AUTHOR]

Copyright of Revista Gerencia y Políticas de Salud is the property of Pontificia Universidad Javeriana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction: The safety climate (SC) measurement in the hospitals, is essential for the development of a patient safety policy (PSP). Information about SC in the operating rooms is scarce. Objective: To measure the dimensions of SC in Colombian Operating Rooms according to characteristics of surgical staff. Methods: Cross-sectional study. The Hospital Survey on Patient Safety and an additional module for operating rooms were administered to healthcare workers in 6 high-complexity hospitals in the Metropolitan Area of Medellín (Colombia). The positive responses percentage for each dimension was measured. Differences by profession and type of contract were analyzed. Results: A total of 442 participants were included. The workers in the operating rooms perceive a weak SC in terms of nonpunitive response to error and workload (49.4% and 59.3% positive responses, respectively). Differences were found between physicians and nurses with lower scores in nursing for dimensions related to patient care. Anesthesiologists present low scores in events reporting. There are also differences by the type of work contract. Conclusion: Despite the PSP, the perception of a punitive culture to error, with a high workload. Recognizing differences between the groups within the surgical units helps to focus interventions strengthening the patient safety. Introducción: La medición del clima de seguridad (CS) en las instituciones de salud es parte fundamental del desarrollo de una política de seguridad del paciente (PSP). Existe poca informacion acerca de la medició de clima de seguridad en las unidades quiróurgicas. Objetivo: Medir las dimensiones del CS en las unidades quirurgicas de seis instituciones de salud colombianas segun las características del personal. Métodos: Estudio de corte transversal. El cuestionario sobre seguridad del paciente en los hospitales (HSOPS) más la adición de un módulo para unidades quirurgicas se aplicó al personal de seis hospitales de III nivel de Medellín (Colombia). Se midio el porcentaje de respuestas positivas para cada dimension del CS. Se analizaron las diferencias por profesion y tipo de contrataci on. Resultados: Se incluyeron 442 participantes. El personal de las unidades quirurgicas percibe un CS débil en respuesta no punitiva al error y carga de trabajo (49,4% y 59,3% de respuestas positivas respectivamente). Se encontraron diferencias entre personal médico y de enfermería con puntajes más bajos de percepcion de CS en enfermería para aquellas dimensiones relacionadas con cuidado del paciente. Los anestesiologos presentan puntajes bajos en el reporte de eventos. Existen además diferencias segun el tipo de contrato de trabajo. Conclusiones: A pesar de la implementacion de políticas de seguridad del paciente, persiste la percepcion de una cultura punitiva frente al error, con una carga de trabajo elevado. El reconocimiento de las diferencias entre los grupos en las unidades quirurgicas permitirá focalizar intervenciones que fortalezcan la seguridad del paciente. [ABSTRACT FROM AUTHOR]

Background: People's different responses to HIV prevention programs have been related to collective patterns of significance that are imposed to their behaviors, and affect the success of health interventions. Objective: To understand the social conditions by which men who have sex with men (MSM) face their risks. Methodology: A qualitative study based on the symbolic interactionism was carried out in Medellín between 1993 and 2006. The places where MSM meet were identified and visited. Focus groups with key informants and 100 in-depth interviews were conducted, of which 39 of them were conducted with MSM. Results: The study identified and studied seven scenarios where MSM face the risk of HIV. In the region, homosexuality continues to be object of social stigma and MSM must create for themselves special stages, where sexual activity can be less difficult. These conditions have been exploited by the market, which perceives MSM as consumers with payment capacity, and it has generated an expansive offer of stages where MSM act out several of their fundamental needs but, at the same time, are also exposed to different risks. The scenarios are built as normative systems generated by the market whose structure is imposed to the individual behaviors, frequently restricting their capacity to be protected from the risk of infection. Conclusion: The findings illustrate the complexity of the subjective decisions involved with the personal protection and the management of the risks; and they question the paradigm of the rational consumer. On the contrary, the conjunction of the structural vulnerability and the individual vulnerability, in a context of social exclusion, conform an intricate net that should be assumed in its complexity and integrity by health policies. [ABSTRACT FROM AUTHOR]