La narratividad como perspectiva transdiscursiva para la formación ético-profesional del universitario

El artículo tiene como objetivo caracterizar las potencialidades formativas de la narratividad como criterio y práctica para la educación ético - profesional del estudiante universitario. Entre los resultados se destacó la propuesta de valores formativos transdisciplinares desde la narratividad y de acciones prácticas con una perspectiva transdisciplinar que permite pasar de los presupuestos de la narración a la narratividad como eje transdiscursivo en la formación ético-profesional de las diversas carreras.

The article aims to characterize the formative potential of narrativity as a criterion and practice for the ethical-professional education of the university student. Among the results, the proposal of transdisciplinary training values ​​from narrativity and practical actions with a transdisciplinary perspective that allows moving from the assumptions of narration to narrativity as a transdiscursive axis in the ethical-professional training of the various careers stood out.

Impact of peritoneal dialysis strategy on technique and patient survival.

Background: The aim of this study was to evaluate the impact of peritoneal dialysis (PD) strategy on technique and patient survival. Methods: This was a retrospective, single-center study conducted on consecutive patients with chronic kidney disease who underwent PD between January 2009 and December 2019. The study sample was stratified into four different groups according to PD technique [automated (APD) or manual (CAPD)] and icodextrin use (yes versus no). The primary endpoints were survival of both technique and patient. Results: A total of 531 patients were included in the analysis. Mean ± standard deviation age was 60.6 ± 14.6 years, 68.4% (363) were men and 34.8% (185) had diabetes. The median technique survival time was 19 (15) months. A total of 185 (34.8%), 96 (18.1%), 99 (18.7%) and 151 (28.4%) patients were included in the CAPD/No-Icodextrin, CAPD/Icodextrin, APD/No-Icodextrin and APD/Icodextrin study groups, respectively. Throughout the study, 180 (33.9%) patients underwent renal transplant, 71 (13.4%) were changed to hemodialysis and 151 (28.4%) died. Age [hazard ratio (HR) 0.975, 95% confidence interval (CI) 0.960-0.990, P = .001] and incidence of early peritoneal infection (HR 2.440, 95% CI 1.453-4.098, P = .001) were associated with technique survival, while age (HR 1.029, 95% CI 1.013-1.045, P < .001), Charlson Index (HR 1.192, 95% CI 1.097-1.295, P < 0.001), use of icodextrin (HR 0.421, 95% CI 0.247-0.710, P < .001) and APD/Icodextrin (HR 0.499, 95% CI 0.322-0.803, P = .005) were associated with patient survival. Conclusions: Icodextrin use and APD/Icodextrin had a positive impact on patient survival, while older age and higher Charlson Index had a negative one. Age and incidence of early peritoneal infection significantly impacted on technique survival.

Resultados iniciales para un estudio sobre competencia comunicativa en el contexto de la relación personal de salud-paciente

Introducción: Las relaciones sociales se erigen sobre la base de la comunicación entre los hombres y desde el punto de vista profesional implican el dominio de la competencia comunicativa que garantice la posesión de saberes que fortalezcan el resultado del intercambio entre los interlocutores. El texto tiene como objetivo exponer los resultados iniciales del proceso de caracterización y diagnóstico de la situación problémica asumida por el proyecto de investigación Estrategia de superación dirigido al desarrollo de la competencia comunicativa profesional en el contexto de la relación personal de salud-paciente en el nivel primario de atención. Método: Es una investigación perteneciente a proyecto asociado a programa sectorial del tipo Investigación + Desarrollo que, por su carácter, es observacional explicativa-causal. Se gestiona en el Centro de Desarrollo de las Ciencias Sociales y Humanísticas en Salud. (CENDECSA), adscrito a la Universidad de Ciencias Médicas de Camagüey; entre enero de 2021 y diciembre de 2023. El estudio cuasi experimental, con un diseño pre y post intervención emplea una muestra aleatoria simple, que conforman profesionales del Policlínico Universitario José Martí, a los que se suman otros del territorio que participan en las acciones de superación que se acometen. Resultados: Se exponen los hallazgos del diagnóstico y caracterización de la situación problémica. Se aplicaron técnicas e instrumentos de investigación a pacientes, familiares y personal de salud. Se constataron insuficiencias que limitan el intercambio discursivo lo cual redunda en estados de insatisfacción que atentan contra el propósito de la interrelación en el proceso de la atención en salud. Discusión: Los resultados confrontados con investigaciones nacionales y extranjeras confirman la justificación del problema científico y la actualidad de la temática.

