Los impactos del restablecimiento de relaciones entre Cuba y EE.UU. en América Latina y el Caribe

Resumen A pesar de la sorpresa y el impacto generado por el anuncio de Raúl Castro y Barack Obama de normalización de las relaciones diplomáticas entre Cuba y Estados Unidos, había considerables elementos de probabilidad, sobre todo en cuatro aspectos analizados en el artículo: 1) la trayectoria de las relaciones entre Estados Unidos y Cuba; 2) peculiaridades de la administración Obama en la definición y enfrentamiento de desafíos al poder nacional, incluyendo componentes de índole generacional; 3) la evolución política de América Latina, en que despuntan gobiernos de posturas más autónomas frente a Estados Unidos, que demuestra mayor activismo en el concierto hemisférico a través de medidas que combinan el pragmatismo con Cuba y el big stick con Venezuela; 4) las transformaciones internas en Cuba, respondiendo a los desafíos en la economía a través de una actualización del modelo, que encuentra campo político favorable en el acelerado cambio de actitud del presidente de Estados Unidos después de la pérdida de mayoría en el Congreso en noviembre de 2014

Capitalismo dependente e governabilidade na América Latina: a herança dos regimes militares

It is an analysis of the development of Latin American capitalism from the 60's to the 80's. Case studies, theoretical problems related to dependence, authoritarism and democracy are some of the focused aspects. It points out the explanatory capacity of some theoretical formulations that contrast with the political function of the speeches in favour of a free-market development.A trajetória do desenvolvimento do capitalismo latino-americano entre os anos 60 e 80 é analisada. Estudos de caso e problemas teóricos ligados à dependência, ao autoritarismo e à democracia são contemplados. Destaca-se a capacidade explicativa de algumas formulações teóricas, em contraste com a funcionalidade política de discursos pró-desenvolvimento com liberdade de mercado

Ejes estratégicos de la política exterior para América Latina y el Caribe en los gobiernos de George W. Bush y Barack Obama

Abstract The paper approaches the U.S. perceptions about the sources of insecurity from Latin America, considered a low risk area and priority of its foreign policy. El análisis se concentra en la evaluación de las amenazas y desafíos a sus intereses estratégicos y las modalidades de actuación privilegiadas en la esfera regional, en que se verifican coincidencias entre las administraciones Demócratas y Republicanas en la adopción de un liderazgo con prerrogativas clasificatorias sobre los tipos de régimen político, con una agenda concebida como promoción de la convergencia hemisférica de democracias y economías liberales. The analysis focuses on assessing the threats and challenges to its strategic interests and privileged modes of action at the regional level, which verifies similarities between Republican and Democratic administrations in taking a leadership prerogatives qualifiers on the types political regime, with an agenda designed as promoting hemispheric convergence of liberal democracies and economies. En ese contexto, cabe destacar la prioridad atribuida a los países de la Alternativa Bolivariana para las Américas (ALBA) como eje opositor de sus políticas. In this context, include the priority given to the countries of the Bolivarian Alternative for the Americas (ALBA) as the linchpin of his political opponent.  El texto aborda la percepción de Estados Unidos sobre las fuentes de inseguridad originarias de América Latina, considerada un área de bajo riesgo y prioridad de su política exterior. El análisis se concentra en la evaluación de las amenazas y desafíos a sus intereses estratégicos y las modalidades de actuación privilegiadas en la esfera regional, en que se verifican coincidencias entre las administraciones Demócratas y Republicanas en la adopción de un liderazgo con prerrogativas clasificatorias sobre los tipos de régimen político, con una agenda concebida como promoción de la convergencia hemisférica de democracias y economías liberales. En ese contexto, cabe destacar la prioridad atribuida a los países de la Alternativa Bolivariana para las Américas (ALBA) como eje opositor de sus políticas.     &nbsp

State of the valorization of household biowaste in large urban centers

En este estudio se revisó el estado del arte de la valorización de biorresiduos de origen residencial (BOR) en grandes centros urbanos (GCU) de países en desarrollo de América Latina y el Caribe (ALC) y países de alto ingreso económico (AIE) a nivel mundial. A partir del análisis de la literatura científica y técnica de entidades oficiales de los dos contextos evaluados, se estudiaron 70 GCU (37 de ALC y 33 de países de AIE) de 34 países. Los resultados señalaron que la valorización de los BOR es una práctica establecida en al menos 27 GCU, tres de ellos en ALC y 24 en AIE de Norteamérica, Europa, Asia y Oceanía. En éstos se identificó la implementación de 14 sistemas-tipo. Aunque con diferencias entre los contextos evaluados, los métodos de tratamiento más usados son el compostaje y la digestión anaerobia. Otros métodos utilizados son el procesamiento térmico para producción de alimentos para animales y el tratamiento mecánico biológico (TMB) con compostaje y digestión anaerobia. Se evidenció que los sistemas implementados producen compost (empleado principalmente en la jardinería y la agricultura), energía eléctrica, calor, combustible vehicular y alimentos para animales. Por último, pese a la relevancia del flujo de BOR en los GCU de ALC y los beneficios de su valorización, los resultados de este estudio evidenciaron la predominancia de la disposición final de BOR en este contexto, para el cual se recomienda establecer a los BOR como una fracción prioritaria cuya valorización debe ser la finalidad de los sistemas de gestiónIn the current study a literature review of household biowaste valorization in large urban centers of developing countries in Latin America and the Caribbean, as well as high-income countries worldwide, was performed. From the analysis of scientific and technical literature of official entities of the two evaluated contexts, 70 large urban centers (37 from Latin America and the Caribbean and 33 from high-income countries), from a total of 34 countries, were studied. The results indicated that household biowaste valorization is established in at least 27 large urban centers, three of them in Latin America and the Caribbean and 24 in high-income countries of North America, Europe, Asia and Oceania. In these, the implementation of 14 type-systems was identified. Although there are differences between the evaluated contexts, the most used treatment methods are composting and anaerobic digestion. Other methods used are thermal processing for animal food production and mechanical biological treatment with composting and with anaerobic digestion. It was evidenced that the implemented systems produce compost (mainly used in gardening and agriculture), electric power, heat, vehicular fuel and animal feed. Finally, despite the relevance of the household biowaste stream in Latin America and the Caribbean large urban centers, and the benefits of its recovery, the results of this study showed the predominance of household biowaste landfilling in this context. In consequence, it is recommended to establish the household biowaste as a priority fraction whose valorization should be the primary aim of management system

