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Bibliographic Details
Main Author:	Klaus Thielmann
Format:	Artículo científico
Language:	es
Published:	Sociedad Cubana de Administración de Salud 2012
Subjects:	Salud salud Determinantes crisis económica
Online Access:	https://www.redalyc.org/articulo.oa?id=21422359011
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La crisis y la salud. ¿La salud en crisis? Klaus Thielmann José Illnait Ferrer Salud salud Determinantes crisis económica La crisis económica y financiera que envuelve al mundo, también afecta la salud, porque los servicios de salud, tal y como se practican hoy dependen cada día más del mercado. En estas circunstancias la salud es convertida en una mercancía que se encarece en la medida en que también lo hacen los productos dedicados al diagnóstico y tratamiento de las enfermedades. Ello genera, a su vez, desigualdad de acceso a la medicina entre grupos de países ricos y países pobres e igualmente entre los ciudadanos al interior de todos aquellos países sometidos a regímenes neoliberales, o constituyen una carga adicional para los países donde los servicios médicos son financiados por la sociedad. El reto de las enfermedades crónicas no transmisibles impone la necesidad de una estrategia proactiva y salutogénica, basada en el fortalecimiento de la salud a través de sus determinantes como contribución no solo a la sostenibilidad y racionalidad de los servicios médicos, sino también al acceso igualitario allí donde se requiera. Un proyecto denominado "Determinantes Individuales y Sociales de la Salud en la Medicina Familiar", se ha iniciado en La Habana Vieja aprovechando la vocación preventiva de la medicina cubana y la preparación de sus médicos en esta práctica y que pretende estudiar la factibilidad y los beneficios de esta estrategia médica. 2012 artículo científico 0864-3466 https://www.redalyc.org/articulo.oa?id=21422359011 es http://www.redalyc.org/revista.oa?id=214 Revista Cubana de Salud Pública application/pdf Sociedad Cubana de Administración de Salud Revista Cubana de Salud Pública (Cuba) Num.2 Vol.38

if (filemtime($filename) + $maxlifetime < time()) { unlink($filename); $count++; } } return $count; } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ protected function saveSession($sessId, $data): bool { $sessFile = $this->path . '/sess_' . $sessId; if ($handle = fopen($sessFile, 'w')) { $return = false; // Lock the file for exclusive access to avoid issues with multiple // processes writing session simultaneously: if (flock($handle, LOCK_EX)) { $return = fwrite($handle, $data); // Make sure that there's no trailing data by truncating the file to // the correct length: ftruncate($handle, strlen($data)); fflush($handle); flock($handle, LOCK_UN); } fclose($handle); if ($return !== false) { return true; } } // If we got this far, something went wrong with the file output... // It is tempting to throw an exception here, but this code is called // outside of the context of exception handling, so all we can do is // echo a message.

// Anecdotal testing Today and Yesterday seems to indicate destroy() // is called by the garbage collector and everything is good. // Something to keep in mind though. return 0; } /** * Write function that is called when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ public function write($sessId, $data): bool { if ($this->writesDisabled) { return true; } return $this->saveSession($sessId, $data); } /** * A function that is called internally when session data is to be saved. * * @param string $sessId The current session ID * @param string $data The session data to write * * @return bool */ abstract protected function saveSession($sessId, $data): bool; }

* * @return void */ public function writeClose() { // The assumption is that we're using PHP's ext/session. // session_write_close() will actually overwrite $_SESSION with an // empty array on completion -- which leads to a mismatch between what // is in the storage object and $_SESSION. To get around this, we // temporarily reset $_SESSION to an array, and then re-link it to // the storage object. // // Additionally, while you _can_ write to $_SESSION following a // session_write_close() operation, no changes made to it will be // flushed to the session handler. As such, we now mark the storage // object isImmutable. $storage = $this->getStorage(); if (! $storage->isImmutable()) { $_SESSION = $storage->toArray(true); session_write_close(); $storage->fromArray($_SESSION); $storage->markImmutable(); } } /** * Attempt to set the session name * * If the session has already been started, or if the name provided fails * validation, an exception will be raised. * * @param string $name * @return SessionManager * @throws Exception\InvalidArgumentException */ public function setName($name) { if ($this->sessionExists()) { throw new Exception\InvalidArgumentException( 'Cannot set session name after a session has already started'

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