Introduction: Social relations are built on the basis of communication between men and from the professional point of view they imply the mastery of communicative competence that guarantees the possession of knowledge that strengthens the result of the exchange between the interlocutors. The objective of the text is to present the initial results of the process of characterization and diagnosis of the problematic situation assumed by the research project Overcoming strategy aimed at the development of professional communicative competence in the context of the personal health-patient relationship at the level primary care. Method: It is a sectorial investigation of the Research + Development type that, due to its nature, is explanatory-causal observational. It is managed at the Center for the Development of Social and Humanistic Sciences in Health. (CENDECSA), attached to the University of Medical Sciences of Camagüey; between January 2021 and December 2023. The quasi-experimental study, with a pre- and post-intervention design, uses a simple random sample, made up of professionals from the José Martí University Polyclinic, as well as cons from the territory who participate in the actions of overcoming that are undertaken. Results: The findings of the diagnosis and characterization of the problematic situation are exposed. Research techniques and instruments were applied to patients, relatives and health personnel. Insufficiencies were found that limit the discursive exchange, which results in states of dissatisfaction that undermine the purpose of interrelation in the health care process. Discussion: The results compared with national and foreign investigations confirm the justification of the scientific problem and the topicality of the subject.

Fundamentos teóricos para un estudio sobre la prevención de los trastornos lingüístico- comunicativos en la primera infancia / Theoretical foundations for a study on prevention of communicative linguistic disorders in early childhood

RESUMEN El objetivo del presente texto está dirigido a fundamentar cuestiones inherentes al proceso de la prevención de los trastornos mencionados, objeto de estudio del área de la lengua materna, como saber imprescindible para que las educadoras se nutran de los elementos esenciales que deben conocer los agentes y agencias educativas participantes en las diferentes modalidades de atención. Se ofrecen, además, sugerencias de cómo proceder en la orientación a las familias para contribuir a que el desarrollo, en cada periodo etario transcurra favorablemente e incluye también las acciones a adoptar ante posibles desviaciones. Estos resultados derivan de las acciones del Proyecto de investigación La atención logopédica integral a la primera infancia, que se encuentra en ejecución desde septiembre de 2019, el cual se extenderá hasta diciembre de 2021 liderado por profesionales del departamento Educación Especial de la Universidad de Camagüey Ignacio Agramonte Loynaz.

ABSTRACT The objective of this text is aimed at substantiating issues inherent to the process of prevention of the aforementioned disorders, an object of study in the area of the mother tongue, as essential knowledge for educators to be nurtured by the essential elements that agents and agents must know. Educational agencies participating in the different care modalities. In addition, suggestions are offered on how to proceed in the orientation of families to help their development, in each age period, pass favorably and also include the actions to be taken in the event of possible deviations. These results derive from the actions of the research project Comprehensive speech therapy care for early childhood, which has been running since September 2019, which will run until December 2021 led by professionals from the Special Education department of the University of Camagüey Ignacio Agramonte Loynaz.

Cultura, comprensión y desarrollo psíquico: implicación de sus nexos para una enseñanza desarrolladora / Culture, understanding and psychic development: implications of their links towards developmental teaching

El presente artículo tiene como objetivo develar la implicación de los nexos entre la cultura y los procesos de comprensión y desarrollo psíquico para la concepción e instrumentación de una enseñanza desarrolladora atendiendo a que el desarrollo psíquico del sujeto es una condición esencial para lograr su papel activo y creador en el desarrollo social. Por ello su tránsito a niveles cualitativamente superiores, constituye una prioridad para los sistemas educativos. La teoría histórico - cultural del desarrollo psíquico le da especial importancia al papel de la cultura y su asimilación en la formación y desarrollo de la personalidad. Además, disciplinas como la semiótica reconocen el papel del texto y los procesos textuales (comprensión y producción) en la conservación, transmisión y re-creación de la cultura. El estudio realizado se basa en la sistematización de postulados básicos de la teoría histórico - cultural del desarrollo psíquico y la semiótica de la cultura.

This article aims at revealing the implications of the links between culture and the processes of understanding and psychic development towards the conception and implementation of developmental teaching taking into account that an individual's psychic development is an essential condition to fulfil its active and creative role in social development. That is why its movement to qualitatively superior levels is a priority for educational systems. The historical-cultural theory gives special importance to the role of culture and its assimilation in the formation and development of the personality. Furthermore, disciplines such as semiotics recognize the role of texts and textual processes (understanding and production) in the conservation, transmission and recreation of culture. This study is based on the systematization of basic postulates of the historical-cultural theory of psychic development and Culture Semiotics.

La apreciación literaria en la formación socio-humanista del estudiante de Medicina / The role of literary analysis in the socio-humanistic education of Medicine students

Las universidades de Ciencias Médicas tienen el reto de graduar un profesional que posea una amplia cultura general integral. El diagnóstico y caracterización del estado actual de la formación socio-humanista de los estudiantes que ingresan a la Casa de Altos Estudios reveló las insuficiencias que existen, por lo cual el objetivo consistió en la elaboración de un sistema de talleres de apreciación literaria para la formación socio-humanista de los estudiantes de Medicina de primer año de la Universidad de Ciencias Médicas de Camagüey que forma parte de un proyecto aprobado en el programa de ciencia, tecnología e innovación nacional número 2, Organización, eficiencia y calidad de los servicios de salud, con el código 152049. El mismo constituye un aporte al Trabajo Educativo y de Extensión Universitaria en la institución.

