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Para la consecución de este trabajo tomamos en cuenta las categorías de la dialéctica en relación con la Cultura Física Terapéutica, desde una reflexión critica que toma en consideración los criterios actuales de la vida moderna; donde los avances de la ciencia y tecnología someten al hombre a un estado de hipoquinesia casi total, que atenta contra su salud aumentando el riesgo de padecer de patología de tipo degenerativo, patologías crónicas no trasmisibles, llevándolo a un deterioro de la salud. Conociendo la importancia de la Cultura Física Terapéutica en la utilización adecuada del tiempo libre a través de la práctica de ejercicio físico y su efecto en el cambio del estilo de vida de las personas, estudiamos el comportamiento de estas categorías desde el punto de vista biomédico en la calidad de vida de los individuos según el estilo de vida que elijan, evidenciándose que este influye directamente en la calidad de vida independiente de la sociedad y del nivel de vida. El modo y nivel de vida pueden influir en la calidad de vida de las personas, pero no es determinante, como el estilo de vida; la Cultura Física Terapéutica toma matices diferentes según las formaciones económico-sociales.To carry out this research paper, some dialectical categories related to therapeutic physical exercises were analyzed from a critical reflection about the current criteria of modern life where the advances of science and technology submit human being to an almost total state of hypokinesis that affects health conditions, increasing the risk of suffering from degenerative and chronic non-contagious pathologies. Knowing the importance of the therapeutic exercises in the proper use of free time and the effect of these exercises on the changes of the life-styles, a study taking into consideration philosophical categories and biomedical view points was conducted to demonstrate that the ways of life and the life-styles can influence the quality of life apart from society and level of life. Way and level of life are not determining as life-styles are. Therapeutic Physical Exercises take different variants according to socio-economic formations.

Estudo descritivo desenvolvido com o objetivo de identificar as concepções de saúde e o itinerário terapêutico adotado por indivíduos adultos em um município de pequeno porte. Os dados foram coletados no mês de julho de 2006 por meio de entrevista semi-estrutrada junto a 29 indivíduos. Constatou-se que os homens referem menos problemas patológicos do que as mulheres e que estas, em sua maioria, iniciam a busca pela solução de problemas de saúde mais precocemente e no sistema formal de saúde. Conclui-se que existem diferenças entre os sexos na maneira de reconhecer a doença e buscar soluções e isto precisa ser considerado pelo sistema de saúde, de forma a facilitar o acesso dos indivíduos respeitando suas particularidades e individualidades.Estudio descriptivo desarrollado con el objetivo de identificar las concepciones de salud y la rutina terapéutica adoptada por individuos adultos en un municipio de pequeño porte. Los datos se recogieron en el mes de julio de 2006, a través de entrevista semi estructurada entre 29 individuos. Se constató que los hombres refieren menos problemas patológicos que las mujeres y éstas, en su mayoría, se dedican a la búsqueda de soluciones a problemas de salud ates que los hombres y lo hacen en el Sistema Formal de Salud. Se concluyó que hay diferencias entre los sexos en la forma de reconocer la enfermedad y de buscar soluciones y esto necesita ser tomado en cuenta por el sistema de salud, a fin de facilitar el acceso de los individuos, respetando sus particularidades e individualidades.Descriptive study, developed with the objective of identifying the conceptions of health and the therapeutic itinerary adopted by adult individuals in a small city. Data was collected during the month of July 2006 using semi-structured interviews with 29 individuals. It was observed that men make fewer references to pathological problems than women, who mostly seek solution for health problems sooner, using the public healthcare system. It was concluded that there are differences between the genders when it comes to recognizing illness and seeking solutions, and that this must be taken into account by the healthcare system, in order to facilitate patient access while respecting the uniqueness and individuality.

Una de las preocupaciones por las consecuencias sociales del crecimiento urbano actual es la desigualdad en salud, generada por las condiciones deficientes de habitabilidad en la vivienda. El estudio de los resultados de la Encuesta Nacional de Salud 2007, la aplicación de un cuestionario mejorado y un sondeo participativo en la localidad de Suba en Bogotá permitieron analizar las relaciones entre la habitabilidad de las viviendas y las disparidades en el estado de salud de la población. Mediante una metodología comprensiva fue posible demostrar disparidades en salud atribuibles a las condiciones de habitabilidad.

Background: The knowledge about mouth health and its risk factors acquires an important significance in the aged population. Objective: to describe the mouth health state and to evaluate the knowledge level that the studied population have about this theme. Methods: A descriptive-correlative study was done that engulfed 174 patients, of the policlinics 1, 2 and 3 from the area III of Cienfuegos municipality, Cuba. An enquiry was applied about risk factors of mouth cancer and the mouth health state of all the enquired was examined. Results: more than 50% of them stated that alcoholic beverage consumption and/or the ingestion of spiced and hot food don’t damage the mouth, or declared not having any knowledge in this field. Only the 32,2 % of the sample had teeth; and of them, 3,4 % had 20 or more teeth. More than 40 % had periodontal illness and a 44,3 % presented consumed and disarranged prosthesis. Most of them (77,1 %) needed prosthesis. The majority of lesions founded was due to wrong adapted prosthesis, which, along with smoking habits, were risk factors related to pre-malignant and malignant lesions.

