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1.

REDESOFT: Hiperentorno educativo sobre redes de computadoras en ciencias de la salud, en Informática Médica/ REDESOFT: Educational Hyper environment on computing nets in health sciences, in Medical Computing

Berenguer Gouarnaluses, Juan Arturo; Bayés Cáceres, Edgar; Roger Medina, Ileana; Díaz Berenguer, Alma; Berenguer Gouarnaluses, Maritza
| Idioma(s): Español
Fundamento: las herramientas que ofrecen las Tecnologías de la Información y las Comunicaciones para crear medios de enseñanza han propiciado cambios significativos en el proceso enseñanza aprendizaje. Objetivo: diseñar un hiperentorno educativo sobre el Tema 2. Redes de computadoras en las ciencias de la salud, de Informática Médica I, para los estudiantes de primer año de Estomatología. Método: se realizó una investigación prexperimental pedagógica, en la Facultad de Estomatología de la Universidad de Ciencias Médicas de Santiago de Cuba durante el curso 2013-2014. Se emplearon métodos teóricos: análisis-síntesis, inducción-deducción, histórico-lógico, y sistémico-estructural; y empíricos: análisis documental, observación y encuesta a estudiantes. Resultados: no siempre los profesores orientaban tareas docentes extraclases que requirieran la búsqueda de nuevos contenidos usando herramientas tecnológicas, tenían insuficiencias en el dominio de recursos metodológicos para el desarrollo de habilidades de los alumnos en interacción con las redes, existía poco adiestramiento en los estudiantes para lograr el mayor aprovechamiento de las herramientas de Internet en el aprendizaje y escaso desarrollo de habilidades para clasificar la información que ofrece Internet, por lo que los autores diseñaron un hiperentorno educativo sobre los contenidos del Tema 2 de Informática Médica I. Conclusiones: los especialistas consultados valoraron el producto como efectivo, por el buen nivel de actualización, precisaron que su diseño se corresponde con un empleo adecuado de las herramientas que ofrecen las Tecnologías de la Información y las Comunicaciones, por lo es perfectamente aplicable para modificar las carencias detectadas, lo cual se comprobó en su puesta en ejecución. Background: the tools that the Information and Communication Technologies offer to create teaching aids have facilitated meaningful changes in the teaching-learning process. Objective: to design an educational hyper environment on the topic 2. Computing Nets in health sciences, in Medical Computing I, for the first year students of Odontology. Methods: it was carried out a pedagogic experimental investigation, in the Odontology Faculty of Santiago de Cuba University of Medical Sciences during the academic year 2013-2014. Theoretical methods were used: analysis-synthesis, induction-deduction, historical-logical, and systemic-structural; empiric methods: documental analysis, observation and a survey was applied to the students. Results: professors not always orient assignments that require the search of new contents using technological tools, they still have an unsatisfactory mastery of methodological resources for the development of the students' abilities in interaction with the nets, the students have little training to achieve a greater use in the tools of Internet in learning and they have a poor development of abilities to classify the information that Internet offers, that´s why the authors designed an educational hyper environment on the contents of topic 2 of Medical Computing I. Conclusions: the consulted specialists assessed the product as effective, for the good updating level, they specified that its design matches with an appropriate employment of the tools that the Communication and Information Technologies offer, that´s why it can be perfectly applied to modify the lacks on the topic, which was tested during its implementation.
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2.

A Atenção Primária e o Programa Mais Médicos do Sistema Único de Saúde: conquistas e limites/ Primary care in Brazil, and the Mais Médicos (More Doctors) Program in the Unified Health System: achievements and limits

Campos, Gastão Wagner de Sousa; Pereira Júnior, Nilton
| Idioma(s): Inglés; Portugués
Análise histórica das políticas de Atenção Primária no Brasil, com ênfase na Estratégia Saúde da Família (ESF) e no Programa Mais Médicos (PMM). Realizaram-se estudos de documentos e dados secundários oficiais, bem como de produção bibliográfica sobre esse tema. Constatou-se que houve consolidação da Atenção Primária como alternativa para o cuidado em saúde para grande parte da população do Brasil. Observaram-se, contudo, entraves estruturais que têm comprometido a efetividade e a sustentabilidade dessa política. Identificou-se que estes obstáculos decorrem, principalmente, do financiamento insuficiente e de modalidades de planejamento e de gestão ineficientes. O Programa Mais Médicos ampliou a cobertura assistencial e tornou mais equitativa a distribuição de médicos na Atenção Básica, não conseguindo, entretanto, resolver problemas estruturais do sistema público. An historical analysis of Brazil's policies in Primary Healthcare, with emphasis on the Family Health Strategy (FHS), and the Mais Médicos Program (PMM). Studies were made of documents and secondary official data, and the bibliography that has been produced on this theme. It was found that primary healthcare has been established and successfully consolidated as an option in healthcare for a great part of the population of Brazil. There have, however, been structural hurdles, which have tended to compromise the effectiveness and sustainability of this policy. It was identified that these obstacles arise principally from insufficient financing and from inefficient modes of planning and management. The Mais Médicos Program has widened care coverage and made the distribution of primary healthcare doctors more equitable, although it has not resolved the structural problems of the public system.
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6.

