Using Multiple Cause-of-Death Analysis to Estimate Systemic Autoimmune Disease Mortality Burden in Low- and Middle-Income Countries.

Autoimmune diseases are not always recognized as urgent health issues, despite a worldwide prevalence of 4%-5%. Most estimates come from high-income countries, as low- and middle-income countries face more issues of under-reporting. Despite this and the lack of recognition under current reporting practices, the role these diseases play in mortality must be acknowledged. In particular, considering multiple causes of death as opposed to a single cause of death results in a 1.5-4.2-fold increase in deaths classified as relating to autoimmune diseases, evidence of their share in overall mortality burden, a factor important for patient care and healthcare policy decision making. However, formulating such policies and programs for timely, appropriate diagnoses and care is stymied in low- and middle-income countries by the shortage of methodologically sound studies on mortality from systemic autoimmune diseases. This limitation exacerbates inequalities and health gaps among patients in different countries and localities. Multiple cause-of-death methodology has been validated for research on other diseases and demonstrates the mortality burden of these illnesses in countries where traditional methodological approaches, primarily based on prospective cohort studies, are not feasible. Studying mortality from systemic autoimmune diseases by analyzing multiple causes of death with data from national mortality registries is a low-cost alternative to traditional mortality analysis. The objective of this paper is to demonstrate and defend the usefulness of this approach to estimate mortality burden.

Software educativo para el aprendizaje de las arritmias cardíacas en Pediatría / Educational software for the learning of cardiac arrhythmias in Pediatrics

Fundamento: las arritmias constituyen un problema de salud pública en todo el mundo, por su frecuencia, morbilidad y mortalidad. Objetivo: diseñar un software educativo para contribuir al aprendizaje de las arritmias pediátricas en los estudiantes de Medicina. Métodos: se realizó una investigación de desarrollo en la Facultad de Medicina de la Universidad de Ciencias Médicas de Villa Clara en el curso 2013-2014. Se utilizaron métodos teóricos para la interpretación y procesamiento de la información y los referentes teóricos del tema; empíricos: análisis documental de los programas y orientaciones metodológicas, y para la valoración del producto por especialistas y usuarios, la encuesta en su modalidad de cuestionario. Resultados: se determinaron los contenidos según el programa de la asignatura, entre ellos: anatomía del corazón, fisiología cardíaca, sistema de conducción eléctrica del corazón, lectura del electrocardiograma y arritmias y sus características, los que fueron incluidos según diseño del software en Generalidades, Arritmias, Libros y Galería. Conclusiones: el producto fue valorado por los especialistas como necesario y útil para la docencia, de gran aplicabilidad, con calidad y profundidad en los contenidos tratados; según el criterio de usuarios fue considerado como funcional, de fácil manejo, novedoso, con calidad estética y adecuados contenidos.

Background: arrhythmias are a public health problem throughout the world, due to their frequency, morbidity and mortality. Objective: to design educational software to contribute to the learning of pediatric arrhythmias in medical students. Methods: a development research was carried out in the Faculty of Medicine of the University of Medical Sciences of Villa Clara in the 2013-2014 academic year. Theoretical methods were used for the interpretation and processing of information and the theoretical referents of the subject; empirical: documentary analysis of the programs and methodological orientations, and for the evaluation of the product by specialists and users, the survey in its questionnaire modality. Results: the contents were determined according to the program of the subject, among them: anatomy of the heart, cardiac physiology, system of electrical conduction of the heart, reading of the electrocardiogram and arrhythmias and their characteristics, which were included according to software design in General, Arrhythmias, Books and Gallery. Conclusions: the product was valued by specialists as necessary and useful for teaching, of great applicability, with quality and depth in the contents treated; according to the criteria of users it was considered as functional, easy to use, innovative, with aesthetic quality and adequate contents.