Plan de formación y docencia en un centro integral de cáncer: estrategia e implementación / Continuing education and teaching plans in a comprehensive cancer centre: strategy and implementation

Introducción. El Institut Català d’Oncologia (ICO) puso en marcha la Unidad de Formación y Docencia (UFiD), en el año2006, con el objetivo de potenciar el desarrollo profesional, la difusión del conocimiento y la calidad de la atención oncológica. En el presente artículo se describe el proceso de puesta en marcha de la UFiD, los resultados del estudio de las necesidades formativas realizada por los profesionales y colectivos de la institución, las acciones formativas organizadas, y en el área de docencia, los resultados de la reorganización de las trayectorias docentes de los diferentes servicios, así como el apoyo de nuevas iniciativas. Materiales y métodos. Durante el periodo 2008-2009, se implantaron acciones formativas y docentes en concordancia con los resultados del estudio de necesidades y con las líneas estratégicas de la institución. Se realizaron un total de 71actividades formativas, con 898 participantes de todas las categorías profesionales, con una tasa de satisfacción de los participantes de 7,8 sobre 10. En el apartado de docencia, durante el mismo periodo se realizaron 3 másteres, 3 posgrados,59 cursos de actualización con metodología semipresencial y 19 cursos con metodología online, todos ellos con acreditación académica. La satisfacción media fue de 8 sobre 10.Resultados y conclusiones. La actividad llevada a cabo por la UFiD ha permitido, por una parte, articular la formación continuada en base al estudio de las necesidades de los profesionales, lo que ha contribuido a promover el desarrollo profesional y la calidad asistencial de éstos, y por otra parte, dar soporte a las actividades docentes ya existentes y promover nuevas iniciativas para favorecer la difusión de conocimientos en el área oncológica, lo que ha posicionado al ICO como un centro absolutamente comprometido con la formación oncológica (AU)

Introduction. The Oncology Catalonian Institute (ICO) launched the training and education unit (UFiD) in 2006, in order to enhance professional development, dissemination of knowledge and quality of the oncology care. Here are described the tune-up of this process and the results of the training needs survey carried out among the professionals and collectives of the centre. Materials and methods. Training and educational actions deployed during 2008 and 2009 and its evaluation results are presented. A total of 60 training activities were carried out in which 719 students of all professional categories participated, and with a score of participant’s satisfaction of 7.8 out of 10. In the area of education, the paths of the different services were reorganized and new initiatives were supported. A total of 3 masters, 3 post-graduate degrees, 59 update courses with semi-presential (blended learning) methodology and 19 on-line methodology courses, all of them with academicaccreditation were imparted with a satisfaction average score of 8 out of 10.Results and conclusions. The activity carried out by the UFiD during this period, has made possible to articulate the continuing training based on the study of the professionals needs. This has allowed promoting the professional development and the quality of the care. Supporting existing training activities and promoting new initiatives encourage the dissemination of knowledge in the area of oncology and has positioned us as a centre committed to oncology training (AU)

PDA self-register system for eating disorders: a study on acceptability and satisfaction.

Self-monitoring techniques, such as the use of dietary registers, are considered to be central to cognitive-behavioral treatment of Eating Disorders (ED). This information allows the clinician to identify the triggers of the behaviors associated to ED as purges and/or binges, and the associated thoughts and emotions, helping to carry out a more accurate assessment. Traditionally these registers are made with paper and pencil mode, where the patient has to register every eating and the emotions/thoughts associated; but this system has some problems, as low portability, low adherence or methodological difficulties. The use of PDA for self-registers can help to solve these problems. The aim of this study is to study the levels of acceptability and satisfaction with PDAs self-register system specifically designed for assessment and treatment of ED. Samples of 30 subjects diagnosed with ED are receiving a PDA with software specifically designed for recording type and amount of food, emotions before and after eating and other behaviors. The participants are completing self-register daily during a week, and afterwards answer an acceptance and satisfaction questionnaire. This work is in progress at the moment. It is expected that the PDA system will show high levels of acceptance and satisfaction.

Study of the surface chemistry of modified carbon nanofibers by oxidation treatments in liquid phase.

Carbon nanofibers (CNF) were grown by thermocatalytic decomposition of methane. Their texture and surface chemistry were modified by different oxidation treatments with HNO3 at different concentrations or a mixture of HNO3-H2SO4 to optimise their ability of dispersing active metal particles, because this material will be used as electrocatalytic support for polymeric electrolyte fuel cells. The effect of liquid phase oxidation on the surface chemistry and the textural properties of the CNF was studied by temperature programmed desorption (TPD), scanning electron microscopy (SEM) and N2-physisorption. Moreover, their thermal stability was studied by temperature programmed oxidation (TPO). During oxidation treatments functional groups were created and their number was function of the oxidation treatment conditions. Results indicated that an increase in severity of the oxidation treatment produces an increase in the number of surface oxygen groups and in the thermal stability. However, a very severe treatment can destroy partially the structure of carbon nanofibers.

