Residents' Perspectives of Pregnancy and Growing a Family During Surgical Training: A Review of the Literature.

As more female surgical residents choose to start families during training, concerns regarding program support and peer perceptions emerge. Delayed parenthood, stress, and even attrition can result from inadequate support systems. Database search (MEDLINE, PubMed, EMBASE) in June 2022 identified 17 relevant studies published between 2012-2022, including systematic reviews and qualitative surveys, focused on surgical residents/fellows and program directors. The thematic analysis explored themes related to supporting residents navigating parenthood. Thematic analysis of 17 studies (systematic reviews and qualitative surveys with residents/fellows and program directors) identified key recurring themes related to challenges experienced by surgical residents navigating parenthood. The themes included modified work schedules, mentorship programs, cross-coverage plans, lactation support, childcare options, and clear leave policies. By understanding these challenges and implementing tailored support strategies, surgical residency programs can foster a more inclusive and supportive environment for residents starting families. This can improve resident well-being, reduce attrition, and create a significantly more enjoyable training experience for all involved. This review aims to provide insight into residents' difficulties while pregnant or considering pregnancy and identify changes programs could implement to promote a more supportive culture for pregnant residents.

FAIR EVA: Bringing institutional multidisciplinary repositories into the FAIR picture.

The FAIR Principles are a set of good practices to improve the reproducibility and quality of data in an Open Science context. Different sets of indicators have been proposed to evaluate the FAIRness of digital objects, including datasets that are usually stored in repositories or data portals. However, indicators like those proposed by the Research Data Alliance are provided from a high-level perspective that can be interpreted and they are not always realistic to particular environments like multidisciplinary repositories. This paper describes FAIR EVA, a new tool developed within the European Open Science Cloud context that is oriented to particular data management systems like open repositories, which can be customized to a specific case in a scalable and automatic environment. It aims to be adaptive enough to work for different environments, repository software and disciplines, taking into account the flexibility of the FAIR Principles. As an example, we present DIGITAL.CSIC repository as the first target of the tool, gathering the particular needs of a multidisciplinary institution as well as its institutional repository.

Adenocarcinoma of the Breast Presenting as Occult Breast Cancer With Axillary and Supraclavicular Lymph Node Metastasis: A Case Report.

Breast cancer is a leading cause of cancer-related mortality in women, with over 250,000 new cases diagnosed annually in the United States. Although mortality rates have decreased, breast cancer remains the second most common cause of cancer death in women. Occult breast cancer (OBC), a rare form of breath cancer that typically presents as axillary lymphadenopathy with no evidence of primary disease, accounts for less than 1% of all breath cancer diagnoses. To date, only three cases of OBC treated with radical mastectomy have been documented in the literature. This case presents a 76-year-old female with a benign left breast mass who was subsequently diagnosed with metastatic estrogen receptor/progesterone receptor (ER/PR)-positive ductal cell breast carcinoma after a visible axillary lymph node was detected on follow-up imaging. Due to the rarity of OBC, standardized treatment guidelines have not been established. Our patient underwent a left radical mastectomy with axillary and cervical lymph node dissection. Clinicians should maintain a high index of suspicion for biopsying axillary lymph nodes in females without evidence of breast malignancy, even though OBC has a low incidence rate. This case report aims to present a documented case of OBC and comprehensibly review the existing literature, discussing the available diagnostic and treatment approaches for this condition. We describe the case of a 76-year-old woman referred to surgery consultation due to a mammographic finding of a left superior lateral mass. The mass was biopsied and found to have no malignancy. On follow-up imaging, she was found to have a left axillary lymph node visible. Her only complaints at this time were breast tenderness and swelling. She underwent fine needle aspiration of the mass, which showed atypical cells that led to an excisional biopsy of the detected axillary node. The biopsy pathology report showed ER/PR-positive ductal cell breast carcinoma. The patient underwent left modified radical mastectomy with left axillary and cervical lymph node dissection. It was during this procedure that the pathology report revealed a 2 cm lesion on the left breast that showed ER/PR-positive infiltrating ductal carcinoma with 32 out of the 37 lymph nodes positive for metastatic disease. This case illustrates the importance of having a low imaging threshold in patients with vague breast symptoms. Surgeons should have a high level of suspicion when metastatic breast cancer is found, even if there is no clinical or radiographic evidence of a primary lesion. This includes conducting lymph node biopsies in patients who present with lymphadenopathy without the initial presence of primary breast cancer. Many studies agree that a modified radical mastectomy with lymph node recession is the treatment of choice for metastatic breast cancer without evidence of primary lesion. However, the efficacy of adjuvant treatments like radiation therapy or chemotherapy should be further studied.

