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En el presente artículo analizamos los abordajes de los medios digitales sobre las necesidades y demandas sociosanitarias de comunidades residentes en zonas rurales, remotas y desatendidas de Santiago del Estero, Argentina. Desde un diseño cualitativo y una perspectiva teórica que vincula comunicación en salud y pensamiento crítico en salud, construimos un corpus de 27 noticias publicadas entre 2016 y 2023, que clasificamos en tres dimensiones, y analizamos su contenido. Los resultados permiten identificar acciones de resistencia y organización frente a la ausencia de respuestas institucionales sociosanitarias, particularmente ante los efectos en salud de la exposición a pesticidas y disciplinamientos sobre la salud sexual y (no) reproductiva. Concluimos que la construcción de relatos periodísticos refleja procesos de subalternización y resistencia y disputas de sentidos relativos a los posicionamientos de diferentes actores sociales. Sobre estos registros, visibilizamos los modos en que los medios ponen en agenda problemas sociosanitarios de comunidades vulneradas.

The impact of the coronavirus disease‐2019 (COVID‐19) pandemic has been felt worldwide. While the United States appears to be on path to recovery, the economic burden and rising medical care expenditures associated with the pandemic remains in the trillions of dollars. Utilizing data from the US Department of Health and Human Services and FAIR Health, this study estimates the economic burden of COVID‐19 for Idaho was estimated through assessment of direct medical costs and indirect costs for years 2020–2021. Total direct medical hospital costs associated with COVID‐19, among adults, were estimated as the sum of hospital costs associated with inpatient visits. The cost of testing was included in the direct cost assessment, with data from the Idaho Division of Public Health and Medicare Administrative Contractor payment rates. To determine indirect absenteeism costs, daily cases were multiplied by 7 to account for days of missed productivity; this number was then multiplied by an employment‐adjusted average daily wage to obtain a lost productivity dollar value. Lastly, premature mortality costs were estimated based on the lost value of future earnings. Results show that in 2020, the associated direct and indirect costs of COVID‐19 amounted to over $608 million and increased to over $1.3 billion in 2021 for the state of Idaho. As the pandemic lingers on with new variants and mutations, rising costs will continue to place a heavy burden on many Idahoans, who are already often face disparate health outcomes and access to health care. Key points: The economic burden of the COVID‐19 pandemic is in the trillions of dollars.Idaho is a uniquely rural and western state with low vaccination rates.In Idaho, direct and indirect costs of the COVID‐19 pandemic were high.Idaho's total economic burden exceeded $601 million in 2020 and $1.35 billion in 2021. [ABSTRACT FROM AUTHOR]

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El objetivo de este estudio fue estimar la prevalencia de diabetes mellitus (DM) y factores de riesgo cardiovascular en una población rural de la provincia de San Luis, Argentina. Estudio transversal desarrollado entre septiembre y noviembre de 2017 con habitantes de 18 años y más de cuatro localidades del departamento Juan Martín de Pueyrredón, San Luis. Los participantes respondieron preguntas por autorreporte sobre aspectos sociodemográficos, hábitos, factores psicosociales y de riesgo para enfermedades no transmisibles; se realizaron mediciones físicas, cuestionario FINDIRSC y extracción de muestras de sangre. Se obtuvieron estimaciones univariadas estratificadas por sexo con su intervalo de confianza del 95% (IC95%). Se trabajó con factores de expansión de la muestra; se calcularon prevalencias crudas y ajustadas. La población estuvo constituida por 424 varones (52,5%, IC95%: 46,0-58,9) y 384 mujeres (47,5%, IC95%: 41,1-54,0). Las prevalencias ajustadas para ambos sexos (por autorreporte) fueron: DM 11,8% (IC95%: 8,2-15,4); hipertensión arterial (HTA): 35,5% (IC95%: 31,0-40,1); colesterol elevado: 20,3% (IC 16,0-24,7). Los varones tuvieron colesterol HDL deseable y tensión arterial elevada en una proporción significativamente superior a las mujeres; las mujeres obesidad abdominal en mayor magnitud. El 16,4 % (IC95%: 11,0 - 23,6) ostentó riesgo alto-muy alto de desarrollar DM tipo 2 en los próximos 10 años. Las prevalencias ajustadas de DM, HTA y colesterol elevado fueron inferiores a la de la población urbana de la provincia de San Luis. Destacamos la contribución pionera de este trabajo al conocimiento del perfil de salud de las comunidades rurales de Argentina.

