Theoretical and methodological foundations for designing learning environments in Cuban Higher Medical Education

The Cuban Higher Medical Education is subject to the current society knowledge and information demands, characterized by its complexity, uncertainty, globalization, development of information technologies and knowledge obsolescence, which determine changes in different aspects of the places where future professionals will work. The theoretical and methodological foundation is then paramount to support on the job teaching, teaching and research practices from learning environments which enable student centered teaching processes from a developing perspective. This work is aimed at systematizing the main aspects which allow leading a process with these characteristics. Systematization, documentary analysis and triangulation were used. It is concluded that the essential dynamics of learning environments structure and function and the proper conception of activity and communication, are core systematizing axes typical of these environments in the teaching learning organizational forms, mainly those of on the job education, oriented to acquiring the necessary contents in this 21st century society, from a student centered developing perspective

El proceso pedagógico de posgrado en la especialización médica. Sus esencialidades y fines

En este trabajo se ofrecen reflexiones relacionadas con el proceso pedagógico de posgrado en la especialización médica, hechas por los autores después de haber leído los planteamientos esenciales realizados en el artículo “Algunas reflexiones relacionadas con el trabajo de terminación de las especialidades” publicado en la revista Medisur. Un análisis profundo del mencionado trabajo suscitó la necesidad de exponer, de manera sintética, algunas consideraciones particulares acerca del tema, no con ánimo de réplica, sino con el propósito de esclarecer algunos puntos invariantes correspondientes al objeto de estudio en el cual se inscribe, en este caso el proceso pedagógico de posgrado en la especialización, sus fines y sus características esenciales, de acuerdo con lo más avanzado de los estudios teóricos sobre el tema, de lo cual se derivan algunas respuestas a las preguntas realizadas por el autor de la citada publicación

Prevalence of Cardiovascular Risk Factors in the Population of the Area I in the Municipality of Cienfuegos

Background: since the beginning of the epidemiological transition, there was a prevalence of morbidity and mortality from non communicable diseases, mainly cardiovascular disease. Objective: to identify the prevalence of cardiovascular risk factors in the population of the Area I in the municipality of Cienfuegos during 2010-2011. Methods: a descriptive cross-sectional study was conducted to determine the prevalence of cardiovascular risk factors in the population of the Area I in Cienfuegos by means of a complex three-stage equal probability sample of 581 people. The sampling units consisted of districts, areas and sections containing the dwellings where the subjects were chosen. A survey with the following variables was applied: age, sex, marital status, skin color, history of hypertension and diabetes mellitus, smoking, physical activity, food intake (fruits, vegetables and fat), body mass index and waist circumference. Results: 35-44-year age group and female sex predominated, as well as white married individuals. Prevalence of diabetes mellitus and smoking was 6.4% and 28.6%, respectively. Only 26.2% of the respondents were engaged in adequate physical activity. Consumption of fruits was 61.3%. Prevalence of hypertension was 33.8%. Conclusions: The risk factors were more prevalent in females, except for smoking and hypertension; they were more evident with increasing age. Role of hypertension as a tracer condition closely related to cardiovascular risk factors was demonstrated

Mortalidad hospitalaria en las salas de medicina interna del Hospital Provincial de Cienfuegos 2013-2015

Introducción: La mortalidad intrahospitalaria es un parámetro importante en el análisis de la asistencia sanitaria y es uno de los elementos que suelen tenerse en cuenta para valorar la calidad de un servicio o institución sanitaria.Objetivo: Describir la mortalidad en las salas de Medicina Interna desde el 1 de enero de 2013 al 31 de diciembre de 2015 en el Hospital Provincial Dr. Gustavo Aldereguía Lima de Cienfuegos.Tipo de estudio: Descriptivo de corte transversal.Universo: pacientes mayores de 18 años fallecidos en las salas de Medicina Interna.Variables: edad, sexo, estadía hospitalaria, causa de muerte.Resultado: El estudio mostró un predominio de las defunciones en el sexo masculino (54.5%); los pacientes de la tercera edad, principalmente el grupo entre los 50 a 80 años con 411 casos. El mayor número de pacientes fallecieron en las primeras 72 horas con una media de 6,7 días. Las patologías con mayor número de defunciones fueron: neumonía/bronconeumonías, tumores malignos y enfermedades respiratorias crónicas de las vías inferiores.Conclusiones:Se recogen datos similares a los planteados por otros autores tanto internacionales como nacionales según las variables estudiadas.Palabras Claves: mortalidad, medicina interna, hospitalización

Estratificación de riesgo de tuberculosis pulmonar en consejos populares del municipio Cienfuegos

