Evaluación de la gestión de calidad en la red de bibliotecas médicas de Villa Clara / Evaluation of quality management in Villa Clara medical library network

La calidad es una exigencia vigente a nivel mundial en el área de la educación, a su vez constituye un indicador fundamental para las instituciones educativas, sujetas a proporcionar un servicio de excelencia. Por ello resulta necesario evaluar la gestión de calidad en las bibliotecas médicas de Villa Clara, de manera tal que se contribuya al mejoramiento de su funcionamiento y lograr un mayor nivel de satisfacción de las necesidades informativas de sus usuarios. Se tomaron como referentes teóricos el modelo de evaluación de bibliotecas universitarias cubanas, y los documentos normativos y teórico-metodológicos del Centro Nacional de Información sobre la temática.

Quality is a worldwide requirement in the education area, and at the same time it is a fundamental indicator for educational institutions which are subjected to provide a service of excellence. For this reason, evaluating the quality management of medical libraries in Villa Clara is a necessity, in order to contribute to the improvement of their functioning and to achieve a higher level of satisfaction of their users' information needs. The evaluation model for Cuban university libraries and the normative, theoretical and methodological documents of the National Information Center of Medical Sciences regarding this subject were taken as theoretical references.

COVID-19: The Impact on Internal Medicine Resident Training.

The novel coronavirus disease 2019 (COVID-19) pandemic has impacted the lives of physicians at all levels. The workloads and working hours have increased tremendously which affected the time spent on administrative and academic duties. The COVID-19 pandemic imposed a lot of challenges on academic institutions in term of providing quality of care to patients and maintaining the quality of education for trainee. Herein, we discuss the challenges and impact of the pandemic on residents training.

An assessment of race and gender-based biases among readmission predicting tools (HOSPITAL, LACE, and RAHF) in heart failure population.

BACKGROUND: The objective of our study is to retrospectively investigate if the HOSPITAL score, LACE index, and RAHF scale exhibit any bias based on gender and race in heart failure readmissions. METHODS: This is a retrospective cohort study with all adult medical patients discharged with congestive heart failure from 2016 to 2018 from Southern Illinois University School of Medicine Hospitalist service. The receiver operating characteristic (ROC) curve was constructed comparing prediction tools (HOSPITAL score, LACE index, and RAHF scale) performance based on gender and race by measuring the area under the curve (AUC). Absolute Between-ROC Area (ABROCA) values were calculated. All statistical analyses were performed using R version 3.6.2. RESULTS: The performance of the HOSPITAL score in the majority and minority population showed a statistically significant difference between AUCs (0.714 and 0.633, p = 0.029) and an ABROCA of 0.081 indicating superior performance in predicting hospital readmissions in the majority group vs. the minority. The performance of RAHF score in females and males showed statistically significant differences between AUCs (0.567 and 0.527, p = 0.04) and an ABROCA of 0.04 indicating the superior performance of the RAHF score in females compared with males. CONCLUSIONS: Our study demonstrated that the HOSPITAL score and the RAHF scale showed significant differences in predicting 30-day readmissions risk based on race and gender, respectively, in heart failure patients, whereas the LACE index did not show any significant difference.

Comprehensive evaluation of cardiovascular efficacy and safety outcomes of SGLT2 inhibitors in high risk patients of cardiovascular disease: systematic review and meta-analysis.

OBJECTIVES: To demonstrate a magnitude of the cardiovascular benefits, concomitantly analyzing the safety outcomes of sodium-glucose cotransporter 2 inhibitor (SGLT2-I) comprehensively, as a class effect in a larger sample size combined from recent randomized control trials. METHODS: We searched electronic databases using specific terms and evaluated 6 efficacy and 10 safety outcomes. Odds ratios (ORs) and 95% confidence interval (CI) were used to compare two interventions. RESULTS: Five studies (n = 41 267) were included, among which 23 539 received SGLT2-I. The SGLT2-I group favored reduction in major adverse cardiovascular events (OR, 0.78; 95% CI, 0.62-0.98; P = 0.03), cardiovascular death (CVD) or heart failure hospitalization (OR, 0.60; 95% CI, 0.46-0.80; P = 0.0004), rate of hospitalization for heart failure (OR, 0.56; 95% CI, 0.44-0.72; P < 0.00001), CVD (OR, 0.68; 95% CI, 0.50-0.93; P = 0.01), all-cause mortality (OR, 0.67; 95% CI, 0.48-0.93; P = 0.02) and myocardial infarction (OR, 0.79; 95% CI, 0.64-0.99; P = 0.04) when compared to the placebo group. Safety analysis showed higher diabetic ketoacidosis (DKA) rate in SGLT2-I group (OR, 2.33; 95% CI, 1.40-3.90; P = 0.001); in contrast, major hypoglycemic events were significantly lower (OR, 0.79; 95% CI, 0.73-0.87; P < 0.00001). AKI was significantly higher in the placebo group (OR, 0.76; 95% CI, 0.65-0.88; P = 0.0004). There were no statistically significant effects on other outcomes. CONCLUSION: In selected high-risk patients of cardiovascular disease, the SGLT2-I is a potential effective class of drugs for improving cardiovascular outcomes and all-cause mortality without an increased risk of all other major complications except DKA on this meta-analysis.