In 1934, Alfonso López Pumarejo, the recently elected president of Colombia, announced that expanding government programs in public health and education would be a priority for his administration. This article analyzes this period's cultural transformation programs, examining the establishment and operation of sanitary units, mixed healthcare centers, and itinerant rural health commissions in the 1930s and the 1940s. It proposes a two-part argument. First, it demonstrates how reformers, intellectuals, and doctors associated with Latin America's first wave of social medicine transformed existing institutional spaces to serve the aims of the government's new public health model, designing and implementing programs to extend healthcare into the countryside. They proposed shifting from campaigns focused on eradicating a single disease to campaigns that tackled multiple diseases and also advocated for an increase in national, departmental, and municipal fiscal contributions to public health programs. Second, it touches upon the fiscal and resource-related challenges that limited these programs' reach. These challenges illustrate the fractured and fragmented nature of the Colombian state and its lack of capacity to effectively integrate the countryside by reaching often neglected remote rural areas. [ABSTRACT FROM AUTHOR]

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Objetivo: Identificar los tipos de estudios realizados sobre el conflicto armado colombiano, sus campos interdisciplinares, métodos y técnicas, así como las concepciones acerca de conflicto armado y ruralidad utilizados en los mismos, y su pertinencia para la salud pública. Metodología: En esta investigación, de índole cualitativa y metateórica, se efectuó una revisión narrativa, para lo cual se empleó un protocolo de búsqueda de artículos, con criterios de inclusión y exclusión. Se incluyeron artículos y trabajos de investigación existentes en bases de datos y repositorios institucionales, los cuales fueron sometidos a análisis de contenido. Resultados: En su mayoría, los estudios analizados provienen de repositorios institucionales universitarios y, en términos disciplinares, surge de las ciencias sociales, humanas y políticas. Por consiguiente, los métodos investigativos utilizados son mayormente los acuñados en dichas disciplinas, como el etnográfico y las historias de vida, aunque se presentan métodos correlacionales y experimentales. Pocos trabajos utilizan referentes conceptuales o teóricos explícitos sobre el conflicto armado y la ruralidad, lo que genera inquietudes académicas, éticas y políticas respecto a las formas en que se comprenden y abordan las realidades en estos temas. De 101 trabajos analizados, solo 7 pertenecen el campo de la salud, y de estos, únicamente 1 al campo de la salud pública. Este hallazgo resulta notable, dados los múltiples efectos que ha generado el conflicto sobre la salud y la vida de diferentes grupos de la población colombiana. Conclusión: Los efectos de la violencia, las guerras, los conflictos y sus efectos sobre la salud poblacional han sido objeto de interés de organismos internacionales y nacionales, y de algunos académicos del campo de la salud pública. Se hace necesario un mayor protagonismo de la salud pública frente a los efectos del conflicto colombiano sobre la población.

Introduction: worldwide, acute respiratory infection (ARI) is one of the principal causes of medical consultation. It is related to a significant burden in terms of morbidity and mortality, especially among people at extreme ages of life. To Identify the respiratory viruses associated with acute respiratory infection in children and adults, at ESE San Rafael de Yolombó, between October 2021 and April 2022. Methodology: following the national recommendations of the Ministry of Health, an ARI surveillance program was implemented. A cross-sectional study was developed under an analysis of a secondary source of information. A total of 212 cases were studied, all of which met the criteria ARI. A descriptive analysis of the demographic and clinical characteristics of the sample was performed. Results: the global percentage of positivity for viral isolation was 15.7 %. The highest positivity (19.2 %) was recorded among children from zero to 4 years old. Of the total positive cases, the respiratory syncytial virus was detected in 54.4 %, influenza A in 24.2 %, metapneumovirus in 15.2 %, and parainfluenza virus 3 in 6.1 %. 78.8 % of cases required hospital treatment, 7.8 % of which were derived to a high-level hospital. 13.5 % of the pediatric population was born prematurely, and 45.8 % of the adult population suffered from some cardiometabolic disease. Conclusions: the care of ARI cases represents a high burden for the health care system in rural areas. The continuity of epidemiological surveillance programs for this event in scattered areas of the country constitutes a crucial tool for planning its management from the field of public health. [ABSTRACT FROM AUTHOR]

