Herramientas de Accesibilidad
Background/Objectives:Psychosocial stress has been proposed to contribute to obesity, particularly abdominal, or central obesity, through chronic activation of the neuroendocrine systems. However, these putative relationships are complex and dependent on country and cultural context. We investigated the association between psychosocial factors and general and abdominal obesity in the Prospective Urban Rural Epidemiologic study.Subjects/Methods:This observational, cross-sectional study enrolled 151 966 individuals aged 35-70 years from 628 urban and rural communities in 17 high-, middle- and low-income countries. Data were collected for 125 290 individuals regarding education, anthropometrics, hypertension/diabetes, tobacco/alcohol use, diet and psychosocial factors (self-perceived stress and depression).Results:After standardization for age, sex, country income and urban/rural location, the proportion with obesity (body mass index ≥30 kg m - 2) increased from 15.7% in 40 831 individuals with no stress to 20.5% in 7720 individuals with permanent stress, with corresponding proportions for ethnicity- and sex-specific central obesity of 48.6% and 53.5%, respectively (P<0.0001 for both). Associations between stress and hypertension/diabetes tended to be inverse. Estimating the total effect of permanent stress with age, sex, physical activity, education and region as confounders, no relationship between stress and obesity persisted (adjusted prevalence ratio (PR) for obesity 1.04 (95% confidence interval: 0.99-1.10)). There was no relationship between ethnicity- and sex-specific central obesity (adjusted PR 1.00 (0.97-1.02)). Stratification by region yielded inconsistent associations. Depression was weakly but independently linked to obesity (PR 1.08 (1.04-1.12)), and very marginally to abdominal obesity (PR 1.01 (1.00-1.03)).Conclusions:Although individuals with permanent stress tended to be slightly more obese, there was no overall independent effect and no evidence that abdominal obesity or its consequences (hypertension, diabetes) increased with higher levels of stress or depression. This study does not support a causal link between psychosocial factors and abdominal obesity.
International Journal of Obesity
The resting sensory discomfort transiently relieved upon movement of the affected area in restless legs syndrome suggests that sensorimotor integration mechanisms, specifically gating, may be altered in the disease. The authors sought to determine the effects of prepulse auditory and tactile stimulation applied to lower limbs on the blink reflex of patients with restless legs syndrome and healthy subjects. Seventeen patients with restless legs syndrome and 17 age- and sex-matched healthy controls were investigated. Auditory stimuli and tactile lower limb stimulation were applied as prepulses. The R2 response of the blink reflex induced by electrical stimulation applied to the right supraorbital nerve was selected as the test stimulus. Time intervals between prepulses and response-eliciting stimuli were 40, 70, 90, 110, and 200 milliseconds. There were no differences in either the auditory or tactile prepulse conditions between patients and controls and no differences between these measures within subject groups. We concluded that the tactile lower limb and the auditory prepulse effects on the brainstem interneurons mediating the blink reflex share common neural pathways. Because forebrain interneurons mediate these prepulse effects, they are likely not involved in the disordered sensorimotor interaction of restless legs syndrome. ©
Journal of Clinical Neurophysiology
The purpose of this study was to analyze the reliability and the criterion-related validity of several lower-body muscular power tests (i.e., standing long jump [SLJ], squat jump, countermovement jump, and Abalakov jump) in children aged 6-12 years. Three hundred sixty three healthy children (168 girls) agreed to participate in this study. All the lower-body muscular power tests were performed twice (7 days apart), whereas the 1 repetition maximum (1RM) leg extension test was performed 2 days after the first session of testing. All the tests showed a high reliability (intertrial difference close to 0 and no significant differences between trials, all p > 0.05). The association between the lower-body muscular power tests and 1RM leg extension test was high (all p < 0.001). The SLJ and the Abalakov jump tests showed the highest association with 1RM leg extension test (R 2 0.700, test result, weight, height, sex, and age were added in the model). The SLJ test can be a useful tool to assess lower-body muscular power in children when laboratory methods are not feasible because it is practical, time efficient, and low in cost and equipment requirements.
