Publicaciones Científicas y Académicas

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El federalismo sanitario argentino: una perspectiva innovadora para integrar el sistema de salud nacional
(2023) Madies, Claudia
Con frecuencia, las publicaciones científicas que describen la organización del sistema de salud argentino, lo caracterizan como un sistema complejo, fragmentado y segmentado, atribuyendo mayoritariamente tales fallos, entre otras causas, a la organización política federal de nuestro país.Este artículo invita a reflexionar sobre tales características de la organización política fe-deral de la República Argentina, cuyo territorio ocupa en extensión el octavo lugar a nivel mundial, el cuarto en el continente americano (luego de Canadá, Estados Unidos de Amé-rica y la República Federativa de Brasil) y el segundo entre los países latinoamericanos.
Nursing care to prevent ventilator-associated pneumonias in adult patients
(2023) Delgado Mejía, María Bertalisa
Introduction: Pneumonia associated with mechanical ventilation is a serious complication in patients with artificial airway in intensive care units, increasing morbidity and mortality. It increases the use of antibiotics, oropharyngeal microbial resistance increasing the risk, driving the need for preventive strategies. Methods: a review of scientific articles published between (2018-2023) in PubMed was conducted. Key terms: nursing prevention, Pneumonia associated with mechanical ventilation in adults. Fourteen relevant studies were selected for analysis, looking for preventive measures of mechanical ventilation-associated pneumonia. Results: 14 articles analyzed in the last 5 years (2018-2023), focused on prevention of mechanical ventilation-associated pneumonia. The most effective preventive measures included head-of-bed elevation, oral hygiene with chlorhexidine, subglottic suctioning, and endotracheal tube pressure control. Implementation of these strategies decreased the incidence of ventilator-associated pneumonia and improved the recovery of patients on mechanical ventilation. Conclusion: ventilator-associated pneumonia represents a challenge in intensive care units, with high mortality. Preventive measures, such as bundles of care, can reduce infections and improve patient health. Nursing staff collaboration is essential for the successful implementation of preventive strategies in older patients to reduce the risks associated with mechanical ventilation and improve care in the intensive care unit
Comparative health governance in Latin America: the case of national policy decisions during pandemic response in five countries
(2023) Alonso, Cristina; Artaza, Oswaldo; Rojas, Karol; Sáenz, Rocío; Glanc, Mario; Vieira Machado, Cristiani; Lopez-Cevallos, Daniel; Torres, Irene
Context: Little is known about pandemic response in Latin America. The aim of this study was to compare key COVID-19 response measures taken by five Latin American countries to understand what elements of public governance are needed for more effective policy strategies, and to inform future pandemic preparedness. Methods: Using a qualitative, iterative approach guided by a governance framework, we analyzed the most salient characteristics of each country’s response (restriction, sanitary, and social protection measures). Findings: A focus on transparency and inclusion, together with attention to the primary level of care, appeared to be more prominent in countries with less Covid-19 incidence and mortality such as Argentina and Costa Rica. In contrast, Brazil, Chile, and Ecuador, with more fragmented and segmented health systems, coupled with less transparency and participatory decision making, were more severely impacted. Conclusions: Pandemic preparedness may benefit from emphasizing organizational, institutional, and informational elements of governance. Since data is essential to decision making in an evolving pandemic, the flow of information interacts with different elements of governance; therefore, more attention should be placed on the relation of the informational dimension with the organizational and institutional dimensions.
Meningococcal burden of disease in Argentina: 10 years epidemiologic review
(2023) Neyro, Silvina; Urueña, Analía; Efron, Adriana; Rancaño, Carolina; Pannunzio, Maria E.; Seoane, Maria B.; Gomez, Jorge A.; Giglio, Norberto
Invasive meningococcal disease (IMD) is an uncommon but serious and potentially fatal condition, mainly affecting infants. In 2017, Argentina introduced a vaccination program against serogroups A, C, W and Y (MenACWY) for infants aged 3, 5 and 15 months and adolescents aged 11 years. The objective of this study was to review the burden of IMD in Argentina in 2010–2019. Data were obtained from national surveillance databases, and the study estimated IMD incidence, mortality, case-fatality rates, and serogroup distributions across age groups. A total of 1,972 IMD cases were reported in the study period, with the highest incidence in infants aged < 1 year. Incidence peaked in 2013 and subsequently declined. Mortality rates were 18 times higher in infants than in other age groups, reflecting the high impact of IMD in this age group. The case-fatality rate was 8.5% on average and increased with age. The proportion of notified cases with serogroup identification increased over the period, reaching 91% in 2019. The most common serogroups over the study period were serogroup B (48%) and serogroup W (42%), with an increase in B relative to W since 2015. In infants aged < 1 year, the proportion of serogroup B increased in recent years, reaching around 70% of characterized cases in 2018–2019. These results show the dynamism of IMD and indicate the importance of vaccination at an early age and offering protection against predominant serogroups. These data are valuable to support evidence-based decision-making in healthcare.