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Objective: To identify the types of studies conducted on the Colombian armed conflict, their interdisciplinary fields, methods, techniques, as well as the conceptions of armed conflict and rurality used in these studies and their relevance for public health. Methodology: In this qualitative and metatheoretical study, we conducted a narrative review, which involved using a search protocol for selecting papers following inclusion and exclusion criteria. We included articles and research papers subjected to content analysis that were found in institutional repositories and databases. Results: Most of the analyzed studies are from university institutional repositories and, in disciplinary terms, from social, human, and political sciences. Thus, the research methods that are used are primarily those coined in these fields, such as the ethnographic and life stories methods, although correlational and experimental methods are also included. Few works use explicit conceptual or theoretical references to armed conflict and rurality. This generates academic, ethical, and political concerns regarding how the realities of these issues are understood and addressed. Of the 101 papers we analyzed, only 7 belong to the field of healthcare, and of these, only 1 belongs to the field of public health. This finding is noteworthy, given the multiple effects that the conflict has had on the health and lives of various groups of the Colombian population. Conclusion: The effects of violence, wars, conflicts, and their effects on population health have been the subject of interest of international and national bodies and of some academics in the field of public health. There is a need for a stronger role of public health in addressing the effects of the Colombian conflict on the population. [ABSTRACT FROM AUTHOR]

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Objetivo: En el marco del proyecto de extensión solidaria universitaria “Laboratorio de salud rural e intercultural comunidad de Bojayá, Chocó”, este artículo presenta los resultados correspondientes a la fase de diagnóstico individual y la aproximación inicial al diagnóstico colectivo de la situación de salud presente en un colectivo afrocolombiano sobreviviente a una masacre emblemática ocurrida en Colombia. Metodología: Exploración preliminar y elementos de diagnóstico comunitario con 66 sobrevivientes de la masacre del 2 de mayo de 2002 en el poblado de Bellavista, en el municipio de Bojayá, Chocó. Resultados: Se identificaron condiciones socioeconómicas deficientes, diagnósticos clínicos desatendidos, y se efectuó la aproximación inicial a potencialidades disponibles para el afrontamiento de las necesidades en salud individuales y colectivas de la población abordada, representadas en saberes comunitarios y posibilidad de acceso a programas y servicios institucionales en salud para víctimas. Conclusiones: Pese a que transcurrieron más de 15 años desde el momento de ocurrencia de la masacre de Bojayá hasta nuestro trabajo con la comunidad, se encontró persistencia de múltiples necesidades insatisfechas que afectan negativamente la situación de salud individual y colectiva, sin adecuada ni oportuna intervención. Cualquier acción futura que se plantee para atender tales asuntos debe tomar en cuenta las condiciones histórico-sociales que configuran los procesos de salud-enfermedad-cuidado en dicha comunidad

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Objetivo: Determinar la percepción de los médicos que realizan el Servicio Rural y Urbano Marginal de Salud (SERUMS) en Perú sobre el trabajo en el primer nivel de atención (PNA) y sus factores asociados. Materiales y métodos: Se realizó un análisis secundario de datos de una muestra de médicos que realizaron el SERUMS el 2016. Para evaluar la variable de interés se utilizó la escala de «Percepción sobre el trabajo en el PNA», cuyos puntajes más altos indican una peor percepción del trabajo en el PNA. Se aplicó una encuesta basal (antes del SERUMS) y una encuesta de seguimiento (8-12 meses de iniciado el SERUMS) y se evaluaron las diferencias en los puntajes. Resultados: De los 780 encuestados, 215 (27,6%) completaron la encuesta basal y de seguimiento. La media del puntaje incrementó considerablemente (de 3,4 a 6,7; p 0,001), lo que indica una peor percepción del trabajo en el PNA tras iniciar el SERUMS. De los tres dominios de la encuesta, el de las percepciones sobre el médico que trabaja en el PNA y el de las percepciones sobre el trabajo asistencial en el PNA incrementaron los puntajes de percepción sobre el trabajo en el PNA. No se encontraron variables sociodemográficas asociadas al cambio en los puntajes. Conclusiones: La percepción de los médicos sobre el trabajo en el PNA se deteriora luego de iniciar el SERUMS. Se deben promover estrategias que incentiven el interés de los médicos en este nivel de atención.

