SALUD Y ADOLESCENCIA

Acciones de Salud

Como sabes, la medicina es la ciencia que se ocupa de la prevención y la curación de enfermedades. Durante los primeros siglos de su historia, la medicina occidental hizo grandes esfuerzos para conseguir el alivio de los síntomas de la enfermedad, y luego se propuso identificar sus causas para lograr la cura. Pero durante los últimos tiempos se piensa el cuidado de la salud en términos de promoción y prevención. Además, como ya se ha explicado, la salud se entiende en un sentido amplio, que va más allá de lo específicamente biológico y de lo individual. A partir de esta visión compleja se definen a las acciones de salud. Se consideran acciones de salud todas las medidas que tienden a evitar las manifestaciones o la propagación, o ambas, de las enfermedades. Estas acciones están dirigidas:

Ø  al individuo, en lo que atañe a la atención médica de las enfermedades o a la acción sobre las causas que puedan provocarlas;

Ø  al ambiente, en todo lo concerniente al saneamiento o a los factores ambientales que puedan provocar la enfermedad.

Tanto para el análisis como para el diseño de las acciones de salud, se las suele clasificar en acciones de promoción y de prevención primaria, secundaria y terciaria.

Uno de los instrumentos fundamentales en la promoción y prevención lo constituye la educación para la salud. Por medio de la provisión de la información, busca, fundamentalmente, fomentar una actitud positiva con respecto a la salud, a la adquisición de hábitos y a la participación para contribuir a una mejora en las condiciones de vida de las personas y las sociedades. Además, la educación permite evaluar los factores de riesgo en las poblaciones e implementar acciones que permitan el mejoramiento de las condiciones de vida.

Promoción

                Es el conjunto de acciones tendientes a disminuir riesgos y a reducir la propagación de enfermedades a través de la educación y capacitación.

                Son acciones fundamentalmente educadoras y su objetivo es la concientización y la difusión de las formas de prevenir las enfermedades y de actuar cuando ellas se producen.

                Se realizan a través de formas de comunicación que tiene por finalidad logar que el mayor número posible de personas desarrolle conductas sanitarias positivas.

Prevención

                Hay tres niveles según los objetivos que se quieran lograr:

                Prevención primaria: incluye a todas las acciones que tienen como objetivo evitar la aparición de enfermedades, lesiones o problemas que afectan tanto a las personas como el ambiente.

                Son acciones de prevención primaria: la higiene personal (de la piel, manos, ojos, pelo, etc.); postura; realizar ejercicio; descanso; dieta equilibrada; vacunación; sanidad ambiental; etc.

                Prevención secundaria: ciertas enfermedades, debido a sus particulares características no siempre pueden ser detectadas o evitadas a tiempo. En estos casos se hace necesario tratar de descubrirlas lo antes posible e iniciar un tratamiento en forma inmediata. Estas medidas denominadas diagnóstico temprano y tratamiento oportuno constituyen la prevención secundaria. Son ejemplos de estas acciones: el examen médico periódico; análisis de sangre y orina; examen psíquico; control bucodental; controles ginecológicos; examen oftalmológico; ecografías; electrocardiograma; etc.

                El diagnóstico temprano también incluye los planes epidemiológicos a nivel poblacional para detectar enfermedades en estado insipiente.

                En síntesis, la prevención secundaria comprende el conjunto de acciones destinadas a descubrir y tratar lo más tempranamente posible las enfermedades que pudieran afectar a individuos y ambientes aparentemente sanos.

Prevención terciaria: Acciones llevadas a cabo desde la aparición de la enfermedad  y la necesidad de aplicar tratamientos para intentar curarla o paliarla hasta el restablecimiento del completo bienestar de la persona o la población afectada. Abarca la recuperación y la rehabilitación.

La recuperación comienza cuando se manifiesta la enfermedad y se acude a la consulta médica. Un tratamiento eficaz, en algunos casos, puede lograr la recuperación.

La rehabilitación tiende a restituir en las personas las capacidades físicas, psíquicas o sociales que pudieron haber sido alteradas por una enfermedad o accidente. Debe permitir que se desarrollen las habilidades para vivir con autonomía social y económica, aun en un estado de salud diferente.

Intervienen en la rehabilitación terapistas físicos, ocupacionales y psicólogos entre otros que trabajan para conseguir que los individuos se adapten a su nueva situación transitoria o permanente.

