The authors examine laypersons' perspectives of illness: the content of causal explanations of diabetes and differences in explanations according to gender. Qualitative research was carried out in Guadalajara, Mexico. A nonprobabilistic sample of 20 diabetic individuals participated in interviews, and the content of the interviews was analyzed. On the origin of their condition, participants offered explanations that match neither the biomedical model nor any other formal causal theory. Participants attributed the onset of diabetes to socioemotional circumstances linked to their life experiences and practices. Men attributed causality to work and social circumstances outside the home; women attributed it to family life and domestic circumstances. The authors discuss how lay theories can be useful for the reorganization of health services.
The illness experience is a relevant issue in current research and academic discussions. A growing number of research initiatives have undertaken to account for the subject's perspective and subjectivity in the health field. This paper discusses our research team's approach and results in studying the experience of people living with chronic illness. Our perspective is based upon the production in this relatively new field as well as health-related discussions in Latin America. The illness experience calls for an understanding of it as a subjective and existential phenomenon, entailing the phenomenological arena, immersed in the process where ill people "produce" and "reproduce" themselves. The unfolding and course of the illness as well as treatment management are some salient dimensions we evoke. Some lines of future work are presented in order to create a research agenda, highlighting its implications for existing proposals pertaining to health reform in our Latin American countries.
The authors examine laypersons' perspectives of illness: the content of causal explanations of diabetes and differences in explanations according to gender. Qualitative research was carried out in Guadalajara, Mexico. A nonprobabilistic sample of 20 diabetic individuals participated in interviews, and the content of the interviews was analyzed. On the origin of their condition, participants offered explanations that match neither the biomedical model nor any other formal causal theory. Participants attributed the onset of diabetes to socioemotional circumstances linked to their life experiences and practices. Men attributed causality to work and social circumstances outside the home; women attributed it to family life and domestic circumstances. The authors discuss how lay theories can be useful for the reorganization of health services.
The use of interventions with computer applications showed to be more effective than educational interventions and incorporation pharmacists into the health team. Future studies are required that include economic variables such as, implementation costs, drug costs and other expenses associated with health care and treatment of diseases.
Background Breast cancer has become a major public health problem around the world, especially in Mexico and Latin America. Screening for breast cancer, which involves self-examination, mammography, and clinical breast examination, is crucial for early diagnosis, which in turn is associated with improved outcomes and survival rates. Although breast cancer prevention and control activities are being implemented in Mexico and Latin America, as in many other countries, there are no comprehensive public reports that provide information on the number, type, and scope of these activities; the impact of the programs and actions implemented; and the policies that form the basis of these programs. Objective This study aims to present the design of a protocol for a scoping review on the policies and action programs for breast cancer care in Mexico and Latin America, as well as their objectives and implementation plans. Methods This scoping review is guided by the methodological reference framework proposed by Arksey and O’Malley. A systematic search of the following electronic databases will be performed: MEDLINE (PubMed), MEDLINE (EBSCOHost), CINAHL (EBSCOHost), Academic Search Complete (EBSCOHost), ERIC, ISI Web of Science (Science Citation Index) in English and Cochrane and MEDES-MEDicina in Spanish. A search will be conducted to identify relevant studies published between 2000 and 2018. Data will be analyzed and presented in descriptive statistics and qualitative content analyses with analysis matrices and semantic networks. The selected studies will be arranged according to the Specific Action Program, Prevention and Control of Female Cancer 2013-2018. Results The intention is to perform this review during the first and second quarters of 2019 and present the results to health authorities by the first quarter of 2020. Results will also be sent for publication to an indexed journal by the second quarter of 2020. Conclusions We present a protocol for a scoping review–type literature revision based on the Arksey and O’Malley methodology to be performed during the first quarter of 2019. According to this 6-stage methodology, we will identify the scientific publications that present or analyze first-level action policies and programs for breast cancer care in Mexican women, as well as the results of these policies and programs, if any. The outcome of this review will be used to define the basis of a research project intended to design an educational intervention strategy for the general public in Mexico to enable them to deal with this public health problem. International Registered Report Identifier (IRRID) PRR1-10.2196/12624
Introducción: En 2017, el INEGI reportó 84 142 defunciones por tumores malignos en México y la Organización Mundial de la Salud indicó que la tasa de mortalidad por cáncer de mama en 2018 fue de 11.2 por 100 mil mujeres. Objetivo: Mostrar la tendencia de la mortalidad por cáncer de mama en mujeres según municipio y región sanitaria de Jalisco en el periodo 2010-2017. Método: Estudio analítico en el que se estimaron tasas estandarizadas de mortalidad y riesgos relativos por municipio de residencia de 3873 mujeres. Se utilizó estadística espacial de dispersión y tendencia central. Resultados: La tasa de mortalidad aumentó de 10.7 a 13.0 por 100 mil mujeres en el periodo 2010-2017. Los valores más altos se encontraron en los municipios de Chapala (21.2) y Guadalajara (19.5), la tasa de mortalidad aumentó en cuatro de cada 10 municipios y el riesgo relativo fue hasta 50 veces mayor en algunos del occidente y centro de Jalisco. Conclusiones: Se observó un incremento de 1.0 % anual, aunque territorialmente diferenciado. Los resultados representan una oportunidad para mejorar los procesos de detección y diagnóstico oportunos, así como para garantizar la cobertura de los servicios.
