Resumo em Inglês:

ABSTRACT INTRODUCTION Shifts in diabetes onset to earlier ages, globally and in Cuba, signify greater risk of early complications and premature death, with consequent economic and social repercussions for families and health systems. OBJECTIVE Describe the trend in diabetes burden in Cuban children and adolescents in the period 1990 to 2010, in terms of disability-adjusted life years. METHODS A descriptive epidemiological study was conducted of diabetes burden in Cuba, analyzing the years 1990, 1995, 2000, 2005 and 2010 for the age group 0–19 years. Disability-adjusted life years were obtained from the sum of potential years of life lost plus years lived with disability. The first is calculated based on total deaths in the country in which diabetes was recorded as underlying cause; the second from the product of severity, as assigned to diabetes in similar studies, and incidence and average duration, provided by the DISMOD II program, which estimates six internally consistent epidemiological indicators. RESULTS Mortality indicators improved, with a decrease in the rate of potential years of life lost in boys from 21.9/100,000 population in 1990 to 0 in 2010, and in girls from 38.8/100,000 in 1990 to 4.9/100,000 in 2010 (1% of disability-adjusted life years in girls in 2010, corresponding to one death). In contrast, years lived with disability increased by 134.5% in boys and 156.4% in girls. The net result was that disability-adjusted life years increased by >100% in both sexes (from 137.2 to 321.9/100,000 in boys and from 157.3 to 403.3/100,000 in girls, increases of 102.3% and 108.1%, respectively). CONCLUSIONS Disability-adjusted life years lost for diabetes in Cuban children and adolescents have increased, due to disability, while mortality has decreased.

Resumo em Inglês:

ABSTRACT INTRODUCTION Systematic measurement of population physical activity levels is an important component of public health surveillance. OBJECTIVES Describe patterns of physical activity in the Cuban population aged 15–69 years and identify factors associated with regular physical activity. METHODS A descriptive cross-sectional study was conducted using a complex sampling design, representative of urban and rural areas, sex and age groups, including 7915 individuals. The International Physical Activity Questionnaire (short format) was applied. The population was classified as active, irregularly active and sedentary, according to sex, age, marital status, education, skin color, employment and perception of health risk related to physical inactivity or overweight. Percentages, odds ratios (OR) and 95% confidence intervals (CI) were calculated and a multinomial regression model was fitted with active persons as the reference category. RESULTS Approximately 71% of the population self-classified as active, 23% as sedentary and 5.9% as irregularly active. Women had a higher probability of being sedentary (OR 2.51, CI 2.12–2.98) and irregularly active (OR 2.56, CI 95% 1.87–3.49). The probability of being sedentary increased with age (OR 1.19, CI 1.12–1.26), and also with the condition of being a homemaker, retired, or unemployed. Perceiving overweight as a high risk to health reduced likelihood of inactivity (OR 0.49, CI 0.29–0.83). CONCLUSIONS Some 7 of 10 Cubans are physically active. The groups with the highest probability of inactivity and irregular activity and associated factors have been identified through national application (for the first time) of the International Physical Activity Questionnaire. The results should be taken into account for implementation of specialized strategies to promote systematic physical activity.

Resumo em Inglês:

ABSTRACT INTRODUCTION The quality of medical training and practice reflects the competency level of the professionals involved. The intensive care and emergency medicine specialty in Cuba has not defined its competencies. OBJECTIVES Identify the competencies required for specialty practice in intensive care and emergency medicine. METHODS The study was conducted from January 2014 to December 2015, using qualitative techniques; 48 professionals participated. We undertook functional occupational analysis, based on functions defined in a previous study. Three expert groups were utilized: the first used various group techniques; the second, the Delphi method; and the third, the Delphi method and a Likert questionnaire. RESULTS A total of 73 specific competencies were defined, grouped in 11 units: 44 in the patient care function, 16 in management, 7 in teaching and 6 in research. A competency map is provided. CONCLUSIONS The intensive care and emergency medicine specialty competencies identified will help improve professional standards, ensure health workforce quality, improve patient care and academic performance, and enable objective evaluation of specialists’ competence and performance.