A Scoping Review of the Impact of COVID-19 on Kidney Transplant Patients in the United States.

SARS-CoV-2, responsible for the COVID-19 pandemic, is a highly infectious virus that quickly became and continues to be a public health emergency, given the severe international implications. Immunocompromised patients, such as those undergoing kidney transplantation, are at an increased risk for severe illness from COVID-19 and require hospitalization for more aggressive treatment to ensure survival. COVID-19 has been infecting kidney transplant recipients (KTRs), affecting their treatment protocols, and threatening their survival. The objective of this scoping review was to summarize the published literature regarding the impact of COVID-19 on KTRs in the United States in terms of prevention, various treatment protocols, COVID-19 vaccination, and risk factors. The databases such as PubMed, MEDLINE/Ebsco, and Embase were used to search for peer-reviewed literature. The search was restricted to articles that were published on KTRs in the United States from January 1, 2019, to March 2022. The initial search yielded 1,023 articles after removing duplicates, leading to a final selection of 16 articles after screening with inclusion and exclusion criteria. Four domains emerged from the review: (1) impacts of COVID-19 on performing kidney transplants, (2) impacts of COVID-19 vaccinations on KTRs, (3) outcomes of treatment regiments for KTRs with COVID-19, and (4) risk factors associated with an increased mortality rate of COVID-19 in KTRs. Waitlisted patients for kidney transplants had a higher risk of mortality compared to nontransplant patients. COVID-19 vaccinations in KTRs are found to be safe, and the immune response can be improved by placing patients on a low dose of mycophenolate before vaccination. Withdrawal of immunosuppressants showed a mortality rate of 20% without increasing the rate of acute kidney injury (AKI). There is evidence to support that kidney transplantation with the accompanying immunosuppressant regimen can provide KTRs with better COVID-19 infection outcomes compared to waitlisted patients. Hospitalization, graft dysfunction, AKI, and respiratory failure were the most common risk factors that increased the risk of mortality in COVID-19-positive KTRs. Withdrawing KTRs from immunosuppressive drugs increased the mortality rate. Further studies are needed to investigate the effects of specific drugs and dosages on the severity and mortality rate of COVID-19 in KTRs.

Component Separation: A Case Report of Hybrid and Synthetic Absorbable Mesh Use for Complex Large Ventral Hernia Reparation.

Ventral abdominal hernias are a common abdominal wall defect in the United States. We present a 50-year-old Caucasian male with a large (>18 cm) abdominal wall defect. An extensive complex abdominal wall reconstruction with advanced bilateral fascial flaps/component separation and repair of the abdominal wall defect was planned to restore the appropriate abdominal wall anatomic contour. The use of double mesh in large abdominal wall defects is still a relatively new documented technique. Only two case series detail the same technique used on this patient, with no articles on using a hybrid mesh with a synthetic absorbable mesh. This case uses an underlay and onlay mesh technique, with a hybrid mesh, Tela Biologics (Malvern, PA, USA), under the muscle, in this case, intraperitoneal bridging the gap. The anterior rectus sheath was reinforced with intercepted 0-Ethibond sutures (Ethicon/J&J, Bridgewater, NJ, USA) and then reinforced with a synthetic absorbable mesh (PhasixTM, Becton Dickinson, Franklin Lakes, NJ). The outcome with this patient shows more research should be conducted on considering long-term results with the types of mesh and the question of whether there are additional benefits when using two different types of mesh and their placement in the sandwich technique.

Oral Microbiome as a Tool of Systemic Disease on Cleft Patients: A New Landscape.

