Abstract This article takes up the concept of surplus labor force as understood in Latin American economic thought, due to its importance in pointing out the difficulties of capitalism in incorporating people into quality jobs and explaining the reproduction of inequalities. To contribute to the study of women’s labor exclusion in the region, two objectives are pursued. The first objective is to construct a theoretical-methodological proposal to study the surplus of the labor force by re-reading the structuralist approach from a feminist economics perspective. The second objective is to analyze with this adapted framework the evolution of the surplus of the labor force, as well as the Argentine welfare policy that aims to regulate it and its link with the reproduction of gender inequalities at the national level between 2003 and 2019. For this purpose, a documentary and statistical analysis of different sources is carried out. The results show the structural persistence of exclusion and gender inequality as a result of the articulation between the labor features of the Argentine development style and the consolidated welfare policy pattern. This pattern is based on conditional cash transfers and was functional to the feminization of the surplus of the labor force during the first two decades of the 21st century.

Resumen En este artículo se retoma el concepto de excedente de la fuerza de trabajo tal como se entiende desde el pensamiento económico latinoamericano, por su importancia al señalar las dificultades del capitalismo para incorporar a las personas en empleos de calidad y explicar la reproducción de las desigualdades. A fin de contribuir al estudio de la exclusión laboral de las mujeres dentro de la región, se persiguen dos objetivos. El primero: construir una propuesta teórico-metodológica para estudiar el excedente de la fuerza de trabajo mediante la relectura del abordaje estructuralista desde la economía feminista. Con el segundo se propone analizar, a partir de este marco adaptado, la evolución del excedente de la fuerza de trabajo, así como la política asistencial argentina que pretende regularlo y su vínculo con la reproducción de las desigualdades de género en el ámbito nacional entre 2003 y 2019. Para ello se realiza un análisis documental y estadístico de distintas fuentes. Los resultados permiten constatar la persistencia estructural de la exclusión y la desigualdad de género producto de la articulación entre los rasgos laborales del estilo de desarrollo argentino y el patrón de política asistencial consolidado. Dicho patrón se apoya en las transferencias monetarias condicionadas y resulta funcional a la feminización del excedente de la fuerza de trabajo durante las dos primeras décadas del siglo XXI.

Resumen Está bien establecido en la literatura que la identificación de Contribuciones de la Naturaleza a las Personas (CNP) y su valoración debe basarse en un proceso participativo. Sin embargo, hay pocos dispositivos disponibles para conducir estos procesos participativos y el concepto de contribuciones de la naturaleza a las personas presenta desafíos para su comprensión y aplicación para muchos actores de las esferas sociales y/o gubernamentales. Aquí se presenta una propuesta metodológica y el diseño de un dispositivo para la identificación, valoración y mapeo de CNP que fue aplicado con éxito en cuatro unidades territoriales en el centro-este de Patagonia, Argentina.

Abstract It is well established in the literature that the identification of Contributions of Nature to People (CNP) and their valuation must be based on a participatory process. However, there are few devices available to conduct these participatory processes and the concept of nature's contributions to people presents challenges for many actors in the social and/or governmental spheres to understand and apply. Here we present the design of a device for the identification, assessment and mapping of CNP that was successfully applied in four territorial units in central-eastern Patagonia, Argentina.

Resumen El artículo busca analizar la desigualdad de género dentro de la estructura del empleo privado, afectada por el fenómeno de la heterogeneidad estructural durante el lapso de crecimiento económico comprendido entre 2003 y 2013. Para abordar este objetivo, se ha construido un enfoque teórico-metodológico a través del diálogo de los estudios de género y de la economía feminista con las contribuciones del estructuralismo latinoamericano. Los resultados de la investigación, que ha aplicado una estrategia metodológica de tipo cuantitativa, evidencian la existencia de una segregación laboral de género anclada al estilo de desarrollo argentino que pone límites a la capacidad del país de crecer y desarrollarse con igualdad de género.

Abstract The article seeks to analyze gender inequality within the structure of private employment, affected by the phenomenon of structural heterogeneity during the period of economic growth between 2003 and 2013. To address this objective, a theoretical-methodological approach has been constructed through the dialogue of gender studies and feminist economics with the contributions of Latin American structuralism. The results of the research, which has applied a quantitative methodological strategy, show the existence of gender labor segregation anchored to the Argentine development style that limits the country's ability to grow and develop with gender equality.

