scholarly journals Description and analysis of primary care-based COVID-19 interventions in Colombia

Medwave ◽  
2021 ◽  
Vol 21 (03) ◽  
pp. e8147-e8147
Author(s):  
Erwin Hernando Hernández Rincón ◽  
Juan Pablo Pimentel González ◽  
Manuel Felipe Aramendiz Narváez ◽  
Raúl Andrés Araujo Tabares ◽  
Julián Mateo Roa González

Introduction The COVID-19 pandemic was declared in early 2020, requiring different prevention and intervention measures on a large scale. In the case of Colombia, a series of measures focused on isolation and remote services provision were introduced in a context marked by health inequities. This article reviews the theoretical and normative references on primary care interventions in the Colombian response to the COVID-19 pandemic. Methods A literature review was conducted in PubMed, LILACS, MEDLINE, and official documents and regulations issued in Colombia, the World Health Organization, and the Pan American Health Organization. A narrative synthesis was done of 33 documents based on their contribution to the implementation of primary care in Colombia and their role in the pandemic. Results The information was organized into two categories: Actions taken in Colombia in response to COVID-19 and Opportunities in primary care in response to COVID-19. Colombia’s actions were contrasted with world experience. Better pandemic control was found in countries that adopted primary care as a response. Primary care has strengthened the handling of the pandemic through community action, the provision of coordinated services, mental health inclusion, and the adoption of telemedicine processes. Conclusions In Colombia, primary care is presented as an opportunity to respond to the COVID-19 pandemic and the problems and needs derived from this situation. However, despite the above, there is resistance in the country to adopt this type of approach and complement the hospital-centric model to face the pandemic.

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712199204
Author(s):  
Alexander D. Slabaugh ◽  
John W. Belk ◽  
Jonathan C. Jackson ◽  
Richard J. Robins ◽  
Eric C. McCarty ◽  
...  

Background: COVID-19 is a severe respiratory virus that spreads via person-to-person contact through respiratory droplets. Since being declared a pandemic in early March 2020, the World Health Organization had yet to release guidelines regarding the return of college or professional sports for the 2020-2021 season. Purpose: To survey the head orthopedic surgeons and primary care team physicians for the National Collegiate Athletic Association (NCAA) Football Bowl Subdivision (FBS) football teams so as to gauge the management of common COVID-19 issues for the fall 2020 college football season. Study Design: Cross-sectional study. Methods: The head team orthopaedic surgeons and primary care physicians for all 130 FBS football teams were surveyed regarding their opinions on the management of college football during the COVID-19 pandemic. A total of 30 questions regarding testing, return-to-play protocol, isolating athletes, and other management issues were posed via email survey sent on June 5, 2020. Results: Of the 210 team physicians surveyed, 103 (49%) completed the questionnaire. Overall, 36.9% of respondents felt that it was unsafe for college athletes to return to playing football during fall 2020. While the majority of football programs (96.1%) were testing athletes for COVID-19 as they returned to campus, only 78.6% of programs required athletes to undergo a mandatory quarantine period before resuming involvement in athletic department activities. Of the programs that were quarantining their players upon return to campus, 20% did so for 1 week, 20% for 2 weeks, and 32.9% quarantined their athletes until they had a negative COVID-19 test. Conclusion: While US Centers for Disease Control and Prevention guidelines evolve and geographic regions experience a range of COVID-19 infections, determining a universal strategy for return to socialization and participation in sports remains a challenge. The current study highlighted areas of consensus and strong agreement, but the results also demonstrated a need for clarity and consistency in operations, leadership, and guidance for medical professionals in multiple areas as they attempt to safely mitigate risk for college football players amid the COVID-19 pandemic.


PEDIATRICS ◽  
1992 ◽  
Vol 89 (3) ◽  
pp. 480-485 ◽  
Author(s):  
Sarah McCue Horwitz ◽  
Philip J. Leaf ◽  
John M. Leventhal ◽  
Brian Forsyth ◽  
Kathy Nixon Speechley

The importance of psychological and social issues for children's well-being has long been recognized and their importance in the practice of pediatrics is well documented. However, many of the studies looking at this issue have emphasized psychiatric problems rather than issues commonly referred to as the new morbidity. The goal of this research was to refocus interest on the problems of the new morbidity. This study examined the rates and predictors of psychological problems in 19 of 23 randomly chosen pediatric practices in the greater New Haven area. Families of all 4- to 8-year-old children were invited to participate and to complete the Child Behavior Checklist prior to seeing a clinician. Clinicians completed a 13-category checklist of psychosocial and developmental problems based on a World Health Organization-sponsored primary care, child-oriented classification system. Of the 2006 eligible families, 1886 (94%) participated. Clinicians identified at least one psychosocial or developmental problem in 515 children (27.3%). Thirty-one percent of the children with problems received no active intervention, 40% received intervention by the clinician, and 16% were referred to specialty services. Not surprisingly, children whose problems were rated as moderate or severe were twice as likely to be referred compared with children with mild problems. Recognition of a problem was related to four characteristics: if the visit was for well child rather than acute care; if the clinician felt he or she knew a child well; if the child was male; and if the child had unmarried parents (all P ≤ .05). The data suggest that, when asked to use a taxonomy appropriate for primary care, clinicians recognize problems in many 4- to 8-year-old children (515/1886; 27.3%). This rate is considerably higher than the rates previously reported. Further, many children with identified problems (56%) were reported by their clinicians to receive some form of active intervention. Characteristics of the visit (type of visit, clinician's knowledge of a child) that influence the recognition of problems were also identified. These results suggest that investigators must define what types of problems they are interested in and under what circumstances to determine accurately what pediatric practitioners know about psychosocial and developmental problems in their young patients and families.


