Impacts of short-term water restriction on Pelibuey sheep: physiological and blood parameters.

One of the projected effects of climate change is a reduction in rainfall in certain regions of the world. Hence, the agricultural and livestock sectors will have to cope with increasing incidences of water shortage while still maintaining productivity levels to feed an ever increasing global population. This short communication reports on the effect of a 2-week water stress on Pelibuey sheep in Cuba. Three treatments were compared, viz. supply of water ad libitum, water supplied once every 3 or 6 days. Following exposure to the water stress, the results showed no changes in sheep body weight or rectal temperature. However, respiration frequency was affected with water stress causing a reduction from 23.3 to 13.3 respirations per min in control and water-deprived animals, respectively. Furthermore, there was evidence for hemoconcentration in response to water stress (levels of hemoglobin increased from 9.2 to 13.1 g L-1 and hematocrits from 27.6 to 39.3% in the control group and animals restricted to water once every 6 days. The imposed water stress was also evident in the reduction of lymphocytes (from ±63 to 43%), and in increase of neutrophils (from approximately 38 to 54%) and leukocytes (from 3133 to 4933 per mm3). The results indicated a decline in the levels of antioxidants, i.e., SOD from approximately 13 to 10 U mg-1 protein and CAT activity from 23 to 9 U mg-1 protein. To the best of our knowledge, this is the first report on the response of Pelibuey sheep to short-term water shortage stress under Cuban environmental conditions.

Fructooligosaccharides production by immobilized Pichia pastoris cells expressing Schedonorus arundinaceus sucrose:sucrose 1-fructosyltransferase.

Fructooligosaccharides (FOSs)-fructose-based oligosaccharides-are typical prebiotics with health-promoting effects in humans and animals. The trisaccharide 1-kestotriose is the most attractive inulin-type FOS. We previously reported a recombinant sucrose:sucrose 1-fructosyltransferase (1-SST, EC 2.4.1.99) from Schedonorus arundinaceus (Sa) that efficiently converts sucrose into 1-kestotriose. In this study, Pichia pastoris PGFT6x-308 constitutively expressing nine copies of the Sa1-SST gene displayed fructosyltransferase activity in undisrupted biomass (49.8 U/ml) and culture supernatant (120.7 U/ml) in fed-batch fermentation (72 hr) with sugarcane molasses. Toluene permeabilization increased 2.3-fold the Sa1-SSTrec activity of whole cells entrapped in calcium-alginate beads. The reaction with refined or raw sugar (600 g/l) yielded 1-kestotriose and 1,1-kestotetraose in a ratio of 8:2 with their sum representing above 55% (wt/wt) of total carbohydrates. The FOSs yield decreased to 45% (wt/wt) when sugarcane syrup and molasses were used as cheaper sucrose sources. The beads retained 80% residual Sa1-SSTrec activity after a 30-day batchwise operation with refined cane sugar at 30°C and pH 5.5. The immobilized biocatalyst is attractive for the continuous production of short-chain FOSs, most particularly 1-kestotriose.

Removal of bacterial dextran in sugarcane juice by Talaromyces minioluteus dextranase expressed constitutively in Pichia pastoris.

A gene construct encoding the mature region of Talaromyces minioluteus dextranase (EC 3.2.1.11) fused to the Saccharomyces cerevisiae SUC2 signal sequence was expressed in Pichia pastoris under the constitutive glyceraldehyde 3-phosphate dehydrogenase promoter (pGAP). The increase of the transgene dosage from one to two and four copies enhanced proportionally the extracellular yield of the recombinant enzyme (r-TmDEX) without inhibiting cell growth. The volumetric productivity of the four-copy clone in fed batch fermentation (51 h) using molasses as carbon source was 1706 U/L/h. The secreted N-glycosylated r-TmDEX was optimally active at pH 4.5-5.5 and temperature 50-60 °C. The addition of sucrose (600 g/L) as a stabilizer retained intact the r-TmDEX activity after 1-h incubation at 50-60 °C and pH 5.5. Bacterial dextran in deteriorated sugarcane juice was completely removed by applying a crude preparation of secreted r-TmDEX. The high yield of r-TmDEX in methanol-free cultures and the low cost of the fed batch fermentation make the P. pastoris pGAP-based expression system appropriate for the large scale production of dextranase and its use for dextran removal at sugar mills.

Dr. C. Ramón Syr Salas Perea y su aporte a la educación en Ciencias de la Salud / Ramón Syr Salas Perea, PhD and his contribution to Health Science Education

Varios autores califican de Maestro a todo aquel que enseña; el Dr. Ramón Syr Salas Perea considerado de esta forma, contribuyó al desarrollo de profesionales de la salud, pues guió, asesoró y estimuló el comportamiento de los profesores en el sector salud, así como la búsqueda del objeto del saber. "Cuando se ha cumplido bien la obra de la vida", quedan el recuerdo y las enseñanzas para siempre en aquellos que se han educado; es este el caso de la fructífera y laboriosa existencia del maestro Dr. Ramón Syr Salas Perea durante su vida y sus aportes en la formación de los recursos humanos en el sector salud.

