Factores de riesgo relacionados con el bajo peso al nacer

La reducción del bajo peso al nacer es importante para obtener mejores resultados en la mortalidad infantil. Por eso nos planteamos el objetivo de: identificar los factores asociados con el riesgo de bajo peso al nacer, por su incremento en el municipio Río Cauto. Se realizó un estudio descriptivo de corte transversal, que incluyó a 51 gestantes que tuvieron recién nacidos con bajo peso al nacer de enero a diciembre del año 2022. Se utilizaron las variables: edad gestacional en el momento del parto, áreas de salud, peso de los nacidos vivos y por grupos de edad materna, paridad y patologías detectadas durante el embarazo. Hubo 528 nacidos vivos y 51 tuvieron un peso inferior a 2500 gramos, con un índice de (9.66 %); el parto pretérmino predominó en el Policlínico "Camilo Cienfuegos" con 5 neonatos (5.00 %) y el crecimiento intrauterino retardado en el Policlínico "Ernesto Guevara" con 14 nacimientos (9.03 %); el mayor por ciento de bajo peso ocurrió de 20 a 34 años de edad, 35 (68.63 %), donde sobresalió el policlínico "Máximo Gómez" con 18 (75 %). En los nacimientos por grupo de edades, el índice de bajo peso fue mayor en pacientes menores de 20 años, 14 (12.84 %). En el bajo peso predominaron: las nulíparas en 25 nacimientos (49.02 %), la anemia y embarazo 27 (52.94 %) y el síndrome de flujo vaginal 20 (39.22).

Summary Reducing low birth weight is important for better outcomes in infant mortality. That is why we set ourselves the objective of: identifying the factors associated with the risk of low birth weight, due to its increase in Río Cauto. A descriptive cross-sectional study was conducted, which included 51 pregnant women who had low birth weight newborns from January to December 2022. The following variables were used: gestational age at the time of delivery, health areas, live birth weight and maternal age groups, parity and pathologies detected during pregnancy. There were 528 live births and 51 had a weight of less than 2500 grams, with a rate of (9.66%); preterm delivery predominated at the Camilo Cienfuegos Polyclinic with 5 neonates (5.00%) and intrauterine growth retardation at the Ernesto Guevara Polyclinic with 14 births (9.03%); The highest percentage of underweight occurred between 20 and 34 years of age, 35 (68.63%), where the Máximo Gómez 18 polyclinic (75%) stood out. In births by age group, the rate of low birth weight was higher in patients under 20 years of age, 14 (12.84%). Nulliparous women predominated in 25 births (49.02%), anemia and pregnancy in 27 (52.94%), and vaginal discharge syndrome in 20 (39.22).

A redução do baixo peso ao nascer é importante para melhores desfechos na mortalidade infantil. Por isso, nos propusemos a identificar os fatores associados ao risco de baixo peso ao nascer, devido ao seu aumento no Rio Cauto. Foi realizado um estudo transversal descritivo, que incluiu 51 gestantes que tiveram recém-nascidos de baixo peso ao nascer no período de janeiro a dezembro de 2022. As seguintes variáveis foram utilizadas: idade gestacional no momento do parto, áreas de saúde, peso ao vivo e faixas etárias maternas, paridade e patologias detectadas durante a gestação. Foram 528 nascidos vivos e 51 com peso inferior a 2500 gramas, com taxa de (9,66%); predomínio de parto pré-termo na Policlínica Camilo Cienfuegos com 5 neonatos (5,00%) e retardo de crescimento intrauterino na Policlínica Ernesto Guevara com 14 nascimentos (9,03%); O maior percentual de baixo peso ocorreu entre 20 e 34 anos de idade, 35 (68,63%), onde se destacou a policlínica Máximo Gómez 18 (75%). Nos nascimentos por faixa etária, a taxa de baixo peso ao nascer foi maior nas pacientes com menos de 20 anos, 14 (12,84%). Nulíparas predominaram em 25 partos (49,02%), anemia e gravidez em 27 (52,94%) e síndrome do corrimento vaginal em 20 (39,22).

Simulación como estrategia de desarrollo de competencias culturales en estudiantes del área de la salud / Simulation as a strategy for the development of cultural competences in students from the health area

El contexto global actual, pluricultural y dinámico requiere de competencias específicas presentes en los profesionales sanitarios, que deben desplegarse con el fin de construir un vínculo terapéutico culturalmente pertinente. El presente artículo tuvo como objetivo exponer las ventajas de la simulación como estrategia de enseñanza-aprendizaje de competencias culturales en estudiantes del área de la salud, a través de distintas experiencias realizadas en Europa y América del Norte. Se sistematizaron las ventajas y desventajas de la estrategia, y se propusieron las consideraciones necesarias que debían incorporarse en las experiencias de enseñanza-aprendizaje de competencias culturales implementadas en nuevos escenarios y espacios educativos. Los autores reconocen potencialidades en la simulación, que deben tenerse en cuenta para lograr el desarrollo de competencias culturales en los estudiantes del área de la salud que cursan estudios superiores. Se concluye que la implementación y adaptación de procesos de simulación en competencias culturales requieren de revisiones extensas de la literatura, junto con contar con equipos interdisciplinarios y disponer de docentes capacitados en la estrategia de enseñanza y aprendizaje particular, que permitan ejecutar tales procesos de manera exitosa(AU)