Background: The objective of performance assessment is to provide governments and populations with appropriate information about the state of their health care system. The objective of this paper is to present the most recent developments in performance assessment and their application in urban contexts. Methods: Literature review in PubMed (1970-2004). We identified additional papers and grey literature from retrieved references. Results: Performance assessment initiatives were identified in Australia, Canada, the United Kingdom, and New Zealand. The World Health Report 2000 is one of the best known examples of a transnational approach to performance assessment. Conclusion: The best developed initiatives to date are those that define precise categories, criteria and indicators with which to analyse and assess health care systems, based on a solid conceptual framework. Performance assessment fits perfectly in urban contexts, as it is a useful tool for designing and monitoring policies, assessing the quality of the services provided, and measuring the health status of city dwellers. Barcelona and Montreal are currently collaborating together on a project to assess the performance assessment of their respective health care services.Objetivos: El objetivo de la evaluación del desempeño es dar información apropiada a los gobiernos y las poblaciones sobre el funcionamiento de su sistema sanitario. El objetivo de este artículo es presentar los desarrollos más recientes en la medida del desempeño y su aplicación en contextos urbanos. Métodos: Revisión de la bibliografía en PubMed (1970-2004). Se identificaron artículos adicionales y bibliografía gris y de las referencias de los artículos seleccionados. Resultados: Se identificaron iniciativas de medida del desempeño en Australia, Canadá, Reino Unido y Nueva Zelanda. La iniciativa transnacional del Informe sobre la salud en el mundo 2000 de la Organización Mundial de la Salud (OMS) es una de las más conocidas. Conclusiones: Las iniciativas más desarrolladas en la actualidad son las que definen categorías, criterios e indicadores para analizar y evaluar los sistemas sanitarios, basándose en un marco conceptual sólido. La medida del desempeño encaja perfectamente en los contextos urbanos, ya que es una herramienta útil para diseñar y hacer un seguimiento del nivel de consecución de las políticas en marcha, medir la calidad de los servicios disponibles y el estado de salud de los habitantes de una población. Barcelona y Montreal están trabajando en un proyecto de colaboración para la evaluación del desempeño de sus servicios sanitarios.

This study sought to evaluate the effect of Alchornea cordifolia leaf meal (ACLM) inclusion and exogenous enzyme supplementation on broiler chickens. Two hundred and fifty-two (252) arbour acre two weeksold broiler chicken were selected from a larger flock that had been brooded on deep litter and raised on commercial diet. These birds were balanced for weight and thereafter distributed into 18 pens of 14 birds each. These pens were randomly allotted to six dietary treatment groups in such way that 3 replicates were fed on each experimental diet. For the starter and finisher phase, six experimental diets were formulated and designated as 0-E, 5-E and 10-E for the diets without enzyme and 0+E, 5+E and 10+E for diets with enzyme. Diet 0-E and 0+E serve as positive and negative control respectively. The experiment was carried out using a 2x3 factorial experiment comprising of 2 enzyme levels (0 and 0.35 g/kg) and 3 ACLM inclusion levels (0, 5 and 10%).The final weight (FW) and weight gain (WG) were significantly affected by enzyme supplementation (p<0.05) while ACLM inclusion levels caused significant (p<0.05) decrease of 15.13% and 11.61% in the total feed intake (TFI) and feed conversion ratio (FCR) respectively in the broiler chickens. Enzyme supplementation significantly (p<0.05) increased the slaughtering weight, drum stick and thigh by 4.90%, 5.06 and 5.33 % respectively, while the ACLM inclusion level reduced the dressing percentage, drum stick, wing weight, thigh, breast and back significantly (p<0.05), decreasing by 17.63%, 25.95%, 10.72%, 9.85%, 21.27% and 19.41% respectively, as the ACLM level increase ranged from 0 to 10 %. The internal organs of the broilers were not significantly affected (p>0.05) by the main factors and their interactions except for the liver and proventriculus that were affected by the level of inclusion of ACLM. Red blood cells (RBC) significantly increased (p<0.05) while mean cell haemoglobin (MCH), mean cell volume (MCV) and monocytes significantly (p<0.05) decreased with an increase in the level of ACLM inclusion ranging from 0 to 10%. Enzyme supplementation caused a significant (p<0.05) increase in cholesterol and SGPT levels and a significant (p<0.05) decrease in SGOT. ACLM also significantly (p<0.05) affected the serum parameters considered, except for total protein, albumin, globulin, creatinine, bilirubin and SGPT in a way in which the increase of the ACLM level ranging from 0 to 5% and then to 10 % in the broiler's diets promoted the declination in the cholesterol, urea, SGOT and glucose levels. Furthermore, the interaction of enzyme levels and ACLM has a significant (p<0.05) effect on cholesterol and SGPT levels. Basing on the data obtained in this study, ACLM is a potential useful feed material for feeding monogastrics. Therefore, it is suggested that 10% ACLM inclusion level could be used in broiler production. [ABSTRACT FROM AUTHOR]

