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La ciencia y la producción del saber científico están cambiando, las partes no son el objetivo, es el todo y sus interrelaciones. La salud enfrenta nuevos retos que no pueden ser explicados por concepciones reduccionistas. Se reconoce el intento de agrupar variadas afecciones en las enfermedades no transmisibles que ocasionan las tres cuartas partes de las muertes en el mundo y en Cuba, constituyen uno de los grandes retos del desarrollo sostenible. Muchas de ellas, a pesar de su heterogeneidad y multicausalidad, comparten factores de riesgo -y protectores- comunes, que pueden ser revertidos con acciones integradas. Se comenta la frecuente comorbilidad de estas enfermedades con otras entidades, la polimorbilidad y el rol del envejecimiento en su aparición. Se resalta la presencia del estado inflamatorio crónico del endotelio y la disfunción de este órgano como posible vía final común de la patogenia, evolución y posterior expresión clínica de muchas de las conocidas como enfermedades no transmisibles, verdaderos síndromes sistémicos. Se dan un grupo de recomendaciones para mejorar su prevención y su control, con énfasis en la participación comunitaria, donde las ciencias sociales pueden aportar mucho para lograr mejores resultados, sin olvidar la susceptibilidad individual o de grupos a padecer determinadas enfermedades no transmisibles. Se considera que directivos, profesionales sanitarios, líderes formales e informales, personas, grupos y comunidades, deben capacitarse y actualizarse, en los conceptos y los enfoques de estas enfermedades para lograr el propósito de revertir sus efectos nocivos para la salud.

Science and the production of scientific knowledge are changing, the parts are not the objective, it is the whole and its interrelationships. Health faces new challenges that cannot be explained by reductionist conceptions. The attempt to group various conditions in non-communicable diseases that cause three quarters of deaths in the world and in Cuba is recognized as one of the great challenges of sustainable development. Many of them, despite their heterogeneity and multi-causality, share common risk -and protective- factors, which can be reversed with integrated actions. The frequent comorbidity of these diseases with other entities, polymorbidity, and the role of aging in their appearance are discussed. The presence of the chronic inflammatory state of the endothelium and the dysfunction of this organ are highlighted as a possible final common path of the pathogenesis, evolution and subsequent clinical expression of many of the so-called non-communicable diseases, true systemic syndromes. A group of recommendations are given to improve its prevention and control, with emphasis on the community participation of all, where the social sciences can contribute a lot to achieve better results, without forgetting individual or group susceptibility to suffering certain non-communicable diseases. It is considered that managers, health professionals, formal and informal leaders, people, groups and communities must be trained and updated in concepts and approaches to these diseases to achieve their purposes.

RESUMO

RESUMEN Fundamento el proceso de actualización del modelo económico y social cubano refrenda la necesidad de asegurar el adecuado equilibrio entre las responsabilidades que competen al Estado y al Gobierno y las correspondientes a los individuos. Se ha producido un reposicionamiento del tema de la responsabilidad personal con la salud a nivel nacional, pero se desconoce la representación social de este término en diferentes actores sociales que intervienen en la gobernanza para la salud en el nivel comunitario y local. Objetivo: explorar los conocimientos y percepciones que poseen diferentes actores sociales de la comunidad sobre la responsabilidad personal con la salud. Método: se seleccionó una muestra de 385 sujetos del área de salud Andrés Ortiz del municipio Guanabacoa en La Habana mediante criterios probabilísticos y discrecionales, compuesta por profesionales y técnicos del sector de la salud, miembros de organizaciones no gubernamentales, de organizaciones políticas, del gobierno local y de la ciudadanía pertenecientes a tres consultorios de la atención primaria de salud. Se construyeron y validaron instrumentos para la recogida de datos. Se obtuvo la información mediante entrevistas semiestructuradas y encuestas. Se realizó análisis de contenido del discurso y análisis descriptivo de los datos utilizando frecuencias absolutas y relativas. Resultados: el 100 % de los profesionales y técnicos del sector de la salud, de los miembros del gobierno local, de las organizaciones políticas y de las organizaciones no gubernamentales poseía referencias previas sobre el término, pero solo el 45 % de la ciudadanía había escuchado acerca de él. Las fuentes del conocimiento previo sobre el término difirieron entre los actores sociales. La percepción de que la responsabilidad personal con la salud debe restringirse al autocuidado individual fue mayoritaria principalmente entre la ciudadanía (83,4 %), los representantes de las organizaciones no gubernamentales (78 %), los miembros del gobierno local y dirigentes del sector salud (62,5 %), los técnicos y profesionales de la salud (59 %) y en menor proporción los profesores de ese sector (50 %). El 100 % de los representantes de las organizaciones políticas percibieron que esta responsabilidad debía tener una visión individual. Conclusiones: existen divergencias en el campo representacional de la responsabilidad personal con la salud entre los diferentes actores sociales consultados. Predominó el entorno discursivo y representacional relacionado con una responsabilidad personal limitada a la salud individual.