The current, multicultural and dynamic global context requires specific competences in health professionals, which must be deployed in order to build a culturally relevant therapeutic link. The objective of this article was to present the advantages of simulation as a teaching-learning strategy concerning cultural competences in students from the health area, through different experiences carried out in Europe and North America. The advantages and disadvantages of the strategy were systematized, and the necessary considerations were proposed that should be incorporated into the teaching-learning experiences of cultural competences implemented in new educational settings and spaces. The authors recognize the potentialities of simulation, which must be taken into account to achieve the development of cultural competences in higher education students from the health area. The implementation and adaptation of simulation processes in cultural competences are concluded to require extensive literature reviews, together with having interdisciplinary teams and having professors trained in that particular teaching and learning strategy, which allow such processes to be executed successfully(AU)

Las tecnologías e-learning y TIC en el aprendizaje a largo plazo de la anatomía humana en estudiantes del área de la salud: una revisión de la literatura / E-learning and TIC technologies in long-term learning of human anatomy of health students: a review of the literature

RESUMEN: Los propósitos de esta revisión literaria fueron, identificar estudios que explorarenlas tecnologías e-learning y TIC y su impacto en el aprendizaje a largo plazo, y evaluar la calidad de los estudios en esta aérea. Se realizaron búsquedas en las bases de datos PubMed (Medline), Ovid (cochrane Central), Ovid (Medline), Ovid (Global Health), Scopus, Web of Science (clarivate) y Science Direct, incluyendo las palabras clave: Education Distance, eLearning, Learning, Learning Curve, Long Term Memory, active learning, Repetion Anatomy, Anatomy Cross-Sectional, Anatomy Regional, Students Health Occupations y Medical education. Tres evaluadores de forma independiente evaluaron la calidad de las investigaciones utilizando el instrumento de Calidad del Estudio de Investigación de Educación Médica (MERSQI). El total de resultados inicialmente fueron 557 artículos de investigación, al aplicar los criterios de inclusión y exclusión por los evaluadores se identificaron un total de 25 artículos. Posterior a la revisión de los artículos se incluyeron 2 investigaciones que cumplieron con los criterios de síntesis en esteestudio. En conclusión, la incorporación de las tecnologías e - learning y TIC permitió evaluar el aprendizaje a largo plazo, aporto motivación y aumento en las habilidades del conocimiento, además de ser una herramienta para el proceso de Enseñanza - aprendizaje -evaluación, sin embargo, se necesitan investigaciones que evalúen cuidadosamente el impacto de los factores preponderantes del aprendizaje largo plazo, mientras se utilizan las tecnologías e-learning y TIC.

SUMMARY: The objective of this review was to identify studies that explore e-learning and ICT technologies and their impact on long-term learning, and to evaluate the quality of studies in this area. Searches were carried out in databases PubMed (Medline), Ovid (Cochrane Central), Ovid (Medline), Ovid (Global Health), Scopus, Web of Science (clarivate) and Science Direct, including keywords: Education Distance, e-Learning, Learning , Learning Curve, Long Term Memory, Active Learning, Repetition Anatomy, Anatomy Cross-Sectional, Anatomy Regional, Students Health Occupations and Medical education. Three evaluators independently assessed the quality of the studies using the Medical Education Research Study Quality (MERSQI) instrument. The to- tal results were initially 557 research articles, and after applying inclusion and exclusion criteria, a total of 25 articles were identified. Following a review of the articles, 2 studies were included that met the synthesis criteria in this study. In conclusion, integrating e-learning and ICT technologies facilitate the evaluation of long- term learning, provide motivation and increase knowledge skills, in addition to being a tool for the Teaching-learning-evaluation process. However, further research is needed to evaluate the impact of the preponderant factors of long-term learning, while using e- learning and ICT technologies.

Opinión de estudiantes de kinesiología relacionado con precauciones estándar, vista de enfermería / Opinion of kinesiology students related to standard precautions, nursing view

INTRODUCCIÓN: Las precauciones estándar corresponden a un grupo de prácticas de prevención de infecciones que se aplican en la atención a todos los pacientes, tiene como objetivo prevenir la transmisión cruzada de microorganismos entre pacientes. OBJETIVO: Develar la opinión de las/os estudiantes de Kinesiología de la Universidad Mayor-Temuco con relación a las Precauciones Estándar. METODOLOGÍA: Estudio cualitativo, descriptivo y exploratorio, estudio intrínseco de caso, la muestra no probabilística, intencionada: 12 sujetos estudiante de kinesiología 2018; criterio de inclusión: haber aprobado la asignatura de Cuidados Básicos del Enfermo; recogida de datos: entrevistas en profundidad, se utilizaron notas de campo y se manejó el método de comparación constante, además esquema de la reducción progresiva. RESULTADOS: Para la categoría de significado de precauciones estándar surge medida de protección y seguridad para usuario y tratante; para precauciones estándar utilizadas en prácticas clínicas emerge las subcategorías de elementos y técnicas de barrera en forma análoga nace como categoría aplicabilidad de precauciones estándar de ella se desprenden campos clínicos, eventos clínicos del usuario y técnicas y procedimientos; para la categoría factores facilitadores: docente y estudiantes; en tanto factores obstaculizadores: curriculum. CONCLUSIONES: En los estudiantes existe un conocimiento deficiente y conceptos aislados sobre PE, utilizan principalmente guantes y lavado de manos; menor grado uso de mascarilla y pechera. Destaca positivamente conocimiento docente; factores obstaculizadores: aspectos teóricos deficientes curriculares; considerar modificaciones curriculares en aspectos conceptuales y procedimentales.

