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Educación del Paciente para el Auto Cuidado de la Diabetes en el Centro de Salud de Primaria Atención: Villa Verde en Partido de Pilar, Buenos Aires
No full textVivir con diabetes cambia toda la vida de una persona. Sin el conocimiento de su autocuidado, el paciente tiene poca oportunidad de seguir viviendo la vida que desean. Sin educación adecuada, los diabéticos probablemente desarrollarán complicaciones que pueden conducir a problemas de salud muy graves y costosos. La prevalencia de diabetes ha ido en aumento en Argentina, y una estrategia efectiva para educar a los pacientes en el autocuidado es más necesaria ahora que nunca. Con un proceso eficiente de orientar a los pacientes a través del autocuidado, Argentina puede manejar mejor a largo plazo el efecto de diabetes y en última instancia mejorar la vida de los diabéticos y reducir los costos de la enfermedad. Esta investigación define los aspectos de autocuidado de la diabetes y también analiza la situación de la educación para el autocuidado en el área metropolitana de Buenos Aires. Mediante la utilización de entrevistas y encuestas, vamos a comprender las perspectivas de los médicos – cuál es su papel es, a qué obstáculos se enfrentan, y cómo creen que el proceso de educación de autocuidado podría ser mejorar. También, examinaremos las perspectivas de los pacientes diabéticos – si entienden los aspectos de autocuidado y son capaces de aplicar la educación para sus vidas. Esta investigación utiliza métodos de investigación cuantitativos y cualitativos. Las perspectivas y datos de profesionales médicos se recolectaron usando entrevistas, que fueron grabadas transcritas y codificadas para encontrar los conceptos y categorías más importantes para sintetizar. Los indicadores se dividen en títulos categóricos y subcategorias para ampliar los datos. Las perspectivas del paciente se recabaron utilizando cuestionarios que se administraron poco después o antes de las consultas médicas. Estos datos estaban aglomerados en una hoja de cálculo de Excel, se generaron gráficos y se llevó a cabo un análisis. Todos los datos de recolección, transcripción, codificación, análisis y conclusiones se realizaron y escribieron durante el mes de mayo de 2016. Los médicos de CAPS Villa Verde explicaron que un equipo interdisciplinario es necesario para educar a los pacientes en el autocuidado y explicaron los componentes del equipo. Aunque tienen un equipo completo y capacitado en Villa Verde, la educación de autocuidado no es siempre éxito en sus opiniones. Hay muchos obstáculos que los médicos no pueden controlar siempre. Estos obstáculos son: diferencias en idioma, falta de tiempo, falta de recursos, mala adherencia al tratamiento, y más. Los pacientes informan que la educación es difícil, pero son en mayoría satisfechos con la educación que han recibido. Para aplicar esta educación a la vida en forma de cambios reales en el comportamiento, los resultados favorecieron la habilidad de cambiar el estilo de vida en respuesta a la educación.
Diabetes is among the most complicated and prevalent cronic diseases facing the world’s healthcare landscape today. It has far reaching effects on the entire life of a diabetic, and without the knowledge of how to self-care for their disease, a patient has little opportunity to continue living the life that they desire. Without proper education, diabetics will likely develop complications that can lead to very serious and expensive health outcomes. The prevalence of diabetes has been increasing in Argentina, and an effective strategy to educate patients on self-care is more important now than ever. With an efficient 4 process of guiding patients through self-care, Argentina can better manage long term affects of diabetes and ultimately improve the life of diabetics and reduce cost in healthcare. This research will define the aspects of self-management of diabetes and also analyze the situation of education for self-care in the metropolitan area of Buenos Aires. Using interviews and surveys, we will examine the perspectives of physicians- their perceived role in the education process, what obstacles they face, and how they believe the process of self-care education could be improved. As well, we will evaluate and compare the perspectives of the diabetic patients- do they understand the aspects of self-care and are they able to apply the education to their lives in the form of long-term lifestyle changes. This investigation utilizes both quantitative and qualitative research methods. Perspectives and data from medical professionals were gathered using interviews, which were recorded and then transcribed and coded to find the concepts and categories most important to synthesize. Indicators were broken down into categorical heading and then subheadings to expand upon the data. Patient perspectives were