ABSTRACT Introduction: The COVID-19 pandemic has been the largest in the current century and the reason for numerous scientific works. In Cuba, the Temporary Group of Pathological Anatomy has been established to study the autopsies of those who died from COVID-19 (more than 400). The medical death certificates, documents of inestimable value, in Cuba are repaired according to the results of the autopsies, to raise their quality. Objectives: To evaluate the results of autopsies with COVID-19 diagnoses, compared to medical death certificates. Methods: The diagnoses of causes of death of 65 autopsies of the year 2020 were evaluated with their medical death certificates. The diagnoses were processed in the Automated System for the Registration and Control of Pathology. Direct causes of death, basic causes of death, intermediate causes of death, and contributing causes of death were analyzed. The total agreement of both diagnoses was defined, partial agreement, diagnostic mismatch or discrepancy, and insufficient data. Results: Diagnostic discrepancies of basic and direct cause of death are 46.2 % and 60.0 % of all cases and 19.4 % and 64.5 % when COVID-19 was basic cause of death. The high figures for diagnostic discrepancies correspond to those reported in previous studies, both in clinical diagnoses and in medical death certificates. Conclusions: There are high numbers of diagnostic discrepancies compared with the results of autopsies with COVID-19 diagnoses, compared to medical death certificates.

RESUMEN Introducción: La pandemia de la COVID-19 ha sido la mayor del siglo actual y motivo de numerosos trabajos científicos. En Cuba se ha constituido el Grupo Temporal de Anatomía Patológica para estudiar las autopsias de los fallecidos por la COVID-19 (más de 400). Los certificados médicos de defunción, documentos de inestimable valor, en Cuba se reparan de acuerdo a los resultados de las autopsias, para elevar su calidad. Objetivos: Evaluar los resultados de las autopsias con diagnósticos de COVID-19, comparadas con los certificados médicos de defunción. Métodos: Se evaluaron los diagnósticos de causas de muerte de 65 autopsias del año 2020 con sus certificados médicos de defunción. Los diagnósticos fueron procesados en el Sistema Automatizado de Registro y Control de Anatomía Patológica. Se analizaron las causas directas de muerte, causas básicas de muerte, causas de muerte intermedias y causas de muerte contribuyentes. Se definió la coincidencia total de ambos diagnósticos, coincidencia parcial, no coincidencia o discrepancia diagnóstica y datos insuficientes. Resultados: Las discrepancias diagnósticas de causa básica y directa de muerte son 46,2 % y 60,0 % del total de casos y 19,4 % y 64,5 % cuando la COVID-19 fue causa básica de muerte. Las elevadas cifras de discrepancias diagnósticas, se corresponden con las reportadas en estudios previos, tanto en diagnósticos clínicos como en los certificados médicos de defunción. Conclusiones: Existe elevadas cifras de discrepancias diagnósticas en los resultados de las autopsias con diagnósticos de COVID-19, comparadas con los certificados médicos de defunción.

Abstract The present study aimed to evaluate, in vitro, the cestocidal effect of Pyrantel-Oxantel on the Dipylidium caninum tapeworm. Each intestine sample was obtained by means of a transversal incision of the abdominal area of each euthanized canine subject, individually dissected via longitudinal incision, and examined for the presence of D. caninum. An optical microscope was used to identify and verify proglottid morphology and viability based on its macroscopic appearance. The cestocidal effects of Pyrantel-Oxantel (75 mg pyrantel pamoate; 75 mg oxantel pamoate) were assessed in adult tapeworms (treated group, n= 21; control group, n= 21) placed on Petri dishes and incubated at 37 °C. One-hour post-incubation, the D. caninum cestodes treated with Pyrantel-Oxantel presented a 28 % decrease (P=0.001) in motility, which rose to a 52 % (P=0.0001) decrease by the end of the second hour. The control group (P=0.0001) presented 55.7 % motility for at least the first six hours of incubation and 4.2 % (P=0.001) motility by the end of the study, while 0 % motility was observed in the treated group by the end of the study. Pyrantel-Oxantel had a lethal effect (P=0.0001) on adult D. caninum, with 100 % mortality observed 6 h after in vitro post-incubation, while the control group presented 55.7 % viability after the same time period. In addition, Pyrantel-Oxantel reduced (P=0.001) tegument thickness by 42.5 % (10.24 ± 0.21 µm), while this was 17.81 ± 0.33 µm for the control group. The results of this study indicate that Pyrantel-Oxantel has a therapeutic effect on the presence of D. caninum, inducing both a reduction of the tegument thickness and increased mortality.