Se propone un modelo conceptual sobre condiciones y medio ambiente de trabajo en salud que integra la evidencia disponible para facilitar el diseño y la evaluación de intervenciones orientadas a mejorar la atracción, captación y retención del personal de salud en el primer nivel de atención de áreas rurales y remotas. Se consultó la evidencia teórica, empírica y testimonial para fundamentar la propuesta y se sintetizaron 15 modelos difundidos en los últimos 20 años. El artículo da cuenta de la diversidad de perspectivas y la complejidad que conlleva establecer las dimensiones que deben considerarse en una propuesta que sea útil para aplicar a las políticas de recursos humanos en salud. El modelo propuesto incluye cuatro categorías de componentes: factores del contexto externo, factores organizacionales, condiciones del empleo y del trabajo, y factores individuales. Los límites entre los componentes –así como el peso y la influencia de cada uno– varían en función de la relación entre ellos y de la interacción con el medio, por lo que su interpretación debe adecuarse al ámbito en que se pretenda aplicar. A partir de este modelo conceptual, el diseño y la evaluación de las intervenciones dirigidas a incrementar la disponibilidad de personal de salud –en particular en el primer nivel de atención de áreas rurales y remotas de la Región de las Américas– deberían surgir de una interacción entre las políticas de salud y empleo, y las realidades y expectativas de los trabajadores y las comunidades.

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Aiming to reveal the rural nursing professionalization, knowledge circulation and state health policies in the Araucania region in Chile, from 1970 to 1990, a historical, descriptive investigation is carried out. Oral history is worked, including 9 nurses through snowball sampling. The data are analysed by coding based on thematic criteria. Rigor is worked by researcher triangulation and Guba and Lincoln criteria. Ezekiel Emanuel's ethical principles are respected. As a result, the following metacategories emerge: Professional rural nursing practice marked by social needs, Professional practice duality, Rural assistants training, Health programs leadership and Personal living conditions transformation. It is concluded that nurses performed their role as health care managers with abnegation and prominent vocation based on the needs they faced, adapting themselves to rurality, living complex realities in an environment of poverty and social vulnerability, thus, developing personally and professionally. [ABSTRACT FROM AUTHOR]

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Este artículo da cuenta de una indagación sobre los significados que han construido sobre la salud un grupo de jóvenes y adultos mayores de Tenjo (Cundinamarca) que tienen prácticas de medicina tradicional. Se encontró que las prácticas y saberes en medicina tradicional han sido aprendidas y transmitidas en entornos familiares y comunitarios; los sanadores comunitarios construyen relaciones de confianza con el otro que sufre, a diferencia de la atención despersonalizada que prestan los profesionales de la salud; y la salud mental emerge como dimensión del mundo privado en donde la relación con los profesionales especializados en el área es casi inexistente. El estudio de los saberes populares sobre medicina tradicional que han construido las comunidades es una tarea científica y política, necesaria para proveer formación y atención psicosocial en salud de carácter intercultural.

Objetivo: describir los aspectos metodológicos del primer estudio epidemiológico sobre el perfil de enfermedades no transmisibles (ENT) en áreas rurales de Argentina llevado a cabo en 2017. Métodos: Se utilizó un diseño transversal. La población de referencia fueron los habitantes de 18 años y más de las localidades de Beazley, Zanjitas, Alto Pelado y Cazador, departamento Juan M. de Pueyrredón, provincia de San Luis, Argentina. El número de habitantes de esa franja etaria, según la última fuente censal, era de 808 habitantes. Se visitaron todas las viviendas de cada localidad; se invitó a participar a todos los sujetos que cumplieran con los criterios de inclusión. La investigación se conformó en dos fases: aplicación de cuestionario por autorreporte en la vivienda, seguida de mediciones físicas, cuestionario FINDIRSC (Finnish Diabetes Risk Score) y determinaciones bioquímicas. Los datos fueron volcados en una base de datos en Epi Info 7. El procesamiento y análisis estadístico se realizó en lenguaje R 3.5.2. Resultados: se obtuvieron 375 registros de encuestas con datos completos, que representó el 46.41% % de la población registrada según fuente censal; 252 realizaron análisis de laboratorio (67,20%) y 250 examen físico (66,67%). Los participantes de la fase de encuesta exhibieron características similares a aquellos que completaron todas las etapas de la investigación para la mayoría de las características estudiadas. Conclusiones: esta investigación fue pionera en generar conocimiento sobre el perfil de ENT en población rural de Argentina. Se espera que constituya un insumo para la planificación de políticas de prevención teniendo en cuenta las particularidades locales.

