Caracterización de la motivación académica de residentes en especialidades de enfermería / Characterization of Academic Motivation in Residents of Nursing Specialties

Introducción: A pesar de la contingencia epidemiológica ocasionada por la COVID-19, la formación académica de los profesionales de enfermería no cesó, y Cuba reinició el proceso de especialización de sus licenciados en cuatro especialidades. Las solicitudes de bajas definitivas recibidas en las primeras semanas motivaron a los autores a realizar este trabajo, en el que se asume que esta formación requiere de elevada motivación hacia el estudio. Objetivo: Caracterizar la motivación académica de los residentes en especialidades de enfermería en Camagüey. Métodos: Estudio descriptivo de corte transversal, realizado desde diciembre de 2020 a febrero de 2021, en los centros hospitalarios de Camagüey, donde se realiza la especialización. Se trabajó con la población de 47 residentes matriculados en las especialidades. Como métodos empíricos fueron aplicados la Escala de Motivación Educativa adaptada, la entrevista semiestructurada y la observación. Se asumieron como dimensiones: motivación intrínseca, extrínseca y amotivación. Para el análisis de los datos cuantitativos se empleó la distribución de frecuencias absolutas y el cálculo porcentual. Se cualificaron los datos mediante el análisis de contenidos del que resultaron dos categorías. Resultados: Predominó la motivación académica de tipo intrínseca en 63,00 por ciento de los residentes, seguido por la motivación extrínseca en 23,00 por ciento. Solo 5,00 por ciento se encontraba desmotivado. Conclusiones: Existen diversas tipologías de motivación académica intrínseca que guardan relación con la especialidad matriculada. Predominó la motivación dirigida al logro. Dentro de la regulación extrínseca, la mayoría de los sujetos de la muestra poseía regulación identificada, seguido por las regulaciones introyectada y externa(AU)

Introduction: Despite the epidemiological contingency caused by COVID-19, the academic training of nursing professionals did not cease, and Cuba restarted the process of specialization of its graduates in four specialties. The requests for definitive quits received in the first weeks motivated the authors to write this article, in which this training is assumed as requiring high motivation towards study. Objective: To characterize the academic motivation of residents in nursing specialties in Camagüey. Methods: Cross-sectional and descriptive study carried out from December 2020 to February 2021 in the hospital centers of Camagüey where the specialization is received. The work was completed with the population of 47 residents enrolled in the specialties. As empirical methods, the adapted educational motivation scale, the semistructured interview and observation were applied. The following dimensions were assumed: intrinsic motivation, extrinsic motivation and amotivation. For the analysis of quantitative data, distribution of absolute frequencies and percentage calculation were used. The data were qualified by means of content analysis, which yielded two categories. Results: Intrinsic academic motivation predominated, accounting for 63.00 percent of the residents; followed by extrinsic motivation, present in 23.00 percent. Only 5.00 percent were unmotivated. Conclusions: There are different typologies of intrinsic academic motivation related to the studied specialty. Achievement-directed motivation predominated. Within extrinsic regulation, most of the sample subjects had identified regulation, followed by introjected and external regulation(AU)

Teoria das filas e sua aplicação no serviço público de saúde / Queue theory and their application in the public health service

Formulada em 1908, pelo dinamarquês Agner Krarup Erlang, a teoria das filas é um método estatístico que utiliza cálculos matemáticos de probabilidade com o objetivo de prover um modelo que explique a formação de uma fila com base no padrão de entrada, atendimento e saída (OLIVEIRA et al., 2017). A finalidade de tais estudos é melhorar o desempenho do serviço e reduzir os custos. Foram citados três aplicações da teoria no serviço público: um trabalho realizado em Duque de Caxias (RJ); um estudo de caso realizado no Hospital das Clínicas de Uberlândia e um realizado no Estado do Rio de Janeiro