What does data literacy means for you (as an educator)nowadays?
(2023) Raffaghelli, Juliana Elisa; Ferrarelli, Mariana; Kühn, Caroline
A pesar del avance en los marcos de alfabetización en datos, asociados a la discusión crítica del fenómeno de la datificación, las y los educadores se muestran inciertosal tener que trabajar en dichos temas. En parte ello se debe a la complejidad de las infraestructuras de datos que atraviesan la práctica educativa misma. En este contexto parece especialmente apropiado comprender los fenómenos discursivos, de construcción de la práctica profesional y por lo tanto del posicionamiento de las y los educadores alrededor de las problemáticas de la datificación en general, y del desarrollo de alfabetismos críticos en datos en particular, lo que llamamos "posicionamiento postdigital" Este trabajo propone un análisis autoetnográfico colaborativo de las experiencias profesionales de las tres autoras, en tanto que educadoras. Como mujeres de identidades migrantes complejas, con raíces en el Sur Global a la vez que portadoras de mestizajes europeos, nuestros caminos se cruzan a partir de un proyecto internacional donde elaboramos materiales y diseñamos actividades educativas. Nuestra historia se apoya en una base interseccional que permite expresar posicionalidades ricas, floridas de ejemplos y recursos que pueden ser caja de resonancia para la construcción de prácticas educativas agentivas en este campo de fuerzas de la postdigitalidad.
Opinions, Attitudes and Factors Related to SARS-CoV-2 Vaccine Uptake in Eight South American Countries
(2023) Urueña, Analía; Machado, Ricardo; Cunha, Juarez; López Colmano, Clara; Rancaño, Carolina; Kfouri, Renato; Pírez, Catalina; Bonvehí, Pablo; Calvo, Mario; Cuadros, Robinson; Muñoz, Greta|Rodríguez, Mónica; Torres, Jaime|Cahn, Florencia; Ballalai, Isabella
This article presents attitudes and practices regarding COVID-19 vaccination in the South American population. The study collected data from a self-administered survey distributed through social media platforms between February and April 2022 (N = 6555). The survey included questions related to participants’ sociodemographic background, flu vaccination practices, sources of information about COVID-19, and opinions regarding pandemic management and vaccination against SARS-CoV-2. The respondents agreed with the statement that COVID-19 vaccines were necessary (86.4%), effective (79.8%), safe (79.1%), and should be mandatory (64%). Overall, 83.4% accepted vaccination and 12.3% refused it completely. Main rejection reasons were safety (65.8%) and efficacy (54.9%) issues, and rushed development and approvals (49.1%). Vaccine uptake was associated with being ≥60 years, being a healthcare worker, previous influenza vaccine uptake, adherence to preventive measures, the death of ≥1 close people from COVID-19, and being informed through mass media or health authorities’ channels. Vaccine uptake inversely correlated with male gender, low educational level, and use of closed social networks for COVID-19 information purposes. This study provides valuable insights into COVID-19 vaccination attitudes and practices in South America that may be used to promote vaccine uptake in the region. Higher COVID-19 vaccination acceptance among people with previously acquired prevention habits reinforces the importance of routine health promotion strategies.