A Teacher is the one who teaches, as several authors have expressed. Dr. Ramón Syr Salas Perea was considered an outstanding teacher who contributed to the development of health professionals since he guided, advised, and encouraged the teachers' behavior in the health sector and made them realize the importance of the search for knowledge. When the work of life has been well fulfilled, memories and teaching actions will ever remain in the memory of those who have been educated. This is the case of the fruitful and hard-working labor carried out by the university teacher Dr. Ramón Syr Salas Perea during all his life, as well as his contributions in the training of human resources in the health sector.

Ruptura esplénica espontánea como complicación en la malaria aguda grave por plasmodium falciparum / Spontaneous splenic rupture as a complication in plasmodium falciparum acute severe malaria

Se presenta el caso clínico de un paciente con rotura espontánea del bazo, como complicación grave y poco frecuente de la malaria aguda. Esta complicación puede acontecer desde la primera semana de enfermedad y su diagnóstico tardío es potencialmente fatal. Debe sospecharse en todo paciente con malaria grave, que evolutivamente presente un abdomen agudo y signos de shock hipovolémico. El manejo médico o quirúrgico dependerá de la magnitud de la ruptura y del estado hemodinámico del paciente. Se presenta el caso por la gravedad y escasa frecuencia de esta complicación(AU)

We present a clinical case of a patient with spontaneous rupture of the spleen, as a serious and uncommon complication of acute malaria. This complication can occur from the first week of illness and its late diagnosis is potentially fatal. It should be suspected in all patients with severe malaria, who evolutionarily present an acute abdomen and signs of hypovolemic shock. Medical or surgical management will depend on the extent of the rupture and hemodynamic status of the patient. The case is presented due to the severity and low frequency of this complication(AU)

Proceso Atención de Enfermería desde la perspectiva docente / Nursing Care Process from the teaching perspective

RESUMEN Fundamento: no es posible lograr una atención completa solo con el cumplimiento de los tratamientos médicos, se necesita de un pensamiento científico donde se aplique la base teórica de la profesión, el Proceso de Atención de Enfermería. Objetivo: argumentar el contenido sobre el Proceso Atención de Enfermería desde la perspectiva docente. Métodos: se realizó una revisión bibliográfica a través de una búsqueda realizada entre los años 1996 al 2017, donde se consultaron bases de datos especializadas y se seleccionaron 25 publicaciones científicas sobre el tema. Desarrollo: el Proceso de Atención de Enfermería se caracteriza por tener una base teórica, pues es un proceso concebido a partir de conocimientos sólidos que le permite al estudiante y al profesional plantear y organizar sus acciones de enfermería, con la finalidad de dirigir y alcanzar un objetivo: la interacción entre enfermera-paciente, familia y comunidad, al establecer relaciones recíprocas e interdisciplinarias donde el proceso sea dinámico y flexible para lograr que en el ejercicio de la Enfermería se adapten a los ámbitos clínico y comunitario o en áreas especializadas, que respondan a las necesidades actuales. Conclusiones: el Proceso de Atención de Enfermería desde la perspectiva docente, ha contribuido a comprender y adaptar un trabajo permanente con los estudiantes para alcanzar la integración docencia-asistencia.

ABSTRACT Background: it is not possible to achieve complete attention only with compliance with medical treatments, scientific thought is needed where the theoretical basis of the profession is applied, the Nursing Care Process. Objective: to argue the content about the Nursing Care Process from the teaching perspective. Methods: a bibliographic review was carried out through a search conducted between 1996 and 2017, where specialized databases were consulted and 25 scientific publications on the subject were selected. Development: the Nursing Care Process is characterized because it has a theoretical basis, as it is a process conceived from solid knowledge that allows the student and the professional to plan and organize their nursing actions, in order to direct and achieve a goal : the interaction between nurse-patient, family and community, establishing reciprocal and interdisciplinary relationships, being dynamic and flexible, trying in the Nursing practice to adapt it to the clinical and community spheres or in specialized areas, and responding to current needs. Conclusions: the Nursing Care Process from the teaching perspective, has contributed to understand and adapt a permanent work with the students building to achieve the teaching-assistance integration.

Formación del capital humano para la salud en Cuba

[RESUMEN]. Se caracterizan los rasgos distintivos del sistema de formación de los profesionales y los técnicos de la salud en Cuba, y se describen las adecuaciones de los modelos educativos para satisfacer las necesidades de los servicios de salud y su adaptación al entorno socioeconómico y científico-técnico. La educación para la salud es universal, gratuita y está vinculada estrechamente al Sistema Nacional de Salud. Los currículos se enfocan en la interrelación entre la formación académica con la clínica y la actividad comunitaria, cuya forma fundamental de enseñanza-aprendizaje es la educación en el trabajo. El principio fundamental de la educación médica es la integración docente, asistencial e investigativa en el sistema de salud, lo que garantiza que los estudiantes se incorporen a los escenarios docente-asistenciales mediante la interacción de la universidad con la sociedad. Los diseños curriculares están basados en los principales problemas de salud de la población y el medioambiente, con hincapié en la atención primaria de salud. Desde 1959 se han graduado cerca de 350 000 profesionales; de ellos, 41 000 extranjeros. Además, en 12 países se forman más de 30 000 estudiantes con las brigadas médicas internacionalistas cubanas. En la actualidad, existen elevadas matrículas que incrementan la carga docente-asistencial de los profesores. Se necesita fomentar el empleo de docentes y tutores jóvenes y la formación de profesores de ciencias básicas.

