viernes, 31 de mayo de 2019
The impact of the method of consent on response rates in the ISAAC time trends study.
Journal: International Journal of Tuberculosis and Lung Disease
Issue Date: 2010-08-01
PubMed ID: 20626953
Abstract
BACKGROUND: Centres in Phases I and III of the International Study of Asthma and Allergies in Childhood (ISAAC) programme used the method of consent (passive or active) required by local ethics committees. METHODS: Retrospectively, relationships between achieved response rates and method of consent for 13-14 and 6-7-year-olds (adolescents and children, respectively), were examined between phases and between English and non-English language centres. RESULTS: Information was obtained for 113 of 115 centres for adolescents and 72/72 centres for children. Both age groups: most centres using passive consent achieved high response rates (>80% adolescents and >70% children). English language centres using active consent showed a larger decrease in response rate. Adolescents: seven centres changed from passive consent in Phase I to active consent in Phase III (median decrease of 13%), with five centres showing lower response rates (as low as 34%). Children: no centre changed consent method between phases. Centres using active consent had lower median response rates (lowest response rate 45%). CONCLUSION: The requirement for active consent for population school-based questionnaire studies can impact negatively on response rates, particularly English language centres, thus adversely affecting the validity of the data. Ethics committees need to consider this issue carefully.jueves, 30 de mayo de 2019
Centro de rehabilitación mental en Pachacamac con énfasis en la fenomenología arquitectónica
Other Titles: Mental Rehabilitation Center in Pachacamac with emphasis on Architectural Phenomenology
Publisher: Universidad Peruana de Ciencias Aplicadas (UPC)
Issue Date: 2019-05-16
Abstract
In Peru, one of seven persons has some type of disability that interferes with their personal, familiar, academic work and/or social performance. In regards to disability due to mental disorders, one in three persons in Peru will have a mental health problem throughout their lives. Despite this situation, people who need care do not receive it because of several reasons, reaching almost 80% of people that do not receive adequate treatment. The Peruvian hospital architecture has not evolved according to the international trends since the mid XX century. The new typology for hospitals has incorporate an improvement in the infrastructure, location and the pertinent materials for a comfortable stay of the patients. For this reason, this project will be based on the investigation on all the necessary terms in order to design an optical Mental Health Center, emphasizing the architectural phenomenology, spaces that induce reflection, introspection and silence, these forms go according to the new psychiatric tendencies where it is incorporated into the community as a means of healing. For this, national and international projects will be analyzed in 4 criteria: context, concept, function and technique. Besides, different ground floors will be analyzed in the south of Lima, specifically in Pachacamac, based on different regulations according to the architectural typology proposed. Finally, there will be an architectural design project, based on the research. It is hoped that this investigation will be contributed to improving the design vision for the psychiatric architecture in the country of Peru.En el Perú, uno de cada siete peruanos tiene algún tipo de discapacidad que interfiere con su desempeño personal, familiar, académico, laboral y/o social. En lo que refiere a la discapacidad por trastornos mentales, uno de cada tres peruanos presentará algún problema de la salud mental a lo largo de su vida. A pesar de esta coyuntura, las personas que necesitan atención no la reciben debido a varias razones, llegando al 80% de las personas no reciben tratamiento adecuado. La arquitectura hospitalaria peruana no ha evolucionado acorde a las tendencias internacionales que se vienen dando desde mitad del siglo XX. Estas tendencias buscan una mejoría constante en la infraestructura, emplazamiento y los materiales pertinentes para una estadía cómoda de los pacientes. Por tal motivo, este proyecto se basará en la investigación de todo lo necesario para diseñar un edificio, con énfasis en fenomenología arquitectónica, espacios que inducen a la reflexión, introspección y silencio; que vaya acorde con las nuevas tendencias psiquiátricas donde se incorpore a la comunidad como medio de sanación. Se analizarán proyectos referenciales nacionales e internacionales exponiendo sus ventajas y desventajas en cuanto a 4 criterios: contexto, concepto, función y técnico. Se analizarán los terrenos tentativos al sur de Lima, específicamente en Pachacamac, a base a criterios establecidos por análisis previamente mencionado y por la normativa según el tipo de establecimiento propuesto. Finalmente, se da a conocer el diseño de un proyecto como conclusión de todo lo investigado. Se espera que esta investigación contribuya a mejorar la visión de diseño para la arquitectura psiquiátrica en el país dado que la situación actual lo amerita.
