Juan C. García-Ubaque

Consumo de alcohol y tabaco en escolares y adolescentes de Tunja, Colombia, 2009

Objetivo Caracterizar, el consumo de tabaco y alcohol y los factores psicosociales de riesgo y de proteccion para el consumo en estudiantes de Secundaria/Media Academica o Tecnica de Tunja durante el ano 2009. Metodos Estudio de prevalencia. Se evaluaron la prevalencia y factores determinantes del consumo en una muestra de 1 515 escolares de entre 13 y 18 anos de edad matriculados en los grados 8° a 11°. Resultados Media de edad 15,2 anos (SD=1,42); 50,2 % mujeres; prevalencia de vida: bebidas alcoholicas 73,47%, embriaguez 51,68 %, cigarrillos 50,56 %. Principales determinantes del consumo: familia disfuncional, presion e influencia de pares y grupo, dificultades academicas, conflictos con padres o tutores. Edad media de inicio: periodo transicional entre los 12 y los 13 anos. Se reporta casi absoluta libertad para acceder a las bebidas alcoholicas y a los cigarrillos. Conclusiones Se encuentra que la frecuencia de consumo de alcohol y tabaco es bastante alta en este grupo de edad, ademas que los determinantes asociados son factores susceptibles de intervenciones educativas que deben considerarse prioritarias, en particular las que tienen que ver con el ambiente familiar y el grupo de pares, dada la enorme influencia que los companeros y miembros de colectivos deportivos o recreacionales pueden tener sobre los adolescentes de este grupo de edad.

Políticas en salud ambiental, con énfasis en contaminación atmosférica e infancia, en ciudades colombianas

Objetivo Se presentan los resultados del proyecto de investigacion sobre salud ambiental en ciudades colombianas con enfasis en contaminacion atmosferica, en respuesta a la iniciativa planteada en el Consejo Nacional de Politica Economica y Social, CONPES 3344 de 2005. Metodo El proyecto se desarrollo entre 2008 y 2009 para el Ministerio de Ambiente Vivienda y Desarrollo Territorial, bajo la metodologia de Evaluacion Ambiental Estrategica formulada en el Analytical Strategic Environmental Assesment Methodology ANSE, para lo cual se conto con la participacion mesas de expertos en diferentes areas. Resultados Se identificaron cinco temas centrales o ejes tematicos sobre los cuales se debe fundamentar este componente de la politica: 1 Planificacion Urbana, 2 Movilidad y Transporte, 3 Industria y Servicios, 4 Fuentes de Energia y 5 Gestion del Riesgo; Dentro de cada eje tematico se hizo un diagnostico sobre su estado actual a partir del conocimiento de los expertos y de informacion oficial. Conclusion Con base en los diagnosticos, se formulo un conjunto de acciones o intervenciones a ejecutar en diferentes niveles por parte de las entidades de estado involucradas. De manera complementaria se proponen recomendaciones para el proceso de toma de decisiones correspondientes a las intervenciones sugeridas. Finalmente se plantean los lineamientos metodologicos para la investigacion sobre variables economicas y de vigilancia epidemiologica a tener en cuenta.

Variables involucradas en la práctica individual y colectiva de hábitos saludables

OBJECTIVE To conduct a descriptive review of the concepts related to the practice of healthy habits by identifying the main variables associated with their managment in terms of health promotion actions. METHODOLOGY In consultation with groups working in health promotion in the city of performed by consulting databases and documentary sources. The strategy and criteria for the selection of documents was previously defined. Finally, we proceeded to organizing and structuring the information. RESULTS It was established that, to promote healthy habits, four groups of behavior are involved: a) consumption, b) phyisical activity and hygiene, c) safety, and d) social participation. All of these are reviewed in order to point out the main concepts contained in each. CONCLUSION The promotion of healthy habits must involve not only the transmission of behaviors associated with them. It must also involve understanding and adapting these habits to the environments of life in which people operate, with consideration for the different roles that they perform and the psychological and cultural demands that each space implies.