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Copyright of Revista de Salud Pública is the property of Universidad Nacional de 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.)

Objective. To analyze the relationship of mental health problems in Spanish population with the economic recession (2006-2012), and find out how it affects the self-perception of health status. Materials and methods. Cross-sectional study using the National Health Survey of Spain, 2006/2007 and 2011/2012. Using logistic regression models, three indicators linked to mental health and perceived health were analyzed. Results. In 2011/2012 the consumption of antianxiety medications and sleeping pills increased in men and women. Mental dysfunction increased during the economic crisis in the male population. The perception of optimal health did not suffer significantly in either men or women. Conclusions. The economic recession showed a changing relation to the mental and general health of the population, coinciding with an increase in mental health disorders, such as anxiety. [ABSTRACT FROM AUTHOR]

Introduction: Patients with myocardial infarction often express emotional states including fear of dying when suffering a cardiovascular event. Objective: To determine the relationship between most frequent emotional states post-myocardial infarction and the compensation degree of somatic health status in patients during convalescence. Method: A prospective study was carried out on 31 patients, selected by (nonprobabilistic) purposive sampling, who attended follow-up cardiology consultation at "Hospital Celestino Hernández Robau" from Santa Clara, from September 2014 to March 2015. Document review techniques, interviews, Rotter, IDARE and IDERE tests were applied. Results: Hypertension was the main cardiovascular risk factor (90.3%). There was a male predominance (64.5%) and a partially unbalanced state of somatic health (51.6%), mostly in men (60.0%). Only 25.8% of compensated patients. Generally the average indicator of anxiety and depression predominated; but we found high levels of these emotional states in decompensated and partially unbalanced patients, especially as a state. ** Conclusions: There was a predominance of partially offset somatic state of health. High levels of anxiety and depression states were identified and it was found the existence of an important relation between anxiety-depression emotional states, and the somatic state of health relating to the cardiovascular system in patients convalescent from myocardial infarction. [ABSTRACT FROM AUTHOR]

Introduction: chronic conditions modify perceived health in affected individuals. For this reason celiac disease, being a chronic condition, may impair health-related quality of life (HRQOL). Objective: to analyze the impact of celiac disease in affected individuals. Method: observational, cross-sectional, prospective study in patients with celiac disease by administering two HRQOL questionnaires: EuroQol-5D and GastroIntestinal Quality of Life (GIQLI). Results: 54 stable patients on a gluten-free diet for a median 60 months, and 9 newly diagnosed individuals still on their usual diet were included. Overall GIQLI score was significantly higher, meaning a better HRQOL, in treated celiac patients versus pre-treated celiac patients (3.1 [2.7-3.5] vs. 2.4 [2.1-2.6], p < 0.01). Similarly, EuroQol's health status preference value was also significantly better in treated patients (0.87[0.8-1.0] vs. 0.7 [0.5-0.8], p < 0.01). EuroQol's visual analogic scale had also better scores, representing a better perceived health, among treated patients (80.0 [70.0-90.0] vs. 65.0 [40.0-71.0], p < 0.05). In comparison to EuroQol-5D scores among the healthy Spanish population, values obtained for celiac patients under treatment are similar to those seen in the general population. Conclusions: celiac disease impairs perceived health in affected individuals, which improves and reaches results similar to those in the general population when on a gluten-free diet.Introducción: las enfermedades crónicas modifican la percepción de salud de los individuos que las padecen. Por este motivo, al ser la enfermedad celiaca una enfermedad crónica, podría causar un deterioro de la calidad de vida relacionada con la salud (CVRS). Objetivo: analizar el impacto de la enfermedad celiaca en las personas que la padecen. Método: estudio observacional transversal prospectivo en pacientes con enfermedad celiaca administrando dos cuestionarios genéricos de medida de la CVRS: el EuroQol-5D y el GastroIntestinal Quality of Life (GIQLI). Resultados: se han incluido 54 pacientes controlados con dieta sin gluten durante una mediana de 60 meses y 9 recién diagnosticados y que aún no habían iniciado la dieta sin gluten. La puntuación global del GIQLI fue significativamente más alta, representativa de una mejor CVRS, en los celiacos tratados que en los que aún no habían iniciado la dieta (3,1 [2,7-3,5] vs. 2,4 [2,1-2,6], p < 0,01). Del mismo modo, el valor de preferencia del estado de salud del EuroQol fue también significativamente mejor en los celiacos tratados (0,87[0,8-1,0] vs. 0,7 [0,5-0,8], p < 0,01). La escala visual analógica del EuroQol fue también mejor puntuada, representativa de una mejor percepción de salud, en los celiacos tratados (80,0 [70,0-90,0] vs. 65,0 [40,0-71,0], p < 0,05). Comparados con los valores del EuroQol-5D en la población sana española, los valores de los celiacos tratados son similares a los de la población general. Conclusiones: la enfermedad celiaca deteriora la percepción de salud de los individuos que la padecen y mejora hasta alcanzar resultados equiparables a los de la población general cuando siguen la dieta sin gluten.