Management of pain reduction in mechanically ventilated care subjects
(2023) Mallqui Cáceres, Yaneth Marleny
Introduction: Pain is an unpleasant emotional experience linked to actual or potential injuries, concerns in intensive care units (ICU), affecting life and recovery of patients. It is essential to address this pain, classifying it with WHO criteria and guidelines. The approach is to explore types of pain and strategies for its management, seeking to improve quality of life during ICU hospitalization. Methods: A PubMed search was performed with "Pain Management" AND "nursing" AND "Artificial Respiration", filtering for studies between 2018 and 2023. After review, 11 irrelevant articles were discarded, selecting 8 that met criteria. Results: The outcome focuses on an independent approach to pain management in nursing, involving non-pharmacological measures and quality standards. This brings with it the responsibility to look for better alternatives to optimize nursing care in adequate pain management. Conclusion: The data from these studies expose relevant information highlighting the importance of adequate independent pain management and sedation by nurses in critically ill ICU patients. The opportunity to implement more effective and patient-centered approaches to improve the well-being and recovery of critically ill patients is emphasized.
Real-World Evidence in Cost-Effectiveness Analysis of Enhanced Influenza Vaccines in Adults ≥ 65 Years of Age: Literature Review and Expert Opinion
(2023) Postma, Maarten; Fisman, David; Giglio, Norberto; Márquez-Peláez,Sergio; Nguyen, Van Hung; Pugliese,Andrea; Ruiz-Aragón, Jesús; Urueña, Analía; Mould-Quevedo, Joaquin
Influenza vaccination can benefit most populations, including adults ≥ 65 years of age, who are at greater risk of influenza-related complications. In many countries, enhanced vaccines, such as adjuvanted, high-dose, and recombinant trivalent/quadrivalent influenza vaccines (aTIV/aQIV, HD-TIV/HD-QIV, and QIVr, respectively), are recommended in older populations to provide higher immunogenicity and increased relative vaccine efficacy/effectiveness (rVE) than standard-dose vaccines. This review explores how efficacy and effectiveness data from randomized controlled trials and real-world evidence (RWE) are used in economic evaluations. Findings from published cost-effectiveness analyses (CEA) on enhanced influenza vaccines for older adults are summarized, and the assumptions and approaches used in these CEA are assessed alongside discussion of the importance of RWE in CEA. Results from many CEA showed that adjuvanted and high-dose enhanced vaccines were cost-effective compared with standard vaccines, and that differences in rVE estimates and acquisition price may drive differences in cost-effectiveness estimates between enhanced vaccines. Overall, RWE and CEA provide clinical and economic rationale for enhanced vaccine use in people ≥ 65 years of age, an at-risk population with substantial burden of disease. Countries that consider RWE when making vaccine recommendations have preferentially recommended aTIV/aQIV, as well as HD-TIV/HD-QIV and QIVr, to protect older individuals.
Cuidados independientes que realizan los profesionales de enfermería en la prevención del delirio
(2023) Calcagno, María Rosenda Fernanda
Introduction: Delirium is a condition that affects attention, consciousness, and cognition, especially in older people. It can result from underlying diseases or medications. It has a great economic and social impact, with the need for special care, increased risk of falls, prolonged hospitalization and institutionalization. Methods: A literature search was performed in SciELO and Scopus with the keywords "delirium", "prevention" and "nursing" establishing inclusion and exclusion criteria to select 15 relevant articles on the independent care provided by nursing professionals in the prevention of delirium occurrence in the last 5 years and open access. Results: The importance of delirium prevention and management through nursing interventions and the use of specific tools is highlighted. The potential of technology for early detection and preventive intervention is highlighted. Nurses play an essential role in the early identification and management of delirium by implementing various interventions and assessment tools. The implementation of standardized measures and protocols to improve the quality of care is recommended, although the need for future studies to improve delirium care is suggested. Conclusion: The importance of nursing interventions in the prevention and management of delirium was observed, highlighting their effectiveness in reducing the incidence and severity. The usefulness of easily accessible tools and technologies for early detection is highlighted. On the other hand, the need for continuous research to improve patient care and quality of life was emphasized.