Objective: to understand the relationship between occupational risks in agricultural work and the negotiation for the health of rural workers. Method: mixed nested concurrent study, combined with equal integration (QUAN + QUAL). It was conducted with 351 farmers, between 2014/2015, using a form and semi- structured interview. For the analysis, descriptive and inferential statistics and the descending hierarchical classification, and the word cloud were used. Results: in the QUAN phase, the average age of 50.58 years old was obtained and a predominance of symptoms of illness in the muscular, endocrine, and urinary systems. In the QUAL phase, it became evident that the negotiation of agricultural products increases the exposure of workers to physical, chemical, and ergonomic risks. Profit represents the goal and allows for the cost of equipment, health care, and drug therapy, through illness. Conclusion: occupational risks are present in agricultural work. Negotiation is reduced to the consumption of health services and products in the presence of illness. [ABSTRACT FROM AUTHOR]

Objective: to know the mental health care notions and practices from the perspective of peasant women. Method: exploratory-descriptive study, with a qualitative approach. The study had the participation of 18 peasant women. Data were produced through a semi-structured interview, from March to April 2017, and subjected to thematic analysis. Results: the mental health notions are still influenced by the religiosity and the conception of madness of the classical age. Socialization, participation in groups, leisure and religiosity stood out as care practices. Conflicting family relationships, idleness, nervousness, suffering, stress, work overload and economic difficulties were factors producing mental illness. Conclusion: the mental health care of the peasants should be considered by public policies, thus requiring actions from health professionals in order to promote this care. [ABSTRACT FROM AUTHOR]

Objective: Within the framework of the project of solidary continuing education "Laboratory of rural and intercultural health community of Bojayá, Chocó", this paper presents the results of the individual diagnostic phase and the initial approach to the collective diagnosis of the health status diagnosis presented in an Afro-Colombian group surviving to a notorious massacre occurred in Colombia. Methodology: Preliminary exploration and community diagnosis elements with 66 survivors of the massacre occurred on May 2, 2002 in the Bellavista village, in the municipality of Bojayá, Chocó. Results: Deficient socio-economic conditions and neglected clinical diagnosis were identified. An initial approach to the available potentialities to face the individual and collective health needs of the approached population was made, represented by community knowledge and accessibility to institutional programs and health services for victims. Conclusions: Although more than 15 years have passed from the occurrence of the Bojayá massacre until our work with the community began, the persistence of numerous unsatisfied needs that negatively affect the individual and collective health status, without adequate and timely intervention, was found. Any further action looking to address such matters should take into account the socio-historical conditions that define the health-illness-care process in that community. [ABSTRACT FROM AUTHOR]

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La presencia de arsénico (As) en las aguas subterráneas es de origen natural y constituye un problema de salud pública debido a que se trata de un evento de alta frecuencia en determinadas regiones de la Provincia de Santa Fe, Argentina. El objetivo fue valorar cambios bioquímicos y genotóxicos en poblaciones rurales con cantidades variables de As en agua de consumo humano. El trabajo incluyó 308 voluntarios que habitan en la región centro de la provincia y que aceptaron participar mediante la firma del consentimiento informado. Se les realizó una entrevista que permitió describir hábitos alimentarios, y valorar cambios bioquímicos (hemograma, glucemia, uricemia, uremia, creatininemia, colesterolemia, trigliceridemia) y de daño oxidativo al ADN (Ensayo Cometa modificado con endonucleasa). Del análisis de la encuesta se pudo observar que un 35 % sigue consumiendo agua subterránea con contenidos variables de As, y solo un 22 % consume agua segura. El resto de los participantes continúa utilizando el agua con As para cocinar sus alimentos, lo que explica los resultados de excreción de As elevados obtenidos en orina. Se observó, además, daño oxidativo en el ADN en los consumidores de agua con As respecto a los que ya no la consumen (p

