Health reforms in Latin America: processes and results

Two types of health reforms in Latin America are analysed: one based on insurance and service commodification and the one referred to the unified public systems of progressive governments. Health insurance with explicit service packages has not fulfilled their purposes of universal coverage, equal access to necessary health services and improvement of health conditions but has opened health as a field of profit making for insurance companies and private health providers. The national health services as a state obligation have developed territorialized health services and widened substantially timely access to the majority of the population. The adoption of an integrated and wide social policy has an impact on population well fare. It faces some problems derived from the old health systems and the power of the insurance and medical complex.

Presentación del monográfico Innovación social, tecnología y Trabajo Social

Presentación del monográfico Innovación social, tecnología y Trabajo Social

El autocuidado y apoyo social de mujeres de un proyecto de seguimiento mamográfico en Porto Alegre/Brasil

Objective: Identify preventive self-care practices and analyze the configurations of the network support for women with and without breast cancer registered in a mammography-monitoring project from Porto Alegre/Brazil.Method: a mixed sequential delimitation was performed, which expanded the results of the quantitative step (cross and correlation section) in a qualitative step (narrative interviews). 37 women diagnosed with breast cancer (group 1) and 72 without this diagnosis (group 2 – monitoring) participated. The following instruments were used: Assessment Questionnaire Self-care Ability (ASA-A) and Assessment Questionnaire Perceived Social Support and Community. There were performed descriptive analysis and comparison of means (t test and ANOVA) between the two groups. To deepen the understanding of the data, we selected four women with breast cancer with extreme levels on the scale of Social Support to participate in the biographical narrative interviews.Results: the analysis indicate that women who had breast cancer have better self-care practices than the women from the monitoring project (t = 1.791, P = 0.027). As for the analysis of social support, there were no statistically significant differences between the two groups. All participants have an average level of perceived social and community support. It was highlighted by the qualitative data that it was after the diagnosis of breast cancer that women lived self-care aspects they had not previously experienced.Conclusions: the self-care was significantly bigger in the group of women with breast cancer, where the cancer diagnosis was a trigger to increase self-care.

Contraprestaciones por los servicios financieros del Consulado de México y sus miembros: los fondos extraordinarios para la guerra contra Gran Bretaña, 1779-1783

Nueva España aportó la mayor parte de los recursos que sostuvieron a las fuerzas armadas españolas durante la guerra contra Gran Bretaña que se desarrolló en el Caribe entre 1779 y 1783. En el artículo se analizan las medidas a las que recurrieron las autoridades reales para obtener recursos extraordinarios del Consulado y varios mercaderes de la ciudad de México. Asimismo se exponen algunas de las contraprestaciones que negociaron a cambio de dichos servicios financieros y se plantean diversas hipótesis acerca de los motivos económicos, sociales y políticos que los llevaron a colaborar con el monarca, teniendo en cuenta los negocios que realizaban durante el conflicto bélico y la forma en que eran afectados por la reciente apertura comercial.