Resumen El presente estudio tuvo como objetivo evaluar, in vitro, el efecto cestocida de Pirantel-Oxantel en la tenia Dipylidium caninum. Cada muestra de intestino se obtuvo mediante una incisión transversal de la zona abdominal de cada sujeto canino sacrificado, se diseccionó individualmente a través de una incisión longitudinal y se examinó para detectar la presencia de D. caninum. Se utilizó un microscopio óptico para identificar y verificar la morfología y viabilidad de la proglótide en función de su aspecto macroscópico. Los efectos cestocidas de Pirantel-Oxantel (75 mg de pamoato de pirantel; 75 mg de pamoato de oxantel) se evaluaron en tenias adultas (grupo tratado, n= 21; grupo testigo, n= 21) colocadas en placas de Petri e incubadas a 37 °C. Una hora postincubación, los cestodos D. caninum tratados con Pirantel-Oxantel presentaron una disminución del 28 % (P= 0.001) en la motilidad, la cual aumentó a una disminución del 52 % (P=0.0001) al final de la segunda hora. El grupo testigo (P= 0.0001) presentó un 55.7 % de motilidad durante al menos las primeras 6 h de incubación y 4.2 % (P= 0.001) de motilidad al final del estudio, mientras que en el grupo tratado se observó un 0 % de motilidad al final del estudio. El Pirantel-Oxantel tuvo un efecto letal (P= 0.0001) en el adulto de D. caninum, con una mortalidad del 100 % observada 6 h después de la postincubación in vitro, mientras que el grupo de control presentó un 55.7 % de viabilidad después del mismo periodo. Además, el Pirantel-Oxantel redujo (P= 0.001) el grosor del tegumento en 42.5 % (10.24 ± 0.21 μm), mientras que éste fue de 17.81 ± 0.33 μm para el grupo testigo. Los resultados de este estudio indican que el Pirantel-Oxantel tiene un efecto terapéutico en la presencia de D. caninum, induciendo tanto una disminución del grosor del tegumento como un aumento de la mortalidad.

Resumen: La aloinmunización es una respuesta biológica frente a la exposición de antígenos no propios. La gestación, las transfusiones de hemocomponentes, los trasplantes de órganos sólidos y células hematopoyéticas, así como el consumo de drogas intravenosas exponen a las pacientes al desarrollo de aloanticuerpos antieritrocitarios. El hallazgo de los mismos debe cumplir con las instancias diagnósticas para identificar la probabilidad de estar asociados a enfermedad hemolítica feto neonatal (EHFN) y su oportuna derivación a policlínica de alto riesgo obstétrico (ARO) para su correcto seguimiento. Es fundamental que sean los laboratorios de inmunohematología de los servicios de hemoterapia y medicina transfusional los encargados de los estudios diagnósticos de aloinmunización eritrocitaria(1). En este sentido hemos elaborado esta guía con el objetivo de protocolizar de manera multidisciplinaria el manejo de las embarazadas aloinmunizadas y sus recién nacidos.

Abstract: Alloimmunization is the biological response to exposure to non-HLA antigens. Pregnancy, transfusion of blood components, solid organ and hematopoietic cell transplantation, as well as intravenous drug use expose patients to the development of anti-erythrocyte antibodies. When the latter are found, they must match diagnostic criteria to identify the potential association to hemolytic disease of the fetus and newborn (HDFN) and its timely referral to the high-risk obstetric risk polyclinic for due follow-up. It is of the essence for erythrocyte alloimmunization diagnostic tests to be carried out by the immunohematology laboratories of the Hemotherapy and Transfusional Medicine services. To that end, we have prepared these guidelines with the purpose of providing a multidisciplinary protocol for the handling of maternal alloimmunization and alloimmunization of the newborn.

Resumo: A aloimunização é uma resposta biológica à exposição a antígenos não próprios. A gravidez, as transfusões de hemocomponentes, os transplantes de órgãos sólidos e células hematopoiéticas, bem como o uso de drogas intravenosas expõem os pacientes ao desenvolvimento de anticorpos antieritrocitários. O achado destes deve obedecer a critérios diagnósticos para identificar a doença e a probabilidade de estarem associados a doença hemolítica feto neonatal (DHPN) e seu encaminhamento oportuno para uma unidade de alto risco obstétrico para acompanhamento adequado. É fundamental que os laboratórios de imuno-hematologia dos serviços de Hemoterapia e Medicina Transfusional se encarreguem dos estudos diagnósticos da aloimunização eritrocitária. Elaboramos este guia com o objetivo de estabelecer um protocolo multidisciplinar para o manejo de gestantes aloimunizadas e seus recém-nascidos.