En este artículo se ha evaluado el grado de satisfacción profesional del personal de salud rural, respecto a la capacitación por medio de teleclínicas del Proyecto ECHO. Se realizó un estudio descriptivo, transversal, de campo y no experimental. A través de la plataforma ZOOM, en las teleclínicas, se presentaron casos médicos de endocrinología e hipertensión, con la asesoría de especialistas y dirigido a profesionales de salud rural. Usando soporte digital gratuito, se aplicó un cuestionario de encuesta a 57 participantes, estructurado en seis dimensiones. Se efectuó la medición en base a la Escala de Likert; el análisis estadístico consistió en la obtención de la media y desviación estándar, así como porcentajes generales de satisfacción. La mayoría de participantes (81,5%) estuvieron satisfechos con la aplicación de las teleclínicas. En todas las dimensiones se observaron puntuaciones que reflejan un elevado nivel de satisfacción. Desde la percepción de los profesionales, las teleclínicas les brindaron un soporte de aprendizaje permanente a bajo costo, contribuyendo al desarrollo profesional y la solución de problemas de la práctica médica.

Introducción: en el marco del nuevo modelo de atención en salud, piloto en Colombia, el cuarto nivel de referencia para el departamento de Guainía correspondió a un hospital universitario localizado en Bogotá. Objetivo: caracterizar las gestantes procedentes de Guainía con atención del parto en el Hospital de San José entre junio 2016 y junio 2018. Metodología: serie de casos con análisis descriptivo de variables. Resultados: 29 fueron embarazos de alto riesgo, edad mediana 24.5 años (rango: 15 a 40), 73% procedían de zona urbana, 72% partos por cesárea, 52% pretérmino. 45% multíparas y dos embarazos gemelares. Todos los diagnósticos de remisión y egreso coincidieron, 55% tuvieron preeclampsia, 24% amenaza de parto pretérmino y 7% restricción del crecimiento intrauterino. En los neonatos 45% tuvieron bajo peso o bajo extremo al nacer, 41% requirieron cuidado intensivo y 38% ingresaron a plan canguro. No hubo casos de mortalidad materna ni perinatal. Discusión: las cero muertes reflejan el beneficio clínico con la remisión extradepartamental. La alta procedencia urbana puede deberse a fallas de registro y/o difícil acceso de las zonas dispersas. Conclusión: la remisión aérea de gestantes con riesgo alto a una institución predefinida de alta complejidad tiene beneficio clínico. Se requiere optimizar en el territorio de origen la atención prenatal y las acciones de salud pública, en especial preeclampsia y bajo peso al nacer.

En el año 2006, el Foro Nacional de la Agricultura Familiar (FONAF), redactó una serie de documentos en los cuales se indicaba la no accesibilidad a servicios de salud de calidad, como un limitante para el desarrollo de las familias en el campo. En ese marco y a propósito de un contexto de definición de políticas públicas para el sector, durante los años 2013 a 2016, se llevó adelante un estudio de casos en el Departamento Paclín (región centro este de la provincia de Catamarca-Argentina) a fin de conocer y analizar los procesos de salud-enfermedad-atención de las familias incluidas en el sector de la agricultura familiar. En este artículo nos centramos en el objetivo de caracterizar el trabajo agrícola familiar, para comprender cómo estos procesos, junto a las características propias de los sistemas de salud, se transforman en determinantes sociales de la salud. Se recuperan así los saberes y prácticas de los sujetos en relación a sus propias búsquedas de salud orientadas a la autoatención, la prevención y el cuidado en un contexto atravesado por el trabajo productivo, doméstico y comunitario. Las autoras detallan la propuesta metodológica considerando algunas de las referencias teóricas orientada a la obtención de datos durante el trabajo de campo, para luego presentar los resultados y la discusión a la luz de las características de los procesos salud-enfermedad-atención (PSEA) que reconstruyeron.