El baño en cama en pacientes adultos en cuidados críticos
(2023) Chavez, Nilda Elizabeth
Introduction: bed bathing is an essential intervention to provide well-being and comfort to critically ill patients, as well as to protect them from risks and threats. Prolonged hospitalization in critical care units can have negative consequences, and bed bathing has been presented as a complementary intervention to improve the care provided by nursing staff Methods: an integrative literature review was carried out in the Scopus and SciELO databases for the last 5 years, using descriptors such as "baths" and "critical care". A total of 60 articles were obtained, from which 22 relevant to the topic were selected. Results: bed bathing with chlorhexidine gluconate (CHG) has been shown to be effective in reducing bacterial colonization, healthcare-associated infections and the incidence of bloodstream infections in critically ill patients. Although positive results were observed with regular use of CHG bathing, more research is needed to define the optimal frequency and duration of treatment, as well as to evaluate possible adverse effects. The use of music to reduce pain in ventilated patients is identified. Conclusion: bed bathing is used more frequently in critical settings with CHG. Further research with larger samples and defined methods is needed to maximize its effectiveness and establish clear guidelines for its appropriate use.
Empathy in nursing professionals for care subjects with depression
(2023) Toconas, Lorena del Carmen
Introduction: empathy in nursing professionals and its impact on quality of care, as well as the challenges they face, are highlighted. Compassion fatigue" due to frequent use of empathy is explored. The study seeks to improve communication and empathic care, especially in patients with psychological health disturbance. The research aims to identify strategies for better care management. Methods: a literature search was conducted in PubMed with the keywords "empathy", "empathy", "nursing" and "depression", establishing inclusion and exclusion criteria to select 7 relevant articles on empathy in nursing professionals for care subjects with depression in the last 5 years and open access. Results: the studies provide valuable information on the psychological health of health professionals and the importance of empathy in their practice. The results highlight the need to implement effective interventions to improve the mental health of these professionals and their empathic capacity in patient care. Conclusions: empathy is crucial in nursing care, but the presence of negative mental states, such as depression, can affect it. The high prevalence of depression and anxiety disorders in mental health also influences empathy towards patients with eating disorders. Addressing stress, burnout, and stigma is essential to improve empathy in health professional practice and benefit patients
The clinical and economic value of enhanced influenza vaccines for the elderly in Argentina
(2024) Urueña, Analía; Micone, Paula; Mould-Quevedo, Joaquín; Saenz, Carolina; Delgado, Micaela; Montes, José Luis; Giglio, Norberto
Background: Enhanced influenza vaccines are the best option for the elderly. In 2021, Argentina introduced the MF59-adjuvanted inactivated influenza vaccine (aIIV) for individuals aged 65 years. and above, in the national immunization program. High dose inactivated influenza vaccine (HD-IIV) is also currently registered. This study evaluates the clinical and economic outcomes of these noted enhanced influenza vaccines for the elderly in Argentina. Methods: Using a static decision-tree model and adopting the payer's perspective during an average influenza season, the analysis incorporated influenza epidemiological data from pre-pandemic Argentinian seasons (2014–2019), strain distribution, vaccination uptake, influenza-related costs and Quality-Adjusted Life-Years (QALYs) gained. Results include two relative vaccine effectiveness (rVE) scenarios from two published meta-analyses, due to reported rVE variability, although without statistical significance expected between enhanced vaccines. Vaccination acquisition costs were obtained from aIIV manufacturer, while HD-IIV costs were estimated using local (Argentinian private sector) and international public sector data (Europe). This assessment considered one GDP per-capita (US$13,696) as a cost-effectiveness threshold and included multiple sensitivity analysis. Results: With an expected lower vaccine cost and non-significant higher rVE for aIIV vs HD-IIV (3.2 %), aIIV generated 41.4 QALYs gained and US$8.7 M savings to the Argentinean public health system. In this scenario aIIV resulted as a dominant strategy over HD-IIV. On a second scenario, where HD-IIV has a non-significant higher rVE compared to aIIV (15.9 % and 13.9 % for HD-IIV and aIIV, respectively, both vs standard-dose IIV), HD-IIV would only result cost-effective compared to aIIV if its public price is up to 25 % the incremental cost in relation to the standard-dose IIV acquisition price. Conclusions: In Argentina, the use of enhanced influenza vaccines in the elderly can increase vaccine effectiveness, reduce mortality and disease-related costs. Based on comparable effectiveness, the economic advantage of aIIV over HD-IIV confirms the current vaccination strategy employing aIIV in Argentina.
