Médicos, enfermeras y pacientes: entre las contradicciones, la incertidumbre y las carencias en tiempo de covid-19 en México / Doctors, nurses and patients: dealing with contradictions, uncertainty and shortages during covid-19 in Mexico

Resumen La pandemia de covid-19 puso al descubierto las innumerables carencias que durante décadas han formado parte del inequitativo y fragmentado sistema nacional de salud. Las siguientes reflexiones tienen como propósito central enunciar la fragilidad en la que labora el personal de salud en México, al igual que las contradictorias declaraciones que han acompañado el desarrollo de la pandemia en el país, una conjunción de elementos que han acentuado la incertidumbre frente a la nueva enfermedad y su manejo.

Abstract The covid-19 pandemic revealed the innumerable shortages that have characterized the nation's inequitable and fragmentary health care system for decades. The main goal of the following reflections is to outline the precarity of working conditions for health care personnel in Mexico, as well as the contradictory statements issued as the epidemic developed in the country, a combination of factors that magnified uncertainty about the new disease and how to deal with it.

Contradicciones sociales en la formación de valores desde la relación médico-paciente-familia en profesionales de las ciencias médicas / Social contradictions in the values formation from the relation doctor-patient-family in the medical sciences professionals

Introducción: En la actualidad existe un incremento de las insatisfacciones en el desempeño de profesionales de las ciencias médicas, de los recién graduados y de los estudiantes en formación para lograr una adecuada relación médico-paciente-familia. Objetivo: Identificar las manifestaciones más significativas que dificultan el perfeccionamiento de la práctica asistencial médica que se brinda y la formación de valores del profesional de las ciencias médicas. Método: Se utilizaron encuestas y entrevistas a pacientes y familiares, estudiantes y profesores. Se aplicó el método histórico-lógico, y se consultaron materiales impresos y revistas médicas cubanas en línea en bases de datos como PubMed, EBSCO y SciELO. Se tuvieron en cuenta los términos contradicciones sociales, profesional de las ciencias médicas, formación de valores, y relación médico-paciente-familia. Desarrollo: Se evidenció que la relación que se establece desde el imaginario social sobre cómo debe ser el profesional modelo en las ciencias médicas y lo que en realidad acontece, revela esencialmente la carencia de una concepción coherente. Conclusión: Se constataron contradicciones sociales en la formación de valores en los profesionales de las ciencias médicas desde la relación médico-paciente-familia, a tenerse en cuenta para mejorar la atención médica que brindan nuestros médicos en formación.

Introduction: There is at present an increase of dissatisfactions in the training of the medical sciences professionals, in the recently graduated doctors and in the students to achieve an adequate relationship doctor-patient-family. Objective: To identify the most significant manifestations obstructing the perfectioning of the medical practice when treating patients and the values formation of the medical sciences professional. Method: Inquiries and interviews to patients and families, students and professors were used. The historical and logical method was applied, and printed documents as well as Cuban medical journals in data base such as PubMed, EBSCO and SciELO were reviewed. Terms such as social contradictions, medical sciences professional, values formation, doctor-patient-family relationship. Development: It was evidenced that the relationship established from the social image on how the model professional of the medical sciences should be and how he really behaves, essentially reveals the scarcity of a coherent concept. Conclusions: Social contradictions in the values formation for the medical sciences professionals in the doctor-patient-family relationship were confirmed, to be taken into account for improving medical care offered by our doctors while performing.

The Cognition and Reflectionon Mediation of Doctor-Patient Disputes / 中国医学伦理学

Through analyzing the current situation of mediation of doctor-patient disputes,this paper cleared the connotation of mediation of doctor-patient disputes and explored diversified measures of mediating medical dis-putes.It included changing the concept of medical education actively and deepening the reform of medical system constantly,improving the level of hospital management actively and cracking down the occupational medical trouble and hospital scalper,taking litigation as backed mediation mechanism and playing the advantage role of people in mediation,taking initiative to communicate the mission knowledge and playing the role of media fully,and thus to reduce the occurrence of doctor-patient disputes from the source.