BACKGROUND: the standard precautions correspond to a group of infection prevention practices that are applied in the care of all patients, it aims to prevent the cross-transmission of microoganisms between patiens. OBJETIVE: to reveal the opinion of Kinesiology students at the Universidad Mayor-Temuco regarding standard precautions. METHODOLOGY: Qualitative, descriptive, and exploratory study, intrinsic case study, non-probabilistic sample, intentional: 12 subjects, kinesiology student of the year 2018; For data collection, in-depth interviews were used, field notes and the constant comparison method were used, in addition to the progressive reduction scheme. RESULTS: 173 units of meaning emerge, for the category of meaning of standard precautions, protection and security measure for user and trafficker arises; For standard precautions used in clinical practices, the subcategories of barrier elements and techniques emerge, the most mentioned, in an analogous way, the applicability of standard precautions is born as a category of clinical fields, clinical events of the user and techniques and procedures; for the category facilitating factors: teacher and student are the least mentioned; as impeding factors: curriculum. CONCLUSIONS: There is a deficient knowledge and isolated concepts about SP, mainly use gloves and hand washing; less degree the use of masks and scrubs. It is positively highlighted teacher's knowledge, and some of the hindering factors are the lack of theoretical aspects of the curriculum and the consideration for curriculum modifications to compensate conceptual and procedural aspects.

Apreciación respecto a la producción de artículos científicos de los estudiantes del área de la salud / Appreciation regarding the production of scientific articles by students in the health area

La universidad es la ventana al conocimiento, pasar por ahí significa enfrentar diversos obstáculos y generar aprendizajes que quedan para toda la vida. Dentro del campus hay muchas oportunidades van surgiendo según el camino que toma cada estudiante, para así poder tener un punto de vista diferente. En ese sentido, la investigación es eso, ver más allá de lo que rodea a la malla académica, es el aumento de la responsabilidad y una decisión que puede cambiar la vida. Para los estudiantes del área de la salud puede resultar difícil el manejo de tal combinación, ya que se requiere de entrega, al igual que en las asignaturas y las prácticas. Por ello, es necesario encontrar estrategias que permitan el aumento de la participación de los estudiantes para promover la investigación y de esta manera contribuir a la producción de literatura científica.

The university is the window to knowledge, passing through it means facing various obstacles and generating learning that remains for life. Within the campus there are many opportunities that are emerging according to the path that each student takes, so that they can have a different point of view. In that sense, research is that, to see beyond what surrounds the academic mesh, is the increase of responsibility and a decision that can change life. For students in the area of health it can be difficult to manage such a combination, as it requires delivery, as well as in subjects and practices. Therefore, it is necessary to find strategies that allow the increased participation of students to promote research and thus contribute to the production of scientific literature.

Adaptación universitaria en estudiantes peruanos de ciencias de la salud. Diferencias por sexo y grupo etario / College adaptation in Peruvian health sciences students: sex and age-group differences

Objetivo: el objetivo del presente estudio fue determinar si existen diferencias en cuanto a la adaptación universitaria en estudiantes peruanos del primer año de ciencias de la salud, respecto al sexo y grupo etario (jóvenes y adultos). Materiales y métodos:la muestra estuvo conformada por 759 estudiantes (74,8% mujeres), en su mayoría estudiantes jóvenes (92,2%), quienes fueron evaluados con el Student Adaptation to College Questionnaire. Resultados: las mujeres tienen una mejor adaptación académica e institucional, aunque exhiben menor adaptación personal-emocional. No se hallaron diferencias en la adaptación social entre hombres y mujeres. Respecto a la edad, los estudiantes jóvenes presentan menor adaptación personal-emocional e institucional que los estudiantes adultos, y no se encontraron diferencias con relación a la adaptación académica. Conclusiones: el sexo y el grupo etario de pertenencia son aspectos relevantes en el estudio de la adaptación universitaria..Au

Objective: the objective of the present study was to determine if there are differences in terms of university adaptation in Peruvian first-year students of health sciences, with respect to sex and age-group (youth and adults). Materials and methods: the sample consisted of 759 students (74.8% women), mostly young students (92.2%), and were assessed with the Student Adaptation to College Questionnaire. Results: women have a better academic and institutional adaptation, although they exhibit less ersonal-emotional adaptation. No differences were found in social adaptation between men and women. Regarding age, young students present less personal-emotional and institutional adaptation than adult students, and no differences were found in relation to academic adaptation. Conclusions: sex and age-group are relevant aspects in the study of university adaptation..Au

Formación ética como soporte del desarrollo moral del alumno de carreras de ciencias de la salud: hacia una enseñanza centrada en las necesidades del estudiante como persona / Ethical training as a support for the moral development of students in health sciences programs: towards a teaching focused on the needs of the student as a person

Tomando como base las encuestas epidemiológicas sobre salud mental aplicadas a estudiantes de las Ciencias de la Salud de la Facultad de Medicina (Medicina, Enfermería, Obstetricia, Nutrición y Tecnología Médica) de la Universidad Nacional Mayor de San Marcos, el autor postula que existen dos formas de entender las necesidades de enseñanza de la ética: 1) Como estrategia curricular, con información teórica a través de cursos específicos; y, 2) Como soporte al desarrollo moral de la personalidad con diversas metódicas innovadoras. Apoyándose en los resultados de las encuestas citadas, que evidencian prevalencias de vida de intento suicida y conductas disociales mayores que en población general, se plantea que tal enseñanza debe planificarse para dos grupos de alumnos con diferentes necesidades: 1) Aquellos que sin patología de salud mental pueden beneficiarse con la estrategia curricular regular; y, 2) Aquellos que, presentando problemas de salud mental e indicadores de dificultades en su conducta social, deben, además, ser ayudados con técnicas orientadas a ofrecerles apoyo en su desarrollo moral. Y que este reto educativo debe ser responsabilidad de la universidad del siglo XXI, bajo la pregunta de ¿qué necesita nuestro país, profesionales de la salud que sepan ética o que se comporten éticamente?.