Formulated in 1908 by the Danish Agner Krarup Erlang, the theory of queues is a statistical method that uses mathematical probability calculations in order to provide a model that explains the formation of a queue based on the pattern of entry, service and exit (OLIVEIRA et al., 2017). The purpose of such studies is to improve service performance and reduce costs. Three applications of theory in the public service were mentioned: a work carried out in Duque de Caxias (RJ); a case study conducted at the Hospital das Clínicas de Uberlândia and one conducted in the State of Rio de Janeiro

O conceito de "vaga zero" na Rede de Atenção às Urgências e Emergências do SUS / The concept of "zero vacancy" in the Emergency Care Network of the SUS

A Rede de Atenção às Urgências e Emergências (RUE), é uma rede complexa, composta por diferentes pontos de atenção, de forma a dar conta de todas as ações necessárias aos atendimentos de urgência. Desse modo é necessário que seus componentes atuem de forma integrada, articulada e sinérgica. Dentre as diretrizes que norteiam a implementação da RUE, estão a integralidade e regionalização da atenção, classificação de risco e a regulação do acesso aos serviços de saúde (BRASIL, 2013).

The Emergency And Emergency Care Network (RUE) is a complex network, composed of different points of care, in order to account for all the actions necessary for emergency care. Thus, it is necessary that its components act in an integrated, articulated and synergistic way. Among the guidelines that guide the implementation of the RUE are the integrality and regionalization of care, risk classification and the regulation of access to health services (BRASIL, 2013).

Outcomes of Community-Based Suicide Prevention Approaches That Involve Reducing Access to Pesticides: A Systematic Literature Review.

OBJECTIVE: Pesticide ingestion is among the most commonly utilized means of suicide worldwide. Restricting access to pesticides at a local level is one strategy to address this major public health problem, but little is known about its effectiveness. We therefore conducted a systematic literature review to identify effective community-based suicide prevention approaches that involve restricting access to pesticides. METHOD: We searched Embase, Scopus, PsycINFO, Cochrane Library, CINAHL, and PubMed for well-designed studies that reported on suicide-related outcomes (i.e., attempted or completed suicide). RESULTS: We identified only five studies that met our eligibility criteria (two randomized controlled trials, two studies with quasi-experimental designs, and one study with a before-and-after design). These studies tested different interventions: the introduction of nonpesticide agricultural management, providing central storage facilities for pesticides, distributing locked storage containers to households, and local insecticide bans. The only sufficiently powered study produced no evidence of the effectiveness of providing household storage containers. Three interventions showed some promise in reducing pesticide suicides or attempts, with certain caveats. CONCLUSIONS: Our review identified three community interventions that show some promise for reducing pesticide suicides by restricting access to means, which will require replication in large, well-designed trials before they can be recommended.

The Response of Retailers in Scotland to the Standardised Packaging of Tobacco Products Regulations and Tobacco Products Directive.

INTRODUCTION: With most marketing channels prohibited, the retail environment has assumed greater importance for tobacco companies, even in markets with a ban on the open display of tobacco products. Research has yet to qualitatively explore how retailers respond to standardized packaging in a country where this has been introduced. METHODS: As part of the DISPLAY study, face-to-face interviews were conducted with 24 small retailers in Scotland between May 23 and June 26, 2017; the interviews were conducted after The Standardised Packaging of Tobacco Products Regulations and the Tobacco Products Directive were fully implemented. RESULTS: We found high retailer compliance with the legislation. With price-marked packs and packs containing less than 20 cigarettes and 30 g of rolling tobacco banned, retailers stated that this helped simplify ordering and stock management. The removal of price-marked packs also allowed them some flexibility to set their own prices, but many chose to stick closely to recommended retail price in order to remain competitive and avoid complaints from customers. In contrast to one of the tobacco industry's arguments against standardized packaging, most retailers suggested that transaction times had not increased, even though the changes had only recently come into force. CONCLUSIONS: This study challenges some of the arguments used against standardized packaging and provides an insight into the storage and pricing strategies adopted by retailers following the removal of price-marked packs. IMPLICATIONS: This study explores the response of the retailers to the introduction of standardized tobacco packaging and provides an insight into the storage and pricing strategies adopted by retailers following the removal of price-marked packs. It explores the importance of the retailer in tobacco companies' desire to maintain tobacco sales and challenges some of the arguments used against standardized packaging, such as an increase in transaction times. Countries seeking to introduce standardized packaging should monitor the experiences of retailers, preferably from preimplementation through to post implementation, to help understand how retailers respond to this policy and to inform compliance.