Fundament: Aging in human beings is the result of a very complex interaction of biological, psychological and social factors. In this stage, not only health problems are affected but also also another group of factors which are called social risk of aging. Objetive : To assess the fctional capacity of elders in a rural community Methods: Correctional transversal descriptive study carried out in theconsulting room number 13 that belong to the policlinic area VIII from Cienfuegos. The study gathered a total of 45 old patients who were selected at random, constituting 47% of the universe which is formed by 96 elders. The variables under study were : age, sex, marital status, occupational situation, and scholarship. The geriatric scale of functional assessment was applied to each of them. Results: Most of them (75,5%) has a satisfactory global functional assessment,. Their mood is fine mainly for those who have a good familial care, the married elders and those who have no difficulties with their basic necessities. There are no signs of an important lack of mobility, audition , sight, sleep and continence in the sample under study. The geriatric population was found to be functionally active.

OBJECTIVE: To estimate the individual-level association of income poverty with being underweight, using tobacco, drinking alcohol, having access only to unsafe water and sanitation, being exposed to indoor air pollution and being obese. METHODS: Using survey data for as many countries as possible, we estimated the relative risk association between income or assets and risk factors at the individual level within 11 medium- and low-income subregions of WHO. WHO and The World Bank data on the prevalence of risk factors and income poverty (defined as living on < US$ 1.00 per day, US$ 1-2.00 per day and > US$ 2.00 per day) were analysed to impute the association between poverty and risk factors for each subregion. The possible effect of poverty reduction on the prevalence of risk factors was estimated using population-attributable risk percentages. FINDINGS: There were strong associations between poverty and malnutrition among children, having access only to unsafe water and sanitation, and being exposed to indoor air pollution within each subregion (relative risks were twofold to threefold greater for those living on < US$ 1.00 per day compared with those living on > US$ 2.00 per day). Associations between poverty and obesity, tobacco use and alcohol use varied across subregions. If everyone living on < US$ 2.00 per day had the risk factor profile of those living on > US$ 2.00 per day, 51% of exposures to unimproved water and sanitation could be avoided as could 37% of malnutrition among children and 38% of exposure to indoor air pollution. The more realistic, but still challenging, Millennium Development Goal of halving the number of people living on < US$ 1.00 per day would achieve much smaller reductions. CONCLUSION: To achieve large gains in global health requires both poverty eradication and public health action. The methods used in this study may be useful for monitoring pro-equity progress towards Millennium Development Goals.

OBJECTIVE: We estimated the global burden of disease attributable to low consumption of fruit and vegetables, an increasingly recognized risk factor for cardiovascular disease and cancer, and compared its impact with that of other major risk factors for disease. METHODS: The burden of disease attributable to suboptimal intake of fruit and vegetables was estimated using information on fruit and vegetable consumption in the population, and on its association with six health outcomes (ischaemic heart disease, stroke, stomach, oesophageal, colorectal and lung cancer). Data from both sources were stratified by sex, age and by 14 geographical regions. FINDINGS: The total worldwide mortality currently attributable to inadequate consumption of fruit and vegetables is estimated to be up to 2.635 million deaths per year. Increasing individual fruit and vegetable consumption to up to 600 g per day (the baseline of choice) could reduce the total worldwide burden of disease by 1.8%, and reduce the burden of ischaemic heart disease and ischaemic stroke by 31% and 19% respectively. For stomach, oesophageal, lung and colorectal cancer, the potential reductions were 19%, 20%, 12% and 2%, respectively. CONCLUSION: This study shows the potentially large impact that increasing fruit and vegetable intake could have in reducing many noncommunicable diseases. It highlights the need for much greater emphasis on dietary risk factors in public health policy in order to tackle the rise in noncommunicable diseases worldwide, and suggests that the proposed intersectoral WHO/FAO fruit and vegetable promotion initiative is a crucial component in any global diet strategy.