Factor de riesgo – Factor de protección – Grupo de riesgo

                Se llama factor de riesgo a toda circunstancia, rasgo, característica o exposición que aumente  las probabilidades de una persona de contraer una enfermedad, lesión o cualquier otro problema de salud. No son las causas de las enfermedades. Los factores de riesgo incluyen los factores ambientales, los hábitos de vida, situación socioeconómica etc. Por ejemplo: la vida sedentaria es un factor de riesgo para desarrollar problemas cardíacos. Exponerse al sol sin protección solar es un factor de riesgo para desarrollar cáncer de piel. La pobreza es un factor de riesgo para desarrollar entre otras cosas problemas nutricionales. Etc. Tener en cuenta que muchas enfermedades se desarrollan cuando la persona está expuesta a muchos factores de riesgo simultáneamente.

En cambio los factores de protección son los aspectos o elementos del entorno que ayudan a transitar circunstancias desfavorables o pueden contribuir o reducir la probabilidad de aparición de enfermedades. Por ejemplo: la información adecuada y oportuna sobre sexualidad puede prevenir entre otras cosas una enfermedad de transmisión sexual. Una alimentación balanceada y ejercitación pueden disminuir el riesgo de obesidad.

Grupo de riesgo o población de riesgo son aquellas personas que debido a ciertas características ya sea biológicas, físicas, geográficas, sociales etc. tienen mayor probabilidad de contraer determinadas enfermedades o accidentes.

Se consideran grupos de riesgo a aquellas personas que por su edad o estado físico puedan ser más vulnerables a contraer ciertas enfermedades. Bebes, niños embarazadas, ancianos, obesos, etc. Por ejemplo, los bebes son un grupo de riesgo para contraer enfermedades respiratorias.

También se consideran grupos de riesgo en relación al trabajo. Por ejemplo los mineros tienen mayor riesgo de contraer afecciones respiratorias o personas que manipulan máquinas de sufrir algún traumatismo.

Otro ejemplo es el grupo de riesgo que lo constituyen personas que ingieren sustancias tóxicas como las drogas, tabaco y alcohol. Estas personas son más propensas a sufrir  problemas cardíacos.

ACTIVIDADES

Lean atentamente el texto y luego realicen las siguientes actividades:

1.       Elaboren un mapa conceptual con los siguientes conceptos clave: acciones de salud, promoción prevención, primaria, secundaria, terciaria, educación para la salud, recuperación, rehabilitación, grupo de riesgo, factor de riesgo, factor de protección, individuo, ambiente, diagnóstico temprano y tratamiento oportuno.

2.       Busquen en diarios y revistas dos campañas de promoción de la salud y analicen: ¿Qué información brindan? ¿Es clara dicha información? ¿A quiénes está dirigida?, etc.

¿Qué otras acciones de promoción has visto, leído o escuchado últimamente?  Analicen cada una.

3.       Piensen un tema que les interese relacionado con la salud y elaboren una campaña de promoción gráfica. Por ejemplo si eligen el cólera deben buscar información para informar cómo prevenir dicha enfermedad, que la causa, síntomas, etc.

4.       Busquen una noticia relacionada con la promoción de la salud. Subrayen las ideas principales, elaboren un cuadro que resuma los conceptos principales.

5.       Elaboren una lista de acciones que realicen cotidianamente y analicen cuales deberían reforzar y/o implementar para mejorar su calidad de vida. De la misma manera elaboren  una lista de acciones que creen perjudican su calidad de vida y como harían para revertirlo.

6.       Nombren por lo menos cuatro factores de riesgo a los que están expuestos los adolescentes y cuáles serían los problemas de salud que podrían contraer por estar expuestos a dichos factores.

7.       Nombren por lo menos cuatro factores de protección y que problemas de salud se podrían evitar por dichos factores.

8.       Los adolescentes como grupo de riesgo ¿A qué problemas de salud son más vulnerables?

                              

SHORT STORY 4 NIVEL A

Tony Wilmot: Skeleton in the Cupboard

He was watching the park gates from his usual bench by the pond. The girl would soon be joining him for her mid-day break.

For several days now they had sat at the same bench and exchanged pleasantries after she had laughed at the way the ducks fought over the crusts he had thrown to them.

She was twenty-ish, attractive, with a pulse-quickening figure, but he did not flatter himself that her interest was in any way sexual. He subscribed to the adage “No fool like an old fool”. Besides, he was more than twice her age.

To him it was a harmless flirtation — a fillip to his middle-aged man's morale — and he had found himself looking forward to their lunchtime “assignations”.

Earlier that morning, however, events had taken a more serious turn. The girl had paid a visit to the Vehicle Registration Department in the Town Hall.