The oral cavity microbiome comprises benign and pathogenic bacteria, with more than 700 species identified. However, the current literature regarding resident bacterial flora in the oropharyngeal cavities in cleft lip/palate (CLP) patients still needs to be completed. This review aims to evaluate the role of the oral microbiome of cleft patients as an indicator in systemic diseases for which cleft patients might be at higher risk in the short or long term. A literature review was performed in July 2020 using Biomedical Reference Collection Comprehensive, Cumulative Index to Nursing and Allied Health Literature (CINAHL) Complete, Dentistry & Oral Sciences Source via Elton B. Stephens Company/Online Database (EBSCO), Turning Research into Practice (TRIP), and PubMed. The keywords used were "oral, bacteria, microbiome, biota, flora, cleft, palate." The resulting 466 articles were deduplicated using Endnote. The total amount of articles' abstracts without duplicates was filtered using a set criterion. The title and abstract filter criteria included 1) cleft lip (CL) and/or cleft palate (CP) patients, 2) changes in the oral microbiome in CL and/or CP patients, 3) male and female patients 0-21 years old, and 4) English language. The full-text filter criteria included 1) CL and/or CP patients vs. non-cleft control patients, 2) oral bacteria, 3) nonprocedural measurements of microorganisms, and 4) case-control studies. A Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) flow chart was created using the EndNote data results. The final five articles of the systematic search indicated that the oral cavity of cleft lip and/or palate patients resulted in 1) contradicting levels of Streptococcus mitis and Streptococcus salivarius; 2) lower levels of Streptococcus gordonii, Bordetella dentium, Fusobacterium nucleatum, Veillonella parvula, Bacillus and Lautropia when compared to the control group; 3) higher levels of Staphylococcus epidermidis and Methicillin-sensitive Staphylococcus aureus compared to the control group; 4) presence of Enterobacter cloacae 36.6%, Klebsiella pneumoni 53.3%, and Klebsiella oxytoca 76.6% vs. absence in the control non-cleft group. Patients with CL and/or CP are at higher risk for caries, periodontal diseases, and upper and lower respiratory infections. The results from this review indicate that relative levels of certain bacteria may be associated with these issues. The lower levels of S. mitis, S. salivarius, S. gordini, and F. nucleatum in the oral cavity of cleft patients could be linked as a possible cause of the higher incidence of tooth decay, gingivitis and periodontal disease as high levels of these bacteria are associated with oral disease. Further, the higher incidence of sinusitis in cleft patients might be linked to low levels of S. salivarius in the oral profile of these patients. Likewise, E. cloacae, K. oxycota, and K. pneumoni have been linked with pneumonia and bronchiolitis, both of which are increased in cleft patients. The oral bacterial dysbiosis of cleft patients observed in this review may play a vital function in the oral microbiome's diversity, which could play a role in disease progression and disease markers. The pattern seen in cleft patients potentially demonstrates how structural abnormalities can lead to the onset of severe infection.

Reducing adverse impacts of Amazon hydropower expansion.

Proposed hydropower dams at more than 350 sites throughout the Amazon require strategic evaluation of trade-offs between the numerous ecosystem services provided by Earth's largest and most biodiverse river basin. These services are spatially variable, hence collective impacts of newly built dams depend strongly on their configuration. We use multiobjective optimization to identify portfolios of sites that simultaneously minimize impacts on river flow, river connectivity, sediment transport, fish diversity, and greenhouse gas emissions while achieving energy production goals. We find that uncoordinated, dam-by-dam hydropower expansion has resulted in forgone ecosystem service benefits. Minimizing further damage from hydropower development requires considering diverse environmental impacts across the entire basin, as well as cooperation among Amazonian nations. Our findings offer a transferable model for the evaluation of hydropower expansion in transboundary basins.

Uptake and Retention of Nanoplastics in Quagga Mussels.