Characterization of carbon nanofibers grown over Ni and Ni-cu catalysts.

Carbon nanofibers were obtained by thermo-catalytic decomposition of methane at 700 degrees C over Ni and Ni-Cu catalysts prepared by different methods (co-precipitation, impregnation and fusion) and using either Al or Mg as textural promoter. Characterization of the carbon thus obtained was performed by N2 adsorption isotherms (BET surface area), temperature programmed desorption (TPD), temperature programmed oxidation (TPO), X-ray diffraction, Raman spectrometry, and electron microscopy SEM and TEM. The carbon obtained possesses high crystallinity and poor surface chemistry. The crystallinity is enhanced when using Mg as textural promoter and in the presence of copper. SEM and TEM examinations show that the fibers have fishbone structure and they grow generally from one nickel particle (tip growing) although there are some bidirectional growing. Copper-doping lead to the formation of thicker filaments and promotes the formation of bamboo-like structures. Catalyst particles higher than 100 nm do not promote the formation of nanofibers and the carbon deposits as uniform coatings.

Carbon nanofiber growth optimization for their use as electrocatalyst support in proton exchange membrane (PEM) fuel cells.

Carbon nanofiber (CNF) growth by catalytic decomposition of methane in a fixed-bed reactor was studied out to elucidate the influence of some important reaction conditions: temperature, space velocity and reactant partial pressure, in the morphological properties of the carbonaceous material obtained. The main objective is to synthesize a suitable carbonaceous nanomaterial to be used as support in platinum based electrocatalysts for Proton Exchange Membrane Fuel Cells (PEMFC) which improves current carbon blacks. High specific surface area is required in an electrocatalyst support since platinum dispersion is enhanced and so a cost-effective usage and high catalytic activity. Good electrical conductivity of carbon support is also required since the fuel cell power density is improved. With this proposal, characterization was carried out by nitrogen physisorption, XRD, SEM and TPO. The results were analysed by a factorial design and analysis of variance (ANOVA) in order to find an empirical correlation between operating conditions and CNF characteristics. It was found that the highest specific surface area and pore volume were found at 823 K and at a space velocity of 10 L gcat(-1) h(-1). The graphitic character of CNF, which is known to influence the electrical conductivity, presented a maximum value at temperatures between 923 K and 973 K. SEM images showed a narrow size distribution of CNF diameter between 40 and 90 nm and homogeneous appearance.

[Evaluation of health surveillance at several primary care units in Cuba]. / Evaluación de la vigilancia en salud en algunas unidades de atención primaria en Cuba.

BACKGROUND: The organization and operation of the epidemiological monitoring carried out at several Primary Care facilities in Cuba was assessed by means of a study conducted for the purpose of ascertaining the effectiveness of the monitoring in question and of contributing to further improve the mechanisms thereof and thus improve the health conditions of the population. This assessment was implemented at eight Polyclinics in the city of Havana throughout the 1998-1999 period. METHOD: By means of the implementation of an integral methodology, an assessment was made of the three factors involved in the monitoring system at the facilities in question, that is, the organization, the process and the results thereof. For this purpose, a survey which quantified some aspects of the system (sensitivity, opportunity, representativeness, usefulness) and a semi-structured survey of epidemiologists and other physicians involved in the monitoring in question in addition to the users of the system was used. RESULTS: The assessment of the organization revealed the monitoring organization to be adequate. In the assessment of the process, sensitivity was found to be low at some polyclinics, problems existing at many of them with regard to the opportunity and flexibility of the system. The assessment of the results of the monitoring revealed them to be satisfactory as regards their effectiveness for detecting acute events, as well as in the perception of the users with regard to the usefulness of these results for solving the problems pinpointed. CONCLUSIONS: The monitoring done at the polyclinics assessed is indicative of there being an adequate organization of the monitoring, although some shortcomings were found to exist with regard to the fulfillment of some aspects of the monitoring. This however has no bearing on the results for the system as a whole, which is capable of detecting any epidemiological situation of importance and of suggesting appropriate measures for controlling the situation.

[Evaluation of surveillance in primary health care: a methodological proposal]. / Evaluación de la vigilancia en la atención primaria de salud: una propuesta metodológica.