Preclinical Development of Cell-Based Products: a European Regulatory Science Perspective.

PURPOSE: This article describes preclinical development of cell-based medicinal products for European markets and discusses European regulatory mechanisms open to developers to aid successful product development. Cell-based medicinal products are diverse, including cells that are autologous or allogeneic, have been genetically modified, or not, or expanded ex vivo, and applied systemically or to an anatomical site different to that of their origin; comments applicable to one product may not be applicable to others, so bespoke development is needed, for all elements - quality, preclinical and clinical. METHODS: After establishing how the product is produced, proof of potential for therapeutic efficacy, and then safety, of the product need to be determined. This includes understanding biodistribution, persistence and toxicity, including potential for malignant transformation. These elements need to be considered in the context of the intended clinical development. RESULTS: This article describes regulatory mechanisms available to developers to support product development that aim to resolve scientific issues prior to marketing authorization application, to enable patients to have faster access to the product than would otherwise be the case. CONCLUSIONS: Developers are encouraged to be aware of both the scientific issues and regulatory mechanisms to ensure patients can be supplied with these products.

Alcohol policies and programmes which reduced alcohol-related harm.

PURPOSE OF REVIEW: This review is a critical reflection on the effectiveness of evidence-based alcohol policies and their implementation, based on studies and observations that have arisen in recent years. RECENT FINDINGS: This article covers themes in recent literature of: the relationship between alcohol consumption and harm, the variability of country contextual factors and the interactions of both country contexts and alcohol policies on changes in alcohol consumption and harm. SUMMARY: These recent observations imply that alcoholic beverage policies and programmes should focus on contextual determinants in each country and community, and address targeted problems (like problem drinking) and harm (such as liver cirrhosis, cancer and road accidents), rather than consumption per se.

A real-time traffic control method for the intersection with pre-signals under the phase swap sorting strategy.

To deal with the conflicts between left-turn and through traffic streams and increase the discharge capacity, this paper addresses the pre-signal which is implemented at a signalized intersection. Such an intersection with pre-signal is termed as a tandem intersection. For the tandem intersection, phase swap sorting strategy is deemed as the most effective phasing scheme in view of some exclusive merits, such as easier compliance of drivers, and shorter sorting area. However, a major limitation of the phase swap sorting strategy is not considered in previous studies: if one or more vehicle is left at the sorting area after the signal light turns to red, the capacity of the approach would be dramatically dropped. Besides, previous signal control studies deal with a fixed timing plan that is not adaptive with the fluctuation of traffic flows. Therefore, to cope with these two gaps, this paper firstly takes an in-depth analysis of the traffic flow operations at the tandem intersection. Secondly, three groups of loop detectors are placed to obtain the real-time vehicle information for adaptive signalization. The lane selection behavior in the sorting area is considered to set the green time for intersection signals. With the objective of minimizing the vehicle delay, the signal control parameters are then optimized based on a dynamic programming method. Finally, numerical experiments show that average vehicle delay and maximum queue length can be reduced under all scenarios.