[ABSTRACT]. The distinctive features of the training system of health professionals and technicians in Cuba are characterized, and the adaptations of the educational models to meet the needs of health services and their adaptation to the socio-economic and scientific-technical environment are described. Education for health is universal, free and is closely linked to the National Health System. The curricula focus on the interrelation between academic training and clinical practice and community activity, whose fundamental form of teaching-learning is based on education at work. The fundamental principle of medical education is the integration of teaching, health care, and research within the health system, which ensures that students are embedded into the teaching-care scenarios through the interaction of the university with society. The curricular plans are based on the main health problems of the population and the environment, with emphasis on primary health care. Since 1959, nearly 350 000 professionals have graduated, including 41 000 foreign students. In addition, more than 30 000 students are trained in 12 countries with the Cuban international medical brigades. Currently, high enrollments increase the teaching-care burden of faculty staff and faculty is subject to frequent changes, representing a challenge to maintaining high-quality training. The scarcity of basic science teachers also affects training. The recruitment of teachers and young tutors needs to be encouraged.

[RESUMO]. As características distintivas do sistema de treinamento de profissionais e técnicos de saúde em Cuba são caracterizadas e as adaptações dos modelos educacionais para atender às necessidades dos serviços de saúde e sua adaptação ao ambiente sócio-econômico e científico-técnico são descritas. A educação para a saúde é universal, gratuita e está intimamente ligada ao Sistema Nacional de Saúde. Os currículos centram-se na inter-relação entre o treinamento acadêmico com a prática clínica e a atividade comunitária, cuja forma fundamental de ensino-aprendizagem é a educação no trabalho. O princípio fundamental da educação médica é a integração do ensino, do cuidado de saúde e da pesquisa no sistema de saúde, o que garante que os alunos sejam incorporados nos cenários de ensino-cuidado através da interação da universidade com a sociedade. Os projetos curriculares são baseados nos principais problemas de saúde da população e do meio ambiente, com ênfase na atenção primária à saúde. Desde 1959, cerca de 350 000 profissionais se formaram, incluindo 41 000 profissionais estrangeiros. Além disso, mais de 30 000 alunos são treinados em 12 países com as brigadas médicas internacionalistas cubanas. Atualmente, há altas matrículas que aumentam a carga de ensino-cuidado dos professores e mudanças freqüentes são feitas na faculdade, o que complicou os desafios para manter um treinamento de alta qualidade. A escassez de professores de ciências básicas também afeta o treinamento. O emprego de professores e jovens tutores deve ser encorajado.

Resultados de trabajo del Grupo para el Estudio de las Competencias en Salud / Work outcomes of the Group for the Study of Health Competences

Introducción: las competencias y el desempeño laboral de los profesionales de la salud han constituido una preocupación de los sistemas de salud en el mundo para incrementar la calidad de los servicios y ha exigido a las universidades de ciencias médicas aportarles un profesional con adecuada capacidad y modo de actuación profesional. Objetivo: informar a la comunidad científica los resultados de trabajo y aportes científicos del Grupo para el Estudio de las Competencias en Salud durante los años 2015-2016. Métodos: se realizó un estudio cualitativo de carácter descriptivo de la actividad científica que ha desarrollado el Grupo para el Estudio de las Competencias en Salud. Se efectuaron diversas actividades como talleres, conferencias, presentación de temas y grupo de discusión. Resultados: el grupo integrado por 15 profesionales de la Universidad de Ciencias Médicas de La Habana, se trazó diferentes objetivos de trabajo y debatió sobre temas relacionados con definiciones, historia y evolución de las competencias, metodologías, cienciometría y competencias profesionales en Medicina Interna, Medicina Intensiva y Emergencias y Pediatría, fundamentalmente. Se realizaron 15 publicaciones científicas en 7 revistas nacionales e internacionales, dos tesis doctorales y se aplicó un programa académico en el internado vertical de la carrera de medicina por competencias profesionales. Conclusión: el Grupo para el Estudio de las Competencias en Salud ha realizado un encomiable trabajo de desarrollo tecnológico, prospectivo, propositivo y de proyección estratégica en múltiples esferas de las ciencias biomédicas, con resultados muy positivos en su producción científica para desarrollar y perfeccionar el enfoque de las competencias en salud en Cuba(AU)

Introduction: Competences and work performance of health professionals have been a concern of the health systems in the world for increasing the quality of services, and have required, from the universities of medical sciences, to provide them with professionals with adequate capabilities and professional performance. Objective: To inform the scientific community of the results of work and scientific contributions of the Group for the Study of Health Competences during the years 2015-2016. Methods: A qualitative study of a descriptive nature of the scientific activity developed by the Group for the Study of Health Competences was carried out. Various activities were carried out, such as workshops, conferences, presentation of topics and discussion group. Results: The group made up by 15 professionals from the University of Medical Sciences of Havana, set out different work objectives and discussed issues related to the definitions, history and evolution of competences, methodologies, scientometrics, and professional competences in Internal Medicine, Intensive Medicine and Emergencies and Pediatrics, mainly. Fifteen scientific publications were made in seven national and international journals, two doctoral dissertations and an academic curriculum was applied in the vertical internship of the medical major for professional skills. Conclusion: The Group for the Study of Health Competences has carried out a praiseworthy work of technological development, also prospective, propositive and of strategic projection in multiple areas of the biomedical sciences, with very positive results in its scientific production for developing and improving the approach of health competences in Cuba(AU)

