INTRODUCCIÓN Durante los últimos 40 años, se ha reportado una alta prevalencia de tabaquismo en Cuba, que incluye la ciudad de Cienfuegos en la parte central de la isla.
OBJETIVO Determinar la prevalencia de tabaquismo y los potenciales factores de riesgo asociados en la ciudad de Cienfuegos durante 2010-2011.
MÉTODOS Se realizó un estudio descriptivo de corte transversal en la ciudad de Cienfuegos, en el contexto de CARMEN (Conjunto de Acciones para Reducir Multifactorialmente las Enfermedades no Transmisibles), una iniciativa de varios países de la OPS para un enfoque multidimensional de las enfermedades crónicas no transmisibles. Los participantes, 2 193 (con edades entre 15-74 años), se seleccionaron al azar a través de un complejo muestreo probabilístico en tres etapas. Las variables examinadas en relación con el tabaquismo incluyeron la edad, el sexo, el color de la piel, el estado civil y el nivel de educación.
RESULTADOS Aproximadamente el 25% de los encuestados eran fumadores (el 30.3% de los hombres y el 21.0% de las mujeres). Para los hombres, la mayor prevalencia estuvo en los grupos de 25-34 y 55-64 años; para las mujeres, en el grupo de 45-54 años. Con respecto al color de la piel, las tasas de tabaquismo fueron mayores entre los negros y los mestizos (29.5%); y en relación con el estado civil, entre los que estaban separados, viudos o divorciados (30.0%). La prevalencia de tabaquismo disminuía al aumentar el nivel educacional; de acuerdo con esa tendencia, el grupo con educación universitaria tuvo la menor prevalencia (16.2%).
CONCLUSIONES Aunque uno de cada cuatro residentes en Cienfuegos con edades ≥15 años fumaba en 2010-2011, la prevalencia allí fue menor que en encuestas anteriores. Las diferencias observadas por: edad, sexo, color de la piel, estado civil y nivel educacional pueden ser útiles para la planificación de las acciones futuras de prevención y control del tabaquismo.
PALABRAS CLAVE Tabaco, tabaquismo, prevalencia, encuestas de salud, vigilancia de factores de riesgo, Cuba
There has been a notable decrease in the global practice of clinical autopsy; the rate has fallen to below 10%, even in high-income countries. This is attributed to several causes, including increased costs, overreliance on modern diagnostic techniques, cultural and religious factors, the emergence of new infectious diseases and negative attitudes on the part of doctors, even pathologists. Alternative methods to autopsy in postmortem studies have been developed based on imaging, endoscopy and biopsy (all quite expensive). These methods have been used in developed countries but never as effectively as the classic autopsy for identifying cause of death and potential medical errors.
Although Cuba has also seen a decrease in its autopsy rates, they remain comparatively high. Between 1996 and 2015, there were 687,689 hospital deaths in Cuba and 381,193 autopsies, 55.4% of the total. These autopsies have positively affected medical care, training, research, innovation, management and society as a whole. Autopsies are an important tool in the National Health System’s quest for safe, quality patient care based on the lessons learned from studying the deceased.
KEYWORDS Autopsy, postmortem examination, postmortem diagnosis, quality of care, patient safety, medical error, Cuba
INTRODUCTION Cuba’s science policy is grounded in a scientific and technological innovation system applicable to all institutions. In hospitals, the system should influence medical care and administrative and teaching processes, as well as promotion of scientific activity as such.
OBJECTIVE Describe results of the Scientific and Technological Innovation System at the Dr Gustavo Aldereguía Lima University Hospital, the main provincial hospital in Cienfuegos, Cuba.
METHOD This was a key informant survey and document review concerning the hospital’s scientific activity during 2000–2014. A questionnaire was administered to 22 key informants to select key indicators and area. Data on the hospital’s scientific activity related to these indicators were retrieved from hospital, provincial public health and scientific publishing databases. A second group of 35 key informants confirmed linkages between scientific outputs and the innovation system’s main activities.
RESULTS The following were reported over the study period: sustained development of scientific human resources (40% grade II specialists, 30% master’s degree holders and 11.4% accredited academic researchers among the hospital’s professional staff), high scientific output (annual average of 445 studies completed, 118 publications and 203 projects under way) and high visibility (national and international recognition) of the hospital’s achievements in science and innovation. Key informants considered that results related to development of scientific potential were influenced by the following activities of the Scientific and Technological Innovation System: promotion of grade II specialty training, researcher accreditation and awarding of master’s degrees and PhDs in the sciences, development of an extensive continuing education program (for researchers and their mentors), public recognition of professionals with good scientific results, promotion of research and other scientific activities, and the requirement that professional and technical staff participate in national events sponsored by scientific societies.
CONCLUSIONS Implementation of a Scientific and Technological Innovation System can contribute to a hospital’s scientific capacity and productivity.
KEYWORDS Hospitals, health services research, organizational deve-lopment, organizational innovation, technology, research, science, Cuba
INTRODUCTION Over the last 40 years, high smoking prevalence has been reported throughout Cuba, including in Cienfuegos city in the central part of the island.
OBJECTIVES Determine smoking prevalence and potential associated risk factors in Cienfuegos city for 2010–2011.
METHODS A descriptive cross-sectional study was conducted in Cienfuegos city in the context of CARMEN (Collaborative Action for Risk Factor Prevention & Effective Management of Non-communicable Diseases), a PAHO multi-country initiative for a multidimensional approach to chronic non-communicable diseases. Participants totaled 2193 (aged 15–74 years), randomly selected through complex probabilistic three-stage sampling. Variables examined in relation to smoking included age, sex, skin color, civil status and educational level.
RESULTS Approximately 25% of those surveyed were smokers (30.3% of men and 21.0% of women). For men, prevalence was highest in the groups aged 25–34 and 55–64 years; for women, in the group aged 45–54 years. Concerning skin color, smoking rates were higher among black and mestizo persons (29.5%); and concerning civil status, higher among those who were separated, widowed or divorced (30.0%). Smoking prevalence fell with higher educational level; in keeping with that trend, the university-educated group had the lowest prevalence (16.2%).
CONCLUSIONS Although one in four Cienfuegos residents aged ≥15 years smoked in 2010–2011, prevalence there is lower than in previous surveys. Knowledge of differences observed in age, sex, skin color, civil status and educational level can be useful for planning future smoking prevention and control actions.
KEYWORDS Tobacco, smoking, prevalence, health surveys, risk factor surveillance, Cuba