Journal of Strength and Conditioning Research
Background Reduced muscular strength, as measured by grip strength, has been associated with an increased risk of all-cause and cardiovascular mortality. Grip strength is appealing as a simple, quick, and inexpensive means of stratifying an individual\'s risk of cardiovascular death. However, the prognostic value of grip strength with respect to the number and range of populations and confounders is unknown. The aim of this study was to assess the independent prognostic importance of grip strength measurement in socioculturally and economically diverse countries. Methods The Prospective Urban-Rural Epidemiology (PURE) study is a large, longitudinal population study done in 17 countries of varying incomes and sociocultural settings. We enrolled an unbiased sample of households, which were eligible if at least one household member was aged 35-70 years and if household members intended to stay at that address for another 4 years. Participants were assessed for grip strength, measured using a Jamar dynamometer. During a median follow-up of 4·0 years (IQR 2·9-5·1), we assessed all-cause mortality, cardiovascular mortality, non-cardiovascular mortality, myocardial infarction, stroke, diabetes, cancer, pneumonia, hospital admission for pneumonia or chronic obstructive pulmonary disease (COPD), hospital admission for any respiratory disease (including COPD, asthma, tuberculosis, and pneumonia), injury due to fall, and fracture. Study outcomes were adjudicated using source documents by a local investigator, and a subset were adjudicated centrally. Findings Between January, 2003, and December, 2009, a total of 142 861 participants were enrolled in the PURE study, of whom 139691 with known vital status were included in the analysis. During a median follow-up of 4·0 years (IQR 2·9-5·1), 3379 (2%) of 139691 participants died. After adjustment, the association between grip strength and each outcome, with the exceptions of cancer and hospital admission due to respiratory illness, was similar across country-income strata. Grip strength was inversely associated with all-cause mortality (hazard ratio per 5 kg reduction in grip strength 1·16, 95% CI 1·13-1·20; p<0·0001), cardiovascular mortality (1·17, 1·11-1·24; p<0·0001), non-cardiovascular mortality (1·17, 1·12-1·21; p<0·0001), myocardial infarction (1·07, 1·02-1·11; p=0·002), and stroke (1·09, 1·05-1·15; p<0·0001). Grip strength was a stronger predictor of all-cause and cardiovascular mortality than systolic blood pressure. We found no significant association between grip strength and incident diabetes, risk of hospital admission for pneumonia or COPD, injury from fall, or fracture. In high-income countries, the risk of cancer and grip strength were positively associated (0·916, 0·880-0·953; p<0·0001), but this association was not found in middle-income and low-income countries. Interpretation This study suggests that measurement of grip strength is a simple, inexpensive risk-stratifying method for all-cause death, cardiovascular death, and cardiovascular disease. Further research is needed to identify determinants of muscular strength and to test whether improvement in strength reduces mortality and cardiovascular disease. Funding Full funding sources listed at end of paper (see Acknowledgments).
The Lancet
Introduction: There are certain variables that help us to determine the probability of an individual developing cardiovascular disease, those variables are called risk factors. The more risk factors a person has, the more likely of cardiovascular disease. Objectives: To determine prevalence of cardiovascular risk factors in Latin America. Material and methods: A literature review published during the period 2010-2015, with the participation of Latin American countries, of which items were selected in English and Spanish data bases recognized worldwide as PubMed, OMIM, SCIELO, EBSCO and magazines cardiology and public health of each Latin American country. Results: Identifi ed 3,645 articles of which 45 were selected; after examine and evaluate the methodological framework of the 45 articles, the information of these variable allowed did add up the sample of the articles (n = 7,192,262) for conclude than latin american have a higher prevalence of overweight/obesity, physical inactivity, smoking and alcohol intake. Conclusions: In the Latin American population there is a high prevalence of cardiovascular risk factors without signifi cant differences by gender.
Revista Mexicana de Cardiologia
The present study aims to evaluate the operating costs of biodiesel production using palm oil in a pilot-scale plant with a capacity of 20,000. L/day (850. L/batch). The production plant uses crude palm oil as a feedstock, and methanol in a molar ratio of 1:10. The process incorporated acid esterification, basic transesterification, and dry washing with absorbent powder. Production costs considered in the analysis were feedstock, supplies, labor, electricity, quality and maintenance; amounting to $3.75/gal ($0.99/L) for 2013. Feedstocks required for biodiesel production were among the highest costs, namely 72.6% of total production cost. Process efficiency to convert fatty acids to biodiesel was over 99% and generated a profit of $1.08/gal (i.e., >22% of the total income). According to sensitivity analyses, it is more economically viable for biodiesel production processes to use crude palm oil as a feedstock and take advantage of the byproducts such as glycerine and fertilizers.