Despite the magnitude of the problem of health inequity within and between countries, little systematic research has been done on the social causes of ill-health. Health researchers have overwhelmingly focused on biomedical research at the level of individuals. Investigations into the health of groups and the determinants of health inequities that lie outside the control of the individual have received a much smaller share of research resources. Ignoring factors such as socioeconomic class, race and gender leads to biases in both the content and process of research. We use two such factors - poverty and gender - to illustrate how this occurs. There is a systematic imbalance in medical journals: research into diseases that predominate in the poorest regions of the world is less likely to be published. In addition, the slow recognition of women's health problems, misdirected and partial approaches to understanding women's and men's health, and the dearth of information on how gender interacts with other social determinants continue to limit the content of health research. In the research community these imbalances in content are linked to biases against researchers from poorer regions and women. Researchers from high-income countries benefit from better funding and infrastructure. Their publications dominate journals and citations, and these researchers also dominate advisory boards. The way to move forward is to correct biases against poverty and gender in research content and processes and provide increased funding and better career incentives to support equity-linked research. Journals need to address equity concerns in their published content and in the publishing process. Efforts to broaden access to research information need to be well resourced, publicized and expanded.

Objetivos: Analizar las diferencias entre niños españoles de etnia gitana e inmigrantes extranjeros ingresados en centros de protección, respecto a las características del maltrato, los factores familiares y el estado de salud. Métodos: Se revisaron los expedientes sociosanitarios de 83 niños gitanos españoles y 105 niños inmigrantes que ingresaron desde enero de 1994 hasta diciembre de 2003 por maltratos en centros de protección del Instituto Aragonés de Servicios Sociales (IASS). El maltrato, sus tipos e indicadores se definieron y evaluaron según guías elaboradas por el IASS. Los factores familiares de riesgo sociosanitario asociados con el maltrato se determinaron según estudios nacionales. El estado de salud se evaluó según los protocolos elaborados por el IASS. Se realizó un estudio estadístico descriptivo y comparativo. Resultados: En los niños gitanos españoles predomina el grupo de edad de 0-5 años, mientras que en los inmigrantes es más frecuente el grupo de 12-17 años. En los niños gitanos españoles es también más frecuente la situación de negligencia física, emocional y/o abandono (p < 0,001) y la pertenencia a familias con problemas de delincuencia (odds ratio [OR] = 16,5; intervalo de confianza [IC] del 95%, 6,7-40,7), toxicomanía o alcoholismo (OR = 8,8; IC del 95%, 3,7-21,0) y multiproblemáticas (OR = 9,3; IC del 95%, 3,8-22,8). En los niños gitanos es más frecuente también la presencia de trastornos neurológicos, enfermedades discapacitantes, inmunizaciones ausentes o incompletas y enfermedades dermatológicas. Por su parte, los niños inmigrantes presentaron una frecuencia superior de maltrato físico, psicológico y/o sexual (p < 0,001), así como una procedencia de familias monoparentales (OR = 7,9; IC del 95%, 2,2-27,7). Conclusiones: Conocer las diferencias entre estos 2 grupos de niños maltratados puede ser de utilidad para los profesionales de los servicios sociales comunitarios responsables de desarrollar estrategias de intervención para la prevención y la detección precoz del maltrato, y para los responsables de la salud de estos menores mientras permanecen en un centro de protección.Objectives: To determine whether there are differences between Spanish gypsy and foreign immigrant children admitted to protection centers in the characteristics of the maltreatment, social and familial factors linked to maltreatment, and health status. Methods: The social and health reports of 83 Spanish gypsy and 105 foreign immigrant children admitted to protection centers of the Aragonese Institute for Social Services (Instituto Aragonés de Servicios Sociales [IASS]) because of maltreatment from January 1994 to December 2003 were reviewed. Maltreatment, its types, and warning signs were defined and assessed according to the guidelines drawn up by the IASS. The social and familial risk factors associated with maltreatment were determined according to national studies. Health status was assessed following protocols used by the IASS. A descriptive and comparative statistical study was performed. Results: The Spanish gypsy children were mostly in the age group of 0-5 years, while foreign immigrants were mostly in the age group of 12-17 years. Spanish gypsy children showed a greater frequency of physical and emotional neglect and/or abandonment (p < 0.001) and were more likely to have families with problems of crime (odds ratio [OR] = 16.5; 95% confidence interval [95%CI], 6.7-40.7), drug/alcohol abuse (OR = 8.8; 95%CI, 3.7-21) and families with more than one social and health risk factor (OR = 9.3; 95%CI, 3.8-22.8). Spanish gypsy children showed a greater frequency of neurological disorders, disabling diseases, absent or incomplete immunizations, and dermatologic diseases. Foreign immigrant children showed a greater frequency of physical and psychological and/or sexual abuse (p < 0.001) and were more likely to live in a single parent family (OR = 7.9; 95%CI, 2.2-27.7). Conclusions: Identifying the differences between these two groups of maltreated children could be useful for professionals working in the community social services in charge of developing intervention strategies for the prevention and early detection of maltreatment, as well as for professionals in charge of the health of these children during their stay in a protection center.