Abstract Community-acquired pneumonia (CAP) represents a major health issue and ~20% of the patients require in-hospital attention. The main objective of the study was to determine clinical-imaging features of CAP episodes requiring hospitalization. The secondary objectives were to determine the diagnostic yield of microbiological analyses and the medical complications. A retrospective analytical study was conducted on adults admitted due to CAP in a third-level hospital in the period 2017-2019. Pregnant women were excluded. A total of 340 CAP episodes were identified in 321 patients; the median age was 75 years old (interquartile range 57-85). The most frequent risk factors were immunocompromise 102 (30%), neurological disease 75 (22%), and chronic kidney disease 58 (17%). According to three prognostic scores, CURB65, qSOFA and PSI/PORT, 216 (63.5%), 290 (83.5%) and 130 (38%) patients were identified as low risk, respectively. A total of 49 (14.4%) episodes required admission at the critical care unit and 39 (11.5%) required mechanical ventilation; 30 patients (8.8%) died during hospitalization. The radiologic patterns most frequently found were consolidation in 134 (39.4%), interstitial-alveolar pattern in 98 (28.8%), and the combination of both patterns in 67 (19.7%) episodes. Identification of the causal agent was achieved in 79 (23.2%) episodes. The most frequently isolated microorganisms were influenza virus in 37 (10.9%) episodes and Streptococcus pneumoniae in 11 (3.2%). Most of the hospitalized CAP patients were elderly with consolidative radiological patterns. The causal agent could be identified in less than a quarter of the patients, with the influenza test being the method with the highest diagnostic yield.

Resumen La neumonía adquirida en la comunidad (NAC) representa un importante problema sanitario y ~20% de los pacientes requiere hospitalización. El objetivo principal del trabajo fue determinar las características clínico-imagenológicas de los episodios de NAC que requirieron internación. Los objetivos secundarios fueron determinar el rédito diagnóstico de los estudios microbiológicos e identificar las complicaciones. Realizamos un estudio analítico retrospectivo en un hospital de tercer nivel durante el período 2017-2019, en adultos admitidos por NAC, excluyendo embarazadas. Identificamos 340 episodios en 321 pacientes, la mediana de edad fue 75 años (rango intercuartil 57-85). Los factores de riesgo más frecuentes fueron inmunocompromiso (30%), enfermedad neurológica (22%) y enfermedad renal crónica (17%). Según tres scores pronósticos de gravedad, CURB65, qSOFA y PSI/PORT, 216 (63.5%), 290 (85.3%) y 130 (38%) episodios fueron identificados como de bajo riesgo, respectivamente. Del total de los episodios, 49 (14.4%) requirieron internación en unidad de cuidados intensivos, 39 (11.5%) ventilación mecánica y se registraron 30 (8.8%) muertes durante la hospitalización. Los patrones de imagen más frecuentes fueron consolidativo en 134 (39.4%), intersticio-alveolar en 98 (28.8%) y mixto entre ambos patrones en 67 (19.7%) episodios. Identificamos el agente causal en 79 (23.2%) episodios. Los microorganismos aislados más frecuentemente fueron influenza en 37 (10.9%) y Streptococcus pneumoniae en 11 (3.2%). La mayoría de los episodios afectaron pacientes ancianos y el principal patrón radiológico fue el consolidativo. El agente causal se pudo identificar en uno de cada cuatro episodios y el método con mayor rédito diagnóstico fue el test para influenza.

Abstract Background: The species included in Scleroderma have a worldwide distribution and are ectomycorrhizal, the genus has been recorded as toxic, although antiinflammatory and hemostatic properties have been attributed to some species. In Mexico there are 14 species, one of them, Scleroderma laeve has been recorded as edible from Hueyapan in Morelos State. Objective: To record the edible use of Scleroderma texense, as well as to explain how this mushroom is cooked by the Zapotecs from Santiago Xochiltepec, Santiago Textitlán, Oaxaca. Methods: The information was documented through informal and semistructured interviews applied by high school students from Bachillerato Integral Comunitario N° 9 as a research project about mushrooms. The specimens were studied with the techniques used in Mycology. Results and conclusions: Scleroderma texense is recorded for the first time as an edible species by the Zapotecs from Santiago Xochiltepec in the Southern Sierra of the State of Oaxaca. In this town it receives the name of “duck egg”, “turkey egg” or “guitar”. This record contributes to the knowledge about the uses of mushrooms by the ethnic groups in Oaxaca.