Advisors
Rivarola Vasallo, Marcos Orlando RobertC. M. T. I. Centro Médico de Terapia Integral
Other Titles: Medical Center of Integral Therapy
Abstract
This research proposes, with its critical approach, an architectural typology with an emphasis on natural light for an unconventional therapy center in the district of Pachacámac, Lima-Peru. In this line, we try to show how, through architectural design and work with natural light, we could complement, enrich and enhance, with a preventive approach, the experiences of patients who carry out medical treatments guided by traditional therapies, with a reactive approach. In this line, this thesis consists of six chapters. The first introduces the basic assumptions to understand the problem that serves as the basis for our objectives, as well as the scope and limitations of this research. The second chapter develops the theoretical-referential framework and abounds on the differences between traditional medicine, focused on the disease, and holistic medicine, focused on the person, critically approaching its advantages and disadvantages through the use of non-architectural terms. The third chapter describes the architectural conceptual framework with some referential projects in view. The fourth and fifth chapters deal with the characteristics of the place and the profile of the user: both chapters provide critical elements to elaborate, in the sixth chapter, the architectural program with seven functional modules for a total area constructed of 5,536 m2. In short, a Medical Center of Integral Therapy is located in Pachacámac, which has all the benefits of typological design analyzed and described and, therefore, incorporates as a fundamental element, inescapable, the emotional-sensitive aspect of the human person in the implementation of clinical treatment.La presente investigación propone, con su planteamiento crítico, una tipología arquitectónica con énfasis en la luz natural para un centro de terapia no convencional en el distrito de Pachacámac, Lima-Perú. En esa línea, se procura mostrar cómo por medio del diseño arquitectónico y el trabajo con la luz natural se podría llegar a complementar, enriquecer y potenciar, con un enfoque preventivo, las experiencias de los pacientes que llevan a cabo tratamientos médicos orientados desde las terapias tradicionales, de enfoque reactivo. La tesis consta de seis capítulos. El primero introduce los presupuestos básicos para comprender la problemática que sirve de base a nuestros objetivos, así como los alcances y las limitaciones de la presente investigación. El segundo capítulo desarrolla el marco teórico-referencial y abunda sobre las diferencias entre la medicina tradicional, centrada en la enfermedad, y la medicina integral, centrada en la persona, aproximándose críticamente a sus ventajas y desventajas mediante el empleo de términos no arquitectónicos. El capítulo tercero describe el marco conceptual arquitectónico teniendo a la vista algunos proyectos referenciales. En los capítulos cuarto y quinto se trata sobre las características del lugar y el perfil del usuario: ambos capítulos aportan elementos críticos para elaborar, en el capítulo sexto, el programa arquitectónico. En suma, se plantea un Centro Médico de Terapia Integral ubicado en Pachacámac, que cuente con todos los beneficios de diseño tipológico analizado y descrito y que, por consiguiente, incorpore como elemento fundamental, ineludible, el aspecto emocional-sensitivo de la persona humana en la implementación del tratamiento clínico.
Advisors
Mejía Lucar, LesterKeywords
Asthma control in Latin America: the Asthma Insights and Reality in Latin America (AIRLA) survey.
Editorial: Pan American Health Organization
Journal: Revista Panamericana de Salud Publica/Pan American Journal of Public Health
URI: http://hdl.handle.net/10757/625754
PubMed ID: 15826399
Resumen
Objectives. The aims of this survey were (1) to assess the quality of asthma treatment and control in Latin America, (2) to determine how closely asthma management guidelines are being followed, and (3) to assess perception, knowledge and attitudes related to asthma in Latin America. Methods. We surveyed a household sample of 2 184 adults or parents of children with asthma in 2003 in 11 countries in Latin America. Respondents were asked about healthcare utilization, symptom severity, activity limitations and medication use. Results. Daytime asthma symptoms were reported by 56% of the respondents, and 51 % reported being awakened by their asthma at night. More than half of those surveyed had been hospitalized, attended a hospital emergency service or made unscheduled emergency visits to other healthcare facilities for asthma during the previous year. Patient perception of asthma control did not match symptom severity, even in patients with severe persistent asthma, 44.7% of whom regarded their disease as being well or completely controlled. Only 2.4% (2.3% adults and 2.6% children) met all criteria for asthma control. Although 37% reported treatment with prescription medications, only 6% were using inhaled corticosteroids. Most adults (79%) and children (68%) in this survey reported that asthma symptoms limited their activities. Absence from school and work was reported by 58% of the children and 31% of adults, respectively. Conclusions. Asthma control in Latin America falls short of goals in international guidelines, and in many aspects asthma care and control in Latin America suffer from the same shortcomings as in other areas of the world.
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