Development and validation of an HIV risk exposure and indicator conditions questionnaire to support targeted HIV screening

The aim of our study was to develop a Spanish-structured HIV risk of exposure and indicator conditions (RE&IC) questionnaire. People attending to an emergency room or to a primary clinical care center were offered to participate in a prospective, 1 arm, open label study, in which all enrolled patients filled out our developed questionnaire and were HIV tested. Questionnaire accuracy, feasibility, and reliability were evaluated. Valid paired 5329 HIV RE&IC questionnaire and rapid HIV tests were performed, 69.3% in the primary clinical care center, 49.6% women, median age 37 years old, 74.9% Spaniards, 20.1% Latin-Americans. Confirmed hidden HIV infection was detected in 4.1%, while HIV RE&IC questionnaire was positive in 51.2%. HIV RE&IC questionnaire sensitivity was 100% to predict HIV infection, with a 100% negative predictive value. When considered separately, RE or IC items sensitivity decreases to 86.4% or 91%, and similarly their negative predictive value to 99.9% for both of them. The majority of people studied, 90.8% self-completed HIV RE&IC questionnaire. Median time to complete was 3 minutes. Overall HIV RE&IC questionnaire test-retest Kappa agreement was 0.82 (almost perfect), likewise for IC items 0.89, while for RE items was lower 0.78 (substantial). A feasible and reliable Spanish HIV RE&IC self questionnaire accurately discriminated all non–HIV-infected people without missing any HIV diagnoses, in a low prevalence HIV infection area. The best accuracy and reliability were obtained when combining HIV RE&IC items

Clinical Audits in Outpatient Clinics for Chronic Obstructive Pulmonary Disease: Methodological Considerations and Workflow

Objectives: Previous clinical audits for chronic obstructive pulmonary disease (COPD) have provided valuable information on the clinical care delivered to patients admitted to medical wards because of COPD exacerbations. However, clinical audits of COPD in an outpatient setting are scarce and no methodological guidelines are currently available. Based on our previous experience, herein we describe a clinical audit for COPD patients in specialized outpatient clinics with the overall goal of establishing a potential methodological workflow.Methods: A pilot clinical audit of COPD patients referred to respiratory outpatient clinics in the region of Andalusia, Spain (over 8 million inhabitants), was performed. The audit took place between October 2013 and September 2014, and 10 centers (20% of all public hospitals) were invited to participate. Cases with an established diagnosis of COPD based on risk factors, clinical symptoms, and a post-bronchodilator FEV1/FVC ratio of less than 0.70 were deemed eligible. The usefulness of formally scheduled regular follow-up visits was assessed. Two different databases (resources and clinical database) were constructed. Assessments were planned over a year divided by 4 three-month periods, with the goal of determining seasonal-related changes. Exacerbations and survival served as the main endpoints.Conclusions: This paper describes a methodological framework for conducting a clinical audit of COPD patients in an outpatient setting. Results from such audits can guide health information systems development and implementation in real-world settings.This study was financially supported by an unrestricted grant from Laboratorios Menarini, SA (Barcelona, Spain)

The deep, historical-roots of Cuban anti-imperialism

Colonialism, imperialism and anti-imperialism have been decisive in shaping Cuban political identity for 150 years. US determination to control Cuba, consistent with the Monroe Doctrine, had a strong economic rationale even before Spain was defeated in the War of Independence in 1898. Debate raged between Cubans who aspired to true independence and an annexationalist minority, who favoured union with the US. The Platt Amendment imposed on Cuba by the US in 1903 ‘reduced the independence and sovereignty of the Cuban republic to a myth’. Between then and the Revolution of 1959 Cuba was effectively first a protectorate and then neo-colony of the US, which dominated the Cuban economy, politics and foreign policy. Tackling the terrible socioeconomic and political effects of Cuba’s subjugation under the Spanish empire and then US imperialism necessitated a radical transformation of the Cuban economy, political institutions and power structures. The transition to socialism inevitably meant confronting US imperialism – and vice versa. Since 1959, US imperialism, with its powerful allies in the right-wing exile community based in Miami, have relentlessly tried to destroy the Revolution and Cuban socialism. The issue of imperialism remains key today, in the post-Fidel, President Trump era