Fundamento: el proceso de estratificación epidemiológica sirve de base para categorizar metodológicamente y de manera integral los grupos poblacionales de acuerdo a factores de riesgo. Objetivo: realizar la estratificación de riesgo de la tuberculosis pulmonar en consejos populares del municipio de Cienfuegos. Métodos: se realizó un estudio descriptivo en 18 consejos populares, desde 2007 hasta 2011. La información se obtuvo de los departamentos de estadística de las áreas de salud y la Unidad Municipal de Higiene y Epidemiología. Para estratificar los riesgos se tuvieron en cuenta los criterios de la comisión provincial de tuberculosis, la incidencia de la enfermedad en los últimos cinco años en la provincia y la media de la prevalencia de factores de riesgo según dispensarización del año 2011. Mediante programa MapInfo 7.5, los consejos populares se clasificaron en alto, mediano y bajo riesgo según los valores de la mediana de la incidencia de casos y la media de contactos de pacientes con tuberculosis pulmonar, prevalencia de virus de inmunodeficiencia adquirida/sida, población ex reclusa, alcohólicos, casos sociales, población mayor de 60 años y prevalencia de diabetes mellitus. Resultados: se identificaron tres consejos populares de alto riesgo, 13 de mediano riesgo y dos de bajo riesgo. Los consejos populares clasificados de alto riesgo fueron: Centro Histórico, Punta Gorda y San Lázaro, que representaron el 16,7 %. Conclusiones: se observó una dispersión espacial del riesgo de tuberculosis pulmonar en el municipio de Cienfuegos, lo que representa un incremento de la probabilidad de ocurrencia de la enfermedad

Behavior of Mortality at the Cienfuegos Province. 2013-2015

Foundation: Data about mortality are tools to assess the risk of death in a population and the disease repercussion on health, therefore they constitute essential information for the analysis of the situation of health and surveillance in public health.Objective: to describe the behavior of mortality at the Cienfuegos province.Methods: cross-descriptive study which analyzed the total of deceased (N=10 558) in the period from 2013 to 2015, according the selected clinical- epidemiological variables. Data was obtained through the Automatic System MortaPro y Mortagen, at the Department of Medical Registration and Statistics of the Provincial Health Office. Triennial rates were calculated and the reason for masculinity.Results: there was an increase in general mortality by 3.4% in the period studied and a male over-mortality. The municipality with the highest mortality rate was Cienfuegos, followed by Cumanayagua and Cruces. The deaths occurred mainly at home. Heart diseases, malignant tumors and cerebrovascular diseases occupied the first causes of death, respectively. The mortality of children younger than a year was related to the conditions originated in the perinatal period and among them intra- ventricular hemorrhages. Maternal deaths were due to direct causes.Conclusion: in the province of Cienfuegos there was an increase in mortality in the period studied. Chronic, non-communicable diseases were those that contributed the greatest number of deaths, which draws attention to the need of maintaining vigilance over these</p

Sociodemographic and behavioral characterization of men with infection by the human immunodeficiency virus. Health Area I. Cienfuegos Municipality. 2014

Foundation: The main struggle against the human immunodeficiency virus is prevention, fro that it is necessary to take into consideration the most vulnerable groups and the associated risk factors.Objective: to characterize men infected by human immunodeficiency socio-demographically and behaviorally. Method: Men case and control study from Health Area I, Cienfuegos Municipality. The population was described according to socio-demographic and behavioral variables selected and the differences between cases and controls were set according to these variables. The cases were diagnosed with human immunodeficiency virus, from 1986 to 2013, information obtained in the Department of Epidemiology of this area; the 56 controls were paired by the same age of cases and were selected two from each one. A survey was applied to both groups. The Squared-Ji was used to identify the association for estimating the risks it was used the Odds ratio; A level of significance was set at 0.05. Results: The main factors identified were the marital link or consensual relation, not using condoms, antecedents of sexually transmitted infections, having sex with other men, transactional sex, and the visit to places of meeting. Conclusion: The identified risk factors, behavioral ones with strongest presence, denote that there is still lack of risk perception. For this reason, it is necessary to provide more information to people that allow them building knowledge to have a healthy sexual life.</p

Multimedia for Fifth Year Medicine Professors and Students. Public Health Subject

Background: taking into consideration the potentialities of the use of information technologies, it is necessary for each teacher to develop methods of work where the use of the computer is a strong ally that permit improving the aids and teaching methods to win the quality of learning. Objective: elaborating a multimedia to support the fifth year Medicine teacher and students in Public Health subject. Methods: a multimedia was created departing from the software Creasoft 2, 1 created by a group of information-technology of Medical Sciences of Holguin. The foundations of the project for the introduction of documents, imagery and videos constructed in terms of the program of Public Health subject were created. Documentary revision and work in group of experts was accomplished in order to decide the contents of the software. Results: the multimedia works so that the students and professors can agree to the software and semesters validated for its utilization according to the program of the subject of study, exercises for themes are available, it is accessed to instructive, educational and counsellors videos of different contents, the literature is updated, counts with the health programs, actions of control of focus in transmissible diseases and other documents for fifth year Medicine professor and students. Conclusions: the created multimedia must contribute to elevate the quality of teaching because this means has been presented at the time and opportune conditions, adequately combined in terms of the fulfilment of the objectives