Evaluación de condiciones ambientales: aire, agua y suelos en áreas de actividad minera en Boyacá, Colombia

Objectives To determine concentrations of PM10, mercury and lead in indoor air of homes, water sources and soil in municipalities near mining operations. Method 6 points were evaluated in areas of influence and 2 in control areas. For measurements of indoor air, we used the NIOSH 600 method (PM10), NIOSH 6009 (mercury) and NIOSH 7300 (lead). For water analysis we used the IDEAM Guide for monitoring discharges. For soil analysis, we used the cold vapor technique (mercury) and atomic absorption (lead). Results In almost all selected households, the average PM10 and mercury concentrations in indoor air exceeded applicable air quality standards. Concentrations of lead were below standard levels. In all water sources, high concentrations of lead were found and in some places within the mining areas, high levels of iron, aluminum and mercury were also found. In soil, mercury concentrations were below the detection level and for lead, differences between the monitored points were observed. Conclusions The results do not establish causal relationships between mining and concentration of these pollutants in the evaluated areas because of the multiplicity of sources in the area. However, such studies provide important information, useful to agents of the environmental health system and researchers. Installation of networks for environmental monitoring to obtain continuous reports is suggested.

Gestión de gobiernos locales en la calidad de la atención de la salud para niños

Objetivo Evaluar el componente de calidad de los programas de atencion en salud dirigidos a ninos, ninas y adolescentes establecidos por los gobiernos locales de Colombia en cumplimiento de las normas legales. Metodos Estudio descriptivo en el que se evaluo la evidencia de rectoria de los sistemas de calidad y del cumplimiento de los atributos de accesibilidad, oportunidad, seguridad, continuidad y pertinencia como indicadores de la calidad en la prestacion de servicios. Resultado No se encontro evidencia que demuestre que los gobiernos locales examinados desarrollen programas de salud orientados a la ninez que sean especificos a su realidad epidemiologica. Las actividades que se ejecutan corresponden al minimo legal y no son evaluados en su componente de calidad, por tanto no hay un enfoque de mejoramiento en los mismos. Conclusion Se proponen estos resultados como linea base y dado que la funcion de los gobiernos locales, en materia de calidad en salud, va desde la planeacion, pasando por la rectoria y el control de la calidad de los prestadores, se hace inaplazable la implementacion de programas de gestion de la calidad antes que nuevos programas de atencion.

Informalidad, desempleo y subempleo: Un problema de salud pública

La informalidad, el desempleo y subempleo son problemas que han sido estudiados en profundidad desde la economia y la politica y aunque la salud publica ha tenido una aproximacion a esta problematica, el abordaje, principalmente disciplinario, se ha enfocado en los efectos en la salud de los desempleados y subempleados pero esta en deuda de proponer alternativas desde la politica publica en salud para enfrentar esta problematica. El proposito de este ensayo es: hacer una reflexion del desempleo y la informalidad como problema economico, social y de salud de la poblacion, que requiere estrategias en diferentes niveles en las que se incluyan a los diversos colectivos involucrados y a sus organizaciones, es decir al Estado, las empresas, los gremios y sindicatos, entre otros y no solo a las personas en situacion de desempleo, subempleo o informalidad. Para tal fin se parte de la comparacion de los registros de los diagnosticos efectuados a trabajadores afiliados a una Empresa Promotora de Salud con los mismos datos pero de las personas que utilizaron la red publica de hospitales de Bogota.Unemployment and underemployment are problems that have been studied from the economy and politics points of view. Although public health has taken an approach to this problem, it has been mainly disciplinary, since it has focused on the health effects of the unemployed and underemployed but it has failed to propose alternatives from the public policy to solve this problem. The purpose of this essay is to examine the unemployment as an economic, social and health problem of the population. According to records of diagnosis, we review this situation (which requires different strategies at various levels) including different groups involved and their organizations, the State, companies, trade unions and employers unions, not just people unemployed and underemployed.