Diagnóstico de mielomeningocele en un feto mediante resonancia magnética de bajo campo. Presentación de un caso / Diagnosis of mielomeningocele in a fetus through low field magnetic resonance. Case Presentation

La malformación del tubo neural (mielomeningocele) es una enfermedad genética caracterizada por defecto del cierre posterior de las vértebras. El diagnóstico prenatal suele realizarse por ecografía. Se presenta el caso de una embarazada de 35 años de edad, con 26 semanas de gestación, resultado positivo en prueba de alfa feto proteína y dudas en ultrasonido diagnóstico que valoraba la posibilidad de una malformación del tubo neural, por lo que se sugirió realizar resonancia magnética. Al no contar en Cienfuegos con resonancia magnética de alto campo, se aplicaron parámetros de estos equipos a uno de bajo campo (0,35 tesla), con lo que se confirmó el diagnóstico. Las malformaciones del tubo neural, al no ser frecuentes, deben tomarse en cuenta por su costo familiar, personal, social y económico. Es importante diagnosticarlas de manera oportuna a fin de administrar el tratamiento específico, de ahí la importancia de la presentación de este caso, además de lograr la certeza del diagnóstico con un equipo de bajo campo.

The malformation in the neural canal (mielomeningocele) is a genetic disease characterized by a defect in the posterior wedge vertebral closing. Prenatal diagnosis is done by echography. A case of a 35 year old pregnant woman with 26 weeks of gestation is presented with a possitive result of alphafeto protein test and doubts in diagnostic ultrasound evaluating the possibility of a neural canal malformation. For these reasons it was suggested to perform a high field magnetic resonance. As high field resonance is not available, the parameters of low field were applied to this equipment (0.35 Tesla), which confimed the diagnosis. Neural canal malformations are not frequent therefore familial, personal, social and economical costs should be taken into consideration. It is important to diagnose them timely in order to administer the especific treatment. This is the foundation the case presentation importance, added to having achieved a certain diagnosis with a low field equipment.

[Training of human capital for health in CubaFormação de capital humano para a saúde em Cuba]. / Formación del capital humano para la salud en Cuba.

The distinctive features of the training system of health professionals and technicians in Cuba are characterized, and the adaptations of the educational models to meet the needs of health services and their adaptation to the socio-economic and scientific-technical environment are described. Education for health is universal, free and is closely linked to the National Health System. The curricula focus on the interrelation between academic training and clinical practice and community activity, whose fundamental form of teaching-learning is based on education at work. The fundamental principle of medical education is the integration of teaching, health care, and research within the health system, which ensures that students are embedded into the teaching-care scenarios through the interaction of the university with society. The curricular plans are based on the main health problems of the population and the environment, with emphasis on primary health care. Since 1959, nearly 350 000 professionals have graduated, including 41 000 foreign students. In addition, more than 30 000 students are trained in 12 countries with the Cuban international medical brigades. Currently, high enrollments increase the teaching-care burden of faculty staff and faculty is subject to frequent changes, representing a challenge to maintaining high-quality training. The scarcity of basic science teachers also affects training. The recruitment of teachers and young tutors needs to be encouraged.

As características distintivas do sistema de treinamento de profissionais e técnicos de saúde em Cuba são caracterizadas e as adaptações dos modelos educacionais para atender às necessidades dos serviços de saúde e sua adaptação ao ambiente sócio-econômico e científico-técnico são descritas. A educação para a saúde é universal, gratuita e está intimamente ligada ao Sistema Nacional de Saúde. Os currículos centram-se na inter-relação entre o treinamento acadêmico com a prática clínica e a atividade comunitária, cuja forma fundamental de ensino-aprendizagem é a educação no trabalho. O princípio fundamental da educação médica é a integração do ensino, do cuidado de saúde e da pesquisa no sistema de saúde, o que garante que os alunos sejam incorporados nos cenários de ensino-cuidado através da interação da universidade com a sociedade. Os projetos curriculares são baseados nos principais problemas de saúde da população e do meio ambiente, com ênfase na atenção primária à saúde. Desde 1959, cerca de 350 000 profissionais se formaram, incluindo 41 000 profissionais estrangeiros. Além disso, mais de 30 000 alunos são treinados em 12 países com as brigadas médicas internacionalistas cubanas. Atualmente, há altas matrículas que aumentam a carga de ensino-cuidado dos professores e mudanças freqüentes são feitas na faculdade, o que complicou os desafios para manter um treinamento de alta qualidade. A escassez de professores de ciências básicas também afeta o treinamento. O emprego de professores e jovens tutores deve ser encorajado.

Formación del capital humano para la salud en Cuba / Training of human capital for health in Cuba

Se caracterizan los rasgos distintivos del sistema de formación de los profesionales y los técnicos de la salud en Cuba, y se describen las adecuaciones de los modelos educativos para satisfacer las necesidades de los servicios de salud y su adaptación al entorno socioeconómico y científico-técnico. La educación para la salud es universal, gratuita y está vinculada estrechamente al Sistema Nacional de Salud. Los currículos se enfocan en la interrelación entre la formación académica con la clínica y la actividad comunitaria, cuya forma fundamental de enseñanza-aprendizaje es la educación en el trabajo. El principio fundamental de la educación médica es la integración docente, asistencial e investigativa en el sistema de salud, lo que garantiza que los estudiantes se incorporen a los escenarios docente-asistenciales mediante la interacción de la universidad con la sociedad. Los diseños curriculares están basados en los principales problemas de salud de la población y el medioambiente, con hincapié en la atención primaria de salud. Desde 1959 se han graduado cerca de 350 000 profesionales; de ellos, 41 000 extranjeros. Además, en 12 países se forman más de 30 000 estudiantes con las brigadas médicas internacionalistas cubanas. En la actualidad, existen elevadas matrículas que incrementan la carga docente-asistencial de los profesores. Se necesita fomentar el empleo de docentes y tutores jóvenes y la formación de profesores de ciencias básicas. (AU)