Calidad de vida profesional del personal de enfermería de una institución sanitaria de Buenos Aires
(2024) Báez-Sánchez, Carmen Juliana; Caballero-Gómez, Elvia Evangelista; Díaz, Brenda; Cabral, Marcela Noemí; Canova-Barrios, Carlos
Introducción: La Calidad de Vida Profesional es la percepción del trabajador de la capacidad para responder a las demandas de trabajo, y se ha vinculado con la seguridad del paciente haciéndolo un área de interés en materia de salud pública. Objetivo: Describir la Calidad de Vida Profesional del personal de enfermería del servicio de internación general de una institución sanitaria de la Ciudad de Buenos Aires, Argentina, en el periodo comprendido entre marzo y abril de 2023. Metodología: Estudio descriptivo, cuantitativo y transversal. Se encuestó a 35 profesionales de enfermería y se implementó el cuestionario CVP-35 en su versión en español. Resultados: Los encuestados fueron mayormente mujeres (82,86%), con edades entre los 31 y 40 años (60,00%) y de estado civil solteros (51,43%). Se encontró que el reactivo mayor puntuado fue el contar con la “Capacitación necesaria para hacer mi trabajo” con una media de 9,06 (DE = 1,98) y el menor puntuado fue el contar con el “Apoyo de los compañeros” con una media de 0,40 (DE = 0,77). Las dimensiones Carga de trabajo y Apoyo directivo fueron las mejor y peor percibidas. La Calidad de Vida Profesional obtuvo una media de 5,89 de 10. Conclusión: La Calidad de Vida Profesional fue categorizada como regular y estuvo relacionada positivamente con el turno nocturno de trabajo. Se requiere de implementar intervenciones para mejorar este aspecto en el trabajo en aras de garantizar el mejor desempeño del personal.
Human Health Impact of Municipal Solid Waste Mismanagement: A Review
(2024) De Titto, Ernesto; Savino, Atilio
Management of municipal solid waste (MSW) is frequently not properly performed. Whenever this happens, those working in the different stages of the process, as well as residents close to the dumps, face health risks. Here, we revised the documented evidence of emissions liberated during MSW management and associated health problems to investigate if systematic and reproducible relationships can be established. Besides substances released during collection and transportation, various toxic substances, predominantly in small amounts, can be released in the leachate and the biogases liberated in the disposal of MSW. Activities in the dump produce fine and coarse particles that are dispersed through the air and can enter the respiratory system, causing a series of adverse health effects, as shown by an increase in the demand for health services and the presence of respiratory symptoms and exacerbations of chronic processes. On the contrary, all the studies on the risk of developing some form of cancer by populations living in the vicinity of a waste dump have not been able to conclusively identify a causal or even circumstantial relationship that such a risk exists. Besides, no systematic association between residence near a landfill and any adverse outcome of childbirth has been found. However, the assessment of potential health effects is uncertain because of their diversity, the varied means of exposure, the uncertainty associated with exposures to low amounts of toxins when they occur over long periods, the potential synergies of various pollutants, the difficulty in establishing direct relationships between the toxicants emitted and health problems, the necessary arbitrariness in the delimitation of the dispersion area of the toxics and the practical impossibility of identifying other sources of exposure that could have some share of responsibility in the emerging health, as well as the lack of control of confounding factors like social deprivation, the lack of data on migrations to or from the most critical areas that affect exposure times or considerations about latency periods in pathologies such as cancer that does not usually manifest until years after exposure.
The economic rationale for cell-based influenza vaccines in children and adults: A review of cost-effectiveness analyses
(2024) Fisman,David; Giglio, Norberto; Levin, Myron J.; Nguyen, Van Hung; Pelton, Stephen I.; Postma, Maarten; Ruiz-Aragón, Jesús; Urueña, Analía; Mould-Quevedo, Joaquin F.
Seasonal influenza significantly affects both health and economic costs in children and adults. This narrative review summarizes published cost-effectiveness analyses (CEAs) of cell-based influenza vaccines in children and adults <65 years of age, critically assesses the assumptions and approaches used in these analyses, and considers the role of cell-based influenza vaccines for children and adults. CEAs from multiple countries demonstrated the cost-effectiveness of cell-based quadrivalent influenza vaccines (QIVc) compared with egg-based trivalent/quadrivalent influenza vaccines (TIVe/QIVe). CEA findings were consistent across models relying on different relative vaccine effectiveness (rVE) estimate inputs, with the rVE of QIVc versus QIVe ranging from 8.1% to 36.2% in favor of QIVc. Across multiple scenarios and types of analyses, QIVc was consistently cost-effective compared with QIVe, including in children and adults across different regions of the world.