Resumen Antecedentes: Los hongos ectomicorrizógenos del género Scleroderma tienen distribución mundial, en la literatura se registran mayormente como tóxicos; aunque también se les atribuyen propiedades antiinflamatorias y hemostáticas. En México se conocen 14 especies, una de ellas, Scleroderma laeve está registrada como comestible de Hueyapan en el estado de Morelos. Objetivo: Documentar el uso comestible de Scleroderma texense, así como algunos aspectos sobre la manera de cocinar el hongo por los zapotecos de Santiago Xochiltepec, Santiago Textitlán, Oaxaca. Métodos: Se documentó la información mediante entrevistas informales y semiestructuradas aplicadas por estudiantes del Bachillerato Integral Comunitario N° 9 de Santiago Xochiltepec como parte de un trabajo de investigación sobre hongos silvestres. Los especímenes se estudiaron con las técnicas empleadas en Micología. Resultados y conclusiones: Se registra por primera vez Scleroderma texense como una especie comestible, este hongo es consumido por los zapotecos de Santiago Xochiltepec en la Sierra Sur del estado de Oaxaca. En esta localidad recibe el nombre de “huevo de pato”, “huevo de guajolota” o “guitarra”. Este registro contribuye al conocimiento sobre los usos de los hongos por los grupos étnicos de Oaxaca.

Introduction: the aim of the study was to analyse the clinical characteristics, diagnostic tests performed and treatment used in patients with pertussis evaluated in the paediatric emergency setting. Material and methods: we conducted a retrospective descriptive study of patients with pertussis that sought care in the paediatric emergency department of a tertiary care hospital between March 2014 and October 2017. Results: the sample included 89 patients with a mean age of 1.67 ± 2.9 years. Of the total, 98.9% presented with cough, 33% with inspiratory whoop and 34.8% with apnoea. Sixty-four percent of cases occurred in the context of an epidemic of cough or pertussis. The mean number of emergency visits made during a single episode of disease was 1.4. The most frequent diagnoses in the initial emergency visit were cough (36%), suspected pertussis (22.5%), upper respiratory tract infection (19.1%) and bronchiolitis (9%). Fifty-six patients were admitted to hospital (62.9%) with a mean age of 0.38 ± 1.2 years. Cultures for detection of Bordetella were performed in 88 cases (positive for B. pertussis in 38 and B. parapertussis in 3), and PCR tests in 73 (positive for B. pertussis in 70 and B. parapertussis in 3). Conclusions: the diagnosis of pertussis is usually challenging, as its initial symptoms are nonspecific. Early diagnosis is essential for early initiation of treatment and adequate contact prophylaxis.

Introducción: se analizan las características clínicas, pruebas complementarias y tratamientos recibidos por los pacientes con diagnóstico de tosferina que son valorados en Urgencias de Pediatría. Material y métodos: estudio descriptivo retrospectivo de los casos de tosferina que consultaron en Urgencias de Pediatría de un hospital de tercer nivel entre marzo de 2014 y octubre de 2017. Resultados: se analizaron 89 casos (55% mujeres) con edad media de 1,67 ± 2,9 años. El 98,9% presentó tos, el 33% gallo inspiratorio y el 34,8% apneas. En el 64% de los casos había entorno epidémico de tos o tosferina. La media de visitas en urgencias durante el mismo proceso fue 1,4. Diagnósticos más frecuentes en la primera visita a urgencias: tos (36%), sospecha de tosferina (22,5%), infección respiratoria de vías altas (19,1%) y bronquiolitis (9%). Ingresaron 56 pacientes (62,9%), con una edad media de 0,38 ± 1,2 años. Se realizó cultivo para Bordetella en 88 casos (positivo para B. pertussis en 38 y B. parapertussis en tres) y reacción en cadena de la polimerasa en 73 (positivo para B. pertussis en 70 y B. parapertussis en tres). Conclusiones: el diagnóstico de tosferina habitualmente es difícil, ya que la sintomatología inicialmente es inespecífica. El diagnóstico precoz es fundamental para iniciar un tratamiento inmediato y realizar una adecuada profilaxis de contactos.