Formación del capital humano para la salud en Cuba / Training of human capital for health in Cuba / Formação de capital humano para a saúde em Cuba

RESUMEN Se caracterizan los rasgos distintivos del sistema de formación de los profesionales y los técnicos de la salud en Cuba, y se describen las adecuaciones de los modelos educativos para satisfacer las necesidades de los servicios de salud y su adaptación al entorno socioeconómico y científico-técnico. La educación para la salud es universal, gratuita y está vinculada estrechamente al Sistema Nacional de Salud. Los currículos se enfocan en la interrelación entre la formación académica con la clínica y la actividad comunitaria, cuya forma fundamental de enseñanza-aprendizaje es la educación en el trabajo. El principio fundamental de la educación médica es la integración docente, asistencial e investigativa en el sistema de salud, lo que garantiza que los estudiantes se incorporen a los escenarios docente-asistenciales mediante la interacción de la universidad con la sociedad. Los diseños curriculares están basados en los principales problemas de salud de la población y el medioambiente, con hincapié en la atención primaria de salud. Desde 1959 se han graduado cerca de 350 000 profesionales; de ellos, 41 000 extranjeros. Además, en 12 países se forman más de 30 000 estudiantes con las brigadas médicas internacionalistas cubanas. En la actualidad, existen elevadas matrículas que incrementan la carga docente-asistencial de los profesores. Se necesita fomentar el empleo de docentes y tutores jóvenes y la formación de profesores de ciencias básicas.

ABSTRACT The distinctive features of the training system of health professionals and technicians in Cuba are characterized, and the adaptations of the educational models to meet the needs of health services and their adaptation to the socio-economic and scientific-technical environment are described. Education for health is universal, free and is closely linked to the National Health System. The curricula focus on the interrelation between academic training and clinical practice and community activity, whose fundamental form of teaching-learning is based on education at work. The fundamental principle of medical education is the integration of teaching, health care, and research within the health system, which ensures that students are embedded into the teaching-care scenarios through the interaction of the university with society. The curricular plans are based on the main health problems of the population and the environment, with emphasis on primary health care. Since 1959, nearly 350 000 professionals have graduated, including 41 000 foreign students. In addition, more than 30 000 students are trained in 12 countries with the Cuban international medical brigades. Currently, high enrollments increase the teaching-care burden of faculty staff and faculty is subject to frequent changes, representing a challenge to maintaining high-quality training. The scarcity of basic science teachers also affects training. The recruitment of teachers and young tutors needs to be encouraged.

RESUMO As características distintivas do sistema de treinamento de profissionais e técnicos de saúde em Cuba são caracterizadas e as adaptações dos modelos educacionais para atender às necessidades dos serviços de saúde e sua adaptação ao ambiente sócio-econômico e científico-técnico são descritas. A educação para a saúde é universal, gratuita e está intimamente ligada ao Sistema Nacional de Saúde. Os currículos centram-se na inter-relação entre o treinamento acadêmico com a prática clínica e a atividade comunitária, cuja forma fundamental de ensino-aprendizagem é a educação no trabalho. O princípio fundamental da educação médica é a integração do ensino, do cuidado de saúde e da pesquisa no sistema de saúde, o que garante que os alunos sejam incorporados nos cenários de ensino-cuidado através da interação da universidade com a sociedade. Os projetos curriculares são baseados nos principais problemas de saúde da população e do meio ambiente, com ênfase na atenção primária à saúde. Desde 1959, cerca de 350 000 profissionais se formaram, incluindo 41 000 profissionais estrangeiros. Além disso, mais de 30 000 alunos são treinados em 12 países com as brigadas médicas internacionalistas cubanas. Atualmente, há altas matrículas que aumentam a carga de ensino-cuidado dos professores e mudanças freqüentes são feitas na faculdade, o que complicou os desafios para manter um treinamento de alta qualidade. A escassez de professores de ciências básicas também afeta o treinamento. O emprego de professores e jovens tutores deve ser encorajado.

Desarrollo de habilidades investigativas en el campo de la Salud Pública / The development of research skills in the field of public health

Introducción: el desarrollo de habilidades investigativas a través de programas docentes se adquieren a medida que se va ejecutando en su vinculación con el proceso de investigación en diferentes momentos. Objetivo identificar los contenidos que permiten a los estudiantes la construcción de conocimientos, la creación y desarrollo de habilidades investigativas en el campo de la salud pública. Método: se realizó un estudio descriptivo, donde fueron revisados los programas de estudio del doctorado curricular, las maestrías, los diplomados, especialidades y otras formas organizativas de la educación de posgrado que se imparten en la Escuela Nacional de Salud Pública en el curso académico 2013-2014. Resultados: se revisaron un total de 13 programas docentes, de ellos 6 (46,2 por ciento) fueron programas de maestría, 4 (30,8 por ciento) programas de diplomados, 2 (15,4 por ciento) programas de especialidad y un programa de doctorado para un 7,7 por ciento. Conclusiones: en los programas de estudios de la Escuela Nacional de Salud Pública la investigación constituye un eje central de las habilidades que el estudiante debe adquirir, por tanto, esto fortalece el desarrollo de las líneas de investigación en la institución, las que se responden a los principales problemas de salud identificados(AU)