accumulated using questionaires and conducted shortly after or before medical consultations. These data were agglomerated in an excel spreadsheet, graphs were generated, and analysis was conducted. All data collecting, transcribing, coding, analysis, and conclusions were performed and written during the month of May, 2016. The physicians revealed that an interdisciplinary team is vital to educate patients in self-care practices, and explained the components necessary for a functional team. Although they have a complete and well-trained team at CAPS Villa Verde, the education 5 for self-care is not always successful in the eyes of the doctors. This ineffectiveness is due to the many persistent obstacles that the medical team cannot control, for example differences in language, lack of time and resources, poor compliance with treatment, and more. The patients reported that although the education was difficult to comprehend, they were mostly satisfied with the education that they received. When applying the education to their life in the form of actual behavioral changes, the results revealed a correlation between the amount of satisfaction the patient experienced with the education process and the amount of changes in lifestyle they accomplished. Changing the lifestyle of a patient can cause profound benefits in quality of life, health outcomes, and overall costs of care
El método anticonceptivo implante subdérmico para prevenir la repetición del embarazo adolescente en la provincia de Tucumán
No full textInformación Contextual: El método anticonceptivo implante subdérmico se utiliza para prevenir la repetición del embarazo adolescente entre mujeres de 14 a 24 años de edad que no tienen cobertura de salud (es decir, sin cobertura de una obra-social o pre-paga) y que han tenido un evento obstétrico (parto o aborto) en los últimos 12 meses. La prevención del segundo embarazo adolescente es una línea estratégica sumamente importante porque la tasa de embarazo adolescente ha mantenido su valor cercano al 15% por los últimos 20 años. En el caso particular de la provincia de Tucumán, está presenta un contexto interesante lo que lleva a realizar esta investigación ya que no tiene su propia ley provincial de salud sexual y reproductiva y es la única provincia que no está adherida a la ley nacional sobre este tema. La pregunta que surge a partir de esta problemática es: ¿Cómo se implementa el uso del implante subdérmico en la provincia de Tucumán por parte del programa provincial? Metodología: El trabajo se basó en entrevistas con distintos actores relacionados con el uso del implante subdérmico como método anticonceptivo. Fueron entrevistados 7 trabajadores en el equipo de salud del Hospital Eva Perón, en Banda del Río Salí, Tucumán, y del Instituto de Maternidad Nuestra Señora de las Mercedes en San Miguel de Tucumán, Tucumán y se les ha solicitado sobre el uso particular del implante subdérmico en los respectivos hospitales. Además, se han observado varias consultas médicas con madres adolescentes. Dos madres adolescentes, de 18 años de edad, fueron entrevistadas sobre sus experiencias personales y datos demográficos. Asimismo, dos referentes del programa provincial de Salud sexual y procreación responsable del sistema provincial de salud fueron entrevistadas sobre el funcionamiento del programa. Finalmente, se ha consultado la base de datos de todas las mujeres de entre 14 y 24 años que recibieron el implante subdérmico en el sistema público entre marzo, 2015 y marzo, 2016—1274 mujeres en total—se han analizado los datos sobre edad, número de partos y abortos anteriores, previo uso de métodos anticonceptivos, y ubicación. Resultados y Conclusiones: Las entrevistas con los referentes del programa provincial muestran cómo el programa nacional y provincial trabaja para distribuir los insumos a los efectores. Las entrevistas con los trabajadores de los equipos de salud muestran perspectivas diferentes sobre si el embarazo adolescente es planificado o no planificado, pero creencias similares que las mujeres son muy vulnerables debido a su estatus socioeconómico y contexto cultural y existe una profunda falta de información disponible y correcta sobre los métodos anticonceptivos. La falta de esta información refleja algunos factores culturales, como mitos sobre los métodos anticonceptivos en las comunidades. La base de datos releva que la mayoría de las mujeres que recibieron el implante indicaron que no hubieran usado ningún método anticonceptivo antes de la colocación del implante. Algunos efectos secundarios del implante se relacionan con la extracción del implante pero, por lo general, el método es bien-tolerado con muchas ventajas y una grande aceptación por parte de la comunidad. En la actualidad no existen más implantes debido al costo, aunque todavía existe mucha demanda y una importante oportunidad de usarlo en la estudiada provincia.