Given the development of public health, hygiene and epidemiology in Cuba and their linking with primary care, and particularly, the novel approach to health surveillance in its different implementation alternatives, it is necessary to develop new forms and methods for surveillance evaluation at this level. The paper is aimed at presenting methodological proposal for assessing surveillance in primary health care. We made a literature review of known documents, guides or manuals which have been published in Cuba and in other countries and we interviewed a group of experts in this field. An initial instrument was worked out and tested in three health areas of the capital and afterwards, it was modified accordingly. The process of assessment was divided into 4 aspects: structure, process or functioning, results or usefulness and economic evaluation. To assess functioning of surveillance, we took the analysis of its attributes into account, i.e., simplicity, flexibility, acceptability, sensitivity positive predictive value, representativity, opportunity and also integrality and responsiveness capacity. We described steps to be implemented and elements to be considered. Generally, the evaluation should be carried out in a week. The cost of implementing each evaluating process is estimated at 40 Official Announcement. V Workshop of university libraries of Latin and the Caribbean. Upon finishing the evaluation, a report should be submitted with the comprehensive assessment and recommendations for the evaluated level.

[The value of the parathyrin-related protein (PTH-RP) in the diagnosis of cancer-associated hypercalcemia]. / Valor de la proteína relacionada con la paratirina (PTH-RP) en el diagnóstico de la hipercalcemia asociada al cáncer.

BACKGROUND: The parathyrine related protein (PTH-RP) is very similar, both in structure and in function, to the PTH and is considered as a mediator in humoral hypercalcemia in cancer. The aim of this study was to know the clinical value of PTH-RP measurement. METHODS: Serum PTH-RP concentrations were studied in 22 healthy subjects, 13 patients with primary hyperparathyroidism, 9 patients with solid neoplasms and normocalcemia, 26 patients with solid neoplasms and hypercalcemia and 4 patients with hematologic neoplasms and hypercalcemia. The PTH-RP was quantified by a competitive radioimmunoassay technique using a specific antibody of the PTH-RP 1-40 fragment. Intact parathyrine (i-PTH) was quantified by an IRMA method using 2 polyclonal antibodies (INCSTAR). RESULTS: Fifteen (68%) of the healthy controls presented undetectable serum PTH-RP concentrations. The serum PTH-RP concentration was normal in all those patients with hyperparathyroidism. Elevated serum PTH-RP values were not found in patients with solid neoplasms and normocalcemia or in those with hematologic neoplasms and hypercalcemia. High values of PTH-RP were observed in 8 out of 9 (88%) of the patients with solid neoplasms and hypercalcemia with bone metastasis and in 7 out of 11 (63%) of the patients with bone involvement. CONCLUSIONS: Serum parathyrine-related protein was found to be high in a large proportion of patients with solid neoplasms and hypercalcemia. Serum PTH-RP determination is useful in the clinical investigation of patients with hypercalcemia. Even in patients with bone metastasis, hypercalcemia may have a humoral background.

Protective effect of the PAF antagonist BN 52021 in an experimental renal warm ischemia model.

Platelet activating factor is involved in warm ischemic damage. We studied the effect of the PAF receptor antagonist BN 52021 in an experimental model of 60 min of renal warm ischemia in which the left kidney was flushed with Euro-Collins solution and a right nephrectomy was performed. Eighty Wistar rats were divided into a sham-operated group, two control groups, and four study groups, according to the dosage and route of BN 52021 administration. BN 52021 was used in the flush solution at concentrations of 0.1 and 0.5 mg/ml, or intravenously prior to ischemia at 5 and 10 mg/kg body weight. Creatinine clearance per 100 g body weight, fractional sodium excretion, and conventional histology were studied. Rats that received BN 52021 intravenously showed a significantly higher creatinine clearance than controls. Intravenous BN 52021 produced a higher acceleration of renal function recovery at 10 mg/kg than at 5 mg/kg body weight. Conventional histology was better in animals that received BN 52021 at 10 mg/kg body weight than in controls. Addition of BN 52021 to Euro-Collins flushing solution showed no protective effect. We conclude that intravenous BN 52021 shows a renal protective effect against warm ischemia.

La educación ambiental para la prevención del parasitismo intestinal

El presente manual va dirigido a los maestros, los profesores, las auxiliares pedagógicas y otros educadores y educadoras de los distintos tipos y niveles de enseñanza, así médicos, enfermeros, técnicos y otros trabajadores y trabajadoras de la salud y los profesores y trabajadores del sector de agua y saneamiento, además a los actores de las organizaciones comunitarias y la población en general. El manual es aplicable previa adaptación a otras zonas rurales ubicadas en parques nacionales, reservas de la biosfera, otras áreas protegidas y sistemas montañosos de Cuba(AU)