ABSTRACT Background: the updating process of the Cuban economic and social model support the need to ensure the proper balance between the responsibilities that concern the State and the Government and those corresponding to individuals. There has been a repositioning of the issue of personal responsibility with health at the national level, but the social representation of this term in different social actors that intervene in health governance at the community level, community and local level, is unknown. Objective: to explore the knowledge and perceptions that different social actors in the community have on personal responsibility with health. Method: a sample of 385 subjects from the Andrés Ortiz health area of ​​the Guanabacoa municipality in Havana was selected using probabilistic and discretionary criteria, composed of professionals and technicians from the health sector, members of non-governmental organizations, political organizations, and the government local and citizens belonging to three clinics of primary health care. Instruments for data collection were built and validated. The information was obtained through semi-structured interviews and surveys. Discourse content analysis and descriptive data analysis were performed using absolute and relative frequencies. Results: the 100 % of professionals and technicians from the health sector, members of local government, political organizations and non-governmental organizations had previous references to the term, but only the 45 % of the public had heard about him. The sources of prior knowledge about the term differed among social actors. The perception that personal responsibility for health should be restricted to individual self-care was the majority mainly among citizens (83.4 %), representatives of non-governmental organizations (78 %), members of the local government and leaders of the health sector (62.5 %), technicians and health professionals (59 %) and, to a lesser proportion teachers in this sector (50 %). The 100 % of the representatives of the political organizations perceived that this responsibility should have an individual vision. Conclusions: there are differences of opinion in the representational field of personal responsibility with health among the different social actors consulted. The discursive and representational environment predominated, related to personal responsibility limited to individual health.

RESUMO

Obesity is a complex disease caused by a wide array of behavioral, biological, and environmental factors. However, obesity is often attributed to oversimplified and stigmatizing causal factors such as laziness, lack of willpower, and failure to take personal responsibility for one's health. Understanding of the causal factors that contribute to obesity among people with obesity may affect their weight management efforts. The current study explored associations between causal attributions for obesity and long-term weight loss, as well as examined potential changes in attributions with weight reduction. The 16-item Causal Attributions for Obesity scale (rated 1-7) was administered to 178 patients seeking behavioral/pharmacological weight-loss treatment. Causal attributions and weight were assessed at baseline, after 14 weeks of a low-calorie diet, and again at weeks 24 and 52 of a subsequent randomized trial (i.e., 66 weeks total). Logistic and linear regression examined effects of baseline causal attribution ratings on weight loss. Higher baseline ratings of personal responsibility attributions predicted 38% reduced odds of achieving ≥10% weight loss at week 52 (p = 0.02). Causal attribution ratings did not change over time or correlate continuously with weight change. Thus, attributing obesity to a failure of personal responsibility may impair long-term weight management efforts for individuals seeking ≥10% weight loss. Targeted techniques are needed to reduce patients' stigmatizing beliefs about the causes of obesity.