Fertilization is a cultural practice of maximum importance in management to achieve a high-yield sugarcane crop. Its high cost requires timely and effective use of fertilizer to achieve maximum efficiency. The objective of this work was to compare the operating costs of different fertilizer application alternatives, two types of nitrogen sources and to find the most effective combination in terms of economic and environmental sustainability. Productive, operative and economic parameters were determined for two fertilizer applicator machines, a 9-furrow pneumatic machine that applied the fertilizer on the surface, and a cultivator and fertilizer applicator with the capacity to apply two furrows simultaneously both on the surface and incorporating the fertilizer into the soil. The cost of fertilizing with the pneumatic machine varied between 12 USD/ha and 13 USD/ha, while for the fertilization-cultivator machine it was between 33 USD/ha and 59 USD/ha. In Tucumán, the optimal time to fertilize is about 40 days; with the pneumatic applicator more rows could be fertilized during this period (1,660ha). In addition, the pneumatic fertilizer machine requires an investment and application cost 3-5 times lower, a lower fuel consumption, shorter operating time and greater efficiency in the logistics of loading and distribution of the product than the fertilizer cultivator machine. The pneumatic fertilizer machine is an important alternative to fertilize sugarcane within the framework of sustainability, especially in large areas.

La fertilización nitrogenada en el cultivo de caña de azúcar es una práctica cultural de gran importancia dentro de una gestión orientada al logro de plantaciones de alto rendimiento. Su alto costo requiere un uso oportuno y efectivo de fertilizantes para lograr los máximos beneficios. El objetivo de este trabajo fue comparar los costos operativos de diferentes alternativas de aplicación de fertilizantes, dos tipos de fuentes de nitrógeno y encontrar la combinación más efectiva en términos de sostenibilidad económica y ambiental. Se determinaron parámetros productivos, operativos y económicos para dos fertilizadoras, una neumática de 9 surcos que aplica el fertilizante en superficie, y un fertilizador cultivador con la capacidad para aplicar 2 surcos simultáneamente en la superficie e incorporando el fertilizante al suelo. El costo con una fertilizadora neumática varió entre 12 USD/ha y 13 USD/ha, mientras que el fertilizador-cultivador fue entre 33 USD/ha y 59 USD/ha. En Tucumán el momento óptimo para realizar la fertilización comprende aproximadamente 40 día; con la fertilizadora neumática se podría llegar a fertilizar una mayor cantidad de surcos dentro del período oportuno (1.660 ha). Se concluye que la fertilizadora neumática requiere una inversión y un costo de aplicación de tres a cinco veces menor, también, menor consumo de combustible y tiempo operativo. Otro beneficio es la mayor eficiencia en la logística de carga y distribución del producto. La fertilizadora neumática es una alternativa interesante para fertilizar la caña de azúcar en el marco de la sostenibilidad, especialmente en grandes extensiones.

Resumo Visando estudar a trajetória de egressos de duas turmas de Mestrado Profissional realizou-se estudo exploratório, com questionário eletrônico on line, anônimo, com quatro blocos: pessoal; atividade profissional atual; relação do curso-situação profissional e ainda perguntas abertas para pontos positivos/negativos. Resultados: a maioria mantinha-se na área da atenção primária e em serviços públicos; na assistência à saúde e muitos como preceptores; desenvolviam atividade no trabalho relacionada ao curso e 75% relatam alto o impacto do curso. Menor efeito foi percebido na remuneração e maiores na formação profissional, nas redes de relações; no crescimento pessoal e no trabalho. As estratégias pedagógicas ativas foram bem avaliadas. Conclusão: metodologia de avaliação factível e aplicável para sistemas de acompanhamento de egressos; permite conhecer a relação formação e trabalho.

Abstract A four-block exploratory study was conducted with an electronic online, anonymous questionnaire to study the path of postgraduates from two professional master’s degree classes, as follows: personal, current professional activity, course-professional situation relationship, and open-ended questions for positive/negative points. Results: Most of them remained in the primary care area and public services; in health care and as tutors; developed a course-related work activity, and 75% reported a high impact of the course. A lower effect was perceived in the remuneration. A higher effect was noted in the professional training, the networks of relationships, personal growth, and work. The active pedagogical strategies were well evaluated. Conclusion: This is a feasible and applicable evaluation method for graduate monitoring systems, and it allows knowing the relationship between training and work.