Bioresource Technology
Hypertension affects 1 billion people worldwide and is considered the leading cause of death, stroke, myocardial infarction and congestive heart failure. Sodium intake is reported to be a modifiable determinant of hypertension and reductions in its consumption have been widely recommended. Various strategies have been proposed to address the observed epidemic of cardiovascular diseases, particularly in medium and low-income countries. Among these strategies, reducing dietary sodium intake and increasing dietary potassium intake are commonly included in guidelines for the treatment of hypertension and the prevention of cardiovascular disease. In the present article, we review the results of recent studies that have raised questions about potential adverse effects associated with low sodium intake on important health outcomes, including cardiovascular diseases and death. It is clear from these studies, that there are contradictory and irreconcilable positions in the interpretation of the evidence, a situation that indicates that there is an urgent need for international randomized controlled trials that consistently demonstrate that the low levels of sodium intake recommended in the guidelines are safe and beneficial for different populations around the world. In the interim, and in accordance with a number of experts, we agree that the current evidence argues against the reduction of dietary sodium as an isolated public health recommendation and that an alternative approach of recommending high quality, potassium rich diets, might achieve greater health benefits, including blood-pressure reduction, than aggressive sodium reduction alone.
Current Hypertension Reviews
Clinical Neurology and Neurosurgery
Objective: To describe and compare the burden level of the male and female relative caregivers of people with chronic diseases in Colombia. Methodology: A descriptive and comparative cross-sectional study that was carried out between 2012 and 2014 with 1,555 relative caregivers of people with chronic disease living in the five geographical regions of Colombia. The GCPC-A-C instruments for characterization and the Caregiver Perception of Burden Survey of Zarit in order to determine the perceived burden were used. Results: In the group of relative caregivers of the study, 80.3% belong to the Andean region, 5.6% were from the Pacific region, 3.6 % from the Orinoco region, 6.6% from the Caribbean region, and 3.6% from the Amazon region. The average age is 50. Most of them are spouses, children or parents of the care receiver and they spend at least a quarter of the day for his/her work as caregivers. Most of them have more than 36 months caring for the sick relative. 31% of male caregivers and 33% of female careers expressed to be experiencing an overload with the care of his/her relative. Conclusions: The findings reflect the existence of a majority of female relative caregivers of people with chronic disease, as reported in another studies in Latin America. Unlike previous research, there is no strong difference in the perceived and the expressed load by caregivers, according to gender.
Salud Uninorte
Journal of Physical Activity and Health
Objective: To describe the functional capacity of subjects who participated compared to those who did not participate in a Fitness program after undergoing coronary angioplasty. Methodology: A cross-sectional study was conducted in 19 subjects (68.4% men) with acute coronary syndrome undergoing coronary angioplasty between June and August 2010, who were appropriate for conducting a stress test. The dependent variable was functional capacity assessed by the modified Bruce and Bruce protocols. The main independent variable was participation in the fitness program. Simple and multiple linear regression analyses were performed to establish the variables associated with functional capacity. Results: We found that the subjects who attended the program achieved 2.57 MET above those who did not attend the program (P=.003), adjusted for history of hypertension and obesity. Conversely, obese people reached 3.04 MET less when compared with non-obese individuals, adjusted for program assistance and hypertension (P=.003). Conclusions: In the adjusted analysis, an association was found between participation in a fitness program and functional capacity. Thus, inclusion and participation of subjects who have received percutaneous revascularization in a fitness program within their rehabilitation process is recommended.
Fisioterapia
Developmental Medicine and Child Neurology
Hypertension is a leading cause of premature death worldwide and the most important modifiable risk factor for cardiovascular disease. Effective screening programs, communication with patients, regular monitoring, and adherence to treatment are essential to successful management but may be challenging in health systems facing resource constraints. This qualitative study explored patients\' knowledge, attitudes, behaviour and health care seeking experiences in relation to detection, treatment and control of hypertension in Colombia. We conducted in-depth interviews and focus group discussions with 26 individuals with hypertension and 4 family members in two regions. Few participants were aware of ways to prevent high blood pressure. Once diagnosed, most reported taking medication but had little information about their condition and had a poor understanding of their treatment regime. The desire for good communication and a trusting relationship with the doctor emerged as key themes in promoting adherence to medication and regular attendance at medical appointments. Barriers to accessing treatment included co-payments for medication; costs of transport to health care facilities; unavailability of drugs; and poor access to specialist care. Some patients overcame these barriers with support from social networks, family members and neighbours. However, those who lacked such support, experienced loneliness and struggled to access health care services. The health insurance scheme was frequently described as administratively confusing and those accessing the state subsidized system believed that the treatment was inferior to that provided under the compulsory contributory system. Measures that should be addressed to improve hypertension management in Colombia include better communication between health care professionals and patients, measures to improve understanding of the importance of adherence to treatment, reduction of co-payments and transport costs, and easier access to care, especially in rural areas.