Based on the epidemiological surveys on mental health applied to Health Science students of the School of Medicine (Medicine, Nursing, Obstetrics, Nutrition, and Medical Technology) of Universidad Nacional Mayor de San Marcos, the author postulates that there are two ways to understand the teaching needs of ethics: 1) as a curricular strategy, with theoretical information through specific courses; and, 2) as a support to the moral development of the personality with diverse innovative methods. Based on the results of the surveys mentioned, which show lifetime prevalence of suicide attempts and dissocial behaviors greater than in the general population, it is proposed that such teaching shall be planned for two groups of students with different needs: 1) those without a mental health pathology and who can benefit from the regular curricular strategy; and, 2) those who, with mental health problems and indicators of difficulties in their social behavior, shall also be helped with techniques aimed at offering them support in their moral development. And that this educational challenge must be the responsibility of the university of the 21st century, under the question: What does our country need, health professionals who know ethics or who behave ethically?.

Expectativas y experiencias de aprendizaje en la práctica profesional de estudiantes del área de la salud / Learning expectations and experiences in the profesional practice of students from the health area

Introducción: la experiencia clínica a nivel intrahospitalario es un aspecto fundamental en la formación de los estudiantes de las carreras de la salud, lo que constituye una instancia de aprendizaje altamente significativa. Objetivo: analizar las expectativas y experiencias que tienen los estudiantes de la carrera de Tecnología Médica de la Universidad de Chile, durante su práctica profesional en el área de tomografía computada. Métodos: estudio de tipo cualitativo, descriptivo con enfoque hermenéutico. La muestra fue de 25 estudiantes, que se logró a través de la saturación de categorías. La producción de información se realizó con portafolios que realizaron los estudiantes durante toda su práctica. Se utilizó el análisis de discurso para el estudio de la información. Resultados: tanto en las expectativas como en las experiencias emergieron 6 categorías, a saber: Equipo de trabajo, aplicación de conocimientos teóricos, relación paciente-estudiante, incorporación de nuevos conocimientos, trabajo a realizar en la práctica y estado emocional. Se encontró que el desempeño de los estudiantes en la práctica es influenciado de forma importante por sus expectativas. Las experiencias vividas dependen en gran medida de factores emocionales propios, del equipo médico-docente a cargo y la capacidad del estudiante de desenvolverse en el lugar de práctica profesional. Conclusiones: la formación profesional de los alumnos en el área de la salud es compleja, ya que no solo consiste en aprendizaje teórico, la práctica se convierte en un proceso fundamental, en donde aprender a manejar no solo las condiciones patológicas y técnicas resultan importantes, sino que es relevante que los alumnos logren la capacidad de la atención integral del paciente, preocupándose de la persona, sus emociones y de su bienestar(AU)

Introduction: The clinical experience at hospital level is a fundamental aspect in the training of students of health majors, constituting a highly significant setting of learning. Objective: To analyze the expectations and experiences of the students of the Medical Technology major at University of Chile, during their professional practice in the area of Computed Tomography. Methods: Qualitative, descriptive study with a hermeneutic approach. The sample was 25 students, which was achieved through the saturation of categories. The production of information was carried out with portfolios made by the students throughout their practice. Discourse analysis was used to study the information. Results: Expectations and experiences both produced six categories, namely: work team, application of theoretical knowledge, patient-student relationship, incorporation of new knowledge, work to be done in practice and emotional state. The performance of students in practice was found to be highly influenced by their expectations. The experiences lived greatly depend on their own emotional factors, the medical-teaching team in charge and the student's ability to function in the place of professional practice. Conclusions: The professional training of students in the health area is complex, since not only does it consist of theoretical learning, but also practice becomes a fundamental process, where learning to manage not only the pathological and technical conditions are important; it is important for the students to achieve the capacity of the patient's comprehensive care, taking care of the person, their emotions and their well-being(AU)

Valor humano del enfermo mental / Human value of the mentally ill

En este artículo se sostiene que la no estigmatización y la defensa de los derechos personales de los enfermos mentales dependen esencialmente de que se reconozca que su trastorno psíquico constituye un déficit en su humanidad. Con ese objetivo se consideran trespuntos. En el primero se analiza qué es lo que se ®asiste¼ psicológicamente en el ®área de saludmental¼ y qué segmento de esa ®asistencia¼ esestigmatizado; en el segundo se analiza cómo y por qué se ha pasado del modelo médico de la patología mental a la construcción social que afirma que la enfermedad mental es un mito (Th. Szasz, M. Foucault), entendiendo que esa afirmación debe ser cuestionada; en el tercero se afirma que el reconocimiento de que el déficit de autonomía personal de los diferentes tipos psicopatológicos está determinado por un proceso mórbido es lo que fundamenta el valor humano del enfermo mental.

This article argues that the non-stigmatization and defense of the personal rights of the mentally ill depend essentially on the recognition that their psychic disorder constitutes a deficit in their humanity. To this end, three points are considered. In the first, what is analyzed is analyzed psychologically in the "health area" and which segment of that "assistance" is stigmatized; in the second one, it is analyzed how and why the medical model of mental pathology has been passed to the social construction that affirms that mental illness is a myth (Th.Szasz, M. Foucault), understanding that this affirmation must be questioned; in the third it is affirmed that the recognition that the deficit of personal autonomy of the different psychopathological types is determined by a morbid process is what bases the human value of the mentally ill.