His secretary had come into his office. “There's a young lady here, Mr Smythe, asking if we keep records of car ownership... MG sports cars in particular. I said I thought not.”

He had felt a twinge of unease at the mention of the car type.

“Quite so,” he had replied. Tell her registrations are all on the national computer now. In any case, we couldn't give out that kind of information.”

He had peered at the reception desk through his offices glass partition. The enquirer was the girl from the park bench.

An odd coincidence, he had thought. Or was it something more?

Now, as she entered the park gates with that long stride and purposeful expression, his unease returned.

"Hello — we meet again," she said, sitting beside him.

"Ah, yes... sky looks a bit overcast. Hope we aren’t in for some rain." He gestured at the apple she was peeling with a penknife. "Lunch?"

"Yes, worse luck. I’m on a diet."

He smiled. "You seem to be here most days. Do you work hereabouts?"

"Oh no. In fact, I don’t live here. I’m just staying in town while I’m doing some research. I’m from Elmston, actually."

"Really? I know Elmston..." he began. The words were out before the warning bell rang. "Well, I don’t exactly know it...pal of mine... knew him years ago... used to live there. Is this your first visit here?"

"Yes."

"Nice place," he said. "Bit dull, though."

"Not at all. It’s charming."

"What are you researching? Our town’s chequered history, perhaps? Parts date from the Roman occupation."

"How interesting. But no — I’m trying to trace someone."

"Ah! Bit of detective work?"

She smiled. "In a way, I’m beginning to find out what a job it is tracing someone who may not want to be traced. No wonder the police have to spend so much time on investigations."

"And the “trail” has led from Elmston to here?"

"Indirectly, yes, But I’ve had to spend time in several places first. I’m hoping this will be the last."

"Sounds very intriguing," he said, hoping to entice her to reveal more without seeming to be prying into her private life.

"I suppose it is, in a way. I’m going back more than twenty years, though." She made a wry face. Which is setting myself a difficult task."

"I don’t suppose you were even born then?" he said.

"I was—just! Anyway, I’ve managed to unearth a few clues. The person I’m looking for had an MG sports car then and got married during the same period. I know it’s a bit of a long shot, but it might just pay off."

His unease became a shiver which set him on edge even more. He was like the rabbit hypnotized by the snake, wanting to get away but unable to move. "But I mustn’t bore you with my personal affairs," she went on. What about you? What line of business are you in?"

"Oh, nothing much. Civil servant, actually. Quite dull, I’m afraid. I wish I could be an 007 like you but... I’m just a nine-to-five chap."

"Don’t be so modest. There’s nothing wrong with being a civil servant."

He made a deprecating gesture but inwardly he was thrilled that a pretty girl was finding him interesting enough to want to flirt with him.

"Married, of course?"

He was on the point of saying no when he noticed her glance at the ring on his left hand. He nodded.

"The dishy men always are! Lived here long, have you?"

He did not like the turn the conversation was taking. "Oh, quite some time." He made a show of checking his wristwatch. "Well, I must be getting back. The grindstone waits for no man! I, er... that is, perhaps we might see each other again tomorrow?"

"Yes, let’s. About one o’clock?"

He said that would be fine.

As he walked back to the Town Hall doubts and fears scurried around his head like cornered rats. It was just too damned close to be coincidence any more. For he used to run an MG. And he had married twenty years ago.

He could not concentrate at the office. An hour before finishing time, he got his car from the staff car-park and drove to his semi in a leafy suburb on the outskirts of town.

Margaret, his wife, was doing some work in the garden. 'Robert, is that you? You're early. Nothing wrong at the office, is there?'

'No, of course not.' Why did women always think the worst? 'I thought I'd finish off that lampstand in the shed while there's still some day-light.'

'Right-O! I'll call you when dinner's ready.'

He put the inside catch on the shed door and made sure his wife was still in the front garden. Then he got a metal box from behind his workbench.

The key to the box was hidden under a bottle of weedkiller. Inside the box were two yellowing clippings from the Elmston Observer.

One was headlined: GIRL, 10, KILLED IN HIT-AND-RUN.

For the umpteenth times he read how the girl had been knocked down on a pedestrian crossing while on her way home from a school friend's house.

The details were embedded in his memory. He had driven over to Margaret's parents' house in the MG that evening. They had lived just outside Elmston then.

Because of some road works, the traffic had been diverted.

He had been exceeding the speed limit, too. It was an unfamiliar route and the crossing had taken him by surprise.

The car's brakes were slack because he'd skipped a service to save money, and a shower had made the road surface slippery...