Epidemiology of Dengue in Argentina during the 2010/11 to 2019/20 Seasons: a Contribution to the Burden of Disease
(2024) Rapaport, Solana; Mauriño, Mariana; Morales, María Alejandra; Fabbri, Cintia; Luppo, Victoria; Buyayisqui, María Pía; Varela, Teresa; Giovacchini, Carlos; Urueña, Analía
Background: Dengue is an important public health problem in Argentina, as in many other countries. We reviewed and updated information on the dengue disease burden in Argentina over a 10-year period. Methods: We conducted a retrospective descriptive study from 2010 to 2020 based on data from the National Health Surveillance System. The main outcomes included dengue cases, incidence rates, deaths, and serotype distribution by season, age group, and region. Results: A total of 109,998 confirmed cases of dengue were reported. Seasonality stands out, prevailing during summer and autumn. Two main outbreaks (seasons 2015/16 and 2019/20), with increasing magnitude, were observed. The 2019/20 season showed the highest number of cases (58,731) and incidence rate (135/100,000). The Northeast region had the highest number of cases and incidence rate. In 2020, for the first time, autochthonous cases were registered in the Cuyo region. The only region with no autochthonous cases was the South. Adolescents and young adults showed the highest incidence rate. The case fatality rate for the period was 0.05%. Four serotypes circulated, but the predominant one was DEN-1 (78%). Conclusions: Dengue has been expanding temporally and spatially. Although the DEN-1 serotype widely predominated, the increasing circulation of other serotypes raises concerns regarding re-exposure and the severity of future cases. Understanding epidemiological trends is key to defining public prevention and control policies.
Zero-dose children in Latin America: analysis of the problem and possible solutions
(2025) Avila-Aguero, Maria L.; Brenes Chacon, Helena; Melgar, Mario; Becerra-Posada, Francisco; Chacon-Cruz, Enrique; Gentile, Angela; Ospina, Martha; Sandoval, Nancy; Sanwogou, Jennifer; Ureña, Analia; Valenzuela, Maria T.; Morice, Ana
Introduction: Zero-dose children (ZDC) are defined as those that have never been reached by routine immunization services. In Latin America, almost 2.7 million infants younger than 1 year of age, have incomplete vaccination schedules, and vaccine preventable diseases such as measles or polio have increase worldwide. ZDC are reported to reside in high risk and fragile settings, including remote-rural areas, urban slums, and conflict-affected areas. Identifying the problem and settings in each country is mandatory to propose possible solutions to the immunization coverage situation.
Presentación de la sección especial: Didáctica universitaria. Nuevos alfabetismos para entornos expandidos
(2025) Suarez-Guerrero, Cristóbal; Arroyo-Sagasta, Amala; Ferrarelli, Mariana
El tema central de este monográfico es entender la hibridación de los entornos educativos físicos y tecnológicos como un reto teórico y práctico que suscita otras problematizaciones, exigencias docentes y compromisos con la actividad didáctica. Esa hibridación constituye el contexto donde discurre con naturalidad la experiencia universitaria en la actualidad. La geografía -y la misma noción- del aula, sus aspiraciones, sus agentes, sus dinámicas, su cultura o sus recursos, se entretejen de forma más compleja, aunque no exentas de dilemas como también de oportunidades, mimetizando la tecnología en su quehacer. La novedad, si cabe, es que la hibridación de los entornos educativos no es un terreno exclusivo de las universidades estrictamente virtuales o semipresenciales (tradicionalmente apoyadas en la modalidad b-learning), sino que la enseñanza y el aprendizaje se despliegan en entornos educativos cada vez más difusos, sin costuras, pero, complementarios y más difíciles de separar. La hibridación es el nuevo tejido donde también se entrama la construcción de la didáctica. Lo anterior supone, entre otras cosas, visibilizar con más énfasis la pregunta sobre dónde -en qué tipo de entornos- y cómo -desde qué enfoques didácticos- enseñar y aprender en la universidad. Los aportes de los trabajos que forman este monográfico van en esa línea en la cual se imbrican prácticas didácticas con desarrollos recientes, tecnológicos o no.