Enablers and barriers of maternal and neonatal immunization programs in Latin America.

BACKGROUND: The Region of the Americas has a long history of implementing maternal and neonatal immunization (MNI) programs. Our study aimed to understand the state of MNI policies, strategies and implementation practices in Latin America (LA). METHODS: Study conducted in 5 middle-income countries: Argentina, Brazil, Honduras, Mexico and Peru. The methods included a desk review, interviews with national stakeholders and health care providers, focus groups with pregnant women and observations in health facilities. Enablers and barriers were identified and categorized as individual, societal or related to the health system. RESULTS: All 5 participating countries had similar MNI policies and high access to antenatal care. Key enablers were the high acceptability of vaccination during pregnancy, high-level of political will and a national legal framework ensuring free access to vaccines. At the health system level, implementation was facilitated by the existence of immunization advisory committees, a pooled vaccine procurement mechanism, complementary vaccine delivery strategies, conditional cash transfer to users and performance incentives to health facilities. The main programmatic barriers were the lack of adequate MNI information; limited coordination between antenatal and immunization services; inadequate supply, resources and infrastructure; high staff turnover; insufficient training for health care providers; and weak monitoring and reporting systems. CONCLUSION: Middle-income countries in LA have successfully implemented MNI programs and several enablers were identified. To overcome remaining barriers, there is a need to focus on improving the "immunization journey" for pregnant women through providing more clear and timely information to users and providers; removing barriers to access; ensuring adequate supply, human resources and infrastructure; making the health service experience positive; and establishing integrated information systems that allow for monitoring the progress toward achieving MNI goals. Strengthening the MNI programs can also improve equitable access to health services and prepare for the introduction of future vaccines for pregnant women.

Man vs. man-made marijuana: A case of drug-induced posterior reversible encephalopathy syndrome (PRES) due to K2, a ynthetic cannabinoid (SCB).

Synthetic Cannabinoids (SCB) are engineered chemical compounds that share a similar chemical structure with the active ingredient of marijuana, delta-9-tetrahydrocanabinol. Although the FDA has not approved the use of SCB without a prescription from a licensed health-care provider, the cost effectiveness and availability of SCB has made it a popular choice among recreational drug users. Manufacture of SCB as a street drug is not regulated. These SCB are highly potent chemicals that cause various severe toxicities. In this case report, we describe an adult who suffered from PRES after consuming K2, a synthetic cannabinoid.

Takotsubo Cardiomyopathy and QTc Prolongation with Subsequent Improvement of QTc Interval and Resolution of Apical Ballooning: A Case Report.

Stress-induced cardiomyopathy, also known as Takotsubo cardiomyopathy (TTS), is characterized by transient regional systolic dysfunction. Furthermore, electrocardiogram (ECG) changes can vary as TTS evolves. We report a case of a 67-year-old woman who presented to the ER after cardiac arrest. She was found to have stress-induced cardiomyopathy with prolonged QTc interval. The patient developed torsades de pointes for which she required cardioversion, followed by improvement of QTc interval corresponding to resolution of echocardiographic evidence of apical ballooning.

Heart Failure Drug Class Effects on 30-Day Readmission Rates in Patients with Heart Failure with Preserved Ejection Fraction: A Retrospective Single Center Study.