2003 ◽  
Vol 182 (3) ◽  
pp. 205-209 ◽  
Author(s):  
Petros Skapinakis ◽  
Glyn Lewis ◽  
Venetsanos Mavreas

BackgroundUnexplained fatigue has been extensively studied but most of the samples used were from Western countries.AimsTo present international data on the prevalence of unexplained fatigue and fatigue as a presenting complaint in primary care.MethodSecondary analysis of the World Health Organization study of psychological problems in general health care. A total of 5438 primary care attenders from 14 countries were assessed with the Composite International Diagnostic Interview.ResultsThe prevalence of unexplained fatigue of 1-month duration differed across centres, with a range between 2.26 (95% CI 1.17–4.33) and 15.05 (95% CI 10.85–20.49). Subjects from more-developed countries were more likely to report unexplained fatigue but less likely to present with fatigue to physicians compared with subjects from less developed countries.ConclusionsIn less-developed countries fatigue might be an indicator of unmet psychiatric need, but in more-developed countries it is probably a symbol of psychosocial distress.


Author(s):  
Vikas Sharma ◽  
Chandana Majee ◽  
Rahul Kaushik ◽  
Shivani Saxena ◽  
Salahuddin Salahuddin ◽  
...  

Herbal digestive tablets are meant for treating indigestion problems. The indigestion problem is one of the major problems of all (the) ages of human beings. As trends for eating fast foods is increasing, simultaneously the improper digestion also tends to increase. There are a number of digestive tablets in the market but in attempt to improve their taste the actual motto behind their use is masked. To combat the indigestion problems, in the present study an attempt has been made to formulate, develop and evaluate herbal digestive tablets. The formula of the digestive tablet has been decided after deep review of Ayurvedic formulary of India. The ingredients of this formulation have been procured from authentic sources. The wet granulation method was used to prepare the granules for punching the tablets. After preparation, the herbal digestive tablets were subjected to various pharmaceutical evaluations and quality control evaluations as per the guidelines from World Health Organization (WHO). The formulation was also subjected to antioxidant screening using Phosphomolybdenum method. The digestive tablets are obtained as light brown-colored round tablets with pleasant odour and spicy taste with an average size of 8mm and smooth edges. Maximum extractive value was observed as 34% in methanol with a total ash value of 10.16%. Other parameters reported as bitterness value- 0.69 units, volatile oil content-8%, loss on drying- 12.3%, swelling and foaming index of 0.27 and less than 100 respectively. The tablets showed a total antioxidant potential of 0.51mg/mg as Ascorbic acid equivalent. Tablets also pass various pharmaceutical evaluation parameters like hardness, friability, weight variation, and disintegration test. Herbal digestive tablets have very excellent taste due to less bitter drugs. The tablet formula can be applied to prepare large scale production of digestive tablets.


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Ole Lagatie ◽  
Ann Verheyen ◽  
Stijn Van Asten ◽  
Maurice R. Odiere ◽  
Yenny Djuardi ◽  
...  

Abstract Infections with intestinal worms, such as Ascaris lumbricoides, affect hundreds of millions of people in all tropical and subtropical regions of the world. Through large-scale deworming programs, World Health Organization aims to reduce moderate-to-heavy intensity infections below 1%. Current diagnosis and monitoring of these control programs are solely based on the detection of worm eggs in stool. Here we describe how metabolome analysis was used to identify the A. lumbricoides-specific urine biomarker 2-methyl pentanoyl carnitine (2-MPC). This biomarker was found to be 85.7% accurate in determining infection and 90.5% accurate in determining a moderate-to-heavy infection. Our results also demonstrate that there is a correlation between 2-MPC levels in urine and A. lumbricoides DNA detected in stool. Furthermore, the levels of 2-MPC in urine were shown to rapidly and strongly decrease upon administration of a standard treatment (single oral dose of 400 mg albendazole). In an Ascaris suum infection model in pigs, it was found that, although 2-MPC levels were much lower compared to humans, there was a significant association between urinary 2-MPC levels and both worm counts (p = 0.023) and the number of eggs per gram (epg) counts (p < 0.001). This report demonstrates that urinary 2-MPC can be considered an A. lumbricoides-specific biomarker that can be used to monitor infection intensity.


2011 ◽  
Vol 8 (1) ◽  
pp. 12-14
Author(s):  
Miguel R. Hernández ◽  
Tresha Ann Gibbs ◽  
Luisa Gautreaux-Subervi

The Dominican Republic is located in the Caribbean Sea and comprises three-quarters of the island Hispaniola, which it shares with Haiti. According to the 2002 census, approximately 8.5 million people live in the Republic, with 64% residing in urban areas (Oficina Nacional Estadística, n.d.). During 1990 and 2000, the Dominican Republic was a leader in economic development for Latin America and the Caribbean; however, this was not reflected in the areas of human and social development (Pan American Health Organization & World Health Organization, 2007). Less than 1 % of the health budget administered by the Ministry of Public Health and Social Assistance (MISPAS) is allocated to mental health and the public system is generally underfunded (Pan American Health Organization & World Health Organization, 2008). However, there is an array of mental health services within the country when privately funded facilities are taken into account.


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