Introduction: The research skills developed through teaching programs are acquired as they are implemented linking them with the research process at different times. Objective: To identify contents that allow the students to build knowledge, as well as create and develop research skills in the field of public health. Method: A descriptive study was carried out, for which we reviewed the programs of study of the doctorates, masters, degrees, specialties, and other organizational forms of postgraduate education at the National School of Public Health in the academic year 2013-2014. Results: We reviewed a total of 13 teaching programs, out of which 6 (46.2 percent) were master's programs, 4 (30.8 percent) diploma courses programs, 2 (15.4 percent) specialty programs, and a doctoral program (7.7 percent). Conclusions: In the programs of study at the National School of Public Health research is a central axis of the skills the student must acquire; therefore, this strengthens the development of the institution's research lines, which respond to the main health problems that were identified(AU)

Scaling-up batch conditions for efficient sucrose hydrolysis catalyzed by an immobilized recombinant Pichia pastoris cells in a stirrer tank reactor

Background: Invert sugar is used greatly in food and pharmaceutical industries. This paper describes scaling-up batch conditions for sucrose inversion catalyzed by the recombinant Pichia pastoris BfrA4X whole cells expressing Thermotoga maritima invertase entrapped in calcium alginate beads. For the first time, we describe the application of a kinetic model to predict the fractional conversion expected during sucrose hydrolysis reaction in both, a model and a prototype bioreactor with 0.5- and 5-L working volume, respectively. Results: Different scaled-up criteria used to operate the 0.5-L bioreactor were analyzed to explore the invert sugar large scale production. After model inversion studies, a 5-L scaled-up reaction system was performed in a 7-L stirred reactor. Both scaled-up criteria, immobilized biocatalyst dosage and stirring speed, were analyzed in each type of bioreactors and the collected data were used to ensure an efficient scale-up of this biocatalyst. Conclusions: To date, there is not enough information to describe the large-scale production of invert sugar using different scaled-up criteria such as dose of immobilized biocatalyst and stirring speed effect on mass transfer. The present study results constitute a valuable tool to successfully carry out this type of high-scale operation for industrial purposes.

Tiempo de lactancia materna exclusiva y estructura familiar / Duration of exclusive breastfeeding and the family structure

INTRODUCCIÓN: la alimentación influye en el adecuado desarrollo del niño. El establecimiento de la lactancia materna es un aspecto fundamental, y en muchas ocasiones un dilema familiar. OBJETIVO: evaluar las características de la familia, su funcionamiento familiar y su relación con el tiempo de lactancia materna exclusiva durante el primer semestre de vida. MÉTODOS: se realizó una investigación descriptiva y prospectiva entre el 1º de noviembre de 2013 y el 30 de octubre de 2014 en 60 lactantes y sus familias de los consultorios del área rural del Policlínico Universitario "Santiago Rafael Echezarreta Mulkay", de San José de las Lajas, Mayabeque, Cuba, que cumplieron los criterios de inclusión. Las variables fueron: composición de las familias, evaluación de funcionamiento familiar a partir de la aplicación del FF-SIL a cada madre, y tipos de alimentación recibida en cada uno de los meses. RESULTADOS: al cuarto mes el 46,6 % de los niños recibía lactancia materna exclusiva, y solo el 16,6 % al 6to. mes. El mayor número de familias fueron extensas, nucleares y funcionales. Exhibieron porcentualmente mejores resultados de lactancia materna exclusiva los niños que pertenecían a familias por su tamaño medianas, por su ontogenia nucleares, y con adecuado funcionamiento familiar. CONCLUSIONES: aunque no se obtuvieron cifras idóneas de lactancia materna exclusiva a los 4 y 6 meses de vida, los niños enmarcados en familias medianas y nucleares logran los mejores resultados. También se hizo evidente esta positiva asociación en aquellas familias clasificadas como funcionales según el FF-SIL.

INTRODUCTION: feeding influences the adequate child's development. The breastfeeding is a fundamental aspect that frequently becomes a family dilemma. OBJECTIVE: to evaluate the characteristics of the family, its functioning as family and its relation with the duration of exclusive breastfeeding in the first six months of life. METHODS: a prospective and descriptive research study was conducted from November 1st 2013 to October 30th 2014 in 60 breastfed infants and their families who were seen at the physician's offices of the rural area of "Santiago Rafael Echezarreta Mulkay" university polyclinics in San Jose de las Lajas, Mayabeque municipality, who met the inclusion criteria. The variables comprised the composition of the families, the evaluation of their functioning according to the application of FF-SIL to each mother, and types of food taken each month. RESULTS: on the fourth month, 46.6 % of infants were exclusively breastfed whereas just 16.6 % were so on the 6th month. Most of the families were big, nuclear and functional. The best percentages in exclusive breastfeeding went to children from medium-size families, nuclear because of their ontogeny and adequate family functioning. CONCLUSIONS: althoguh the figures of exclusive breastfeeding are not the best for the 4th and 6th months, the children from medium-size and nuclear families achieved the best results. This positive association was also evident in those families classified as good functional ones by the FF-SIL.