Resumo Visando estudar a trajetória de egressos de duas turmas de Mestrado Profissional realizou-se estudo exploratório, com questionário eletrônico on line, anônimo, com quatro blocos: pessoal; atividade profissional atual; relação do curso-situação profissional e ainda perguntas abertas para pontos positivos/negativos. Resultados: a maioria mantinha-se na área da atenção primária e em serviços públicos; na assistência à saúde e muitos como preceptores; desenvolviam atividade no trabalho relacionada ao curso e 75% relatam alto o impacto do curso. Menor efeito foi percebido na remuneração e maiores na formação profissional, nas redes de relações; no crescimento pessoal e no trabalho. As estratégias pedagógicas ativas foram bem avaliadas. Conclusão: metodologia de avaliação factível e aplicável para sistemas de acompanhamento de egressos; permite conhecer a relação formação e trabalho.

Abstract A four-block exploratory study was conducted with an electronic online, anonymous questionnaire to study the path of postgraduates from two professional master’s degree classes, as follows: personal, current professional activity, course-professional situation relationship, and open-ended questions for positive/negative points. Results: Most of them remained in the primary care area and public services; in health care and as tutors; developed a course-related work activity, and 75% reported a high impact of the course. A lower effect was perceived in the remuneration. A higher effect was noted in the professional training, the networks of relationships, personal growth, and work. The active pedagogical strategies were well evaluated. Conclusion: This is a feasible and applicable evaluation method for graduate monitoring systems, and it allows knowing the relationship between training and work.

For several years the issue of care has been raising special attention in public policy agenda. Thanks to Academia and civil society organizations, conceptual and empirical aspects were contributed, that allowed to notice the centrality of the problem of the social organization of care as a vector of reproduction of inequality, and contribute to an informed debate about the ways to face this social issue. This article intends to update this contribution through: i) a systematization of the fundamental conceptual contributions to understand the issue as a social problem; ii) an update of the existing evidence to account for the current shape of the social organization of the care of the dependent population and a characterization of the attention gaps; and iii) a reflection on the continuities and ruptures of the attention of these population groups through public policy. The work focuses on the issue of care for the dependent population in three population groups: i) children in early childhood; ii) elder population in a situation of severe dependence; and iii) persons with disabilities in need of direct care. Based on the scarce and scattered information available, the article concludes that the offer of public services of direct care for children, elderly and disabled persons is insufficient, segmented and dispersed. The deficits are minor but notorious for early childhood, and very substantive for the elderly and disabled.

Desde hace varios años la cuestión del cuidado viene ocupando un espacio de atención en la agenda de discusión de políticas públicas. La academia y organizaciones de la sociedad civil aportaron aspectos conceptuales y empíricos que permitieron advertir la centralidad del problema de la organización social del cuidado como vector de reproducción de desigualdad y contribuir a un debate informado sobre las maneras de enfrentarlo. El presente artículo pretende actualizar esta contribución mediante: i) la sistematización de los aportes conceptuales fundamentales para entender la cuestión como problema social; ii) la actualización de la evidencia existente para dar cuenta de la forma que adopta la organización social del cuidado de la población dependiente y la caracterización de las brechas de atención; y iii) la reflexión sobre las continuidades y rupturas de la atención de estos grupos poblaciones desde la política pública. El trabajo se enfoca en la cuestión del cuidado de la población dependiente en tres grupos poblacionales: i) los niños y niñas en la primera infancia; ii) las personas adultas mayores en situación de dependencia severa; iii) las personas con discapacidad con necesidad de cuidados directos. A partir de la escasa y dispersa información disponible, el artículo concluye que la oferta de servicios públicos de cuidado directo para niños y niñas, personas mayores y con discapacidad es insuficiente, segmentada y dispersa. Los déficits son menores pero notorios para la primera infancia, y muy sustantivos para las personas mayores y con discapacidad.