Etiquetado de alimentos en Ecuador: implementación, resultados y acciones pendientes / Food labeling in Ecuador: implementation, results, and pending actions

RESUMEN Las enfermedades no transmisibles representan la principal causa de muerte en el mundo entero, siendo responsables de 38 millones de las defunciones registradas en 2012. Esta epidemia se asocia, principalmente, al tabaquismo, al consumo excesivo de alcohol, el sedentarismo y cambios en el patrón alimentario, caracterizado por el consumo de dietas con un elevado contenido de azúcar y grasas saturadas, propio de los alimentos procesados y bebidas azucaradas, sumado a una escasa ingesta de frutas y hortalizas. El Ecuador no escapa a ese perfil epidemiológico ni a los cambios en el patrón de consumo de alimentos, por lo cual, el Estado Ecuatoriano diseñó e implementó un plan de acción orientado a modificar el entorno obesogénico, que contempla seis líneas estratégicas, una de las cuales es la implementación de un sistema de etiquetado nutricional tipo semáforo a los alimentos procesados, a finales de 2014, orientado a garantizar el derecho de las personas a la información oportuna, clara, precisa y no engañosa sobre el contenido y características de estos alimentos. El presente artículo analiza el proceso de implementación del etiquetado de alimentos procesados, los resultados alcanzados hasta la fecha y propone medidas complementarias que se requieren para el logro de la meta prevista en el Plan Nacional del Buen Vivir, a la luz de la nueva evidencia científica y los distintos acuerdos y marcos regulatorios disponibles en nuestra Región. La metodología de estudio incluyó revisión bibliográfica y de actas, entrevistas a informantes clave, y análisis y procesamiento de fuentes secundarias.

ABSTRACT Noncommunicable diseases are the world’s leading cause of death, responsible for 38 million deaths in 2012. This epidemic is primarily associated with smoking, excessive alcohol consumption, sedentary lifestyle, and changes in dietary patterns, characterized by diets high in sugar and saturated fat, typical of processed foods and sugar-sweetened beverages, plus low intake of fruits and vegetables. Ecuador is no exception to this epidemiological profile or to changes in eating patterns. Thus, Ecuador’s government designed and implemented an action plan aimed at changing the obesogenic environment, which includes six strategic lines. One of these is implementation of a traffic-light nutritional labeling system for processed foods, in late 2014, aimed at guaranteeing people’s right to timely, clear, accurate, and non-deceptive information on the content and characteristics of these foods. This article analyzes implementation of processed food labeling and results to date, and proposes complementary measures needed to reach the goal in the National Plan for Good Living, in light of new scientific evidence and different agreements and regulatory frameworks in our Region. Methods included a literature and documentary review, key informant interviews, and analysis and processing of secondary sources.

Tobacco control laws in Pakistan and their implementation: A pilot study in Karachi.

OBJECTIVE: In order to limit the high prevalence of tobacco use in Pakistan various tobacco control laws have been implemented. The objective of this study is to serve as a pilot study to assess the implementation of these laws in the largest city of Pakistan, Karachi. METHODS: A cross-sectional study was conducted in Karachi. The implementation of tobacco control laws in 'smoke-free' places, the adherence of tobacco companies to these laws, the regulation of cigarette sale, and the awareness and views of the general public regarding tobacco control laws were assessed via direct observation by visits and through self-administered questionnaires. RESULTS: The implementation of tobacco control laws in 'smoke-free' public places was found to be poor. Out of 37, only 23(62%) brands displayed pictorial warnings on their packs. 3(8%) of the brands were available in two different kinds of packs, both with and without pictorial warnings. Cigarette sale to minors was taking place at 80(85%) of the visited cigarette outlets. 50(53%) of the outlets displayed cigarette advertisements in the form of posters. 46(40%) of the persons questioned had awareness regarding the existence of ban on smoking in public places and 126(90%) of these were in favour of it. CONCLUSIONS: The implementation of tobacco control law in Pakistan is poor. Non adherence to the law in public places was alarmingly high. Also, the study demonstrates the poor compliance to the tobacco control laws by tobacco companies. The sale of cigarettes is almost unregulated.