Enfermedades transmitidas por el agua y saneamiento básico en Colombia

Objective To analyze the relationship of sewerage coverage and wastewater treatment with waterborne disease behaviour. Methods A descriptive retrospective study was conducted using secondary sources (document review and information available in databases) about basic sanitation coverage, treatment of domestic sewage in the country and the prevalence of waterborne diseases during the period 2008-2014. Results The country invested USD 1,100 million in the implementation of wastewater treatment systems from 2011 until the first half of 2013. However, the incidence of waterborne diseases, such as acute diarrheal disease, foodborne diseases and typhoid and paratyphoid fever did not decrease during the period 2008-2014; only hepatitis A registered a decrease. Discussion Investment in water supply and sewerage systems is relevant to improve health conditions of the population and to reduce the incidence and prevalence of various health conditions; however, it is necessary to address other aspects such as health education and social empowerment to address this problem more efficiently.

Tendencia y causas de la mortalidad infantil en municipios de frontera en Colombia, 2005-2011

Objective To evaluate the registered trends and main causes of Infant Mortality (IM) in border areas of Colombia between 2005 and 2011. Methodology Ecological study in border areas, developed from the analysis of institutional information on IM and its causes, using the list of leading causes of death of infants and children by the WHO. For analysis, descriptive statistics and cluster analysis techniques were measured using Excel and the R-Project processing software. Results IM decreased steadily in the country and border areas between 2005 and 2011.The existence of significantly higher numbers in some of the municipalities studied was evident. Municipalities with lower IM had significantly higher average scores related to congenital malformations, deformations and chromosomal abnormalities (conditions originated during the perinatal period), circulatory system diseases, digestive system diseases, and tumors and neoplasms. In contrast, municipalities with higher IM rates presented higher average scores related to endocrine, nutritional and metabolic diseases, infectious and parasitic diseases, and respiratory system diseases, many of them considered preventable. Discussion Border areas are affected by economic, political and cultural aspects that make them risk zones and generate interest for health. Findings reveal inequalities in the IM behavior when compared to the rest of the country. Understanding the peculiarities in these municipalities is crucial for the health sector to implement strategies and to pose health services that adequately meet the needs, and, thus, achieve health equity for these populations.

Quality of life related to health in the mining population of Boyacá

OBJECTIVE To evaluate the perception of quality of life in inhabitants of mineral mining areas of mineral coal and agricultural areas. MATERIALS AND METHODS Descriptive cross-sectional study of 229 individuals living in coal mining municipalities (n=151) and municipalities with agricultural activities (n=78). Those who answered SF36 survey and socio-demographic test. RESULTS It was found that the perception of the health-related quality of life is lower in the inhabitants of the area of coal exploitation compared to the inhabitants of agricultural zone only with statistical difference in the general perception of the scale and with no difference pro each one of the scales. DISCUSSION Pollution generated in coal mining areas has an impact on the health of people and their perception of quality of life. The evidence is weak in showing no statistically significant differences by area in each subscale and was only demonstrated in general perception.

Calidad de vida relacionada con la salud en población minera de Boyacá

OBJECTIVE To evaluate the perception of quality of life in inhabitants of mineral mining areas of mineral coal and agricultural areas. MATERIALS AND METHODS Descriptive cross-sectional study of 229 individuals living in coal mining municipalities (n=151) and municipalities with agricultural activities (n=78). Those who answered SF36 survey and socio-demographic test. RESULTS It was found that the perception of the health-related quality of life is lower in the inhabitants of the area of coal exploitation compared to the inhabitants of agricultural zone only with statistical difference in the general perception of the scale and with no difference pro each one of the scales. DISCUSSION Pollution generated in coal mining areas has an impact on the health of people and their perception of quality of life. The evidence is weak in showing no statistically significant differences by area in each subscale and was only demonstrated in general perception.