PLoS ONE
Demand Side Management is a key concept within the Smart Grid vision to promote energy efficiency, load flexibility and interaction between the consumers and other power grid stakeholders. Disaggregated information requires an advanced load monitoring system of individual appliance consumption. A smart house is envisioned to include a Nonintrusive Load Monitoring (NILM) system to support demand side management and motivate the users to adopt energy saving practices. NILM systems use input electrical measurements taken at the energy meter point of a house and estimate the individual appliance operation and consumption through mathematical algorithms. Each appliance can be distinguished from others through a set of particular attributes namely load signatures that can be computed from transient signals, steady state signals or both. This paper aims to characterize current switching transients, for NILM applications and to discuss how they are affected by variation of factors such as point on wave of switching, network impedance, supply voltage distortion and sampling frequency of the meter. For that purpose, measurements of residential appliances of several categories are acquired and processed. The conclusion of this work is the assessment of suitability, robustness and efficiency of appliance identification based on current transients.
Renewable Energy and Power Quality Journal
Purpose: To evaluate the effect of simulated soccer on the hamstrings eccentric torque-angle profile and angle of peak torque (APTeccH), and on the hamstrings:quadriceps torque ratio at specific joint angles (ASHecc:Qcon). Methods: The authors assessed dominant-limb isokinetic concentric and eccentric knee flexion and concentric knee extension at 120°/s in 9 semiprofessional male soccer players immediately before and after they completed the Loughborough Intermittent Shuttle Test (LIST). Results: The LIST resulted in significant decreases in eccentric hamstrings torque at 60°, 50°, and 10° and a significant (21.8%) decrease in ASHecc:Qcon at 10° (P < .05). APTeccH increased from 7.1° ± 1.0° to 18.8° ± 4.2° (P < .05). Eccentric hamstrings peak torque significantly declined from 185.1 ± 70.4 N·m pre-LIST to 150.9 ± 58.5 N·m post-LIST (P = .002), but there were no significant changes in hamstrings or quadriceps concentric peak torque (P = .312, .169, respectively). Conclusions: Simulated soccer results in a selective loss of eccentric hamstrings torque and hamstrings-to-quadriceps muscle balance at an extended joint position and a shift in the eccentric hamstrings APT to a shorter length, changes that could increase vulnerability to hamstrings injury. These findings suggest that injury-risk screening could be improved by evaluating the eccentric hamstrings torque-angle profile and hamstrings strength-endurance and that the development of hamstrings fatigue resistance and long-length eccentric strength may reduce injury incidence.
International Journal of Sports Physiology and Performance
Objective: The jiggle of the motor evoked potential (MEP) induced by transcranial magnetic stimulation (TMS) depends on a number of factors including the assessment of this stochastic signal by the method known as area under curve (AUC). We aim to ascertain the MEP findings assessed by the AUC method obtained from individuals affected by lesions at different levels of the neuroaxis.Methods: We systematically search and critically appraise the scientific reports publishing on the MEP obtained from individuals with hypo- or hyperkinetic disorders of the neural system, and dissect the neurophysical assessment of the obtained data. To accomplish this, we used the instruments named to as U-Pen Instrument for Neurometric Evaluation Uncommonly and Rarely Obtained from NeuroSignals 1.0 (UPINEURON 1.0), and the Quality of Assessment Statistics Index (QuASI).Results: The MEP differences found by the classical peak-to-peak method decreased or disappeared when the AUC was used. The opposite was also true (Kappa. =. <. 0.00). The internal consistency of the UPINEURON was 0.88. The mean of the UPINEURON 1.0 indicator was 34.8 (range. =. 16-50), and the mean of the QuASI scores was 56.5 (range 30-80). Spearman correlation between UPINEURON 1.0 and QuASI was 0.513.Conclusions: The MEP jiggle found in individuals with disordered neural function is not a \"minor\" factor; it is beyond the underlying neural condition, sample size, type of coils, and number of trials, among other variables. The use of the novel indicators introduced in this investigation will help to improve the analysis of the AUC of neural signals. They may also lead to the reconsideration of current practices.
