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Search Results: 1 - 10 of 7479 matches for " Oscar Bernal "
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A Better Understanding of Reasons for the Failure of the Healthcare Reform in Colombia  [PDF]
Oscar Bernal, Diana C. Zamora
Health (Health) , 2014, DOI: 10.4236/health.2014.621330
Abstract: The Colombian healthcare crisis is evidenced by obstacles to health service, diminished working conditions and medical autonomy, financial infeasibility, loss of leadership and legitimacy of the healthcare system. In the year 2013 twelve reform projects were presented to Congress, including a statutory law that defines health as a fundamental right which was approved and another ordinary one which sought a complete reform of the system but was rejected and criticized by different opinion leaders. For this study we have made an adaptation to Q methodology, which assigns quantitative values to the most frequent statement variables obtained from secondary sources (norms, articles, media, forums) giving objective information about the diverse positions in the proposals to healthcare reform. We analyzed from the most objective position and from academic independence the different views of the opinion leaders for a better understanding of the reasons for this failure in healthcare reform. There was a great polarization in the diverse statements which made an agreement with the government unlikely and, when added to a political moment in which the presidential election was being held, made the new reform non-viable. Although there is an agreement about the existence of a crisis, this has not been the case about the analysis of its causes or solutions. At the present time, the government is not presenting a new reform proposal and is focusing on some decree to create a model of healthcare in rural zones, define financial conditions for the EPSes (health providers), update norms for membership in a healthcare system and regulate biotechnological drugs. Even though to date there have been no opinions, plus taking into account the previous analysis, it is very possible there will be much criticism from those who demand a structural change in the system.
Morbidity Due to Obesity, Hypertension and Diabetes II Attributable to Non-Breastfeeding and Low Birth Weight during the 1000 Days of Life: Estimation of the Population Attributable Fraction  [PDF]
Andrea Ramírez, Oscar Bernal, Jesús Rodríguez, José David Pinzón
Health (Health) , 2016, DOI: 10.4236/health.2016.85041
Abstract: Introduction: There is evidence that malnutrition during the first 1000 days of life contributes to the development of chronic diseases in adulthood and therefore may produce a lasting impact on the health of the population. Colombia, like other middle-income countries suffers the double burden of malnutrition in pregnant women and children under 5 years. Also, chronic diseases have positioned within the leading causes of morbidity and mortality. Objective: The aim is to estimate the burden of disease of noncommunicable chronic diseases-NCD’s (hypertension, obesity, diabetes mellitus II) in adults attributable to nutritional risk factors (no-breastfeeding and low birthweight) in the period of 1000 days in Colombia. Methods: The population attributable fraction and the number of NCD’s (hypertension, diabetes mellitus II and obesity) cases due to the risk factors (low birthweight and no-breastfeeding) were estimated. Prevalences of NCD’s and risk factors of interest were taken from national health surveys. Effect measures (odds ratios/relative risks) of the associations 1—low birthweight and hypertension, diabetes mellitus II and 2—no-breastfeeding and obesity were obtained after a systematic literature search. Results: It was estimated that not receiving breastfeeding in the 1000 days could contribute up to 29.9% of all cases of obesity, equivalent to about 4,009,779 cases across the country. Low birth weight could contribute up to 2.1% of cases of hypertension in men and to 4.0% of cases in women, equivalent to 103.769 cases across the country. In addition, low birth weight could contribute to 6.3% of diabetes mellitus II cases, which is equivalent to 23.857 cases in the country. Conclusion: In Colombia, risk factors during the first 1000 days like not receiving breastfeeding and having low birth weight could contribute up to 4,113,549 cases of obesity, hypertension and diabetes mellitus II, with important implications for the health of the population and the Colombian health system.