Contradições do cotidiano nos homicídios por motivo fútil no baixo São Francisco: pistas para pensar a interiorização da violência / Contradictions of everyday life at futilely motivated homicides in the baixo São Francisco: indications to think the increasing of violence in the countryside / Contradicciones del cotidiano en homicidios por moivo trivial en el baixo São Francisco: pistas para pensar el desplazamiento de la violencia para nucleos urbanos periféricos

O estudo dos homicídios por motivo fútil serve como base analítica para refletir acerca do tema da interiorização da violência, fenômeno que se faz presente em recentes estudos sobre criminalidade e violência no Brasil. O aspecto deste tipo de homicídio que permite a análise pretendida é sua íntima vinculação com o cotidiano da vida social e suas contradições, condição que, por sua vez, favorece uma visão da segurança pública não focada no controle da penalidade criminal. Para tal intento, recorre-se a uma pesquisa sobre homicídios por motivos fúteis ocorridos no período de 2008 a 2011 na região do Baixo São Francisco em Sergipe, cuja análise de 48 ocorrências homicidas se fez no campo de tensões entre ‘lógica desenvolvimentista’ e ‘modos de vida tradicionais’, mais precisamente nos conflitos de práticas entre Estado, corporações e comunidades locais.

The study of futilely motivated homicides (a brazilian penalty typification category) serves as an analytic basis to ponder the subject of the increasing of violence in the countryside, a phenomenon that is shown in recent studies on violence and criminality in Brazil. The aspect of this kind of homicide that allows the intended analysis is its intimate bonding with the everyday social life and its contradictions, conditions that support a vision of public security that is not focused on the controlling of criminal penalties. In order to accomplish that, the analysis relies upon a research on futilely motivated homicides that occurred between 2008 and 2011 at the Baixo São Francisco region of the state of Sergipe in which the analysis of 48 homicidal occurrences was build up among the strain between the ‘developmentalism’s way’ of operating and the ‘traditional ways of living’, precisely in the conflicts between practices of the State, corporations and local communities.

El estudio de los homicidios por motivo trivial sirve como base analítica para reflexionar sobre el crescimiento de la violencia en los nucleos urbanos perifericos, fenómeno presente en recientes estudios acerca de criminalidad y violencia en Brasil. El aspecto de este tipo de homicidio que permite la análisis pretendida es su íntima vinculación con el cotidiano de la vida social y sus contradiciones, condición que, por su vez, favorece una visión de la seguridad publica que no se centra en el control de sanción penal. Para este propósito, se recurre a una investigación acerca de homicidios por motivo trivial ocurridos en el periodo de 2008 a 2011 en la región de lo Baixo São Francisco en Sergipe, cuya análisis de 48 ocurrencias homicidas se hice en el campo de tensiones ideológicas entre la ‘lógica desarrollista’ y ‘los modos de vida tradicionales’, mas precisamente en los conflitos de las prácticas entre el Estado, corporaciones y comunidades locales.

Contradictions of the Health-care System in India and a Strategy for Health-care for All.

The contradiction between the socialized nature of the modern health-care system (inclusive of both clinical and social medicine) versus the narrow control over it is obvious in private health-care. However, this contradiction is present to some extent, in its own way, even in the public health facilities in India. To formulate a program for health-care for all in India, it is necessary to grasp these contradictions in both private and public health-care and accordingly conceptualize a strategy to overcome, resolve these contradictions.