Jogos olímpicos: espetáculo de entretenimento planetário / Olympic games: world entertainment spectacle

Este artigo situa os Jogos Olímpicos como espetáculo de entretenimento planetário, explícito na dimensão da infraestrutura, na expectativa quanto ao desempenho dos atletas, na midiatização do evento, nas razões do Estado e nos interesses privados em sediar, no montante dos custos econômicos, nos exemplos de superação e na possibilidade de enaltecer ou abalar o orgulho nacional. A pesquisa documental foi realizada via mídia ?Folha de S. Paulo?, sobretudo, entre o período de 1992 a 2012. Como procedimento de interpretação, utilizamos os pressupostos da análise de conteúdo. Os Jogos Olímpicos apresentam-se como um fenômeno planetário de controle ideológico da sociedade capitalista, transformado em mercadoria para a satisfação imediata do público, rentável para a indústria do entretenimento; e como um elemento gerenciador dos interesses do Estado.

This article situates the Olympic Games as a world spectacle of entertainment, explicit in the dimension of the infrastructure, in the expectation for the performance of athletes, in the media coverage of the event, in the grounds of the State and in the private interests in hosting the games, in the amount of the economic costs, in the examples of overcoming limits, and in the possibility of enhancing or undermining national pride. The documentary research was conducted, through print media "Folha de S. Paulo" especially in the period from 1992 to 2012. As for the interpretation procedure, content analysis has been employed. The Olympic Games are a planetary phenomenon of ideological control of capitalist society, transformed into merchandise for the immediate satisfaction of the public, profitable for the entertainment industry; and as an element explorer of state interests.

A comparison of emotion regulation strategies in response to craving cognitions: Effects on smoking behaviour, craving and affect in dependent smokers.

AIM: The effects of three emotion regulation strategies that targeted smoking-related thoughts were compared on outcomes relevant to smoking cessation. METHOD: Daily smokers applied defusion (n = 25), reappraisal (n = 25) or suppression (n = 23) to thoughts associated with smoking during a cue-induced craving procedure. Smoking behaviour, approach/avoidance behavioural bias, and subjective measures of experiential avoidance, craving, and affect were assessed during the experimental session, with additional behavioural and subjective outcomes assessed at 24 h and seven day follow-up. The influence of baseline group differences in smoking level and nicotine dependence were explored statistically. RESULTS: Defusion and reappraisal were associated with greater restraint in smoking behaviour in the immediate post-session period as well as reduction in smoking at seven day follow-up compared to suppression. Relative to suppression, reduced subjective craving was seen in the reappraisal group, and reduced experiential avoidance in the defusion group. Differences in approach/avoidance responses to smoking and neutral cues were observed only between the suppression and reappraisal groups. Although suppression was rated as lower in both credibility and strategy-expectancy compared to defusion and reappraisal, neither credibility nor expectancy mediated the effect of any strategy on changes in levels of smoking. CONCLUSION: Defusion and reappraisal produced similar benefits in smoking-related behavioural outcomes but, relative to suppression, were associated with distinctive outcomes on experiential avoidance and craving. The effects appear to be independent of perceived expectancy and credibility of the different strategies. Overall, the results suggest a role for reappraisal and defusion strategies in the development of psychological treatments for addiction-related disorders.

Estudo comparativo das regulamentações de reprodução assistida e das leis de abortamento de Brasil, Alemanha, Colômbia e França / Comparative study of regulations of assisted reproduction and abortion laws between Brazil, Germany, Colombia and France

OBJETIVO: Descrever as regulamentacões de Reprodução Humana Assistida (RHA) e as leis de abortamento do Brasil, Alemanha, Colômbia e Franc¸a. MÉTODO: Foi feito estudo qualitativo transversal das regulamentações referentes à reproducão humana assistida e ao abortamento no Brasil, na Colômbia, Alemanha e Franca entre agosto de 2014 e março de 2015. RESULTADOS: Para a RHA o Brasil tem a resolucão do Conselho Federal de Medicina 2.013/2013, a Colômbia o decreto 1.546/1998 para a doacão de gametas, a Alemanha e Franc¸a leis específicas. Em relacão à lei do abortamento, os quatro países têm leis específicas. CONCLUSÃO: Considerando todas as regulamentacões de RHA e leis de abortamento, verificamos que os países encontram-se em situacões distintas em relacão à RHA e que todos têm leis específicas para o abortamento.