Here, a set of experiments to assess the feasibility of using an invasive and widespread freshwater mussel (Dreissena rostrformis bugensis) as a sentinel species for nanoplastic detection is reported. Under laboratory experimental conditions, mussels ingest and retain fluorescent polystyrene (PS) beads with carboxylic acid (-COOH) termination over a size range of 200-2000 nm. The number of beads the mussels ingested is quantified using fluorescence spectroscopy and the location of the beads in the mussels is imaged using fluorescence microscopy. PS beads of similar size (1000-2000 nm) to mussels' preferred food are trafficked in the ciliated food grooves of the gills. Beads of all sizes are observed in the mussels' digestive tracts, indicating that the mussels do not efficiently reject the beads as unwanted foreign material, regardless of size. Fluorescence microscopy shows all sizes of beads are concentrated in the siphons and are retained there for longer than one month postexposure. Combined atomic force microscopy-infrared spectroscopy and photothermal infrared spectroscopy are used to locate, image, and chemically identify the beads in the mussel siphons. In sum, these experiments demonstrate the potential for using mussels, specifically their siphons, to monitor environmental accumulation of aquatic nanoplastics.

Immune Monitoring of Human Mucosal-Associated Invariant T Cells by Quantitative Proteomics.

Molecular phenotypes of mucosal-associated invariant T (MAIT) cells are correlating with individual susceptibilities and outcomes in human diseases. Quantitative proteome strategies can examine such variations in the functional and druggable inventory of MAIT cells comprehensively, but protocols for the support of translational and clinical studies are still rare. Here, we describe a protocol in which MR1-restricted MAIT cells were isolated from blood donations by FACS and are then characterized by quantitative proteomics (iTRAQ-LC-MS/MS) to complement information about their unique effector phenotype and to investigate donor-/patient- or disease-specific variations in protein networks with high precision.

Cathepsin K inhibition preserves compressive load in lumbar vertebrae of osteoporotic monkeys.

Anti-resorptive drugs treat bone loss by blocking osteoclast activity through a variety of mechanisms of action. Once significant bone loss has occurred, the ability to restore biomechanical function may differ based on the drug chosen. To assess this question, bisphosphonate (alendronate, ALN) and cathepsin K inhibitor (MK-0674, CatKi) were employed in treatment mode to compare the relative changes to cancellous bone microstructure and mechanical properties in ovariectomized (OVX) cynomolgus monkeys. Lumbar vertebrae (LV) bone mineral density (BMD) values taken two years post-surgery prior to drug treatment show a 10-15% decrease (p < 0.05) for all OVX animals. OVX animals were then treated with vehicle (VEH), ALN (0.03 mg/kg weekly), or CatKi MK-0674 (0.6 or 2.5 mg/kg daily, CatKi-L and H respectively) for two years and compared to a control Sham surgery group. Ex-vivo microcomputed tomography (µCT) of LV2 and compression testing of LV4-6 were used to measure cancellous bone microstructure and changes in bone mechanics, respectively. After two years of treatment, ALN-treated animals showed no significant difference in µCT or biomechanical parameters when compared to Veh. However, treatment with CatKi-H resulted in a 30% increase in yield and peak loads, and apparent peak and yield stress as compared to Veh (p < 0.05) and gave average mechanical values greater than the Sham sample. Treatment with CatKi-L exhibited a similar trend of increase to CatKi-H (p < 0.08). Intriguingly, these changes were realized despite no significant differences in mean values of trabecular bone morphologic parameters. Together these data suggest matrix-level changes in bone composition that are unique to the CatK inhibition mechanism, resulting in the preservation of bone compressive load with treatment.

Clostridioides difficile Activates Human Mucosal-Associated Invariant T Cells.