Perfil de ingreso de estudiantes en carreras del área de la salud / Students entrance profile in health area field careers

Objetivo: identificar el perfil académico de los estudiantes que ingresan a carreras del área de la salud (Fonoaudiología, Kinesiología, Nutrición y Dietética y Terapia Ocupacional). Métodos: se realizó un estudio cuantitativo de carácter descriptivo. La información se obtuvo a partir de la aplicación de un instrumento de caracterización académica inicial. Los hallazgos fueron resumidos en tablas y presentados a partir de números absolutos y porcentajes. Para el análisis de resultados se utilizó el paquete estadístico SPSS 22. Resultados: fueron evaluados 800 estudiantes (93,1 por ciento del total de la cohorte 2016). Entre los principales resultados destacan: 72 por ciento son mujeres, 52 por ciento son primera generación académica, 28 por ciento declara que trabajará durante el año académico, y 44 por ciento y 49 por ciento se encuentra en un nivel "bajo" en el desarrollo de las habilidades de razonamiento lógico y numérico, respectivamente. Además, los estudiantes reportan problemas para concentrarse, manejar la ansiedad en contextos académicos, seleccionar ideas principales, administrar el tiempo de estudio y preparar exámenes. Conclusiones: se establece la importancia de generar programas de apoyo que consideren las características de ingreso de los estudiantes a fin de favorecer el rendimiento académico, la permanencia y la integración al contexto universitario(AU)

Objective: Identify the entrance academic profile of students from the Health area field: Speech Therapy, Kinesiology, Nutrition and Dietetics, and Occupational Therapy. Method: A descriptive quantitative study was conducted. The information was obtained from the application of an academic initial characterization instrument. The findings were summarized in tables and presented from absolute numbers and percentages. For the results analysis SPSS 22 was used. Results: A total of 800 students (93.1percent of 2016 entrance cohort). The main results are: 72 are women, 52 percent are first academic generation, 28% say they will work during the academic year, and a 44 percent and 49 percent of the students are located in a "low" level of development of Logical Reasoning Skills and Numeric Abilities, respectively. In addition, students report problems with the Concentration and Anxiety management in academic contexts, Selecting main ideas, Time study management and Exams preparation strategies. Conclusions: The importance of generating support programs that consider the entrance characteristics of students in order to promote academic achievement, retention and integration into the university context is established(AU)

Application of Cost-Utility Analysis in Health Area of China:a Systematic Review / 中国药房

OBJECTIVE:To evaluate the application of cost-utility analysis in health area of China in recent year. METH-ODS:From CNKI,Wanfang and VIP database,settingcost utilityorcost-utilityastitleorkeyword,related literatures were retrieved during Jan. 2011-Dec. 2015,with subject field ofmedical science and technologyin CNKI,medical sciencein Wanfang database,clinical medicineChinese medicinepreclinical medicinepreventive medicine hygieneorpharmacyin VIP. The comprehensive evaluation involved research design,research perspective,cost measurement,utility index and measure-ment method,cost-utility analysis index,discount and sensitivity analysis. RESULTS:A total of 31 literatures meeting inclusion cri-teria were selected,including 12 prospective studies,9 retrospective studies,9 Markov model studies,1 mixed study. Thirteen lit-eratures worked in medical institutions. Seven literatures explicitly mentioned research perspective;most literatures only measured direct cost(19 literatures)and adopted QALY as utility index(27 literatures). Twenty eight literatures described measurement meth-od of utility index(direct measurement,indirect measurement or literature method)in detail. More than half(16 literatures)analyzed cost-utility by using cost-utility ratio(CUR);7 literatures adopted incremental cost-utility ratio(ICUR)and 6 literatures adopted both CUR and ICUR. Five literatures used the threshold of ICUR. Eleven literatures described discount,and the majority was Markov mod-el study. Sensitivity analysis was conducted in 16 literatures,among which 11 literatures adopted single factor analysis. The most com-monly involved influential factor was cost,followed by utility value and discount rate. CONCLUSIONS:Cost-utility analysis has been widely used in China,but the quality and normalization of studies have much room for improvement. Learning more experiences from international researches can help to promote the quality of domestic studies,guide the practice of clinical rational use of drugs and sup-port the government decision-making process and medical insurance payment in the future.

Modificación de conocimientos sobre educación ambiental en la carrera de Higiene y Epidemiología / Modification of knowledge about environmental education in the major Hygiene and Epidemiology

Introducción: la educación ambiental desarrolla hábitos, habilidades, actitudes y contribuye a la formación de valores, favoreciéndose que se armonicen las relaciones entre los hombres y con el resto de la sociedad y la naturaleza. Objetivo: elevar el nivel de conocimientos sobre educación ambiental en estudiantes de la carrera de Higiene y Epidemiología. Métodos: se realizó un estudio de intervención educativa en el curso 2014 - 2015. El universo de estudio estuvo constituido por los 33 estudiantes que pertenecían a la carrera de Higiene y Epidemiología y la muestra se correspondió con la población. Se aplicó una encuesta al inicio de la investigación, se implementó la intervención educativa y se comparó el nivel de conocimientos antes y después del estudio. Resultados: antes de la intervención educativa solo un 12 por ciento poseía conocimientos satisfactorios; después de la intervención educativa esta cifra ascendió a un 93,94 por ciento. Conclusiones: la intervención resultó eficaz al elevar el nivel de conocimientos de los alumnos, de modo que hubo una gran diferencia entre lo que sabían antes del estudio y lo que aprendieron en favor del medio ambiente después de su ejecución(AU)