Even though it was twenty years ago, he could still remember the sickening thud... the scream... the crumpled body on the side of the road.

Of course, he should have stopped, but he had panicked. He had been short-listed for a new job for which a clean driving licence was a condition of employment and it was only days away from his wedding. Reporting the accident would have ruined everything.

The second clipping, headed POLICE APPEAL FOR WITNESSES, said several people had heard the screech of brakes but none had seen the accident.

A police spokesman was quoted as saying they were 'pursuing several lines of enquiry'.

He locked the clippings away again and returned the box to its hiding place. He had never fully understood why he had kept them all those years. What, he wondered, would the psychologists make of that? A guilt complex, perhaps? A subconscious desire to punish himself for his crime?

It was his favourite tuna-fish salad for dinner but the memory of the accident had dulled his appetite. He pecked away at it, nodding absently as Margaret related the events of her day.

All through the meal the thought kept hammering in his brain: how long before the girl found out that he was the hit-and-run driver?

More than likely she was a former schoolfriend wanting to see justice done. Or a relative... the dead girl's sister, even.

The police enquiries had no doubt fizzled out years ago—they would have had far more pressing cases on their plate — but the little girl's family and friends would not have given up the search.

That night he hardly slept. At the office next day he clockwatched until it was time to go to the park.

The girl was already there when he arrived.

"I was hoping I'd see you today" she said. "You see, I'm certain I've come to the right town. You know I mentioned an MG... well, how's this for amateur sleuthing?... There's the car's number."

A muscle in his cheek began to twitch rapidly as he read what was in her notebook. His MG's number. But how had she...? The newspaper report said there had been no eyewitnesses.

"I'm missing the middle one or two digits in the numberplate — but it's enough."

"Very cloak-and-daggerish" he said, forcing a smile. "Have you tried the local Vehicle Registration Department? Perhaps they can help."

"Oh yes. No luck, though. But guess what? I've got a photograph of the car."

The park seemed to spin. He gripped the bench with both hands.

"You all right?" she asked.

"What? Oh yes. Just a twinge of indigestion."

"Well, I haven't actually got the photograph," she went on. "I've only seen the negative. I'm having a ten-by-eight print done from it."

"You have been busy!" His voice sounded unreal. "Look, that friend of mine from Elmston. I've just remembered. He had an MG. He could be who you are looking for... I might still have an address for him at home... Have you got a phone number where I can contact you? Better still, an address in case I miss you here tomorrow."

She wrote down both in her notebook and tore the page out for him. "Now I must be off," she said. "I've got more sleuthing to do. l'll look out for you here again tomorrow."

He gave her a minute or two's start, then began to follow her.

Her first stop was at a photographic shop near the main square. She came out carrying a large buff-coloured envelope.

That would be the MG print, he thought, as he observed her getting her bearings.

He kept about fifty yards behind as she crossed the town centre to the offices of the Evening Gazette.

He followed her through the revolving doors, keeping the public newspaper stands in the foyer between himself and the point where she was talking at the enquiry counter.

Pretending to leaf through the week's back numbers, he could hear snatches of conversation above the din of typewriters and telephones.

"... wedding report twenty-one years ago... would it be possible to..."

... archives are on the fourth floor... first door on the right as you come out of the lift..."

He watched the girl take the lift. Time passed. People came and went. He felt clammy and conspicuous.

Eventually she reappeared out of the lift. The receptionist smiled. Had she found what she had been looking for?

Yes, she had.

He was in a cold sweat now, but he had no difficulty keeping her in sight, for he knew the town like the back of his hand. Where would she head next? Oh God, he thought, don't let it be the police station.

"Robert! Long time no see!" He started. It was a man he knew from the Parks Department. He felt like a schoolboy caught playing truant. "Stretching your legs, eh, Robert?"

"Oh, er, yes." He could see the girl disappearing down a side turning. "Popped out for cigarettes."

The man was grinning. "Some looker, eh?"

"What?"

"That girl you were staring at."

"Oh," he forced a smile. "Look, can't stop now. Let's have a drink next week. I'll ring you."

When he finally got away the girl was nowhere to be seen. He spent the rest of the afternoon fretting at his desk. Whose wedding had she looked up? And why?

It was not until he and Margaret were watching TV that evening that the answer came to him; in fact, it was staring him in the face...