The political and economic turmoil that occurred in south-eastern Europe in the last decade of the twentieth century left a legacy of physical damage. This aspect of the conflict has received considerable coverage in the media. However, surprisingly less has been reported about the effects of that turmoil on the health of the people living in the region. In an attempt to identify and synthesize data on these effects, we carried out a systematic review and used the results to put together a searchable online database of documents, reports, and published material, the majority of which have not previously been easily accessible (http://www.lshtm.ac.uk/ecohost/see/index.php). The database covers the period from the early 1990s to 2003 and will be of considerable interest to policy-makers. It contains 762 items, many of them annotated and available for downloading. This paper synthesizes the main findings obtained from the material in the database and emphasizes the need for concerted action to improve the health of people in south-eastern Europe. Furthermore, we also recommend that agencies working in post-conflict situations should invest in developing and maintaining online databases that would be useful to others working in the area.

En el presente trabajo, hacemos consideraciones generales sobre la importancia que tiene una orientación nutricional correcta para la elevación del estado de salud de la población. También hacemos referencia de los efectos que producen las combinaciones incompatibles de alimentos sobre el organismo, y presentamos una tabla guía que nos ayudará a orientarnos en la elección diaria de dietas apropiadas. De esta forma intentamos llamar la atención de los profesionales de la salud para que desarrollen adecuadamente las acciones educativas-preventivas que deben ejercer sobre la población que atienden y que logren tener el adiestramiento básico que les permitan desarrollar con eficiencia acciones de orientación nutricional como parte de la atención integral al individuo.In this paper, general considerations are made on the importance of an adequate nutritional guidance to improve the health status of the population. Reference is also made to the effects produced by the incompatible combinations of food on the organism and a table that will help us in the daily selection of appropiate diets is shown. This way, we intend to call the attention of health professionals so that they develop the appropiate educative-preventive actions that they should put into practice with the population they attend, and have the basic training allowing them to carry out an efficient nutritional guidance as part of the comprehensive attention to the individual.

Se describe el consumo de frutas y su relación con el estado de salud y los factores socioeconómicos en una población adulta costarricense. Se realizó un estudio transversal y descriptivo en hombres y mujeres mayores de 18 años de edad. Se seleccionó una urbanización o caserío y en cada una de ellos se seleccionó por afinidad igual, un bloque de diez viviendas. Los datos se recolectaron en Cartago, por medio de encuesta, utilizando la técnica de entrevista directa estructurada la cual se realizó en el hogar en horas de la tarde y los fines de semana, durante el mes de febrero del 2000. De un total de 161 personas, 80% correspondió al sexo femenino. Las mayores de 60 años de edad, de estrato socioeconómico medio-alto y de alta escolaridad, consumen mayor cantidad de frutas al día (2,3± 1,0, 2,50± 1,3 y 2,0± 1,3 porciones respectivamente). No existió diferencias significativas (r > 0.05) entre las variables estudiadas. Además, contrariamente a lo esperado, aquellas personas que consideraron su estado de salud como malo, las que reportaron enfermedades crónicas, las que practican ejercicio, toman suplementos vitamínicos y las que fuman, consumen mayor cantidad de fruta que los que no presentan estas condiciones, no siendo este resultado estadísticamente significativo. En ambos casos la cantidad de fruta consumida no es adecuada. Se concluye que la cantidad y frecuencia de consumo de frutas en esta población es inadecuada, por lo que sería necesario desarrollar estrategias de educación nutricional donde se promueva el consumo gradual, hasta lograr la meta propuesta por las guías alimentarias de nuestro paísConsumption of fruits in an adult Costa Rican population. The consumption of fruits and it relation with the health and socioeconomic condition of an adult Costa Rican population is described. The study included a cross sectional and descriptive analysis in men and women 18 years old or older. Ten-house blocks were selected by affinity in a community or neighborhood in Cartago. Data were collected in a survey using home direct structured interviews carried out in the afternoons or during the weekend in February, 2000 . Eighty percent of the 161 people interviewed were women. Results showed that the higher consumption of fruits was described in women who were older that 60 years old and, who proceed from a medium-high economic stratum or have a high schooling condition (2,3± 1,0, 2,50± 1,3 y 2,0± 1,3 portions, respectively). No statistical significant difference was found in any of the variables evaluated. Data also showed that, in contrast with what it was expected, people that considered their health condition as bad, suffered chronic diseases, practiced physical exercise, took vitamin supplement or smoke, showed a higher consumption of fruits that those who do not have those conditions. The difference, however, showed to be no significant and the consumption of fruit showed to be not adequate in both groups. In conclusion, the amount and frequency of fruit consumption were inadequate in the population studied. The necessity of developing nutritional education strategies to promote a gradual increment in the consumption of fruits to approach the recommendation of the National Alimentary Guidelines is recommended