Estado, política social e saúde: estratégias para o controle decâncer de mama em Cuba/ State, social and health policy: strategies for breast cancer control in Cuba

Silva, Amanda Frazão da
| Idioma(s): Portugués
Cuba possui um sistema de saúde de acesso universal e de responsabilidade total do Estado. O país enfrenta grandes dificuldades de ordem política e econômica que afetam o universo das públicas cubanas, incluindo a Saúde. Com o envelhecimento populacional, Cuba convive com um expressivo crescimento no número de casos de diagnósticos de câncer. No que se refere ao câncer de mama, atualmente é a segunda causa de morte entre as mulheres cubanas. Nesse contexto, este estudo teve como objeto a análise do Sistema de Saúde cubano no que se refere ao controle do câncer de mama feminina no país, entendendo a complexidade existente no enfrentamento da doença. O estudo teve como bases a discussão sobre sistemas de saúde, controle de câncer de mama e atuação do Estado junto à Saúde.A análise documental e a revisão bibliográfica foram utilizadas metodologia. A rigidez do bloqueio econômico e o isolamento político da ilha após a dissolução da União das Repúblicas Socialistas Soviéticas (URSS), aprofundaram os problemas de ordem econômica no país, culminando em limitações impostas ao sistema de saúde.Com vistas a amenizar a crise econômica que a ilha convive há décadas, a partir dos anos 2000, o governo se utilizou da abertura comercial como uma estratégia. A forte atuação do Estado cubano nas suas mais diferentes frentes torna-se um diferencial no controle do desenvolvimento da política de saúde, garantindo ao Estado alta governabilidade. As ações de caráter coletivo destacam-se no âmbito do sistema de saúde cubano. Esse fato possivelmente está associado à ênfase que o sistema dá a Atenção Primária... Cuba has a universal with access health care system and total state responsibility.The country faces great difficulties of political and economic order that affect the public politics, including Health. With the aging population, Cuba coexists with a significant increase in the number of cases of cancer diagnoses. As regards the breast cancer is currently the second leading cause of death among women in Cuba. In this context, this study had as its object the analysis of the Cuban health system with regard to the control of female breast cancer in the country, understanding the complexity existing in fighting the disease. The study had as bases the discussion about health care, breast cancer control and state action at the Health. The document analysis and literature review were used as methodology. The rigidity of the economic blockade and political isolation of the island after the dissolution of the Union of Soviet Socialist Republics (USSR), deepened the problems of economic order in the country, culminating in limitations imposed on the health care system. Inorder to ease the economic crisis that the island lives for decades, from the 2000s, the government has used the trade liberalization as a strategy. The strong performance of the Cuban state in its different fronts becomes a differential in control of health policy development, ensuring the state high governance. The collective actions stand out within the Cuban health system. This fact is possibly due to the emphasis that the system gives the Primary Health Care. This scenario happens quite the focus on high solving the problems at the primary level, as well as to reduce system costs. The problem of breast cancer and the difficulty of disease control in Cuba demonstrate that even with a public health system, universal, quality, scarcity of financial resources and the difficulty in obtaining inputs and technologies impacting directly on coping policy breast cancer...
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7.

Factores ambientales, conductuales y sanitarios relacionados con el cólera en Santiago de Cuba/ Environmental, behavioural and health factors related to cholera in Santiago de Cuba