La interdisciplinariedad, una experiencia desde la disciplina Informática Médica con enfoque filosófico / The interdisciplinary, an experience of medical informatics discipline with a philosophical approach

Introducción: la interdisciplinariedad como tendencia de la educación superior a nivel mundial, es acogida por la educación médica cubana, lo cual se manifiesta en el diseño curricular.Objetivo: argumentar, a partir de experiencias profesionales de los autores, la necesidad del enfoque interdisciplinario en la Informática Médica, mediante una visión filosófica.Material y métodos: se realizó una revisión bibliográfica sobre interdisciplinariedad. En la búsqueda avanzada de Google académico, se emplearon los términos: interdisciplinariedad, leyes filosóficas, categorías dialécticas y carrera de Medicina. Se tomó como eje central la Resolución Ministerial No. 23/2013, sobre el Plan de Estudio, se añadió la vivencia de los autores como docentes.Desarrollo: los ejercicios académicos interdisciplinarios que parten de un problema real del desempeño, constituyen fuente vital para el aprendizaje significativo. El enfoque filosófico del proceso enseñanza aprendizaje, implica que los docentes estudien el macrocurrículo y el microcurrículo, de la disciplina que se imparte. El colectivo de profesores de la disciplina Informática Médica, en carreras donde es unidad curricular de formación general, debe realizar un análisis holístico del plan de estudio, interactuar con la disciplina principal integradora y potenciar el rol activo, dinámico y creador de los alumnos.Conclusiones: la interdisciplinariedad, precisa de un enfoque filosófico por docentes de la disciplina Informática Médica, que comprenda desde el macrocurrículo hasta el microcurrículo, lo cual ofrece la oportunidad de explorar contenidos, que constituyen nodos interdisciplinarios, relacionados con modos, niveles y esferas de actuación del profesional a formar, para potenciar el aprendizaje significativo. (AU)

Introduction: the interdisciplinary like worldwide trend of the higher education, is welcomed by Cuban medical education and it is present in the curriculum design. Objective: to argue, throughout a philosophical view and with the author's professional experiences, the need for the interdisciplinary approach.Material and Methods: a bibliographic review was conducted about Interdisciplinary. In the advanced search of Academics Google, following words were used: Interdisciplinary, philosophical laws, dialectical categories and Career in Medicine. The Ministerial Resolution No. 23/2013, about the Plan of Study, was taken as central axis, and was added the experience of authors as teachers.Development: conducting interdisciplinary academic exercises that start from the performance of a real problem, is a vital source for significant learning. The philosophical approach to the teaching-learning process, involves the study by teachers the macro and micro curriculum of their teaching subject. The group of teachers of medical informatics discipline, in careers where this is general education curricular unit, must conduct a holistic analysis of Study Plan, interact with Integrative Principal Discipline and promote active, dynamic and creative role of students.Conclusions: the Interdisciplinary requires a philosophical approach by teachers of medical informatics discipline. It comprises the macro curriculum and micro curriculum, and gives the opportunity to operate the contents which constitute interdisciplinary nodes, related to modes, levels and spheres of action of the professional in training, promoting a meaningful learning. (AU)

Curso básico de educación médica impartido por la Escuela Nacional de Salud Pública / Medical education basic course given by the National School of Public Health

El dominio amplio y profundo de la materia que se instruye constituye el punto de partida para ejercer la enseñanza. En la medida que sea superior la preparación científica de los docentes en el área de las ciencias de la educación, aumenta la pertinencia, calidad y eficiencia de la enseñanza. Se realizó un estudio descriptivo con el objetivo de caracterizar las 3 ediciones del Curso básico de educación médica impartido en la Escuela Nacional de Salud Pública en el período 2010-2012, las variables estudiadas fueron programa de estudio, profesores, categoría docente de los cursistas, satisfacción de estudiantes, entre otras. Como principales resultados se obtuvo que en las 3 ediciones realizadas en los cursos académicos 2010-2011, 2011-2012, se capacitaron un total de 48 profesionales de la salud vinculados a las actividades docentes, de ellos el 10,4 por ciento sin categoría docente, un 39,6 por ciento Instructores, el 22,9 por ciento con categoría de Asistente, todos inmersos en el proceso de obtención o promoción de categorización docente. Es de señalar que un 27,1 por ciento de los cursistas era profesor Auxiliar o Titular. De forma general se reconoció por parte de los estudiantes la gran satisfacción con la calidad del programa y del claustro que impartió el curso. Se concluye que el Curso básico en educación médica facilita a los docentes apropiarse de herramientas que permitan profundizar en el proceso de enseñanza aprendizaje, así como estudiar las principales tendencias, problemas y desafíos contemporáneos en la formación de recursos humanos para la salud...