Clostridioides difficile infection (CDI) causes severe inflammatory responses at the intestinal mucosa but the immunological mechanisms underlying CDI-related immunopathology are still incompletely characterized. Here we identified for the first time that both, non-toxigenic strains as well as the hypervirulent ribotypes RT027 and RT023 of Clostridioides difficile (formerly Clostridium difficile), induced an effector phenotype in mucosal-associated invariant T (MAIT) cells. MAIT cells can directly respond to bacterial infections by recognizing MR1-presented metabolites derived from the riboflavin synthesis pathway constituting a novel class of antigens. We confirmed functional riboflavin synthesis of C. difficile and found fixed bacteria capable of activating primary human MAIT cells in a dose-dependent manner. C. difficile-activated MAIT cells showed an increased and MR1-dependent expression of CD69, proinflammatory IFNγ, and the lytic granule components granzyme B and perforin. Effector protein expression was accompanied by the release of lytic granules, which, in contrast to other effector functions, was mainly induced by IL-12 and IL-18. Notably, this study revealed hypervirulent C. difficile strains to be most competent in provoking MAIT cell responses suggesting MAIT cell activation to be instrumental for the immunopathology observed in C. difficile-associated colitis. In conclusion, we provide first evidence for a link between C. difficile metabolism and innate T cell-mediated immunity in humans.

Proteomic definition of human mucosal-associated invariant T cells determines their unique molecular effector phenotype.

Mucosal-associated invariant T cells (MAIT) constitute the most abundant anti-bacterial CD8+ T-cell population in humans. MR1/TCR-activated MAIT cells were reported to organize cytotoxic and innate-like responses but knowledge about their molecular effector phenotype is still fragmentary. Here, we have examined the functional inventory of human MAIT cells (CD3+ Vα7.2+ CD161+ ) in comparison with those from conventional non-MAIT CD8+ T cells (cCD8+ ) and NK cells. Quantitative mass spectrometry characterized 5500 proteins of primary MAIT cells and identified 160 and 135 proteins that discriminate them from cCD8+ T cells and NK cells donor-independently. Most notably, MAIT cells showed a unique exocytosis machinery in parallel to a proinflammatory granzyme profile with high levels of the granzymes A, K, and M. Furthermore, 24 proteins were identified with highest abundances in MAIT cells, including CD26, CD98, and L-amino-oxidase (LAAO). Among those, expression of granzyme K and CD98 were validated as MAIT-specific with respect to non-MAIT CD8+ effector subsets and LAAO was found to be recruited together with granzymes, perforin, and CD107a at the immunological synapse of activated MAIT cells. In conclusion, this study complements knowledge on the molecular effector phenotype of MAIT cells and suggest novel immune regulatory functions as part of their cytotoxic responses.

The Relationship of Collagen Structural and Compositional Heterogeneity to Tissue Mechanical Properties: A Chemical Perspective.

Collagen is the primary protein component in mammalian connective tissues. Over the last 20 years, evidence has mounted that collagen matrices exhibit substantial heterogeneity in their hierarchical structures and that this heterogeneity plays important roles in both structure and function. Herein, an overview of studies addressing the nanoscale compositional and structural heterogeneity is provided and connected to work exploring the mechanical implications for a number of tissues.

Estructura factorial, confiabilidad y validez de la prueba de percepción del funcionamiento familiar en adultos angolanos / Factor-related structure, reliability and validity of the perception test of family functioning in Angolan adults

Introducción: la familia constituye el espacio por excelencia para el desarrollo del hombre, en el contexto es necesario angolano la existencia de pruebas validadas que permitan su evaluación. Objetivo: validar la Prueba de Percepción del Funcionamiento Familiar para la población angolana. Método: se efectuó un estudio instrumental, bajo un paradigma cuantitativo, con una muestra de 326 sujetos seleccionados aleatoriamente. El procesamiento de datos se llevó a cabo mediante el paquete estadístico SPSS/Windows 21.0, aplicándose el coeficiente Alpha de Crombach y el Análisis Factorial Exploratorio. Resultados: se reveló el ajuste a un solo factor de la prueba que explicó el 36,52 por5 ciento de la varianza acumulada, además de excelentes comunalidades y una elevada consistencia interna. Conclusiones: puede afirmarse que la prueba posee adecuadas propiedades psicométricas, permitiendo la evaluación del constructo funcionamiento familiar en la población angolana(AU)

Introduction: The family constitutes the space per excellence for the man's development; in the Angolan context, the existence is necessary of validated tests that permit its assessment. Objective: Validate the perception test of family functioning for the Angolan population. Methods: An instrumental study with a qualitative paradigm was carried out on a sample of 326 individuals randomly chosen. Data processing was performed using the statistical package SPSS in Windows 21.0, applying the Cronbach's Alpha and exploratory factor analysis. Results: An adjustment to one factor only was shown for the test, which explained the 36.52 percent of accumulated variance, as well as excellent communalities and a high internal consistency. Conclusions: We can affirm that the test has adequate psychometric properties, which permits assessing the family functioning construct in the Angolan population(AU)

Lake Spray Aerosol: A Chemical Signature from Individual Ambient Particles.