Necesidad social de un modelo didáctico-holístico para la formación de la cultura investigativa en discentes de las carreras de ciencias médicas / Social need of a didactic-holistic model for the training for investigative culture in students of the medical sciences careers i: en

La presente actualización bibliográfica aborda, desde una óptica de ciencia, tecnología y sociedad, cómo la necesidad social promueve la relación entre la formación de la cultura investigativa y la educación médica superior. Asimismo, se realizó un análisis basado en las contradicciones fundamentales del modelo del profesional, el plan de estudio y los programas de Metodología de la Investigación, a lo largo de las carreras de ciencias médicas, y su relación con el proceso formativo en cuanto a la cultura investigativa, lo que unido al diagnóstico fáctico, permiten revelar las fisuras en el proceso de enseñanza-aprendizaje del futuro egresado, que limitan su formación integral en los aspectos epistemológico, científico, cultural, ético, didáctico, teórico-práctico, praxiológico y dialéctico. De tales consideraciones, emerge un problema social expresado en el insuficiente desempeño de los profesionales de la salud en la esfera de la investigación, como vía de solución a los problemas inherentes a la salud humana, lo cual atenta contra un servicio de excelencia en este sector.

The present literature updating approaches, from a scientific, technological and social point of view, how the social need promotes the relationship between the training in the investigative culture and the high medical education. Likewise, an analysis based on the fundamental contradictions of the professional's pattern, the curricula and the programs of the Investigation Methodology was carried out, during the careers of medical sciences, and their relationship with the training process regarding the investigative culture, which together with the factual diagnosis, allow to reveal the fissures in the teaching-learning process of the future graduate, which limit their comprehensive training in the epistemological, scientific, cultural, ethical, didactic, theoretical-practical, praxiological and dialectical aspects. From these considerations, a social problem emerges in the poor performance of the health professionals in the investigation field, as a solution to the inherent problems to the human health, that which hampers an excellence service in this sector.

Contradicciones sociales expresadas en la práctica de la Atención Farmacéutica Hospitalaria en Cuba / Social contradictions in pharmaceutical care practice at hospital setting in Cuba

Introducción: en Cuba el ejercicio de las funciones clínicas y la práctica de la Atención Farmacéutica a nivel hospitalario son limitadas pues, aunque existe un acercamiento a la concepción de estas funciones en los actuales manuales de procedimientos, los profesionales farmacéuticos realizan mayormente funciones administrativas y de dirección, además de las relacionadas con el suministro de medicamentos. Objetivo: analizar las contradicciones sociales (causas) que repercuten en la práctica de la Atención Farmacéutica Hospitalaria, específicamente en Santiago de Cuba, para trazar líneas estratégicas que permitan el perfeccionamiento de esta actividad. Métodos: se aplicó una herramienta que facilita el análisis de problemas y sus soluciones, el diagrama de causa-efecto, así como el método de consenso de votación ponderada, para determinar las causas principales y secundarias que frenan dicho ejercicio a nivel hospitalario. Las principales causas analizadas fueron los recursos humanos, los métodos y estilos de dirección, los recursos materiales, los medios y las condiciones de trabajo. Resultados: los resultados de la votación ponderada mostraron que las causas de mayor ponderación en orden descendente fueron las relacionadas con los métodos y estilos de dirección con 37 puntos, los recursos humanos con 33 puntos y los recursos materiales con 18,5 puntos. Conclusiones: las contradicciones identificadas marcan caminos de investigación para resolver las problemáticas planteadas, lo que permitirá desarrollar un modelo que establezca principios para el desarrollo de la Atención Farmacéutica a nivel hospitalario diseñado sobre la base de las evaluaciones y las valoraciones realizadas y los principios de las Buenas Prácticas de Farmacia

Introduction: the clinical functions and the practice of pharmaceutical care at hospital setting are limited in Cuba. Although there is an approach to the conception of these functions in the current manuals of procedures, the pharmacists mostly carry out administrative and managing functions in addition to those of drug supply. Objective: to analyze the social contradictions (causes) that have an effect on the practice of pharmaceutical care at hospital, particularly in Santiago de Cuba, in order to draw up strategies for improvement of this activity. Methods: a tool facilitating the analysis of problems and their solutions, the cause-effect diagram and the weighed voting consensus method were applied to determine the main and secondary causes that hinder the above-mentioned practice at hospital. The main analyzed causes were human resources, methods, management styles, material resources, working means and conditions. Results: the results of the weighed voting revealed that the highly weighed causes in descending order were managing methods and styles with 37 points, the human resources with 33 points and the material resources with 18.5 points. Conclusions: the identified contradictions mark paths of research to solving the stated problems, which will allow creating a model of principles for the development of pharmaceutical care at hospital setting, on the basis of evaluations and assessments carried out and on the principles of the Good Practice of Pharmacy