On the piano was an ornately framed picture of him and Margaret on their wedding day. Of course! Why hadn't he thought of it sooner? The other photos in the family album: there was one of the MG.
He found the album and flicked through it. There it was — the pair of them, snapped in the MG as they were leaving the reception to go off on honeymoon.
He stared at himself from twenty years ago: thin face, unlined, thick curling hair. Now he had a double chin, was balding, wore a moustache and bifocals. Unrecognisable!
On the back of the MG was a 'Just married' placard, which obscured the middle two digits on the rear number plate.
The girl must have gone to every photographer in the district until she found the one who had taken their wedding pictures. The negatives would have been on file, probably in a storeroom.
The girl had got a print. Then she had searched the Evening Gazette's back issues for the paper's own picture of the same couple in the MG... which would tell her the names and parents' addresses.
And there the search would stop, for Margaret's parents had emigrated long ago and his own parents were dead. He was safe.
Then it struck him like a blow. 'The electoral roll,' he said out loud. 'She simply goes through it, street by street, until she finds my name...'
'Did you say something, Robert?' Margaret called.
'What? No, nothing.'
It would be only a matter of time now before his skeleton was out of its cupboard. He would be branded a child-killer, all the more heinous because he had covered his tracks (he had sold the MG immediately they had got back from honeymoon).
He would get at least five years for manslaughter. He would lose his job; his reputation would be ruined; everything he had built up over the years... down the drain!
He knew he had not got the strength of character to begin all over again; he was too set in his ways...
'I think I'll go to The Swan for a pint, love. Don't wait up. I might be late.'
'Oh, all right. I'll leave something out for your supper.'
At times like this, he mused, it was positively an advantage having a conventionally predictable spouse.
It was a fifteen-minute drive to the block of service flats where the girl was staying; hers was on the ground floor.
She came to the door in a dressing-gown with a towel wrapped round her hair.
He was sorry to barge in on her unannounced, he blurted; but he had found himself in the neighbourhood, so he had thought he would give her that information about his friend.
'Oh, well, come in. You'll have to forgive my appearance — I'm in the middle of washing my hair. Can I get you a drink?'
'I won't, thanks. I'm driving.'
'Ah yes... the old breathalyser!
'He tried to smile but couldn't move his face muscles. 'That friend,' he began, swallowing. 'His name's... Smythe... Robert Smythe.'
'That's it,' she cried. 'The same one I've been looking for! I found his address this afternoon, in the electoral roll at the Town Hall.'
So it was true, he thought; she was tracking him down.
'Perhaps I will have that drink,' he said, slipping a hand into his jacket pocket.
She was at the drinks cabinet, her back to him. 'Gin and tonic all right?'
'Fine.' He pulled out a length of cord. It went round her neck so easily. He did not make a sound as he pulled it tight. Nor did she...

At the breakfast table next morning Margaret thought Robert looked pale and drawn; there were dark rings round his eyes and he seemed unusually preoccupied. Clearly he needed a holiday; he was working far too hard at that office.
She knew it probably would not be much good urging him to take the day off but she decided to try; to her surprise, he agreed.
'I do have a bit of a migraine, love,' he said.
'The rest will do you good. I'll ring the office and tell them you're not well.'
The 'plop' on the mat inside the front door told her the post had arrived. 'I'll go,' she said.
Two letters. One was Robert's bank statement, the other was for her. An unfamiliar handwriting.
She tore it open on her way back to the kitchen. It was a three-page letter, with a snapshot. The sudden shock, as she began to read, made her giddy.

... all I had to go on was your maiden name... you'd be surprised how many Margarets with that surname have got married since I was born... it meant checking each one to find if it was the right Margaret...

She stared at the attractive, fair-haired girl in the snap. Could it be... after all these years? It was something she had buried in her memory, something she had thought would remain buried; but, deep down, hadn't she always known she would never be able to escape from her past?

... when I first learned the truth about myself, I was hurt and angry ... but now that I'm grown up myself, I'm able to understand why you did what you did...

She sat at the table and rested her hands on the scrubbed pine to stop them from trembling. She glanced at Robert but he seemed unaware of her agitation.

...finally traced you through your marriage to Robert Smythe... and now I feel I must meet you... of course, my adoptive parents will always be 'Mum' and 'Dad' to me but...

Blinking back the tears, she heard Robert asking if the letter was bad news.
'Bad? Oh no...' Quite the contrary, she thought. But how would her husband take it?
The guilt she had borne all those years suddenly overwhelmed her and she pushed the snapshot across the table.
'Robert, I don't quite know how to... there's something I've got to tell you... something that happened before I met you...'

"Tales of the Unexpected" (1987)

Prof. Galeano

BIOLOGIA

Características de los seres vivos ap1 from blogdevon