Longevidad femenina: los avatares en la construcción de ser mujer mayor
(Universidad ISALUD. Centro de Envejecimiento Activo y Longevidad., 2024) Gascón, Silvia
Argentina, uno de los países ya envejecidos de América Latina comenzó el proceso de envejecimiento de su población, a mediados del siglo XX, acompañando el desarrollo socioeconómico de la época. En la actualidad, esta población asiste además, al aumento de la esperanza de vida en las edades avanzadas, por lo que las proporciones de personas de edad extrema sobre el total de la población se ha incrementado y lo seguirá haciendo en el futuro. Las mujeres tienen una esperanza de vida al nacer mayor que los varones. En Argentina esta diferencia se establece en 7 años más para las mujeres y si bien disminuye a medida que avanza edad, por ahora se mantiene en todos los grupos de edades. A través de este artículo reflexionaremos acerca de ¿Cuáles son los desafíos principales que presenta la longevidad para las mujeres? Y ¿Cuáles características subyacen en las mujeres mayores?
Sistemas de cuidados para personas mayores dependientes
(Universidad ISALUD, 2021) Gascón, Silvia
La pandemia de COVID 19 está afectando a la región iberoamericana profundizando desigualdades preexistentes y generando raves crisis a nivel sanitario, social y económico. La cuestión no significa sólo una crisis sanitaria, más allá de ello, se trata de un hecho social que nos replantea nuevas formas de vida, cambios en el rol y dinámica de las instituciones, así como de las normas y valores. Porque la pandemia develó en Latinoamérica una realidad imposible de ocultar la intensa desigualdad. Una altaconcentración de la riqueza con su contracara más feroz, elevado número de habitantes sumidos en pobreza extrema, sin acceso a agua potable, con altos niveles de informalidad laboral, jóvenes con pocas oportunidades de acceso a trabajo y educación. Estas desigualdades también se reflejan de forma singular en cada una de las generaciones, donde las cohortes de edad avanzada constituyen un grupo de riesgo en las que el virus intensifica su letalidad. Justamente, es menester remarcar, que este riesgo epidemiológico se ve agravado, por la condición de sus vidas precarias, la desposesión1 y el avasallamiento de sus derechos fundamentales. En tal sentido, comprendemos que las personas mayores requieren un esfuerzo adicional para incorporarse a los sistemas sociales o de salud y se encuentran más propensos a la exclusión y la pobreza. En síntesis, la andemia ha visibilizado lo que el Papa Francisco ha llamado “la cultura del descarte” y pone en evidencia la soledad y el aislamiento a la que se ven expuestos los mayores: la falta de respeto y conocimiento de sus hábitos, preferencias y costumbres, la baja adecuación del sistema de salud para atender las enfermedades crónicas propias de la vejez, la escasa regulación y control de las residencias para mayores y otros dispositivos de cuidado, así como la escasez de recurso humano capacitado para comprender el proceso de envejecimiento normal y patológico. Es en este sentido que se vuelve crucial poder reflexionar respecto al lugar que ocuparon y ocupan las personas mayores en la sociedad reconociéndolos como sujetos de derecho. Varias veces hemos dicho que los derechos no se pierden con los años. El derecho a recibir una atención eficiente, oportuna y de calidad debe estar garantizado para todas las edades. Y este es el momento en el que no alcanza con hacer mejor lo que se venía haciendo. Habrá que reinventar modelos de atención progresiva basados en las comunidades, para que las personas mayores en situación de dependencia, puedan contar con alternativas a la internación, puedan envejecer en sus comunidades y ser atendidas por profesionales cercanos y conocidos. También habrá que revisar los modelos de residencias para mayores, para que cuando está sea la opción requerida se pueda decidir tranquilos y confiados que los derechos serán respetados, con residencias centradas en derechos y de puertas bien abiertas para que superada la pandemia el afuera y el adentro sea sólo una línea imaginaria. Reflexionar al respecto de esta situación nos exige proponer un “pacto social por los cuidados en el que el Estado, el sector privado, las organizaciones sociales, las familias y las propias personas mayores asuman su cuota de responsabilidad, para que más allá de la pandemia, envejecer sea un logro de la humanidad y se haga realidad el derecho de todos y todas a acceder a un sistema de apoyos continuos, integrales y centrados en las personas.

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