Contextual Information: The implant contraception method is used to prevent repeated adolescent pregnancy among adolescents between the ages of 14-24 who do not have secure healthcare coverage (without coverage from a union-supported healthcare plan [obra social] or a private healthcare plan) who had an obstetric event (birth or abortion) in the last 12 months. It has been guaranteed free and available in primary attention centers, clinics and hospitals since 2014 as part of the national Sexual and Reproductive Health Program. The prevention of teen pregnancy as a strategic objective is incredibly important because the teen pregnancy rate in Argentina has maintained its value of around 15% for the past 20 years. Tucumán province provides an interesting context for the study because it does not have its own provincial sexual and reproductive health law and is the only province that is not fully adhering to the national law on the subject. The question that arises is, “How is the sub-dermic implant implemented in Tucumán province as part of the national program?” Methodology: The investigation is based in in-depth interviews with distinct actors related to the use of the sub-dermic implant contraception. Seven professionals in the healthcare teams of Hospital Eva Perón, in Banda del Río Salí, Tucumán, y Instituto de Maternidad Nuestra Señora de las Mercedes in San Miguel de Tucumán, Tucumán were interviewed about the use of the sub-dermic implant in the hospital. Additionally, a variety of consults about contraception methods were observed. Two adolescent mothers, 18 years old, were interviewed about their personal experiences and demographic information. Additionally two advisors from the provincial sexual and reproductive health program were interviewed about the operation of the national and provincial sexual and reproductive health programs. Finally, the database of all the women between 14-24 years of age who received the sub-dermic implant in the public healthcare system between March, 2015 and March, 2016—1,247 women in total—was analyzed for age, number of previous births and abortions, previous use of contraception, and location. Results and Conclusion: The interviews with the advisors from the provincial program demonstrated how the provincial and national program work to distribute the contraceptive method to health centers. The interviews with professionals in the healthcare teams showed different perspectives on whether adolescent pregnancy is planned or unplanned, but an agreeement that the women are very vulnerable due to their socioeconomic status and cultural context and there exists a profund lack of avaible and correct information about contraception methods. The lack of information reflects some cultural factors, like myths about contraception in the communities. The database revelead that the majority of women indicated that they did not use a contraception method before the insertion of the implant. Some secondary effects of the implant resulted in the removal of the implant but in general the method is well-tolerated with many advantages and acceptance with the community. Now, there are not any more implantes due to cost, although there still exists demand and opportunity to use them
Fish Diversity and Coral Health of Tanzania\u27s Reefs: A comparative study between the Ushongo Village Reef and the Fungu Zinga Reef over time
Get PDFThe world’s oceans are becoming increasing acidic due to global climate change, posing a threat to marine ecosystems, including coral carbonate systems. Environmental threats are exacerbated by human development stressors as well: growing populations, dependency on marine resources, and unsustainable practices invaluable marine ecosystems at risk. Tanzania’s coral reef system extends for 3580 km2 (Muhando et al. 2008) near the Tanga region, serving over half a million people who are highly dependent on fishing and other marine resources as their livelihoods (Samoilys et. al. 2008). With Tanzania’s population rapidly growing, the unsustainable pressure on coral reefs for sustenance and livelihood will only get worse. East African reefs have shown good recovery since the 1998 bleaching event, but progress is slowing due to destructive fishing practices (Muthiga et al.2008). This study compares coral and fish health between two reefs along Tanzania’s coast, Ushongo Village Reef (UVR) and Fungu Zinga Reef (FZR). It was hypothesized that FZR would be healthier than UVR due to its natural protection with distance from human populations and the presence of a sand bar. There is a trend in past studies of improving reef health and increased understanding of conservation among fishermen (Henderson et al. 2014; Azoff and Mecham et al. 2014: Houlihan et al. 2010). UVR and FZR were found to have statistically significant differences between fish abundance, number of species, number of coral genera and percentage of live coral coverage (p = 0.0227, 0.000024, 0.0374; 0.0432). FZR was found to be the healthier reef, while both reefs are improving in overall health
Maternal Healthcare in Eastern Uganda: The Three Delays, Mothers Making Empowered Choices, and Combatting Maternal Mortality
Get PDFMaternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also looked at what factors are contributing to high maternal mortality rates and what can be done to combat this issue. Throughout this study I have used a variety of qualitative ethnographic methods including participant observation, in-depth one-on-one interviews, as well as focus groups to explore why women choose to give birth in a health centre or hospital with a biomedical midwife, or with a Traditional Birth Attendant (TBA). Midwives are trained and their certification is nationally accepted while TBA’s may have not received any professional training and are not necessarily recognized by the government. However, they play a highly important yet contested role in Uganda. Further I will look at what delays and boundaries are contributing to high maternal mortality rates and what interventions are being used and can be used by hospitals, health centres, TBAs and