Aerosol production from wave breaking on freshwater lakes, including the Laurentian Great Lakes, is poorly understood in comparison to sea spray aerosol (SSA). Aerosols from freshwater have the potential to impact regional climate and public health. Herein, lake spray aerosol (LSA) is defined as aerosol generated from freshwater through bubble bursting, analogous to SSA from seawater. A chemical signature for LSA was determined from measurements of ambient particles collected on the southeastern shore of Lake Michigan during an event (July 6-8, 2015) with wave heights up to 3.1 m. For comparison, surface freshwater was collected, and LSA were generated in the laboratory. Single particle microscopy and mass spectrometry analysis of field and laboratory-generated samples show that LSA particles are primarily calcium (carbonate) with lower concentrations of other inorganic ions and organic material. Laboratory number size distributions show ultrafine and accumulation modes at 53 (±1) and 276 (±8) nm, respectively. This study provides the first chemical signature for LSA. LSA composition is shown to be coupled to Great Lakes water chemistry (Ca(2+) > Mg(2+) > Na(+) > K(+)) and distinct from SSA. Understanding LSA physicochemical properties will improve assessment of LSA impacts on regional air quality, climate, and health.

Particularidades del afrontamiento familiar al niño con diagnóstico y rehabilitación por parálisis cerebral / Particularities of the family coping with a child diagnosed as cerebral palsy patient and under rehabilitation

Introducción: la parálisis cerebral es considerada la primera causa de invalidez en la infancia, afecta la organización familiar y la inserción social. Requiere rehabilitación prolongada y una intensa labor de cuidados para mejorar la calidad de vida del menor. Objetivo: describir las particularidades del afrontamiento familiar ante el diagnóstico y rehabilitación de niños con parálisis cerebral. Métodos: estudio descriptivo transversal de tipo cualitativo. La unidad de análisis fue la familia. Se realizaron entrevista en profundidad a familiares de los pacientes, niños 0 a 4 años de edad ingresados en el Hospital de Rehabilitación Julio Díaz González en el 2013. Se indagó el comportamiento familiar ante el diagnóstico de la enfermedad y el proceso de rehabilitación. Para el procesamiento de datos se empleó el enfoque de análisis en progreso de Taylor-Bogdan. Resultados: las regularidades establecidas a partir de las configuraciones emergentes especificaron el afrontamiento a la enfermedad de las familias estudiadas: duda, búsqueda de información, esfuerzo familiar, contradicciones en la reorganización de la vida en el hogar, demanda de apoyo y agotamiento familiar. Conclusiones: el afrontamiento familiar está transversalizado por un eje motivacional. El balance familiar, entre las expectativas de mejora de la situación de salud del niño, su lenta evolución en el proceso de rehabilitación y el sobreesfuerzo que representa enfrentar la discapacidad del menor en el contexto de la vida cotidiana, provoca el tránsito gradual desde un afrontamiento familiar motivado a uno desmotivado. Tal comportamiento potencializa una acción destructiva en la salud del grupo familiar(AU)