Introduction: Environmental education develops habits, skills, attitudes and contributes to raising values, which favor the harmonization of the relationships among the men and with the rest of the society and nature. Objective: Increase the level of knowledge about environmental education in students majoring in Hygiene and Epidemiology. Method: An educative intervention study was carried out in the academic year 2014-15. The target group was made up by the 33 students majoring in Hygiene and Epidemiology, while the sample corresponded with the population. A survey was conducted at the beginning of the investigation, the educative intervention was implemented, and the knowledge level before and after the study were compared. Results: Before the educative intervention, only 12 percent of the students had satisfactory knowledge; after the educative intervention, this figure increased up to 93.94 percent. Conclusions: The intervention resulted useful because it increased the students' knowledge level, so that there was a big difference between what they knew before the survey and what they learnt in favor of the environment after the intervention was applied(AU)

Muerte súbita cardíaca. Comportamiento en las áreas de salud municipio Arroyo Naranjo. Ciudad de la Habana 2000-2004 / Sudden cardiac death. Behaviorin the Arroyo Naranjo communities in Havana City during the period 2000-2004

Problema científico: ¿Cómo se ha comportado la Muerte Súbita Cardíaca en las áreas de salud del Municipio Arroyo Naranjo, en Ciudad de La Habana durante el período 2000-2004? Propósito: Describir el comportamiento de la Muerte Súbita Cardíaca en las áreas de salud del Municipio Arroyo Naranjo, en Ciudad de La Habana durante el período 2000- 2004. Material y Método: Se realiza un estudio epidemiológico en una población de 210000 habitantes en las áreas de salud de la municipalidad de Arroyo Naranjo (Julián Grimau, Eléctrico, Párraga, Mantilla, Capri, Los Pinos y Managua), con un seguimiento de 5 años. Participaron el Grupo Cubano para el Estudio de la Muerte Súbita Cardíaca (GEMSC), el Centro de Investigaciones y Referencias de Aterosclerosis de La Habana (CIRAH) y la Universidad de Ciencias Médicas "Julio Trigo López". El estudio SUCADES I (SUdden CArdiac DEath Study) incluyó 5 098 fallecidos de muerte natural, a quienes se les aplicó los criterios de Muerte Súbita Cardiaca (MSC) de la Organización Mundial de la Salud (OMS). Resultados: El 9.3 % de las muertes estudiadas acontecieron de forma súbita. El 50.6 % de los eventos se manifestó en el sexo masculino, en edades de 60-74 años. La localidad de Párraga resultó la más afectada (23.4 %). El domicilio de la víctima fue el lugar de ocurrencia de 35.0 % de los eventos. El Infarto agudo del miocardio (IAM) se corroboró en 58.4 %. Conclusiones: Existió un predominio de la Muerte Súbita Cardíaca en el sexo masculino, en el grupo de 60-74 años, en el área de salud de Párraga, documentándose con mayor frecuencia en el medio extrahospitalario (domicilio de la víctima). El Infarto agudo del miocardio, los trastornos del ritmo cardíaco y la disfunción miocárdica ventricular izquierda constituyeron los principales diagnósticos definitivos.

Scientific Problem: How has the Sudden Cardiac Death behaved on the Clinical-Pathological bases in Arroyo Naranjo communities, in Havana City during the period 2000-2004?Objective:To describe the Sudden Cardiac Death behavior in the Arroyo Naranjo communities, in Havana City during the period 2000-2004. Material and method: An epidemiologic study was carried out in a population of 210000 inhabitant in the health areas of the Arroyo Naranjo municipality (Julián Grimau, Eléctrico, Párraga, Mantilla, Capri, Los Pinos y Managua), followed for 5 years. The Cuban Group for the Sudden Cardiac Death Study (GEMSC), The Research and Reference Center for Aterosclerosis from Havana (CIRAH) and the Medical Sciences Faculty "Julio Trigo López" took part. The SUCADES I study (SUdden CArdiac DEath Study) included 5098 dead of natural causes, to which the criteria of Sudden Cardiac Death (MSC) from the World Health Organization (OMS) were applied. Results:The 9.3 % of the deaths studied happened in a sudden way. The 50.6 % of the events occurred in the male sex, in ages between 60-74 years old. Párraga was the most affected area (23.4 %).The victim's house was the place where the 35.0% of the events happened. The acute myocardial infarct (AMI) was corroborated in the 58.4 %. Conclusions: Sudden Cardiac Death was predominant in the male sex, in the group between 60-74 years old, in Párraga's health area, most frequently documented in the extra hospital media (victim's house). The acute myocardial Infarct, the cardiac rhythm troubles and the left ventricular myocardial dysfunction constituted the main definitive diagnosis.

Mercado de trabalho dos odontólogos no Brasil / Labour market for dentists in Brazil

A partir das transformações no mundo do trabalho no setor de saúde, este artigo investiga a inserção dos odontólogos nesse cenário, por meio de dados sobre oferta e demanda. Os resultados revelaram grande crescimento, concentração geográfica e privatização da formação desses profissionais, assim como mudanças substanciais relativas à sua inclusão no mercado de trabalho em saúde, antagônicas ao paradigma liberal da profissão. Acredita-se que o produto desta investigação, além de subsidiar organizações profissionais, contribua para a formulação de políticas de recursos humanos voltadas ao Sistema Único de Saúde, no âmbito da gestão do trabalho e da formação na área de saúde.

Taking into consideration the changes in the health-labor market, this article investigates the introduction of dentists in this scenario through data about offering and demand. The results showed high growth, geographic concentration, all privatization of the formation of these profissionais as well as many substantial changes related to the introduction in the health-labor market, contrary to the liberal paradigm of the profission. The product of these investigations is believed to be a contribution to the formulation of human resources policies for the Unified Health System, in the ambit of labor management and formation in the health sector as well as to give subsidies to profissional organizations.