Situational Analysis and Expert Evaluation of the 1000 Days: Nutritional and Health Status in 4 Countries in Latin America  [PDF]
Andrea Ramírez, Sofía Velasco, Oscar Bernal, José Fernando Vera-Chamorro, Gabriela Olagnero
Health (Health) , 2016, DOI: 10.4236/health.2016.85047
Abstract: Background: The first 1000 days of life, including pregnancy and the first 2 years of age have been considered essential for an adequate development and growth. Several studies have stated that malnutrition during pregnancy and not having a normal birth weight have negative impact on childhood and adulthood, and contribute to burden of disease. Adequate information on this matter provides the possibility for making recommendations on health and nutrition policies. Objective: The aim is to describe the nutritional status during the first 1000 days in four countries of Latin America: Colombia, Argentina, Chile and Brazil. Methods: The analysis consists of two complementary approaches: 1) An extensive search on published and gray literature and a critical analysis of secondary data bases was conducted in Colombia, Argentina, Chile and Brazil following a standardized methodology in 2013. Maternal and child nutritional status, breast feeding, nutri-tional deficiencies, and dietary habits during the first 1000 days were the variables of interest; 2) Information gaps were identified, interviews to local experts from academia, government and hospitals were conducted to fill each of the countries information gap. Data was organized in an online data base called NutriPl@net. Results: Despite the inherent country differences, the nutritional challenges during the first 1000 days are similar. Obesity prevalence is increasing in pregnant women. Under weight remains a problem in all 4 countries, with the highest prevalence in Argentina. Over weight prevalence is highest in Chile and obesity prevalence in Brazil. Micronutrient deficiencies in pregnant women have been described, especially high for folic acid, iron, zinc, vitamins A, B6, B12, C, E and riboflavin. Moreover, in the region, anemia is the most common micronutrient deficiency during pregnancy. Gestational diabetes, hypertension, obesity and pre-eclampsia are major causes of maternal, perinatal and infant morbidity and mortality. Conclusions: In order to understand regional and country-specific needs, it is fundamental to collect standardized information related to the nutrition status during the first 1000 days. The low prevalence of exclusive breastfeeding and micronutrient deficiencies such as iron, zinc and vitamin A as risk factors for morbidity and mortality in children 0 - 2 years old is common and priority issues in the region. Persistence of anemia despite the use of fortified foods and supplementation remains a problem, and no complete data regarding sugar, sodium and fatty acids consumption and
El consumidor potencial de durazno (Prunus persica) orgánico en Zacatecas, Aguascalientes y San Luis Potosí
Padilla-Bernal, Luz E.;Pérez-Veyna, Oscar;
Agrociencia , 2008,
Abstract: the world market of organic food is undergoing accelerated growth, and méxico exports most of its production to this market. there are factors that can lower mexico's probabilities of increasing its presence in international markets, and developing the incipient domestic market could be an alternative to reduce dependence on the external market. peach (prunus persica) growers in zacatecas are in the process of converting conventional production to organic, and are willing to sell their produce on the domestic market if they can earn a price premium. this study examines variables that have an influence in local and regional consumers' motivation and willingness to pay a price premium for organic peach. interviews were conducted: 459 in zacatecas, 428 in aguascalientes, and 399 in san luis potosí. the sample size was determined by a simple random method considering the employed population that earned more than five times the minimum wage in the fourth quarter of 2003. the data were processed with a multiple bounded probit model, using maximum likelihood techniques. it was found that the premium consumers are willing to pay is minimum or nil, considering a statistical significance of the estimators of up to 10%.
Sistemas de información en el sector salud en Colombia
Bernal-Acevedo,Oscar; Forero-Camacho,Juan Camilo;
Revista Gerencia y Políticas de Salud , 2011,
Abstract: objective: characterizing and evaluating information systems on the health sector in colombia. methodology : a conceptual frame that included the legal context of the country and organization of information systems in other countries was developed. later on, colombian health information system was characterized starting on interviews with important actors and papers. finally, the organization of the system, information flows and its strengths and weaknesses were analyzed in order to propose some recommendations. results and conclusions: information system of the colombian health sector is divided and evidencing quality issues, as in other countries. the development of a production, diffusion and use of information culture is essential. we must take advantage of the change that is occurring in the health system for improving the information. capture mechanisms for information require a simplification and standardization.