Introduction: cerebral palsy is considered as the first cause of disability in childhood, but it also affects family organization and social insertion. It requires rehabilitation for long time and intensive care to improve the quality of life of a child. Objective: to describe the particularities of the family coping with the child diagnosed as cerebral palsy patient under rehabilitation. Methods: qualitative-type descriptive and cross-sectional study in which the unit of analysis was the family. In-depth interviews were made to families of patients aged 0 to 4 years, who were admitted to "Julio Diaz Gonzales" rehabilitation hospital in 2013. The family behaviors in facing the diagnosis of the disease and the process of rehabilitation were ascertained. For the data processing, the Taylor-Bogdam's in-progress analysis approach was used. Results: the set regularities from the emerging configurations characterize the family coping with the disease: doubts, search for information, family efforts, contradictions in family life reorganization at home, demand for support, family worn-out. Conclusions: the family coping is being crossed by a motivational axis. The family balance, the expectations for improvement of the child's health situation, the slow progress of the rehabilitation process and the extreme efforts that are needed to face the disability of a child in everyday life brings about the gradual transition from motivated to demotivated family coping. This behavior potentiates harmful actions affecting the health of the family group(AU)

Bosquejo del desarrollo de la psicología y su relación con la salud en Cuba 1900-1958 / Outline of psychology development and its relationships with health in Cuba in the 1900-1958 period

El objetivo de este trabajo es describir algunos antecedentes de la psicología en Cuba relacionados con la salud. Se utilizaron los métodos heurístico, hermenéutico y de la historia crítica; la consulta de fuentes primarias y secundarias de información así como testimonios de los autores. Se consultó bibliografía en bibliotecas públicas y privadas, hemerotecas, centros de información y en Internet. Se obtuvo una descripción documentada y crítica de los orígenes de la psicología y su relación con la salud en Cuba durante el periodo de 1900-1958, los escenarios de formación, algunos profesionales destacados en lo científico y lo político así como las teorías y explicaciones del papel de lo psicológico en la determinación de la salud, la afiliación a paradigmas de las ciencias, publicaciones, los primeros puntos de encuentro de la psicología o de los psicólogos relacionados con la salud en Cuba así como los inicios de la enseñanza de la psicología hasta la fundación de las primeras escuelas. Se concluye que existió un determinado nivel de desarrollo de la psicología clínica y psicopedagógica en el periodo estudiado, que predominó el positivismo como concepción teórica aunque existieron algunos críticos a esta corriente y al mercantilismo en la salud, proveniente de la influencia norteamericana durante la república mediatizada. Las personalidades relevantes descritas posibilitaron la posterior formación masiva de psicólogos que constituyen antecedentes del surgimiento de la psicología de la salud en Cuba en la década de los 60 del siglo XX(AU)

The objective of this paper is to describe some antecedents of psychology related to health in Cuba. The heuristics, hermeneutic and critical history methods were used in addition to consulting primary and secondary data sources and authors´ testimonies. Bibliography found in public and private libraries, newspaper and periodical archives, information centers and Internet was reviewed. There was obtained documented critical description of the origins of psychology and its relationship with health in Cuba in the 1900-1958 period, the formative settings, some outstanding professionals in the scientific and the political fields as well as theories and explanations about the role of the psychological elements in determination of health, about the affiliation to paradigms of sciences; publications, the first points of meeting of psychology and of psychologists related to health in Cuba, and the beginning of psychology teaching in Cuba until the foundation of the first schools. It was concluded that there was certain level of development of clinical and psychopedagogic psychology in the studied period when positivism prevailed as a theoretical concept, although there were some people who criticized this trend and health mercantilism as a result of the US influence before 1959. The outstanding personalities described in this paper made the subsequent massive formation of psychologists possible, which represent antecedents of the emergence of health psychology in Cuba in the 60´s of the 20th century(AU)

Principales características psicosociales de adolescentes con intento suicida / Major Psychosocial Characteristics of Adolescents with Suicide Attempt