Introduction: The Situation Room is a physical or virtual space where experts systematically analyze information to characterize a health situation, especially during emergencies. Decision-making processes are made toward solving health needs and promoting collaboration among institutions and social sectors. This paper presents the context and circumstances that led the University of Guadalajara (UdeG) to install a local health situation room (HSR) to address the COVID-19 pandemic at this institution based in the state of Jalisco, Mexico, a narrative is also made of its working processes and some of its results.Methods: The design of this situation room for COVID-19 was based on the methodology established by the Pan American Health Organization (PAHO)/WHO. This local-type situation room was installed on February 12, 2020. The health problem was characterized, and strategic lines, objectives, and goals were established; the first analysis was derived from an action plan deployed at the UdeG. The strategic lines were situational diagnosis, preventive actions, and containment strategies.Results: The situation room influenced the activities of the UdeG before the epidemic cases started in the state. One of the actions with the greatest impact was developing a mathematical model for predicting COVID-19 cases. Subsequently, new models have been developed according to the epidemiological evolution of the disease, helping manage the epidemic in the state. Another important result was the early closing of face-to-face university activities, reducing contagion risks and the mobility of more than 310,000 students, faculty, and administrative personnel throughout Jalisco.Conclusions: A consequence of the closure was that the confinement generated by the pandemic was the change to virtual meetings from April 2020 to date; but at the same time, this working format was a strength, since it influenced the decision of the university board to change all the academic activities to virtual format before other educational, economic, and social activities in the state did. By April 2020, the situation room transcended its institutional boundaries and was invited to participate at the Jalisco State's Health Committee. Its recommendations have helped to maintain the state with one of Mexico's lowest COVID-19 incidence and mortality rates.
Este trabajo reporta los hallazgos parciales de un estudio más amplio sobre la experiencia de vivir con enfermedades crónicas; el mismo se centra en la perspectiva de sujetos enfermos sobre los servicios de salud. Un estudio cualitativo fue realizado en un barrio popular de Guadalajara, con treinta sujetos con diabetes. La información se obtuvo mediante entrevistas semi y no estructuradas aplicadas en sus hogares. Los datos se obtuvieron durante un año, los mismos fueron analizados mediante análisis de contenido y conversacional. Tres valoraciones generales identificamos sobre la atención médica por parte de los participantes del estudio: algunos la consideran buena, para otros es ambivalente y para el resto es mala. Estas valoraciones se relacionan estrechamente con la trayectoria del padecimiento y los recursos materiales disponibles que posibilitan optar por distintos tipos de servicios. Tales perspectivas son cambiantes a lo largo del tiempo, incluyen los diversos servicios existentes y se construyen incorporando otros padecimientos crónicos. Quienes acuden al Seguro Social la definen en términos eminentemente negativos, a diferencia de aquellos con acceso a los servicios públicos de asistencia y a la medicina privada. Se discuten sus implicaciones en referencia a la reforma del sector salud.
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