Fundamento: Hoy en día, en los países desarrollados, llegar a una edad avanzada ha dejado de ser algo excepcional, sin embargo muchas personas no logran envejecer con una buena calidad de vida. El presente trabajo tiene como objetivos, contribuir a un mejor conocimiento de los principales factores que influyen en la calidad de vida y la percepción de la salud de los mayores de 65 años, así como determinar qué ventajas y desventajas presenta cada uno de los tres instrumentos de medida de la salud y la calidad de vida frente a los otros dos instrumentos utilizados. Métodos: A partir de 911 encuestas a personas mayores de 65 años no institucionalizadas, realizadas a domicilio, se hizo un análisis multivariante mediante regresión logística, poniendo en relación los resultados obtenidos en el Perfil de Salud de Nottingham (PSN), el Euroqol y el EAS con las caracterísiticas sociodemográficas, el nivel de recursos económicos, el grado de apoyo sociofamiliar, el estado de salud física y mental y la capacidad funcional. Resultados: Los principales factores que se asocian con la percepción de un mal estado de salud y mala calidad de vida en el Euroqol y el PSN son los trastornos de ansiedad (Odd Ratios entre 1,8(IC:1,2-2,8) para movilidad y 7,9(IC:4,5-13,9) para Perfil ≠11111), trastornos depresivos (OR:1,8(IC:1,3-2,6) para dolor/malestar- 3,3(IC:2,1-5,1) para aislamiento social), falta de ejercicio (OR:1,4 (IC:1-2,1) para ansiedad/depresión -3,9(IC:2,5-6,2) para actividades cotidianas), dependencia para las actividades básicas de la vida diaria (OR:0,5(IC:0,3-0,9) para reacción emocional - 4,8(IC:3-7,6) para actividades cotidianas) y dependencia para las actividades instrumentales de la vida diaria (OR:1,5(IC:1,1-2,1) para Escala Visual Analógicac

El cuidador de un niño con discapacidad está sometido al estrés, sobrecarga, síntomas de ansiedad (SA) y de depresión (SD), factores que afectan su calidad de vida (CV). El objetivo de estudio fue describir la relación entre sobrecarga, SA y SD con CV de cuidadores de alumnos con discapacidad, mediante un estudio descriptivo a 31cuidadores que resultaron con baja CV en la investigación sobre “CV de cuidadores primarios de niños con discapacidad dependiente, del CRIT Chihuahua”. Se aplicó un cuestionario sociodemográfico, inventarios de ansiedad y depresión de Beck y, la escala de sobrecarga de Zarit. Los resultados exponen sobrecarga moderada (31.9%), SA moderados (21.3%) y, SD leves (13.4%). Encontrando relaciones nulas entre CV y SA (r = -.174), nulas entre CV y SD (r = -.20) y, mínimas entre sobrecarga y CV (r = .030). Resultaron relaciones moderadas entre sobrecarga y SA (r =. 349), moderada pero significativa entre sobrecarga y SD (r = .482) y, moderada y significante entre SA y SD (r =.407). Se reveló que cuatro cuidadores tienen pensamientos suicidas manifestando SA y sobrecarga graves. Los cuidadores más expuestos a padecer algún trastorno mental por la gravedad en los SA y SD son los empleados de medio tiempo, los que tienen una carrera técnica y los que viven en unión libre. Se concluye que la relación entre las variables de estudio con CV no fue significativa, pero los resultados exhiben información relevante para investigaciones encaminadas a conocer más sobre la CV de cuidadores de alumnos con discapacidad.

Las competiciones deportivas cada vez más tienen una mayor exigencia en cuanto a la intensidad del esfuerzo, precisando controlar minuciosamente todos los aspectos que afectan al rendimiento deportivo. La alimentación, hidratación y suplementación del deportista, antes, durante y después del entrenamiento o la competición, afecta directamente sobre la salud, la composición corporal y, por consiguiente, sobre el rendimiento y la recuperación del deportista. Para un correcto asesoramiento del deportista, es necesaria la valoración del estado nutricional a través de analíticas sanguíneas para controlar el proceso de adaptación al entrenamiento. El objetivo del presente trabajo es ofrecer una herramienta práctica a los dietistas-nutricionistas para el control de la salud y el estado nutricional de los deportistas, así como para monitorizar su adaptación a las cargas de trabajo y periodos de competición. La realización de pruebas analíticas para el control del metabolismo proteico, perfil lipídico, iones (por su relación con el estado de hidratación del individuo), pruebas hematológicas y metabolismo del hierro pueden ser de gran interés, además de revisar algunos parámetros hormonales con el fin de observar la posible existencia de estados de sobreentrenamiento. La comprensión y la correcta interpretación de los análisis de laboratorio serán de máxima importancia para los dietistas-nutricionistas que realicen asesoramiento dietético-nutricional en deportistas, ya que permitirá determinar el estado del deportista y proponer diferentes estrategias individualizadas de alimentación, en función de la fase de entrenamiento en la que se encuentre y la respuesta al mismo.