Este estudio tiene como objetivo evaluar la prevalencia del dolor cervical y los factores asociados entre agricultores que producen tabaco. Se realizó un estudio transversal en el que participaron 2.469 agricultores que producen tabaco en el sur de Brasil. Para la caracterización del dolor cervical se utilizó una adaptación del cuestionario nórdico para síntomas musculoesqueléticos. El análisis multivariante se realizó mediante la regresión de Poisson, siguiendo un modelo teórico jerárquico. La prevalencia del dolor cervical en el año previo entre la población estudiada fue del 7,4%. Las variables que se asociaron con el dolor cervical entre las mujeres trabajadoras fueron la edad, el consumo de tabaco, el enfardado del tabaco, el uso de motosierras pesadas, trabajar en un ritmo intenso o acelerado y la enfermedad del tabaco verde, mientras que, entre los varones, fueron la edad, el uso de motosierras pesadas, el trabajo sentado en el suelo, la intoxicación por plaguicidas y la enfermedad del tabaco verde. El estudio refuerza la importancia de las cargas de trabajo ergonómicas y fisiológicas en la determinación del dolor cervical. Se necesitan estudios futuros para comprender el papel de la exposición a los plaguicidas y a la nicotina en los problemas musculoesqueléticos. La mecanización de la cosecha del tabaco podría reducir la exposición ergonómica y química, mejorando así la salud de los agricultores.

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Botswana was the first African country to introduce free antiretroviral treatment (ART) to people living with human immunodeficiency virus (HIV), but today it has the third highest HIV prevalence rate (20.3 per 100 population) in the world. This study investigates the availability and accessibility of ART facilities in Botswana and the utilization of ART services in districts with high HIV prevalence and low percentages of ART uptake. Availability and accessibility are measured using Botswana's ART site model and road network analysis. Microdata on HIV status from the Botswana AIDS Impact Survey IV (BAIS IV) survey, and patient data on antiretroviral (ARV) utilization is examined at the health district level. The results show the spatial mean centers of hierarchically clustered ART facilities within ART sites are strategically located in areas of high population density. Many rural people across the country travel more than three hours to ART services. Within five rural health districts there are substantial ART facility patient deficits. Future planning should focus on increasing ART services and road infrastructure in rural areas, ART uptake for men, and ART adherence in relation to circular migration and social stigmas in rural destinations to ensure the success of the Treat All Program in Botswana. [ABSTRACT FROM AUTHOR]

This study aims to assess neck pain prevalence and associated factors among tobacco farm workers. This is a cross-sectional study of 2,469 tobacco farm workers in southern Brazil. An adapted version of the Nordic Questionnaire of Musculoskeletal Symptoms was used to characterize neck pain. Multivariate analysis was performed using Poisson regression, following a hierarchical theoretical model. Neck pain prevalence in the last year among the population studied was 7.4%. Worker age, tobacco smoking, tobacco bundling, use of heavy chainsaws, working at an intense or accelerated pace and green tobacco sickness were variables associated with neck pain in females. Among males, age, use of heavy chainsaws, working in a sitting position on the ground, pesticide poisoning, and green tobacco sickness were associated with the outcome. The study reinforces the importance of ergonomic and physiological workloads in the determination of neck pain. Future studies are needed to understand the role of pesticides and nicotine exposures on musculoskeletal problems. The mechanization of tobacco harvesting could reduce ergonomic and chemical exposure, thereby improving farmers' health. [ABSTRACT FROM AUTHOR]

Objective: to describe the conceptions of Community Health Workers about disabled persons who live in rural contexts. Method: descriptive-exploratory research, with a qualitative approach, performed in four municipalities in the northwest region of Rio Grande do Sul, Brazil. It had the participation of thirteen Community Health Workers. Data collection took place between January and February 2018 through semi-structured interviews, analyzed by thematic modality. Results: the conceptions of these professionals are especially anchored in the words "difficulty", "attention", "care", "contempt" and "access". Moreover, they reveal the poor knowledge about disabled persons living in the rural setting, by ignoring the different types of disabilities or pointing out conditions that do not fit their conception. Conclusion: we should highlight the urgent need for instrumentalization of these health professionals on the theme, in order to provide health care based on integrality and equity. [ABSTRACT FROM AUTHOR]

In 1956 the first health promotion agencies were founded in Colombia and were intended to enhance the health condition in the populations in the most alienated territories. The promoters, especially women, became leading actors in the rural community when their role transcended the public health endeavors. This study seeks to critically understand both the social and public-health roles of the health promoters in the town of Andes, Antioquia during 1976-2015. A study case was conducted using interviews and document reviews. Female promoters with a wide track record, public servants and community leaders took part in the study. The institutionalization of the promoters emerged as the main health alternative for the rural communities in our country. The transformations in the health system have brought about some pressure on this social practice, even though they still prevail. The promoters have had a role with an impact beyond the public-health care as they perform an important function in the construction of the social fabric and the management for a social cultural change in the Colombian rural life. [ABSTRACT FROM AUTHOR]

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Copyright of Revista Salud Bosque is the property of Universidad El Bosque 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.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem 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.)

