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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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3.

Molecular Titration Promotes Oscillations and Bistability in Minimal Network Models with Monomeric Regulators.

Cuba Samaniego, Christian; Giordano, Giulia; Kim, Jongmin; Blanchini, Franco; Franco, Elisa
| Idioma(s): Inglés
Molecular titration is emerging as an important biochemical interaction mechanism within synthetic devices built with nucleic acids and the CRISPR/Cas system. We show that molecular titration in the context of feedback circuits is a suitable mechanism to enhance the emergence of oscillations and bistable behaviors. We consider biomolecular modules that can be inhibited or activated by input monomeric regulators; the regulators compete with constitutive titrating species to determine the activity of their target. By tuning the titration rate and the concentration of titrating species, it is possible to modulate the delay and convergence speed of the transient response, and the steepness and dead zone of the stationary response of the modules. These phenomena favor the occurrence of oscillations when modules are interconnected to create a negative feedback loop; bistability is favored in a positive feedback interconnection. Numerical simulations are supported by mathematical analysis showing that the capacity of the closed loop systems to exhibit oscillations or bistability is structural.
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5.

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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6.

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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7.

Aplicación de los enfoques de salud de la población y los determinantes sociales en Cuba/ Implementation of population health approaches and the social determinants in Cuba

Linares Pérez, Nivaldo
| Idioma(s): Español
Este trabajo reflexiona sobre algunas ideas en torno a la integración y aplicación de los enfoques de salud de la población y los determinantes sociales del proceso salud-enfermedad-atención en el actual contexto de transformación del Sistema de Salud en Cuba. Se discuten ideas para el fortalecimiento de la conceptualización social de la salud pública y la priorización de las acciones de salud poblacional sobre las de atención médica individual y para que se repiense el objeto y la práctica de esta como practica social. El trabajo intenta poner a debate nuevas y renovadas propuestas estratégicas de cambio basadas en una perspectiva ampliada de la salud pública y en el pensamiento de la medicina social privilegiando el enfoque basado en la población y la inclusión definitiva de un amplio rango de determinantes de la salud. Se sugiere la necesidad de desarrollar o ampliar la polémica sobre la concepción y practica social de la epidemiología y la salud pública sin que ello signifique renunciar a la implementación de necesarias transformaciones de los servicios de salud y de atención médica. Se sostiene la conveniencia de desarrollar un proceso de discusión técnica entre todos los actores y protagonistas, no solo del sistema de salud sino de todo el sector de la salud para lograr una mejor integración y operacionalización del enfoque de salud de la población y los determinantes sociales de la salud. This paper included some ideas about the integration and implementation of different population health approaches and the social determinants of the health-disease-care process in the current setting of health system changes in Cuba. Several ideas were discussed in order to strengthen the social conceptualization of public health and the prioritization of population health actions over those of individual medical care, as well as to rethink the object and practice in this field as social practice. The paper was intended to put forward new and renewed strategic change proposals based on wider perspectives of public health and on the social medicine thinking, thus favoring the population-based approach and the final inclusion of a wide range of health determinants. The paper also underlined the need of developing or extending the debate on the theory and social practice of epidemiology and public health within the implementation of necessary changes in health services and in medical care. It also stated that it is desirable to carry out a process of technical discussions among all the actors of the health care sector so that better integration and operationalizing of the population health approach and the social determinants of health can be attained.
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8.

Salud ambiental, evolución histórica conceptual y principales áreas básicas/ Environmental health, historical conceptual evolution and basic areas

Martinez Abreu, Judit; Iglesias Durruthy, Migdeala; Pérez Martínez, Alina; Curbeira Hernández, Eduardo; Sánchez Barrera, Odalys
| Idioma(s): Español
La importancia de los problemas de salud ambiental en cualquier contexto geográfico, así como su impacto en la salud, hace que el tema sea susceptible de ser revisado sistemáticamente. Los términos empleados en la literatura para definir conceptos históricamente vinculados a la salud ambiental son muchos y diversos. Un acercamiento a su evolución histórica y a sus principales áreas básicas puede contribuir a orientar el aprendizaje y a propiciar nuevas ideas para el análisis. El objetivo del trabajo es describir el transito histórico del concepto de salud ambiental e identificar las principales áreas básicas. Se encontraron 12 artículos pertinentes al tema que sirvieron de sustento teórico para este informe. Las consideraciones más relevantes fueron: el término salud ambiental es el más empleado en la actualidad, incluye salud ambiental que es el conjunto analítico, y servicios de salud ambiental como sistema de recursos; las áreas básicas están bien definidas y los componentes son: determinantes de la salud ambiental; procesos de la salud ambiental y funciones de la salud ambiental. En la literatura revisada no se consideran ni el sistema socioeconómico globalizado, ni el desarrollo tecnológico, ni la pobreza como problemas ambientales, lo cual valdría la pena analizar teniendo en cuenta los enfoques y definiciones actuales... The importance of environmental health problems in any geographic setting as well as their impact on the general health prompts the systematic review of this issue. The terms that literature uses to define concepts historically linked to the environmental health are numerous and various. An approach to the historical evolution of such concepts and their basic areas may contribute to guide the learning and to provide new ideas for analysis. The objective of this paper was to describe the historical transition of the environmental health concept and to identify the basic areas. Twelve articles on this topic served to theoretically support this report. The most relevant findings were: the term environmental health is the most used nowadays including environmental health as the analytical set and environmental health services as system of resources; the basic areas are well-defined with components like environmental health determinants, processes and functions. The reviewed literature did not consider globalized socioeconomic system, technological development or poverty as environmental problems, so it will be worthy analyzing this issue on the basis of the current approaches and definitions...
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10.

Adecuación del comportamiento humano en higiene, para la prevención de enfermedades y promoción en salud/ Adequacy of human behavior in hygiene, disease prevention and health promotion

Jiménez Hernández, Juana María; Jorge Valera, José Antonio; Cruz Trujillo, Acela; Alpízar Caballero, Lourdes Bárbara
| Idioma(s): Español
Resultados  1-10 de 504