OBJECTIVE: This study aims to describe the regulations of Assisted Human Reproduction (AHR) and the abortion laws of Brazil, Germany, Colombia and France. METHOD: A cross-sectional qualitative study of regulations relating to assisted human reproduction and abortion in Brazil, Colombia, Germany and France between august 2014 and March 2015. RESULTS: For the AHR Brazil has the resolution of the Federal Council of Medicine 2013/2013, Colombia has the 1546/1998 decree for the donation of gametes, Germany and France have specific laws. Regarding the abortion law, the four countries have specific laws. CONCLUSION: Considering all the regulations of AHR and abortion laws, we found that these countries are in different situations regarding the AHR and that they all have specific laws for abortion.

Enfoque de la Autoridad Reguladora Cubana sobre la reglamentación para la Medicina Natural y Tradicional / Approach of the Cuban regulatory authority to natural and traditional medicine regulations

INTRODUCCIÓN: la medicina natural y tradicional (MNT) ocupa un espacio renovado en la salud y la sociedad cubana. OBJETIVOS: caracterizar la reglamentación para la MNT y contribuir a su desarrollo mediante la recuperación de disposiciones nacionales que pautan los estándares para medicamentos y dispositivos médicos relacionados con la misma. MÉTODOS: se realizó un estudio descriptivo, transversal y retrospectivo; la base reglamentaria se recuperó mediante revisión de las publicaciones de artículos científicos entre 1989 y 2012, así como de sesiones de trabajo con funcionarios clave y entrevistas a expertos. RESULTADOS: el número de disposiciones compiladas ascendió a 22. El Centro para el Control Estatal de Medicamentos, Equipos y Dispositivos Médicos (CECMED) se identificó entre los 6 principales reguladores en esta esfera y las instituciones reguladas fueron 5. CONCLUSIONES: se mostró por primera vez un panorama general de la evolución de la reglamentación sobre la MNT, sus hitos, estructuras y necesidades de desarrollo. Se evidenció que el CECMED ha dado respuesta al mandato del Consejo de Ministros sobre el control en este campo, e investiga estrategias para cumplir las direcciones trazadas para la transformación del modelo económico y social del país con la perspectiva de la garantía sanitaria de medicamentos a utilizar en las modalidades de la MNT y dispositivos médicos con calidad, seguridad, eficacia y efectividad, en favor de preservar el derecho a la salud de los cubanos.

INTRODUCTION: Natural and traditional medicine (NTM) has gained space in Cuban health and society. OBJECTIVES: characterize NTM regulations and contribute to their development by means of the retrieval of national regulations about standards for NTM drugs and medical devices. METHODS: a descriptive cross-sectional retrospective study was conducted. The regulatory bases were retrieved from a review of scientific papers published between 1989 and 2012, as well as work sessions with key officials and interviews with experts. RESULTS: a total 22 regulations were collected. The Center for State Control of the Quality of Drugs and Medical Equipment (CECMED) was identified as among the 6 main regulators in this field, with 5 institutions regulated. CONCLUSIONS: for the first time a general overview was provided of the evolution of NTM regulations, their milestones, structures and development needs. It was shown that CECMED has accomplished the mandate of the Council of Ministers about regulation in this field, and that it investigates strategies aimed at fulfilling the directives received in relation to the transformation of the Cuban economic and social development model ensuring the quality, safety, efficacy and efficiency of NTM drugs and medical devices to preserve the right of Cubans to health care.