Broad and deep mastery of the subject that is taught constitutes the starting point for teaching practice; as the scientific training of professors in the field of education sciences is higher, the relevance, quality and efficiency of teaching increases. A descriptive study was conducted to characterize the three rounds of the basic medical education course taught at the National School of Public Health in the period of 2010 through 2012. The studied variables were curriculum, professors, teaching category of the course participants, student satisfaction, among others. The main results of the three rounds of this course held in the 2010-2011 and the 2011-2012 academic years were 48 teaching-linked health professionals were trained; 10.4 percent of them had no teaching category, 39.6 percent were instructors, 22.9 percent with assistant category and all of them involved in the process of obtaining or raising their academic category. It should be noted that 27.1 percent of the participants was assistant or full professor. The students generally expressed their great satisfaction with both the quality of the course program and the faculty who gave the course. It was concluded that the basic course in medical education provides professors with appropriate tools to delve into the process of teaching and learning, as well as to study the main contemporary trends, issues and challenges in the formation of human resources in the healthcare field...

Evaluación y certificación de las competencias laborales en el Sistema Nacional de Salud en Cuba / Evaluation and certification of work competencies in the national health care system

Se establecen las bases teóricas y metodológicas de la evaluación de las competencias profesionales del médico especialista en el marco de su desempeño laboral en las instituciones y unidades del Sistema Nacional de Salud cubano. Se puntualiza que se requiere valorar junto con los elementos de competencias, las condiciones laborales y personales requeridas para su buen desempeño. Se deben evaluar todas las funciones de este profesional en su trabajo. Su ejecución requiere identificar previamente las evidencias de cada elemento de competencia que componen cada competencia profesional. Para evaluarlas hay que verificar su cumplimiento en relación con un patrón o norma previamente establecido. El proceso se ejecuta con el pleno conocimiento de los trabajadores, y principalmente sobre la base de la observación de su desempeño laboral y de los productos del trabajo. Se exponen los diferentes momentos del proceso, así como las técnicas y procedimientos evaluativos más empleados a nivel mundial. Se definen las responsabilidades en el diseño y ejecución de la evaluación, cómo se deben analizar los resultados y cómo proceder para la certificación de la competencia laboral. Se plantea el conjunto de decisiones laborales posibles a adoptar, y se fundamenta la necesidad de evaluar el impacto de la estrategia aplicada en la calidad del servicio de salud brindado, a fin de asegurar su perfeccionamiento y extensión hacia el resto de los trabajadores de salud...

The theoretical and methodological bases for the evaluation of the professional competencies of the specialist physician were laid down within the framework of his/her performance in the health care system institutions and units of Cuba. It was underlined that the working and the individual conditions required for good performance must be assessed together with the various competency elements. Additionally, all the functions of this professional at the workplace must be evaluated, taking into account that his/her performance requires previously identifying the evidence of each competency element that makes up each professional competency. For evaluating them, it is necessary to verify their fulfillment according to a previously set pattern or standard. This evaluative process is carried out with the workers being fully aware of it, and takes into account their work performance and the results of work. The different phases of this process as well as the evaluative techniques and procedures that are most used worldwide were explained in this paper. The responsibilities involved in designing and making the evaluation, how to analyze results and how to act in order to certify a work competency were all defined. The set of possible labor decisions to be adopted were pointed out as well as the need of evaluating the impact of the applied strategy in the quality of the rendered health service was substantiated, in order to assure the improvement and spread of this methodology for evaluation of the rest of the health care workers...

La Medicina Interna en el ambiente hospitalario / The Internal Medicine in the hospitable environment

Introducción: los cambios del contexto de trabajo en los hospitales para los internistas exigen perfeccionar el funcionamiento de sus servicios. Objetivos: identificar problemas que afectan a la especialidad Medicina Interna y los cambios organizativos necesarios para su solución, en un hospital clínico-quirúrgico. Material y Métodos: se realizó investigación cualitativa, basada en la actividad de un grupo nominal que dio salida a tareas propias de la dirección estratégica. Resultados: se definió la misión, visión y líneas estratégicas de trabajo del Servicio de Medicina Interna, se caracterizó el contexto y definieron como problemas en orden de prioridad: Deterioro del método clínico; práctica de una Medicina biologicista; insuficiente disponibilidad de camas; limitaciones en los recursos humanos, materiales y financieros para la máxima calidad de la atención y sobrecarga de los servicios clínicos. Se definieron las fortalezas, debilidades, amenazas y oportunidades. De ellas se derivaron propuestas de acciones ofensivas, adaptativas, defensivas y de supervivencia para lograr un cambio positivo en el trabajo de esta especialidad. Conclusiones: la gestión del capital humano en Medicina Interna implica una estructura colaborativa más eficiente para el hospital, que depare mejor utilización de los internistas como médico generalista e integrador, lo que contribuiría a disminuir las fronteras físicas de las salas y centrar el trabajo en los enfermos.

Introduction: the work context changes of the internists demand to make perfect the functioning of their services. Objectives: identify problems that affect the Internal Medicine and the necessary organizative changes to solve them, at a clinical-surgical hospital. Material and Methods: it was a qualitative research based on the activity of a nominal group that gave vent to own tasks of the strategic direction. Results: the mission, vision and the Internal Medicine service's strategic lines of work were defined; the context was assigned priority to its problems: Deterioration of the clinical method; the practice of a biologist medicine; insufficient availability of beds; Limitations in human, materials and financiers resources for the maximum quality of attention; Overload of the clinical services. It was defined fortresses, weaknesses, threats and opportunities. The offensive, adjustatives, defensives and survival actions to achieve a positive change were derived. Conclusions: the management of the human capital in internal medicine implies a collaborative structure more efficient for the hospital, that better utilization of the internists like generalist and integrative doctor that would contribute to diminish the physical frontiers of the wards and centering the work in the sick persons.