Medical universities face the challenge of graduating a professional with a comprehensive cultural background. The diagnosis and characterization of the current situation in regards to the socio-humanistic education of the students entering Camaguey´s Medical University revealed several insufficiencies. Due to this, the objective of this research was to prepare a system of literary analysis workshops to enable the socio-humanistic education of first year Medical students at Camaguey´s Medical University. This investigation has been approved as a project belonging to a national science, technology and innovation program (Organization, efficiency and quality of health services) with the code 152049 and is a contribution to the educational work of the university.

Improvement of mineral and bone metabolism markers is associated with better survival in haemodialysis patients: the COSMOS study.

BACKGROUND: Abnormalities in serum phosphorus, calcium and parathyroid hormone (PTH) have been associated with poor survival in haemodialysis patients. This COSMOS (Current management Of Secondary hyperparathyroidism: a Multicentre Observational Study) analysis assesses the association of high and low serum phosphorus, calcium and PTH with a relative risk of mortality. Furthermore, the impact of changes in these parameters on the relative risk of mortality throughout the 3-year follow-up has been investigated. METHODS: COSMOS is a 3-year, multicentre, open-cohort, prospective study carried out in 6797 adult chronic haemodialysis patients randomly selected from 20 European countries. RESULTS: Using Cox proportional hazard regression models and penalized splines analysis, it was found that both high and low serum phosphorus, calcium and PTH were associated with a higher risk of mortality. The serum values associated with the minimum relative risk of mortality were 4.4 mg/dL for serum phosphorus, 8.8 mg/dL for serum calcium and 398 pg/mL for serum PTH. The lowest mortality risk ranges obtained using as base the previous values were 3.6-5.2 mg/dL for serum phosphorus, 7.9-9.5 mg/dL for serum calcium and 168-674 pg/mL for serum PTH. Decreases in serum phosphorus and calcium and increases in serum PTH in patients with baseline values of >5.2 mg/dL (phosphorus), >9.5 mg/dL (calcium) and <168 pg/mL (PTH), respectively, were associated with improved survival. CONCLUSIONS: COSMOS provides evidence of the association of serum phosphorus, calcium and PTH and mortality, and suggests survival benefits of controlling chronic kidney disease-mineral and bone disorder biochemical parameters in CKD5D patients.

Aprendizaje y comprensión. Una mirada desde las humanidades / Learning and comprehension. A glance from the humanities

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The learning has been one of the categories more studied by Psychology and the Didactics. It reflects the importance that has in the formation and development of the personality. The most recent and significant contributions in that field refer the existing bonds between the learning processes and comprehension. By the importance of the subject, in the article it is persecuted like objective to reflect around the existing relations between the mentioned processes. The made study is based on the analysis of the referred subject from the systematization of basic postulates of humanistic and social sciences, such as: Psychology, the Linguistics, the Semiotics, the Hermeneutics and the Didactics.

Malignant solitary fibrous kidney tumor with peritoneal disease: a case report.

We report a case of a large malignant solitary fibrous kidney tumor. A complete surgical resection of the primary tumor and peritoneal disease was carried out, and a histological examination confirmed the initial diagnosis. We describe and discuss the characteristics of this rare kidney neoplasm.

Use of phosphate-binding agents is associated with a lower risk of mortality.

Hyperphosphatemia has been associated with higher mortality risk in CKD 5 patients receiving dialysis. Here, we determined the association between the use of single and combined phosphate-binding agents and survival in 6797 patients of the COSMOS study: a 3-year follow-up, multicenter, open-cohort, observational prospective study carried out in 227 dialysis centers from 20 European countries. Patient phosphate-binding agent prescriptions (time-varying) and the case-mix-adjusted facility percentage of phosphate-binding agent prescriptions (instrumental variable) were used as predictors of the relative all-cause and cardiovascular mortality using Cox proportional hazard regression models. Three different multivariate models that included up to 24 variables were used for adjustments. After multivariate analysis, patients prescribed phosphate-binding agents showed a 29 and 22% lower all-cause and cardiovascular mortality risk, respectively. The survival advantage of phosphate-binding agent prescription remained statistically significant after propensity score matching analysis. A decrease of 8% in the relative risk of mortality was found for every 10% increase in the case-mix-adjusted facility prescription of phosphate-binding agents. All single and combined therapies with phosphate-binding agents, except aluminum salts, showed a beneficial association with survival. The findings made in the present association study need to be confirmed by randomized controlled trials to prove the observed beneficial effect of phosphate-binding agents on mortality.