the government alike. In maternal health care, scholars and organizations alike often talk about the three delays. The first delay refers to a lapse in making the decision to receive care. The second delay refers to that of being unable to reach a health facility while the third delay refers to that of not receiving high quality, appropriate care. Throughout this study, I found that each of these delays were present and took form in a variety of ways in Mbale Town and the surrounding rural districts. I also discovered that despite these delays being present, mothers felt empowered by making the decision to give birth where they wanted whether it was in a health facility, or at home with a TBA. I also discovered that most biomedical health workers were aware of these delays and the many challenges they faced, and had deeply considered ways in which they and others can reduce the rates of maternal mortality. Finally, maternal health care is inherently important when considering the development of Uganda. When looking to implement solutions to reduce the three delays and improve maternal healthcare, it is important to approach this not only in terms of human development but also economic growth
Continuous Care in Complex Contexts: Access to Health Services for Noncommunicable Diseases among Syrian Refugee Women in Jordanian Host Communities
Get PDFThis study examines how, when and where Syrian refugee women living in a host community in central Jordan access health services related to noncommunicable diseases. Noncommunicable diseases are the leading cause of death and disability worldwide, but can be effectively managed through timely treatment. Examining access to care for these diseases in the context of humanitarian emergencies, such as war and displacement, is particularly important because they require continuous care, which may be interrupted during emergencies, and because they can cause acute complications, which may be exacerbated by emergencies (WHO, 2016).
Previous studies indicate a high burden of NCDs among Syrian refugees living in Jordan. They also confirm that many Syrian refugees living in Jordanian host communities have difficulties accessing health services, and identify cost as the most formidable barrier to access. The cost of medications has emerged as particularly significant. This study, which also identifies cost as the most significant barrier in accessing health services, supports previous findings.
By analyzing ten in-depth interviews with Syrian refugee women living in central Jordan, this study builds on previous research through qualitative descriptions of barriers in accessing health services. Specifically, this study analyzes the ways in which barriers to accessing health services interact, concluding that problems in physical accessibility and, to a lesser extent, acceptability, often exacerbate cost-related barriers.
By analyzing the barriers Syrian refugee women encounter in accessing health services for NCDs, this research contributes to a body of knowledge that may be useful to a variety of actors (policy maker, NGOs, health services providers, etc.) seeking to improve access to health services and address NCDs among refugees living in Jordanian host communities
Tapez le Tam-Tam and the People Will Come: A Study of Theater for Social Justice in Kaolack, Senegal
Get PDFThis purpose of this study is to examine the effectiveness of theater to create social change and raise awareness of social issues as used by the troupe Bamtaare in Kaolack, Senegal. Further study was done to determine why theater was successful and whether this type of theater can be implemented in the United States. I spent four weeks in Kaolack working with the troupe to understand their methods. While in Kaolack, I observed rehearsals and performances, conducted interview with actors and audience members, and reviewed relevant literature. My research showed that Bamtaare’s performances in urban neighborhoods and rural villages did empower people to change their beliefs and actions. Bamtaare adapts traditional cultural practices, such as drumming and dance, to engage their audiences, and forum theater to encourage participation and gauge comprehension. I concluded that Bamtaare’s work is effective because they use music that is culturally significant, share information in a simple, understandable manner, and ask audience members to contribute to the performance. While this method of theater for social change is successful in Kaolack, Senegal, I believe that the exact format would not work in the United States, but with modifications it could be valuable there, as well
Estudio acerca del apoyo educacional y laboral para alumnos en situación de discapacidad intelectual: El caso de cinco instituciones de educación especial en Santiago, Viña del Mar y San Antonio / Study on educational and work support for students in situations of intellectual disability: The case of five special education institutions in Santiago, Viña del Mar and San Antonio
Get PDFResearch Question: How effective are special education organizations and programs in helping students with intellectual disabilities with job pursuits, education, and independence?
Objectives: The general objective of this study is to describe the support that students with intellectual disabilities receive from the special education system and how this support promotes autonomy. The specific objectives are to investigate the teachers’ roles, discover the level of autonomy students have, and identify how the education system supports labor insertion.
Antecedents: Historically, job placement has been difficult for people with disabilities. Many people are misinformed regarding their true abilities. There also exists an ignorance of the laws and decrees that explain their rights and duties. For many reasons, many people with intellectual disabilities return home during adulthood due to the difficulty they experience while pursuing a job. The special education system should be made aware of these issues in order to improve the way in which it prepares students for labor insertion and an independent life.
