Determinantes de la gestión clínica en atención médica domiciliaria de personas con secuelas de enfermedad cerebro-vascular

La atención domiciliaria constituye hoy una modalidad de atención que permite solventar las dificultades derivadas de la sobreocupación hospitalaria y la cronicidad, los cuales constituyen un problema de interés en salud pública en los países desarrollados y que pueden ser manejados en el domicilio del paciente como una opción costo-efectiva y segura. Para lo cual es necesario buscar estrategias que permitan su desarrollo, gestión de riesgos y modelos de atención, logrando mejorar las condiciones de salud de la población. Uno de los principales retos de la gestión de programas de atención en salud, se encuentra en definir los aspectos donde intervenir para potenciar la eficacia y la calidad en la prestación del servicio, por lo que dichos aspectos se constituyen como determinantes de la atención del paciente y su familia. En este documento se abordan los principales determinantes en la atención de personas con secuelas de Enfermedad cerebrovascular, que reciben manejo medico domiciliario, con el objetivo de identificar las áreas prioritarias de intervención, garantizando una mejor gestión clínica en tres áreas específicas: sobrecarga del cuidador, Polimedicación y ulceras por decúbito.

Medical Evaluation Processes in Clinical settings. Qualitative Analysis through the Experience of Teachers and Studens

Evaluation processes in clinical practice have not been well, being their study focused on the technical issues concerning these processes. This study tried an approach to the evaluation processes through the analysis of perceptions from teachers and students about the methodology of evaluation considering the teachinglearning processes performed in a clinical practice of the Medicine Program –Universidad El Bosque from Bogota. With this purpose we conducted interviews with teachers and students searching the manner in which the evaluative, learning and teaching processes are done; then we analyzed the perception from both agents concerning the way these processes are related. The interviews were categorized bath deductively and inductively, and then contrasted with some current theories of learning, teaching and evaluation in medicine. The study showed that nowadays the evaluation and, in general, the educative processes are affected by several factors which are associated to the manner the professional practice is developed, and the educative process of the current teachers. We concluded there is no congrency between the approach of the evaluation, mainly conductivist, and the learning and teaching strategies mainly constructivist. This fact cause dissent in teachers and students.

Residential Mobility: a Sociological Concern

The aim of this paper is to present a theoretical-conceptual approach to residential mobility, in general, and residential trajectories, in particular. It seeks to understand how from the unequal distribution and appropriation of social resources —both material and symbolic— different trajectories are developed and how socio-territorial structures constrain, shape and enable interactions between families, their members and the various contexts of action towards meeting their housing needs. From sociological contributions of different traditions, we present a scheme that pays attention to articulating the relationship between structural factors, position in social structure and decisions elating to changes of residence. We conclude that mobility patterns are relational patterns that are defined in dialogue with the opportunities and limitations that are set up around the housing stock and new or vacant land, the land market dynamics and housing, the labor market, the provision of nfrastructure services and social facilities, etc.

Social housing and land use planning in Medellin during the period 2006-2011. Steps towards socio economic and residential segregation

This paper presents an approach to the relationship between land use planning and socioeconomic residential segregation, from the location of social housing in Medellin, Colombia, during the period 2006-2011. The first part introduces the land use regulations regarding the location of social housing, identifying ambiguities in the current spatial plan. Next, we present the intersection of  regulatory information and the location of the projects that were under construction during the  study period, highlighting the need to consider the location as an important characteristic of social housing and residential segregation as a phenomenon that must be recognized and worked on land  use planning in our cities.