Effect of four tillage methods on the physical properties and loss of soil in the potatoa€“grass rotation in hillside areas of a high Andean region in Colombia Efecto de cuatro métodos de labranza sobre las propiedades físicas y la pérdida de suelo en la rotación papaa€“pastos en áreas de ladera en una región alto andina de Colombia
Bernal Napoleón,Montealegre Guillermo,Ipaz Sandro,Chaparro Anaya Oscar
Acta Agronómica , 2008,
Abstract: This study evaluated the loss and the changes in the soil physical properties, and the production of yellow potato Solanum phureja, as a result of four tillage systems (Human traction, THT; Animal traction, ATT; Mechanical, MT; and Mechanical combined, CMT) in Santa Lucia, Tuluá municipality, high andean region of Colombia to 2.870 masl. Treatments were evaluated using a completely randomized blocks desing with three replicates, and the data examined by means of a matrix of change for each physical property. Soil loss was determined by the ditch of runoff. Mechanical traction affected the soil physical properties negatively, that became evident in the increment of losses with the runoff. The bigger loss of soil was correlated with MT use and it diminished to the 50 % with HTT: (MT 6.12 tha–1 year–1; CMT 5.0 tha–1 year–1; ATT 3.7 tha–1 year–1 and HTT 2.73 tha–1 year–1). ATT generated the bigger cost–reducing and environmental retribution, because his production (13 tha–1) was major than the average obtained in the treatments (12.4 tha–1) and the lost one belonging to ground was minor than the generated for MT and CMT. Este estudio avaluó la pérdida y los cambios en las propiedades físicas del suelo y la producción de papa amarilla Solanum phureja, como resultado de cuatro sistemas de labranza (Tracción humana, LTH; Tracción animal, LTA; Mecánica, LM; y Mecánica combinada, LMC) en Santa Lucía, municipio de Tuluá, región alto andina de Colombia a 2.870 msnm. Los tratamientos se evaluaron usando un dise o de bloques completos al azar con tres repeticiones. La pérdida de suelo se determinó por medio de canaletas de escorrentía. La información se analizó por medio de una matriz de cambio para cada propiedad física. La tracción mecánica afectó negativamente las propiedades físicas del suelo, lo que se evidenció en el incremento de pérdidas por escorrentía. La mayor pérdida de suelo se asoció con el uso de LM y disminuyó hasta el 50% con LTH: (LM 6.12 t ha–1 a o–1; LMC 5.0 t ha–1 a o–1; LTA 3.7 t ha–1 a o–1 and LTH 2.73 t ha–1 a o–1). LTA generó la mayor retribución económica y ambiental, porque su producción (13 t/ha) fue mayor que el promedio obtenido en los tratamientos (12.4 t/ha) y la pérdida de suelo fue menor que la generada por LM y LMC.
Efecto de cuatro métodos de labranza sobre las propiedades físicas y la pérdida de suelo en la rotación papa-pastos en áreas de ladera en una región alto andina de Colombia
Bernal,Napoleón; Montealegre,Guillermo; Ipaz,Sandro N.; Chaparro,Oscar; Ramírez,Luis M;
Acta Agronómica , 2008,
Abstract: this study evaluated the loss and the changes in the soil physical properties, and the production of yellow potato solanum phureja, as a result of four tillage systems (human traction, tht; animal traction, att; mechanical, mt; and mechanical combined, cmt) in santa lucia, tuluá municipality, high andean region of colombia to 2.870 masl. treatments were evaluated using a completely randomized blocks desing with three replicates, and the data examined by means of a matrix of change for each physical property. soil loss was determined by the ditch of runoff. mechanical traction affected the soil physical properties negatively, that became evident in the increment of losses with the runoff. the bigger loss of soil was correlated with mt use and it diminished to the 50 % with htt: (mt 6.12 tha-1 year-1; cmt 5.0 tha-1 year-1; att 3.7 tha-1 year-1 and htt 2.73 tha-1 year-1). att generated the bigger cost-reducing and environmental retribution, because his production (13 tha-1) was major than the average obtained in the treatments (12.4 tha-1) and the lost one belonging to ground was minor than the generated for mt and cmt.