Physiology and Behavior
The current epidemic of obesity and cardiometabolic diseases in developing countries is described as being driven by socioeconomic inequalities. These populations have a greater vulnerability to cardiometabolic diseases due to the discrepancy between the maternal undernutrition and its consequence, low-birth weight progeny, and the subsequent modern lifestyles which are associated with socioeconomic and environmental changes that modify dietary habits, discourage physical activity and encourage sedentary behaviors. Maternal undernutrition can generate epigenetic modifications, with potential long-term consequences. Throughout life, people are faced with the challenge of adapting to changes in their environment, such as excessive intake of high energy density foods and sedentary behavior. However, a mismatch between conditions experienced during fetal programming and current environmental conditions will make adaptation difficult for them, and will increase their susceptibility to obesity and cardiovascular diseases. It is important to conduct research in the Latin American context, in order to define the best strategies to prevent the epidemic of cardiometabolic diseases in the region.
BMC Medicine
Objective To identify the achievement of the condition of technological and scientific capacity of a sample of physical therapy and respiratory services from the urban area of Floridablanca and Bucaramanga. Methodology A descriptive study was performed with a set of samples not based on probabilities out of convenience. The sample consisted of four health service provider institutions in the town of Floridablanca and three institutions from the urban area of Bucaramanga. During the year 2011, two check lists were applied in order to verify the fulfillment of standards of habilitation and to find the reasons for their non-compliance in some of their requisites. Results Three institutions in Floridablanca belong to the first level of care and one to the second level of care; the standards with the lowest fulfillments are: Risk follow-up with a median fulfillment score of 0 (Range: 0-12); Medical Records of care with a median of 9.5 (Range: 0-100) and the standard of priority procedures with a median of 18 (Range: 9-27). In Bucaramanga, two institutions belong to the second level of care and one to the third level of care. The lowest standards in fulfillment were: Medications and devices with zero for one institution, Priority procedures with a median of 60 (Range: 0-89) and physical installations with a median of 73 (Range: 64-84). Conclusions The results show a non-compliance with the essential requisites of habilitation even though these are demanded by the territorial organizations in each health department, district, and municipality.
Revista de Salud Publica
Core stability training (CST) has increased in popularity among athletes and the general fitness population despite limited evidence CST programmes alone lead to improved athletic performance. In female athletes, neuromuscular training combining balance training and trunk and hip/pelvis dominant CST is suggested to reduce injury risk, and specifically peak vertical ground reaction forces (vGRF) in a drop jump landing task. However, the isolated effect of trunk dominant core stability training on vGRF during landing in female athletes had not been evaluated. Therefore, the objective of this study was to evaluate landing kinetics during a drop jump test following a CST intervention in female capoeira athletes. After giving their informed written consent, sixteen female capoeira athletes (mean ± SD age, stature, and body mass of 27.3 ± 3.7 years, 165.0 ± 4.0 cm, and 59.7 ± 6.3 kg, respectively) volunteered to participate in the training program which consisted of static and dynamic CST sessions, three times per week for six weeks. The repeated measures T-test revealed participants significantly reduced relative vGRF from pre- to post-intervention for the first (3.40 ± 0.78 vs. 2.85 ± 0.52 N·NBW-1, respectively [p<0.05, effect size = 0.60]), and second landing phase (5.09 ± 1.17 vs. 3.02 ± 0.41 N·NBW-1, respectively [p<0.001, effect size = 0.87]). The average loading rate was reduced from pre- to post-intervention during the second landing phase (30.96 ± 18.84 vs. 12.06 ± 9.83 N·NBW·s-1, respectively [p<0.01, effect size = 0.68]). The peak loading rate was reduced from pre- to postintervention during the first (220.26 ± 111.51 vs. 120.27 ± 64.57 N·NBW·s-1 respectively [p<0.01, effect size = 0.64]), and second (99.52 ± 54.98 vs. 44.71 ± 30.34 N·NBW·s-1 respectively [p<0.01, effect size = 0.70]) landing phase. Body weight, average loading rate during the first landing phase, and jump height were not significantly different between week 0 and week 6 (p=0.528, p=0.261, and p=0.877, respectively). This study provides evidence that trunk dominant core stability training improves landing kinetics without improving jump height, and may reduce lower extremity injury risk in female athletes.