Introducción: la investigación sobre el intento suicida en la adolescencia reviste mayor importancia, por la inmadurez, vulnerabilidad psicológica y las particularidades de la relación familiar. Objetivo: describir el acto suicida y las características socio familiares y psicológicas de los adolescentes que intentaron contra su vida. Métodos: se realizó estudio descriptivo transversal con los 23 adolescentes atendidos por intento suicida en el Centro de Salud Mental de Playa Baracoa, Artemisa, en el período 2008 ­ 2011. Se utilizaron las técnicas: entrevista semiestructurada, encuesta de declaración obligatoria para el intento suicida, inventario de problemas juveniles, una composición sobre "Mi mayor problema", la prueba de percepción de funcionamiento familiar FF ­ SIL y el inventario de ansiedad y depresión rasgo - estado para niños y adultos. Se contó con el consentimiento informado, se respetó la confidencialidad de la información, la privacidad y el anonimato. Resultados: el método más utilizado por los adolescentes para el intento suicida fue la ingestión de medicamentos combinados y no abundó la recurrencia del acto. La frecuencia mayor fue en las adolescentes mujeres, de piel blanca, entre los 16 y 19 años que proyectaron subvaloración, marcada ansiedad y depresión; viven en áreas urbanas con bajos ingresos económicos, en malas condiciones materiales de la vivienda, en familias reconstituidas y disfuncionales(AU)

Introduction: Researching on adolescent suicide attempt is of greater importance due to immaturity, psychological vulnerability, and the peculiarities of family relationship. Objective: Describe the suicidal act, family and socio- psychological characteristics of those adolescents who attempted on their life. Methods: a descriptive study was conducted with 23 adolescents treated for suicide attempt at the Mental Health Center in Playa Baracoa, Artemisa, from 2008 to 2011. Several techniques were used such as semi-structured interview, survey for notifiable to the suicide attempt, a short essay on "My biggest problem", test of family functioning perception FF ­ SIL, and inventory on trait anxiety and depression - state for children and adults. Informed consent was obtained. Confidentiality of information, privacy and anonymity was respected. Results: the method mostly used by adolescents for their suicidal attempt was combined ingestion of drugs and it did not elaborate recurrence of the act. The highest frequency was in white-skinned adolescent women, aging 16 and 19 who projected undervaluation, marked anxiety, and depression; they live in urban areas with low income, poor housing conditions, reconstituted and dysfunctional families(AU)

Implicaciones familiares y sanitarias del envejecimiento poblacional en la cobertura universal / Familial and health implications of the population aging for the universal health coverage

El movimiento de cobertura sanitaria universal llama la atención a los gobiernos del mundo, sobre el derecho a la salud para todos los estratos sociales y los grupos más vulnerables. El objetivo es examinar las implicaciones familiares y sanitarias del proceso de envejecimiento de la población cubana que constituyen desafíos para el sostenimiento de la cobertura de salud con calidad. Se hizo análisis e interpretación crítica de indicadores de salud seleccionados y de resultados de investigaciones revisadas. Resultados. Las políticas de salud, los logros que ilustran los indicadores de salud en Cuba, dan cuenta de las fortalezas de la CSU en Cuba, y de la protección a la salud del adulto mayor. El proceso de envejecimiento poblacional tiene serias implicaciones a la sociedad, al sistema de salud y a la familia. La prolongación de la vida, el incremento de la morbilidad y la discapacidad, unido a las políticas de equidad y justicia social, elevan las demandas de atención a los ancianos en el hogar y la necesidad de servicios. No obstante, la voluntad política, ciertas condiciones sociales, económicas y organizativas, rebasan la capacidad resolutiva del sistema de salud y de la asistencia social que requieren las personas de edad avanzada, lo que genera desafíos importantes para mantener la cobertura con calidad, la sostenibilidad del sistema y la satisfacción de los usuarios y sus familias(AU)

The universal health coverage movement appeals to the governments of the world to recognize the right to health for all the social strata and for the most vulnerable groups. The objective of the paper was to examine the familial and health implications of the Cuban population aging that represent real challenges for the sustainability of the quality health coverage. Critical analysis and interpretation of the selected health indicators and of the results of reviewed research studies were made. The health policies and the achievements shown in the health indicators of Cuba prove the advances in terms of the universal health coverage and protection of the older adult's health. The population aging process has serious implications for the society, the health system and the family. Longer lifespan, increase of morbidity and disability rates together with the equity and social justice policies raise the demands for care of the elderly at home and for services. Despite the political willingness of the government, certain economic, social and organizational conditions exceed the capacities of the health system to find solutions for and the social assistance required by the aged persons, which creates huge challenges to keep quality coverage, sustainability of the system and the meeting of requirements from the users and their families(AU)