Salas Palacios, Sara Riccis; Pérez Andrés, Irela; aro Guerra, Irlán; Valdés García, Luis Eugenio
| Idioma(s): Español
Introducción: el cólera en América Latina se considera una enfermedad reemergente, influenciada por factores sociales, culturales y ambientales. Objetivo: evaluar los factores ambientales, conductuales y sanitarios relacionados con el cólera en Santiago de Cuba. Métodos: se realizó un estudio descriptivo y transversal de los factores ambientales y de comportamiento poblacional relacionados con el cólera, así como de la organización de los sistemas de salud para el enfrentamiento a la epidemia en la provincia de Santiago de Cuba. El universo estuvo constituido por 356 087 familias tomadas de las unidades de alojamiento, informadas en las cifras preliminares del Censo de Población y Viviendas 2012. Se empleó un muestreo por conglomerados polietápico con probabilidades de inclusión proporcionales al tamaño de cada conglomerado, y se seleccionaron 10 policlínicos, 50 consultorios médicos de familia y 40 familias en cada uno, para un tamaño final de 2 000 familias. Resultados: se consideró que en 80,0 % de las familias las condiciones de almacenamiento de agua eran adecuadas, 21,8 % de las muestras dio algún tipo de positividad de microorganismos patógenos en el muestreo bacteriológico, 30,2 % de las familias poseían un sistema de evacuación de residuales líquidos en mal estado, 61,25 % calificó entre las categorías no funciona y regular, y 27,2 % de las zanjas, los ríos y los canales observados en la muestra presentaban malas condiciones higiénicas, con mayores dificultades en los municipios de II Frente, La Maya, Palma Soriano y Santiago de Cuba. Conclusiones: se identificaron factores ambientales y de comportamiento en la población, que propiciaban la transmisión del cólera e influían en el proceso de control de la enfermedad en la provincia de Santiago de Cuba. Introduction: cholera is considered in Latin America a re-emerging disease, influenced by social, cultural and environmental factors. Objective: to evaluate the environmental, behavioural and health factors related to the cholera in Santiago from Cuba. Methods: a descriptive and cross-sectional study of the environmental factors and population behaviour related to cholera, as well as of the organization of the health systems for the control of the epidemics was carried out in Santiago de Cuba province. The universe was constituted by 356 087 families selected from the care units, informed in the preliminary figures of the Population and Housings Census in 2012. A sampling was used by poly-stage conglomerate with proportional inclusion probabilities to the size of each conglomerate, and 10 polyclinics, 50 doctor's offices and 40 families were selected in each one, for a final size of 2 000 families. Results: it was considered that in 80.0% of the families the conditions of water preservation were adequate, 21.8% of the samples provided certain positive results to pathogens in the bacteriological sampling, 30,2% of the families had a poor system of evacuation of sewage, 61,.25% qualified between the categories "out of service and middle service", and 27.2% of the ditches, rivers and the channels observed in the sample had bad hygiene conditions, with more difficulties in II Frente, La Maya, Palma Soriano and Santiago de Cuba municipalities. Conclusions: environmental and behavioural factors were identified in the population which the transmission of cholera and influenced in the process of disease control in Santiago de Cuba province.
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8.

Building International Sustainable Partnerships in Occupational Therapy: A Case Study.

Tupe, Debra Ann; Kern, Stephen B; Salvant, Sabrina; Talero, Pamela
| Idioma(s): Inglés
Occupational therapy practitioners frequently identify opportunities for international practice. The World Health Organization and the World Federation of Occupational Therapists have encouraged occupational therapists to address transnational issues, social inclusion, and equal access to opportunities grounded in meaningful occupation (WFOT, 2012). This case study describes a partnership between two U.S. schools of occupational therapy and a Cuban community based pediatric clinic. It examines the dynamics that have sustained the partnership despite political, economic, and logistical barriers. The literature is scrutinized to show how this case study fits into other accounts of collaborative international partnerships. Particularly, it investigates structural and institutional conditions that shape international sustainable partnerships. In doing so, we answer the following questions: (1) Under which circumstances do international partnerships emerge and flourish? (2) What structural and institutional conditions shape international sustainable partnerships? And (3) How do partners perceive and experience the bilateral international partnership? It also discusses and illustrates the foundations and development of international partnerships that succeed. Through the use of a case study we illustrate the development of this partnership. Finally, we consider the next steps of this particular sustainable and collaborative international partnership.
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9.

Approaches to Climate Change & Health in Cuba: Guillermo Mesa MD MPhil, Director, Disasters & Health, National School of Public Health. Paulo Ortiz MS PhD, Senior Researcher, Climate Center, Cuban Meteorology Institute.

Mesa, Guillermo; Ortiz, Paulo; Gorry, Conner
| Idioma(s): Inglés
The US National Institutes of Health predict climate change will cause an additional 250,000 deaths between 2030 and 2050, with damages to health costing US$2-$4 billion by 2030. Although much debate still surrounds climate change, island ecosystems-such as Cuba's-in the developing world are arguably among the most vulnerable contexts in which to confront climate variability. Beginning in the 1990s, Cuba launched research to develop the evidence base, set policy priorities, and design mitigation and adaptation actions specifically to address climate change and its effects on health. Two researchers at the forefront of this interdisciplinary, intersectoral effort are epidemiologist Dr Guillermo Mesa, who directed design and implementation of the nationwide strategy for disaster risk reduction in the Cuban public health system as founding director of the Latin American Center for Disaster Medicine (CLAMED) and now heads the Disasters and Health department at the National School of Public Health; and Dr Paulo Ortiz, a biostatistician and economist at the Cuban Meteorology Institute's Climate Center (CENCLIM), who leads the research on Cuba's Climate and Health project and is advisor on climate change and health for the UN Economic Commission for Latin America and the Caribbean (ECLAC).
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10.

Cuba confronts climate change.

Alonso, Gisela; Clark, Ismael
| Idioma(s): Inglés
Among environmental problems, climate change presents the greatest challenges to developing countries, especially island nations. Changes in climate and the resulting effects on human health call for examination of the interactions between environmental and social factors. Important in Cuba's case are soil conditions, food availability, disease burden, ecological changes, extreme weather events, water quality and rising sea levels, all in conjunction with a range of social, cultural, economic and demographic conditions.
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