Concepción didáctica para desarrollar lo ético-ambiental en el proceso de formación del profesional / Didactical conception to develop the ethical-environmental within the professional formation process

El trabajo presenta una concepción didáctica para el desarrollo de lo ético-ambiental en la formación del profesional. Esta tributa a la adquisición de una cultura general integral los estudiantes, según se apropien de los elementos conceptuales, cognitivos, afectivos y conductuales en las actuales condiciones. La propuesta permite la incorporación de los conceptos ambientales a las disciplinas que forman al futuro profesional, generando actitudes responsables el medio ambiente.

This paper presents a didactical conception to develop the ethical-environmental aspect within the education of professionals. It provides students with an integrated general culture, according to their appropriation of conceptual, cognitive, affective and behavioral elements of present circumstances. The proposal allows the incorporation of environmental concepts into the disciplines that form future professionals, which generates responsible attitude towards the environment.

[Nephron sparing surgery for the treatment of renal carcinoma in a functioning graft: case report]. / Cirugia conservadora de cancer renal en injerto funcionante: a proposito de un caso.

OBJECTIVE: We present nephron sparing renal surgery as a therapeutic option for the conservative treatment of renal cancer by reporting one case of de novo renal cell carcinoma (RCC) presenting in a functioning renal graft. METHODS/RESULTS: We describe one case of de novo RCC presenting in a functioning renal graft 51 months after transplantation. Tumorectomy was carried out with a margin of normal parenchyma and the base was free of tumor. Definitive pathologic study showed type I papillary renal cell carcinoma, Fuhrman grade 2, pathological stage I with free margins. There were not post operative complications and immunosuppression therapy was not modified. After almost three years of follow-up there is no evidence of tumor recurrence and an adequate renal function. CONCLUSIONS: Renal graft RCC is rare. Conservative surgery in selected patients may be a safe and effective technique when the tumor appears in a functioning graft, because it offers good oncological control and preserves renal function, avoiding transplant nephrectomy and the need of haemodialysis.

[En bloc transplantation of pediatric donor kidneys to adult receptors]. / Trasplante en bloque de riñones procedentes de donantes pediatricos en receptores adultos.

OBJECTIVES: Analysis of all pediatric donor en bloc transplants to adult receptors performed in our department. METHODS: Retrospective analysis of 73 en bloc kidney transplants and 497 adult transplants performed in our centre from 1990 to 2004. Mean follow-up was 50.23 months (10.18-89.05 months). All patients received the same immunosuppression, although it evolved with time. RESULTS: There were significant differences in terms of nonfunctioning kidneys and delayed graft function, more frequent in pediatric en bloc and adult transplants, respectively. Pediatric kidneys provided better renal function and less proteinuria. Patient and graft survivals were similar in both groups. One and five-year graft survivals were 83.56% and 8 1.47% for pediatric donor kidneys, and 91.50% and 86.99% for adult donor kidneys. Vascular complications were the most frequent cause of graft loss for the en bloc transplants. CONCLUSIONS: Pediatric donor en bloc transplants have an excellent survival and function in the middle and long-term. Vascular complications are the main cause of pediatric donor graft loss. The adoption of a pediatric donor en bloc transplant program increases the transplant activity.

Los niveles de asimilación y niveles de desempeño cognitivo.: Reflexiones / Assimilating Levels and cognitive proficiency levels.: Reflections on these issues

El empleo de la categoría niveles de desempeño ha generado en la práctica pedagógica no pocas polémicas en torno a los grados de similitud y diferenciación con respecto a los ya conocidos niveles de asimilación del contenido, por consiguiente, ofrecer algunas reflexiones sobre esta relación constituye el propósito fundamental del presente trabajo. En el artículo se analizan consideraciones generales sobre los tres niveles de asimilación por los cuales transita el tratamiento del contenido en el proceso de enseñanza aprendizaje de los escolares. Se realiza una contraposición con la categoría niveles de desempeño cognitivo para evaluar el grado de excelencia con que deben manifestarse los conocimientos, las habilidades y las capacidades y se brindan valoraciones sobre la diferenciación entre ambas categorías y sus respectivos alcances en el marco del proceso de enseñanza- aprendizaje.

The use of acting level category has generated inn the pedagogic practice lots of controverses around the similarity and differentiation degrees regarding to the assimilations levels of content already known, consequently, to offer some reflections on this relationships is the main purpose of the present work. This article analyses general considerations on the three levels of assimilation through which the treatment of the content in the students´ learning-teaching process goes. It is carried out an opposition to the actingº level category to evaluate the excellence degree with which they should show knowledge, the abilities and capacities, and valuations are offered about the differentiation between both categories and their respective range in the frame of the learning-teaching process.