En los últimos años se ha observado que el ejercicio de la violencia de género en el seno familiar no deja indiferente a ninguno de sus miembros, especialmente, a los hijos. En estos términos, por lo general, los menores pueden encontrarse en dos situaciones: por un lado, el menor se convierte en objeto-receptor del ejercicio de la violencia (al igual que su madre), o en su defecto, atestigua de manera directa o indirecta los hechos. Con respecto a la primera, numerosos estudios (Appel; Holden, 1998; Edleson, 1999; Fantuzzo; Mohr, 1999; Graham-Bermann; Levendosky, 1998; Howelss; Rosenbaum, 2010) señalan una elevada prevalencia entre la violencia ejercida sobre la mujer y en igual medida sobre los hijos. Incluso, Casanueva, Martin y Runyan (Casanueva; Martin; Runyan, 2009) han observado que las madres que son víctimas de violencia física muestran una mayor predisposición al maltrato infantil. El objetivo general de este trabajo es conocer la trayectoria científica vigente sobre las repercusiones físicas y psicoemocionales en menores que han sido, alguna vez, testigos de conflictos parentales y, en base a ella, reflexionar sobre las nuevas demandas que esta situación plantea.

Fundamento: Algunas características sociales, médicas o funcionales se asocian a mayor consumo de recursos sanitarios, sin que esto signifique un uso inapropiado de éstos. El objetivo de este trabajo es conocer la influencia del estado de salud y otros factores sobre las estancias hospitalarias y las estancias inapropiadas en la población mayor de 64 años. Método: Una cohorte representativa de la población mayor de 64 años del Partido Judicial de Toledo (n=3.214) en la que se había valorado el estado de salud, fue seguida durante 18 meses, identificando sus ingresos y estancias hospitalarias, cuya adecuación fue evaluada con el Appropiateness Evaluation Protocol. Se analizaron las asociaciones entre las características socio-demográficas, de estado de salud y morbilidad de la cohorte con las tasas de frecuentación y hospitalización y con la proporción de estancias e ingresos inadecuados. Resultados: Durante los 18 meses de seguimiento fueron hospitalizados 410 individuos (12,8%), que generaron 546 ingresos (tasa de frecuentación=17,0 ingresos/100 habitantes) y 7.015 días de estancia (tasa de hospitalización = 218,3 estancias/100 habitantes). El 18,9% de los ingresos y el 49,9% de las estancias fueron evaluadas como inadecuados. La hospitalización se asoció al peor estado de salud, institucionalización, género masculino, determinadas patologías y a la utilización previa de servicios sanitarios. No se hallaron asociaciones entre características de los pacientes y proporción de estancias inadecuadas. El 97,5% de las estancias innecesarias fue atribuido a problemas de programación hospitalaria y estilo de practica de los médicos. Conclusiones: Los factores socio-demográficos, de morbilidad, estado de salud y utilización previa de servicios se muestran como buenos predictores de hospitalización en las personas mayores, pero no se relacionan con el uso inadecuado de la hospitalización.

En el presente trabajo se realiza un análisis de la categoría actividad, cuya relevante importancia hace que se le considere como una de las principales dentro de la ciencia psicológica. Esta categoría, que ha sido estudiada desde diferentes enfoques (psicológicos, filosóficos y sociológicos), la abordamos en este trabajo con una óptica práctica, vinculándola directamente a la salud y a la atención primaria. En nuestro enfoque vinculamos la actividad, los elementos esenciales que la componen, y sus formas de manifestarse, con el modo de vida del hombre, el cual tiene una estrecha relación con el nivel de salud; así como también la relacionamos con la intervención comunitaria, sirviéndonos de ella como guía para orientar nuestro trabajo en la prevención de enfermedades y la promoción de salud.In the present work an analysis of the category activity is carried out, a category whose great importance makes it to be considered as one of the key categories within psychological science. This category which has been studied with different approaches (psycologic, philosofic and sociologic), is viewed in this work from a practical perspective, being linked directly to health condition and primary care. In our approach we relate the activity, its essential components, and its forms of manifestation to the life style of man, which is very closely related to health condition, as well as to the role played by the community, using this aspect as directing element for our work in disease prevention and health promotion.

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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.)