Técnicos em saúde: constituição de uma identidade / Health technicians: the constitution of an identity

O artigo revisita o processo histórico de construção da identidade profissional dos técnicos em saúde no Brasil, em busca de subsídios para a compreensão de questões inerentes à educação profissional de nível médio. Como fontes de pesquisa, utilizaram-se a legislação brasileira para a Educação e referenciais, diretrizes e documentos técnicos do Ministério da Educação, além do banco de dados do Censo da Educação Profissional (2003) do INEP. Como conclusão, aponta para o fortalecimento do conceito de equipe multiprofissional em saúde como alternativa para a valorização das profissões não médicas, em especial aquelas de nível médio em saúde.

This paper goes through the historical process of health technician profissional identity construction in Brazil, searching for subsidies to understand questions about the profissional education at High School. It has been used, as sources, the Brazilian legislation for the education and other governmental technical documents, and the 2003's profissional educational census data base of INEP. The article concludes pointing to the reinforcement of the health multiprofissional team concept as an alternative to value non-physician profissions, especially those formed by Brazilian high schools in health.

Conocimientos sobre el proceso de Extensión Universitaria en un área de salud / Knowledges on the University Extent process in a health area

Introducción: la Extensión Universitaria tiene la cualidad de ser integradora y totalizadora. Posee un doble carácter de función y proceso consustancial. Constituye la vía expedita para encauzar la formación cultural integral. Objetivos: evaluar el conocimiento que el claustro de profesores del departamento docente del Policlínico Universitario Ana Betancourt, en el municipio Playa, tiene sobre el proceso de Extensión Universitaria. Método: se trata de un estudio descriptivo exploratorio. La muestra estuvo conformada por 10 profesores a quienes se les aplicó, previo consentimiento, una encuesta semiestructurada de carácter anónimo como herramienta para la recolección de la información. El instrumento tiene 8 preguntas, 7 cerradas y 1 final abierta. Resultados: el 100 por ciento de los encuestados afirmó conocer que en su área de salud se llevan a cabo acciones extensionistas, sin embargo, solo el 60 por ciento señaló, acertadamente, la totalidad de estas acciones. Todos los participantes señalaron inadecuadamente, al colectivo de asignatura, como el marco donde se materializa la planificación estratégica del trabajo extensionista y aseguraron desconocer que en su institución existiera algún departamento que dirija estas acciones. Los encuestados desconocen los documentos rectores del trabajo extensionista y los aspectos fundamentales hacia dónde deben encaminarse las líneas prioritarias para el desarrollo de dicha labor. Sin embargo, la totalidad de la muestra consideró correctamente que la promoción de salud constituye el eje central de la labor extensionista en la Universidad Médica Cubana. Conclusiones: el conocimiento que posee el claustro de profesores es insuficiente y se asienta, entre otros, en el desconocimiento de los principales documentos, lineamientos y prioridades que rigen el trabajo extensionista en Cuba...

Introduction: the University Extent has an integrating totalizator quality. Also, it has a double character of be an integral part and a function of a process. It is the clear rout to direct the integral cultural training. Objectives: to assess the staff knowledge of the educational department of Ana Betancourt University Polyclinic on the University Extent process. Method: it is an exploratory and descriptive study. Authors applied, with previous consent, a semi-structured anonymous survey (8 questions, 7 closed and 1 open final) in 10 professors to collect the information. Results: the 100 percent of person polled confirmed to know that in its health area extension actions are carried out, however, only the 60 percent marked in a correct way, the total of these actions. All participants indicated in an unsuitable way that the subject group was the framework where the strategic planning of extension work is materialized and to assured not to know that in its institution there was a department directing these actions. Person polled not to know the guiding documents of the extension work and the main features to direct the priority lines for the development of such task. However, the total sample considered appropriately that the health promotion is the central axis this extension task in Cuban Medical University. Conclusions: the staff knowledge is insufficient and it is based among other features in the ignorance of main documents, lineaments and priorities governing the extension work in Cuba...

Research and the (free and) informed consent

The aim of this article was to reflect about the Free and Informed Consent (IC) in qualitative researches in the health field. Coming from the experience of being part of a CER (Committee for Ethic in Research) in the health area the authoresses place in debate some important questions, exploring them and conducting suggestions. One of these questions and topic of analysis is the meaning of IC, as for the participant as for the researcher.

Este artigo teve como objetivo refletir sobre o Termo de Consentimento Livre e Esclarecido (TCLE) em pesquisas qualitativas no campo da saúde. Partindo da sua experiência de pertencimento a um CEP (Comitê de Ética em Pesquisa), na área da saúde, as autoras colocam em discussão algumas questões importantes, problematizando-as e encaminhando sugestões. Uma dessas questões e objeto da reflexão é o significado do TCLE, tanto para o participante como para o pesquisador.