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Social justice tends to be narrowly defined as equality without due recognition of human dignity and respect for those whose daily lives continue to be adversely impacted by race. This article seeks to explore key issues and challenges at the intersection of social justice and race for couple and family therapy. These include: (a) defining social justice; (b) diversity and inclusion; (c) power and privilege; (d) witness; and (e) personal responsibility.

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São abordadas e discutidas as tecnologias de melhoramento e sua meta de vender a possibilidade (real ou virtual) de manter e proporcionar aparência de juventude, longevidade e até imortalidade aos seres humanos como modelo de construção da noção de si mesmo. Emprega-se a ideia de "promoção de saúde ampliada" tanto no sentido de intensificação dos discursos sustentando comportamentos saudáveis como alegoria fotográfica no sentido de ampliar a sua imagem e permitir uma visão mais aproximada de detalhes políticos, ideológicos e mercantis das suas proposições. A partir de uma tipologia das ciências contra o envelhecimento feita por John Vincent em: cosméticas, médicas, biológicas e imortalistas, são enfocados os dois últimos itens e suas implicações. Ao final, propõe-se um enfoque analítico da questão, destacando estratégias biopolíticas para lidar com a finitude humana através de enfoques preemptivos sob a égide da hiperprevenção e a busca de um tipo de felicidade como autossatisfação pessoal que necessita de tecnologias de melhoramento para ser alcançada.

In this article, we discuss enhancement technologies and their goal to sell the possibility (actual or virtual) of keeping and providing appearances of youth, longevity and even immortality for human beings as a construction model of the notion of self. We employ the idea of 'amplified health promotion' in the sense of intensification of discourses supporting healthy behaviours and also as a photographic allegory, in the sense of amplifying its image in order to allow a closer view of the political, ideological and mercantile details of its proposals. Based on a typology of the anti-ageing sciences, proposed by John Vincent as cosmetic, medical, biological and immortalist, we deal with the latter two and their implications. Finally, we propose an analytical focus on the subject, emphasizing biopolitical strategies to deal with human finitude through preemptive approaches with the support of hyper-prevention, and the search of a kind of happiness as personal self-fulfillment that needs enhancement technologies to be reached.

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RESUMO

Desde su concepción el ser humano se enfrenta a un sin número de cambios biológicos, emocionales, cognitivos y conductuales, la secuencia de estos cambios permite que cada vez se llegue a un desarrollo y adaptación mayor frente a sus necesidades y a las necesidades externas. Por lo que surge la necesidad de esta investigación, planteándose como objetivo principal, describir las características y establecer cómo se relacionan entre sí, los aspectos del desarrollo adaptativo, en relación a las habilidades de auto ayuda y las tareas que dichas habilidades requieren en niños y niñas de 3 a 7 años que cursan los grados de párvulo a primero en instituciones oficiales de la ciudad de Barranquilla. Para la medición de las variables de estudio se utilizó el Inventario de Desarrollo Battelle. Los resultados obtenidos revelaron que los niños y niñas según su entorno pueden o no realizar ciertas tares de manera eficaz, por iniciativa y con independencia. Por consiguiente, si un niño es más autónomo en el vestido, en el auto cuidado y en la alimentación, también será autónomo en el proceso de aprendizaje, en la relación con otros niños y en la solución de dificultades presentadas en su entorno.

Since its conception, the human being faces a number of biological, emotional, cognitive and behavioral changes. The sequence of these changes leads to a bigger development and adaptation towards its needs and its external needs. Based on the above, the need for this research project is created, considering as its main objective the description of the characteristics of the adaptive development with regards to the self-help skills and the tasks required by these skills in children aged 3 to 7 who attend kindergarten and 1st grade in some public institutions in Barranquilla. In order to measure the study variables, the Battelle Developmental Inventory was used. The results obtained revealed that the girls and boys can or cannot perform certain tasks effectively on their own initiative and independently Consequently if a child is much more autonomous in his dress sense, in his self-care and his food, he will be autonomous in the learning process, in the relationship with other children and in the solution of problems arising in his environment as well.

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