Access to diagnosis and treatment of Chagas disease/infection in endemic and non-endemic countries in the XXI century
Villa, Luís;Morote, Sílvia;Bernal, Oscar;Bulla, Daniel;Albajar-Vinas, Pedro;
Memórias do Instituto Oswaldo Cruz , 2007, DOI: 10.1590/S0074-02762007005000081
Abstract: in this article, médicos sin fronteras (msf) spain faces the challenge of selecting, piecing together, and conveying in the clearest possible way, the main lessons learnt over the course of the last seven years in the world of medical care for chagas disease. more than two thousand children under the age of 14 have been treated; the majority of whom come from rural latin american areas with difficult access. it is based on these lessons learnt, through mistakes and successes, that msf advocates that medical care for patients with chagas disease be a reality, in a manner which is inclusive (not exclusive), integrated (with medical, psychological, social, and educational components), and in which the patient is actively followed. this must be a multi-disease approach with permanent quality controls in place based on primary health care (phc). rapid diagnostic tests and new medications should be available, as well as therapeutic plans and patient management (including side effects) with standardised flows for medical care for patients within phc in relation to secondary and tertiary level, inclusive of epidemiological surveillance systems.
Disponibilidad de datos y perfil de morbilidad en Colombia
Bernal,Oscar; Forero,Juan Camilo; Villamil,María del Pilar; Pino,Rafael;
Revista Panamericana de Salud Pública , 2012, DOI: 10.1590/S1020-49892012000300001
Abstract: objective: to characterize morbidity in the colombian population by diagnosis, sex, age, region, and health coverage system, and evaluate the availability and quality of information on diseases in the country. a descriptive, cross-sectional study to analyze morbidity treated in outpatient visits, hospitalization, and emergencies in colombia during the 2004-2008 five-year period. methods: based on colombia's personal health records (registro individual de prestación de servicios-rips), diagnoses were classified according to world health organization cause groups. each cause group for services utilization was differentiated by geographical region, sex, and type of affiliation to the health system. results: communicable disease diagnoses were more concentrated in younger age groups, while noncommunicable diseases were more frequent in older age groups. external causes (accidents, self-inflicted injuries, and violence) were a major cause of morbidity and more frequently affected the population aged 5-44 years. communicable diseases were more prevalent in females (39.98%) than in males (28%), while males were more affected by external causes than females (18.5% and 7.3%, respectively). conclusions: although diagnoses of noncommunicable diseases have increased in colombia, infections continue to have an important presence in all age groups and health services delivery settings. this situation requires a review of health policies, not only to orient them toward improving the health of the population, but also toward bridging the services gap that exists among the country's different regions. furthermore, although rips are a valuable source of health data, they need to be strengthened with a view to achieving information coverage for all or at least the vast majority of colombians.
CONSECUENCIAS NEUROPSIQUIáTRICAS DEL TRAUMA CRANEOENCEFáLICO
BERNAL-PACHECO,OSCAR; VEGA-RINCóN,MILENA; HERNáNDEZ-PRECIADO,JOSé F.;
Revista Med , 2009,
Abstract: traumatic brain injury (tbi) is one of the main causes of urgent consultations in every hospital in the world, with variability of the severity and consequences, depending on its origins, patients' characteristics (underlying diseases, age, etc.) and treatment received. the national situation deserves special attention due to the armed conflict which has afflicted us for more than 50 years and which has left physical, psychological and psychiatric sequelae in thousands of patients, their families and their surroundings. in this revision we intend to update the sequelae observed at the neuropsychiatric level and the procedures that demonstrate beneficial to the recovery from tce. we also note some procedures and pharmaceuticals, which may have theoretical benefit as yet unproven.
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