Journal of Human Kinetics
Major depression (MD) is associated with increased cardiovascular risk. Although alterations in autonomic regulation have been proposed as one potential pathophysiological mechanism to explain this comorbidity, studies using standard HRV features in depressed subjects have been inconclusive. In this study, 48 patients with MD and 48 healthy controls (HC) were randomly assigned to an audio-visual task with two different versions: one emotionally neutral (N) and the other emotionally arousing (E). ECG signal (lead II) was collected at 250 Hz, and point process nonlinear analysis of heartbeat dynamics was performed to obtain instantaneous features from standard time-domain analysis, as well as spectral (LF, HF, LF/HF) and bispectral (LL, LH, and HH) analysis. Mean values of all features were computed over the 30s segment of the emotional elicitation session. Only bispectral parameters LH and HH were significantly different between patients and HC (p<0.02). Our results suggest that time-varying nonlinear dynamics of parasympathetic activity are significantly reduced in MD compared to HC in response to emotional elicitation. We conclude that instantaneous bispectral analysis could be a promising tool for assessment of autonomic modulation in MD.
Computing in Cardiology
Assisted nordic hamstring curls provide a mechanism for assisting the lower phases of a nordic hamstring curl, allowing training at increased hamstring muscle length positions and the performance of more repetitions. This exercise may be useful to target the specific muscle lengths or fatigue conditions at which injuries occur.
Strength and Conditioning Journal
Journal of Hypertension
CISCI 2015 - Decima Cuarta Conferencia Iberoamericana en Sistemas, Cibernetica e Informatica, Decimo Segundo Simposium Iberoamericano en Educacion, Cibernetica e Informatica, SIECI 2015 - Memorias
Extreme meteorological events associated with climate change are a real issue and have important impact over the economy of infrastructure sector, including highways, hydrocarbon transport by pipelines, mines, etc., because saturation of soils by water can produce landslides and it could produce the fracture of pipelines or other kind of tangible assets. For example, an assessment of historical geotechnical failures in Ecopetrol (Colombian Oil Company) vs. extreme meteorological events shows that during La Niña (extreme rainfall period) geotechnical failures are three times greater. This work shows a method to identify places of risk by extreme meteorological events, mainly La Niña phenomenon, with focus in most probably alteration of rainfall. Our results illustrate the hot spots where there is a high probability of slight excess (120-160% of average rainfall) and high excess (>160%) of average rainfall. The results were intersected in a GIS with pipelines and mass movement risk maps to identify the places of high risk along Santander region.
ASME 2015 International Pipeline Geotechnical Conference, IPG 2015
Background. The competence for home health care is part of the fundamental features required when taking care of people with chronic disease. It is described as the ability, the skill and the preparation the user or their family caregiver possesses in order to perform the work of caring. Objective. To describe and compare the competence for home health care in Colombian people with chronic illness and their family caregivers in the different regions of Colombia. Materials and Methods. Quantitative, descriptive, comparative and cross-sectional study conducted between 2012 and 2014 in the five geographical regions of Colombia. The sample consists of 2231 participants including people with chronic illness and family caregivers. The measurement instruments used were the Survey for the characterization of the caring Dyad patient - family caregiver GCPC-UN-D, and the Home health care competence instrument “GCPCUN- CPC”, both in its patient and family caregiver versions. Descriptive statistics were used to analyze the home health care competence. For comparison of the groups nonparametric tests for independent samples were used. Results. People with chronic illness and their family caregivers have heterogeneous levels of home health caring competence in the different regions of Colombia. In both cases the higher levels are found in the Amazon region, while the lowest are found in the Pacific region. These levels of home health care competence are far away from the required ones to ensure quality and safety in the care of these patients. Conclusion. The indicators for the evaluation of home health care competence must address patients and their family caregiver as well as the health human talent, health institutions and the Social Security System in order to understand in a better way and change the current vulnerability in home health care practices in the country.
Revista Facultad de Medicina
Universidad de Santander UDES. Vigilada Mineducación.
Resolución otorgada por el Ministerio de Educación Nacional: No. 6216 del 22 de diciembre de 2005 / Personería Jurídica 810 de 12/03/96.
Institución sujeta a inspección y vigilancia por el Ministerio de Educación Nacional. Resolución 12220 de 2016.
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