Suchergebnisse

Building on similar research previously conducted in North America, 121 adults from Guayaquil, Ecuador were surveyed. Subjects responded to forty-six items identified in the social exchange literature as traits important to mate selection. The large majority marry for love and within their social class. Religion, height and race are not important considerations in choosing a mate. Sexual, health and drug problems are very damaging to one's status in the marriage market. Differences by gender, age, religion, and marital status are explained. Overall, mate selection preferences in Latin America appear to be very similar to those in the United States. Important differences in reference to age and cohabitation are discussed.

Objective: To determine the association between socioeconomic, political and geographic variables in relation to low vaccination covertures in children under the age of 5 in Santa Bárbara county, Antioquia. This was to be performed by a cases and controls study that allows for the planning of intervention programs. Methods: Cases and controls study with prevalent cases that are representative of the population. Patients were matched by geographic area and by age. n = 352, cases (117) and controls (235). A logistic regression analysis was performed considering X2 , OR, CI 95% and a value of p < 0.05. A Hosmer and Lameshow test was performed in order to determine the level of standardization. Results: Risk Factors: Not taking children to get vaccinated because of disease OR = 3.02, CI 95% (1.68 – 5.42); a lack of money to pay for the transportation OR = 5.10 CI 95% (2.9 – 8.99), other variables with a statistical significance were: not having, forgetting or losing the health ID p = 0.003 and, the care taker not having anyone to leave their other children with p< 0.001. Protective Factors: Related to vaccination campaigns' communication media (radio, health promoter, health staff) and the academic level of the care taker (complete high school). Conclusions: Economic, cultural, administrative and social factors are associated with the reasons of a lack of vaccination of children younger than 5. It is necessary a conjunction action between the mayor office, the local health department and the local hospital if useful vaccination covertures want to be achieved. ; Objetivo: Determinar la asociación existente entre variables socioeconómicas, políticas y geográficas con relación a las bajas coberturas de vacunación en menores de 5 años en el municipio de Santa Bárbara, Antioquia, mediante un estudio de casos y controles que permita la planeación de programas de intervención. Métodos: Estudio de casos y controles con casos prevalentes, representativo de la población. Se hizo equiparamiento por área geográfica y por edad. n = 352, casos (117) y controles (235). Se realizó un análisis por regresión logística considerando X2 , OR, IC 95% y valor de p< 0.05 y se practicó la prueba de Hosmer and Lemeshow para observar la bondad del ajuste. Resultados. Factores de Riesgo: No llevar a vacunar a los niños por enfermedad OR = 3.02, IC 95% (1.68 - 5.42), por falta de dinero para pagar transporte OR = 5.10 IC 95% (2.9 - 8.99). Otras variables con significancia estadística fueron estas: no tener, olvidar o perder el carné de salud p = 0.003 y el cuidador no tiene con quien dejar a sus otros hijos p< 0.001. Factores de Protección: Relacionados con medios de comunicación de las campañas de vacunación (radio, promotor de salud, personal de salud), y con el nivel educativo del cuidador (bachillerato completo). Conclusiones: Factores económicos, culturales, administrativos y sociales están asociados con los motivos de no vacunación de menores de 5 años. Es necesario realizar una acción conjunta entre la Alcaldía, la Dirección Local de Salud y la ESE municipal si se quieren alcanzar coberturas vacunales útiles en esta población.

Abstract Gastric cancer (GC) is a public health issue with high incidence and mortality in Colombia due to tardy diagnosis and barriers to access to curative treatment; this leaves palliative care (PC) as the only option. Our aim is to describe the access barriers to PC perceived by adults with GC, caregivers and physician in Santander, Colombia. A qualitative study was carried out with the analysis of the grounded theory (Strauss and Corbin), through semi-structured interviews, after sampling for convenience we found that the access barriers were: administrative, economic, cultural, knowledge, communication, institutional and geographical; strategies to overcome barriers: screening programs, governmental surveillance, and investment in health. In conclusion, access to PC requires remove barriers to timely and integral access and strengthen health and education policies to facilitate procedures and services that ensure the attention required by the adult with GC.

Abstract
This paper develops the concept of flood problem framing to understand decision-makers' priorities in flood risk management in the Los Angeles Metropolitan Region in California (LA Metro). Problem frames shape an individual's preferences for particular management strategies and their future behaviors. While flooding is a complex, multifaceted problem, with multiple causes and multiple impacts, a decision-maker is most likely to manage only those dimensions of flooding about which they are aware or concerned. To evaluate flood decision-makers' primary concerns related to flood exposure, vulnerability, and management in the LA Metro, we draw on focus groups with flood control districts, city planners, nonprofit organizations, and other flood-related decision-makers. We identify numerous concerns, including concerns about specific types of floods (e.g., fluvial vs pluvial) and impacts to diverse infrastructure and communities. Our analyses demonstrate that flood concerns aggregate into three problem frames: one concerned with large fluvial floods exacerbated by climate change and their housing, economic, and infrastructure impacts; one concerned with pluvial nuisance flooding, pollution, and historic underinvestment in communities; and one concerned with coastal and fluvial flooding's ecosystem impacts. While each individual typically articulated concerns that overlapped with only one problem frame, each problem frame was discussed by numerous organization types, suggesting low barriers to cross-organizational coordination in flood planning and response. This paper also advances our understanding of flood risk perception in a region that does not face frequent large floods.

Significance Statement
This paper investigates the primary concerns that planners, flood managers, and other decision-makers have about flooding in Southern California. This is important because the way that decision-makers understand flooding shapes the way that they will plan for and respond to flood events. We find that some decision-makers are primarily concerned with large floods affecting large swaths of infrastructure and housing; others are concerned with frequent, small floods that mobilize pollution in low-income areas; and others are concerned with protecting coastal ecosystems during sea level rise. Our results also highlight key priorities for research and practice, including the need for flexible and accessible flood data and education about how to evacuate.