Análise do processo ensino aprendizagem na Escola Técnica do Sistema Único de Saúde do Município de São Paulo

O estudo analisa a prática pedagógica dos professores dos Cursos de Educação Profissional de nível técnico da Escola Técnica do Sistema Único de Saúde do município de São Paulo (ETSUS-SP). A investigação, de caráter descritivo-analítico, foi desenvolvida sob a vertente qualitativa. Aos sujeitos do estudo, 13 docentes dos diferentes cursos oferecidos pela ETSUS-SP, foram aplicadas entrevistas semi-estruturadas, com base em roteiro. As informações colhidas foram submetidas à análise de conteúdo, por meio de núcleos temáticos. Os resultados evidenciam que houve apropriação e aplicação do ideário pedagógico da ETSUS-SP pelos professores em sua prática pedagógica, e este, possibilitou a aprendizagem significativa dos alunos. Neste ideário foram destacadas: a metodologia problematizadora de ensino, eixo articulador das dimensões curriculares: filosófica, psicológica e sócio-cultural; e ainda, o currículo integrado que respeita a não fragmentação do conhecimento em disciplinas isoladas, considerando, desta forma, a realidade social enquanto uma totalidade concreta com seus elementos organicamente articulados

The present study analyzes the pedagogical practice of the teachers from the Single Health System Technical School of the city of São Paulo – ETSUS-SP. The investigation, which has an analytical-descriptive nature, was focused on qualitative aspects. As for the subjects of the study, thirteen professor from different courses offered by ETSUS-SP, semi-structured interviews were made, based on a script. The data obtained was submitted to a content analysis, though thematic centers. The results demonstrate that there were appropriation and implementation of the pedagogical idealism of ETSUS-SP by the professors, in their pedagogical practice, and this provided the significant learning by the students. In this idealism was emphasized: the problem-teaching methodology, curricular dimensions main axis: philosophical, psychological and socio-cultural; furthermore, the integrated curriculum that abides by the non-fragmentation of the knowledge in isolated disciplines, considering, thereby, the social reality while a concrete completeness with its elements organically articulated

Análise do processo ensino aprendizagem na escola técnica do sistema único de saúde do município de São Paulo / Analyze the teaching lernin g process of the single health system technical school of the city os São Paulo

O estudo analisa a prática pedagógica dos professores dos Cursos de Educação Profissional de nível técnico da Escola Técnica do Sistema Único de Saúde do município de São Paulo (ETSUS-SP). A investigação, de caráter descritivo-analítico, foi desenvolvida sob a vertente qualitativa. Aos sujeitos do estudo, 13 docentes dos diferentes cursos oferecidos pela ETSUS-SP, foram aplicadas entrevistas semi-estruturadas, com base em roteiro. As informações colhidas foram submetidas à análise de conteúdo, por meio de núcleos temáticos. Os resultados evidenciam que houve apropriação e aplicação do ideário pedagógico da ETSUS-SP pelos professores em sua prática pedagógica, e este, possibilitou a aprendizagem significativa dos alunos. Neste ideário foram destacadas: a metodologia problematizadora de ensino, eixo articulador das dimensões curriculares: filosófica, psicológica e sócio-cultural; e ainda, o currículo integrado que respeita a não fragmentação do conhecimento em disciplinas isoladas, considerando, desta forma, a realidade social enquanto uma totalidade concreta com seus elementos organicamente articulados.

The present study analyzes the pedagogical practice of the teachers from the Single Health System Technical School of the city of São Paulo – ETSUS-SP. The investigation, which has an analytical-descriptive nature, was focused on qualitative aspects. As for the subjects of the study, thirteen professor from different courses offered by ETSUS-SP, semi-structured interviews were made, based on a script. The data obtained was submitted to a content analysis, though thematic centers. The results demonstrate that there were appropriation and implementation of the pedagogical idealism of ETSUS-SP by the professors, in their pedagogical practice, and this provided the significant learning by the students. In this idealism was emphasized: the problem-teaching methodology, curricular dimensions main axis: philosophical, psychological and socio-cultural; furthermore, the integrated curriculum that abides by the non-fragmentation of the knowledge in isolated disciplines, considering, thereby, the social reality while a concrete completeness with its elements organically articulated.

Considerações sobre o Programa de Saúde da Família e a promoção de maior eqüidade na política de saúde / Considerations about the Family Health Program and the promotion of greater equity in health care policy

Na Constituição Brasileira, a eqüidade em saúde é tomada como igualdade, garantida pela gratuidade no acesso aos serviços de saúde, o que pressupõe não só uma divisão quantitativa de recursos, mas sua orientação à redução das desigualdades sociais, por meio do modelo assistencial. Nesse sentido, estratégias como o Programa de Saúde da Família têm sido consideradas como implementadoras do acesso ao sistema de saúde. Este estudo tem como objetivo desenvolver uma reflexão sobre eqüidade e modelo assistencial PSF, através de revisão baseada em autores que discutem o tema. A visão sobre o Programa de Saúde da Família vem mudando com o passar do tempo, desde crítica a seu caráter focalizado até sua consideração como ação afirmativa. Estudos mostram que mudanças no financiamento e no planejamento do sistema aproximaram os municípios e envolveram novos atores no processo, trazendo maior acesso à atenção básica - embora sem influenciar os outros níveis do sistema. Para que o Programa de Saúde da Família assuma caráter de estratégia de inclusão de segmentos populacionais que não têm acesso aos serviços de saúde, deverá realizar-se por meio de sua incorporação a uma política maior, que garanta suporte social, direitos universais e efetiva implementação da política de saúde.

In the Brazilian Constitution, equity in health care is considered equality guaranteed by free access to health services. This presupposes not only a quantitative division of resources but that they are steered toward reducing social inequalities through assistance programs. In this context, strategies such as the Family Health Program are understood to have allowed access to the health care system. The relationship between equity and assistance programs like FHP is discussed based in a review of papers by different authors. Opinions about the Family Health Program have changed over time, from criticism for having a narrow focus to being a form of affirmative action. Studies show that changes in the financing and planning of the system have established a close relationship between the participating municipalities and involved new actors in the process. This has brought greater access to basic care, without influencing the other levels of the system. For the Family Health Program to serve as a strategy for the inclusion of population segments that do not have access to health services, it should be incorporated into a broader policy that guarantees social support, universal rights and the effective implementation of the health policy.