Expresionismo y revolución: el abismo de la realidad / Expressionism and revolution: the abism of the reality / Expressionismo e revolução: o abismo da realidade

En este estudio se plantea el paso de la conciencia expresionista a la conciencia crítica; es decir, la evolución del Expresionismo artístico hacia la creación de la Teoría Crítica sociológica en la Alemania de la República de Weimar. De este modo, se repasan los procesos sociales y culturales que dieron lugar a un tipo de Arte en el que se reflejaban las profundas y dramáticas contradicciones de las primeras décadas del siglo XX, subrayándose por tanto como la Escuela de Frankfurt en su primera Generación (Adorno, Horkheimer, Benjamín) significó el punto de inflexión fundamental para analizar y entender filosófica y sociológicamente estas complejas y profundas contradicciones colectivas, así como sus consecuencias históricas posteriores.

This study emerges from the expressionist consciousness about the critical consciousness; in other words, the evolution of the artistic expresionism toward the creation of the critical Theory in the Germany of the Republic of Weimar. In this way, the social and cultural processes that gave place to a type of Art in which there were reflected the deep and dramatic contradictions of the first decades of the XXth century are revised, being underlined, therefore, that the School of Frankfurt in his First Generation (Adorno, Horkheimer, Benjamin) is the point of fundamental inflection to analyse and to understand philosophical and sociologically these complex and deep collective contradictions, as well as its subsequent and later historical consequences.

Neste estudo expõe o a passagem da consciência expressionista para consciência crítica; isto é, a evolução do Expressionismo artístico até a criação da Teoria Crítica sociológica na Alemanha na República de Weimar. O texto faz uma revisão dos processos sociais e culturais que deram lugar a um tipo de Arte na qual se reflete as profundas e dramáticas contradições das primeiras décadas do século XX, destacando-se como a Escola de Frankfurt, em sua primeira Geração (Adorno, Horkheimer, Bejamin), significou o ponto de inflexão fundamental para analisar e endender filosófica e sociologicamente estas complexas e profundas contradições coletivas, assim como suas consequências históricas posteriores.

Modern Medical Model and Unity of Contradictions of Traditional Chinese and Western Medicine / 国际中医中药杂志

Cultures of traditional Chinese and Western medicine are the different ones of a same kind (medicine) but from the different sources. Their respective advantages, complement and unity are rooted in the differences of the two distinctive cultures. Preventive- biomedical - psychological -social behavior patterns of medicine is a unity of contradictions. Integration of what is different can generate the new while what is exactly the same can hardly be developed. A unity of contradictions of cognitive power is tending to a higher realm beyond both medicines.

Contradictions and the Corresponding Solutions Appearing When A Drugstore Pharmacist Is Doing His Duty / 中国药房

OBJECTIVE:To discuss the contradictions existing during the time when a drugstore pharmacist is doing his duty.METHOD:The existing contradictions were analyzed.RESULTS&CONCLUSIONS:Pharmacists should be educated to solve the contradictions and strengthen propaganda;The evaluating system should be strictly enforced,and the registered pharmacists should be strictly evaluated;Surveillance should be strengthened and the regular supervising system should be established.

Connotative evolution of the concept of Basic Theory of TCM / 中华中医药杂志

There was severe logical contradiction among the basic concepts in Chinese medicine such as syndrome, symptoms and signs, etiopathogenisis and pathogenesis .In this paper, from the comparative reseaech of the different versions of Basic Theory of Traditional Chinese Medicine (TCM) used in higher colleges and universities of TCM in recent 50 years,higher Colleges of Chinese medicine materials, it cleared up the evolution of the basic connotation of syndrome, symptoms and signs, pathogens and pathogenesis, and revealed fundamental reason for the occurance of logical contradiction.