Resumo Este artigo descreveu o contexto histórico da formação em gestão em saúde oferecida no Brasil e buscou identificar suas semelhanças e diferenças com aquela oferecida na Espanha. Adotou-se uma abordagem qualitativa da realidade e o método comparado foi empregado. Como fonte de dados, utilizaram-se a bibliografia científica, os documentos oficiais, que orientam as intervenções no campo da formação em gestão em saúde nos dois países, e a entrevista semiestruturada. As entrevistas foram realizadas com gestores selecionados pelo fato de estarem ocupando ou de terem ocupado cargos de gestão e que tenham participado da conformação da política de saúde, totalizando quatro gestores brasileiros e seis espanhóis. Apoiados na análise de conteúdo temática, os resultados se relacionaram com a categoria “institucionalidade” a partir dos seguintes temas: política de saúde e educação; política de formação de gestores; e profissionalização. Identificou-se como elemento comum o fato de tanto o Brasil quanto a Espanha adotarem a proteção à saúde como direito de cidadania por meio de sistemas públicos e universais de saúde. A diferença mais significativa diz respeito à cobertura populacional, alcançada na quase totalidade na Espanha no final dos anos 1990. Evidenciou-se a inexistência de uma política nacional de formação de gestores nos dois países, considerada central para a profissionalização da gestão em saúde. Ainda que o tema da profissionalização esteja presente no Brasil, na Espanha assumiu contornos institucionais distintos com avanços significativos em período recente.

Abstract The article described the historical context of health management training in Brazil and aimed at identifying similarities and differences between this training in Brazil and Spain, using qualitative approach and comparative method. Data sources included the scientific literature, official documents orienting interventions in health management training, and semi-structured interviews. Interviews were conducted with managers selected on the basis of currently occupying or having occupied management positions, besides experience and participation in shaping policies in health, totaling four managers in Brazil and six in Spain. Based on thematic content analysis, the results were related to the category of “institutionality” according to the following themes: health and education policy, management training policy, and professionalization. A common element was that Brazil and Spain both adopt health protection as a civic right through universal public health systems. The most significant difference relates to population coverage, nearly complete in Spain in the late 1990s. The study showed the lack of a national training policy for managers in both countries and that such a policy is essential for professionalization in health management. Although the theme of professionalization exists in Brazil, in Spain it has distinct institutional characteristics, having achieved important recent progress.

Resumo Este artigo descreveu o contexto histórico da formação em gestão em saúde oferecida no Brasil e buscou identificar suas semelhanças e diferenças com aquela oferecida na Espanha. Adotou-se uma abordagem qualitativa da realidade e o método comparado foi empregado. Como fonte de dados, utilizaram-se a bibliografia científica, os documentos oficiais, que orientam as intervenções no campo da formação em gestão em saúde nos dois países, e a entrevista semiestruturada. As entrevistas foram realizadas com gestores selecionados pelo fato de estarem ocupando ou de terem ocupado cargos de gestão e que tenham participado da conformação da política de saúde, totalizando quatro gestores brasileiros e seis espanhóis. Apoiados na análise de conteúdo temática, os resultados se relacionaram com a categoria “institucionalidade” a partir dos seguintes temas: política de saúde e educação; política de formação de gestores; e profissionalização. Identificou-se como elemento comum o fato de tanto o Brasil quanto a Espanha adotarem a proteção à saúde como direito de cidadania por meio de sistemas públicos e universais de saúde. A diferença mais significativa diz respeito à cobertura populacional, alcançada na quase totalidade na Espanha no final dos anos 1990. Evidenciou-se a inexistência de uma política nacional de formação de gestores nos dois países, considerada central para a profissionalização da gestão em saúde. Ainda que o tema da profissionalização esteja presente no Brasil, na Espanha assumiu contornos institucionais distintos com avanços significativos em período recente.

Abstract The article described the historical context of health management training in Brazil and aimed at identifying similarities and differences between this training in Brazil and Spain, using qualitative approach and comparative method. Data sources included the scientific literature, official documents orienting interventions in health management training, and semi-structured interviews. Interviews were conducted with managers selected on the basis of currently occupying or having occupied management positions, besides experience and participation in shaping policies in health, totaling four managers in Brazil and six in Spain. Based on thematic content analysis, the results were related to the category of “institutionality” according to the following themes: health and education policy, management training policy, and professionalization. A common element was that Brazil and Spain both adopt health protection as a civic right through universal public health systems. The most significant difference relates to population coverage, nearly complete in Spain in the late 1990s. The study showed the lack of a national training policy for managers in both countries and that such a policy is essential for professionalization in health management. Although the theme of professionalization exists in Brazil, in Spain it has distinct institutional characteristics, having achieved important recent progress.