A Rita la encontramos hace poco tiempo, con la sonrisa de siempre, esa mirada penetrante y curiosa, con su compañero de vida Raúl Ayala le solicitamos grabar la conversación mientras bebía su taza de café en medio del bosque húmedo, de este conversatorio resulto el presente resumen.

Copyright of Cadernos de Saude Publica is the property of Escola Nacional de Saude Publica Sergio Arouca 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: Dengue is a public health problem in tropical and subtropical regions of the world. Studies on dengue in rural areas are scarce, since the disease is considered mainly urban. Objective: To determine the knowledge (K), attitudes (A) and practices (P) of dengue in an endemic area in Colombia Materials and methods: A cross-sectional study was conducted with 515 pupils (7-16 years old) in 34 rural schools in Anapoima and La Mesa municipalities, in 2011. Each KAP category was evaluated independently by a scoring system and then categorized into high, medium or low. Results: Pupils recognized knowledge variables such as the symptoms (fever, bone pain), transmission route (mosquito bites) and mosquito breeding sites (uncovered water tanks, solid waste). Average scores on attitude were high in both municipalities, indicating a well-developed perception of disease severity. Seeking treatment in medical centers and self-medication for fever management, use of mosquito net and spacespraying of insecticides were the most frequently identified practices. Discussion: This is the first KAP dengue study performed in rural area in Colombia and contributes to the understanding of dengue perceptions by the inhabitants of these areas. It shows medium level of knowledge about dengue and a lower level of preventive practices in pupils from rural schools. It also shows that pupils considered space-spraying as crucial for vector control. The presence of the vector in rural areas of the country underlines the need to improve surveillance and education to more effectively control the vector and promote prevention methods that include community participation. [ABSTRACT FROM AUTHOR]

Copyright of Biomédica: Revista del Instituto Nacional de Salud is the property of Instituto Nacional de Salud of Colombia 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.)

The objective of this research is to determine the presence of antibodies against hepatitis C virus in the general population of the southern area of Manabí-Ecuador. The absence of HCV antibodies was demonstrated in the studied population, additional studies covering a larger population are needed. [ABSTRACT FROM AUTHOR]

This study examined the role of parenthood and parental influences on substance use patterns for 710 stimulant users age 18–61 living in the rural Midwest and Mid‐south U.S. Longitudinal growth analyses showed that a maternal history of drug use was associated with increased baseline drug use severity, lesser declines in severity, and greater plateau of drug use severity over time. Parental conflict was associated with lesser declines in drug use severity, and drug use severity declined more steeply for participants who were themselves parents. Participants with two parents having a history of alcohol use had a greater baseline severity of alcohol use, with paternal history of drug use associated with lower baseline alcohol use severity. These findings demonstrate the importance of identifying parental influences in evaluating adult substance use, and point to the inclusion of parents in efforts to prevent and treat substance use disorders. [ABSTRACT FROM AUTHOR]

Objective: To describe the sociodemographic and health-related characteristics of elderly residents in the rural area of the municipality of Rio Grande do Sul/Brazil. Method: Quantitative approach study, descriptive and analytical, a household survey. The dates were collected through interviews and analyzed. Results: Participated this interview 290 elderly, with prevalence of females and aged between 60 and 70 years old and married. Most have 3 to 4 children, cohabiting with one to three people and they can read and write. Having a disease is reported by 87.2% of the elderly and 26.48% of them have three or more diseases, with prevalence of arterial hypertension. In the Self-perception of health condition, 60.3% considers it good. When they get sick 38.6% these elderly resort to using teas, followed by hospital 34.5%. Conclusions: The contribution of this study is in the knowledge of sociodemographic characteristics and health of elderly residents in rural areas to assist in implementation of public policies in this population stratum. [ABSTRACT FROM AUTHOR]