Methodology: Twelve teachers and specialists in special education centers, and five adolescent students attending a job-training center were interviewed. In addition, seven parents were surveyed on the topic and all participants were located in Santiago, Viña del Mar and San Antonio. Along with surveys and semi-structured and unstructured interviews, observations also took place within special education centers to achieve a greater depth of analysis.
Results: Although many people were satisfied with the quality of special education, there is not a sufficient amount of special education centers available for students with intellectual disabilities. Some integrated schools do not provide the necessary attention to all students. Although all of the interviewed students and teachers expressed their satisfaction with the support students receive terms of autonomy, 72% of parents felt that there was “almost no support” or “little support”, and 57% of parents also said that there would be no jobs available when their children are old enough to pursue one. While the government has created laws, there still exists a general lack of awareness about the duties and rights of people with intellectual disabilities.
Conclusions: The majority of people expressed that though the quality of support that students with intellectual disabilities receive is satisfactory, often there is not sufficient support. Although the sample of this study was small, some useful discoveries were made regarding the quantity, quality, and effectiveness of schools that provide special education, which could be used to better their functions and centers of focus
A Road to Somewhere: Changing Trade and the Adaptation to Survive in Humla
Get PDFThis paper is an investigation of the changing trade in Humla, one of the most remote regions in Nepal. I particularly focus on the road being built from the village of Hilsa, which lies on the border of China and Nepal, to Simikot, the main town. This road will be accessible by all the villagers who live on the link trail now – the trail they walk on with their animals in order to reach the border site. Trade is especially important in Humla; there are no roads available to get there from the Nepal side, so everything must be flown in by propeller plane, or bought in Purang in China, and carried back to the village with the help of animals such as zopas and horses. By having conversations with shopkeepers, businessmen, and villagers, I hoped to gain insight into how their lives will be affected by the completion of this road, how they have adapted to live in Humla thus far, and how they will adapt to survive once the road brings new economic changes. Sections of this paper include voices from the villages of Muchu and Khangalgaun, and opinions of businessmen working in the Tumkot Bazaar. It also includes an important section that discusses what might happen when the road ultimately enforces modernization. This paper highlights the positive and negative effects of this new road, and also discusses the Tumkot Bazaar and its shopkeepers, noting what will happen to this bazaar once the road is completed
Orientalism and the Archaeological Survey(s) of India
Get PDFThis study is an investigation of the Archaeological Survey of India (ASI). It was inspired by the somewhat incongruous fact that the ASI, which now exhorts visitors to its monuments to feel pride in their heritage, was founded by British colonialists who felt that contemporary Indian society was in shambles and in need of Western domination. In an attempt to investigate the completeness of this transformation, this study traces key events and figures in the ideological, institutional, and academic history of the study of the Indian past, paying close attention to the relationship between scholarship and colonialism. This analysis, combined with observations of the contemporary ASI sites of Ajanta and Badami reveal that while the explicit messaging of the ASI has changed since its colonial inception, its distribution of resources, as well as the type of scholarship it produces remain well within the boundaries of what colonial knowledge
Actually, Let’s Not Talk About Sex: The Value-Laden Sex Education Received by China’s Young Women
Get PDFThis research explored China’s sex education and the values it imparts to China’s young women. Findings indicate that although young women wish to learn about safe sex and sexuality from both schools and parents, communication is restricted by both parties embarrassment, lack of preparation, and fear that open dialogue on such topics will promote sexual activity.
The study found that while sex education classes were informative on physiological topics, in participants\u27 perceptions, they lacked information on safe sex (i.e. use of contraceptives) by sticking to the abstinence narrative, and assuming—or pretending—that China’s young people are not engaging in sex. Although many educators and parents think that they are protecting their children by withholding information about sex and sexuality, past research indicates that more and more Chinese adolescents are becoming sexually active at a younger age; therefore, as a result, sex education—both in schools and in homes—have not kept up with China’s increasingly sexually open youth.
In addition, the values being shared with young people are also outdated. Youth are told sex is an ethical matter, a shameful act, and a measure of their ability to control themselves; however, the reported rapid changes in values and behavior in relation to sex call for safe sex education programs and their associated sexual and reproductive health services. The schools and families ought to develop future programs and services that are more suited to China’s increasingly sexualized society