Background: The pharmacologic management of heart failure with preserved ejection fraction (HFpEF) involves far fewer options with demonstrated additional benefit. Therefore, we examined the effect of combination of multiple classes of HF medication in the 30-day hospital readmission in patients with HFpEF. Methods: All adult patients discharged with a diagnosis of HFpEF and a left ventricular ejection fraction (LVEF) of ≥ 50% reported during the admission or within the previous six months from our institution were retrospectively studied for a 30-day hospital readmission risk. Individual as well as combination drug therapy at the time of hospital discharge were evaluated using Pearson chi2 test and multivariate logistic regression. Results: The overall 30-day readmission rate in this HFpEF cohort of 445 discharges was 29%. Therapy with loop diuretics (p = 0.011), loop diuretics and angiotensin receptor blocker (p = 0.043) and loop diuretics and beta blockers (p = 0.049) were associated with a lower risk of 30-day hospital readmission. Multivariate logistic regression revealed only loop diuretics to be associated with a lower risk of hospital readmission in patients with HFpEF (OR 0.59; 95% CI, 0.39-0.90; p = 0.013). Conclusions: Our study revealed that loop diuretics at discharge decreases early readmission in patients with HFpEF. Further, our study highlights the implication of a lack of guidelines and treatment challenges in HFpEF patients and emphasizes the importance of a conservative approach in preventing early readmission in patients with HFpEF.

Heart Failure with Preserved Ejection Fraction and 30-Day Readmission.

OBJECTIVE: Several studies identify heart failure (HF) as a potential risk for hospital readmission; however, studies on predictability of heart failure readmission is limited. The objective of this work was to investigate whether a specific type of heart failure (HFpEF or HFrEF) has a higher association to the rate of 30-day hospital readmission and compare their predictability with the two risk scores: HOSPITAL score and LACE index. DESIGN: Retrospective study from single academic center. METHODS: Sample size included adult patients from an academic hospital in a two-year period (2015 - 2017). Exclusion criteria included death, transfer to another hospital, and unadvised leave from hospital. Baseline characteristics, diagnosis-related group, and ICD diagnosis codes were obtained. Variables affecting HOSPITAL score and LACE index and types of heart failure present were also extracted. Qualitative variables were compared using Pearson chi2 or Fisher's exact test (reported as frequency) and quantitative variables using non-parametric Mann-Whitney U test (reported as mean ± standard deviation). Variables from univariate analysis with P values of 0.05 or less were further analyzed using multivariate logistic regression. Odds ratio was used to measure potential risk. RESULTS: The sample size of adult patients in the study period was 1,916. All eligible cohort of patients who were readmitted were analyzed. Cumulative score indicators of HOSPITAL Score, LACE index (including the Charlson Comorbidity Index) predicted 30-day readmissions with P values of <0.001. The P value of HFpEF was found to be significant in the readmitted group (P < 0.001) compared to HFrEF (P = 0.141). Multivariate logistic regression further demonstrated the association of HFpEF with higher risk of readmission with odds ratio of 1.77 (95% CI: 1.25 - 2.50) and P value of 0.001. CONCLUSIONS: Our data from an academic tertiary care center supports HFpEF as an independent risk factor for readmission. Multidisciplinary management of HFpEF may be an important target for interventions to reduce hospital readmissions.

Trastornos del sueño en adulto mayor. Actualización diagnóstica y terapéutica / Sleeping disorders in older adults. Diagnostic and therapeutic update

RESUMEN Los trastornos del sueño en el adulto mayor son una afección frecuente. Sin embargo, es una parte de la medicina relativamente nueva, dado que ha sido en los últimos 40 años cuando se ha trabajado realmente en ella. El objetivo de esta revisión es profundizar y actualizar aspectos diagnósticos y terapéuticos sobre dichos trastornos, lo cual constituye siempre un reto para el médico que atiende este grupo poblacional.

ABSTRACT Sleeping disorders in the elderly are a frequent condition. However, it is a part of relatively new medicine, since it has only been in the last 40 years it has really studied. The objective of this review is to deepen and update diagnostic and therapeutic aspects of these disorders, which is always a challenge for the doctor who attends this age group.

Late Atrial Thrombus Formation After Percutaneous Patent Foramen Ovale Closure.

Late thrombus formation is a rare complication associated with patent foramen ovale (PFO) closure devices. We report the case of an incidental discovery of large thrombi in both atria 9 months after percutaneous PFO occlusion that required cardiac surgery for thrombi removal. (Level of Difficulty: Beginner.).

Hospitalizaciones y mortalidad asociada a influenza, Honduras. 2011-2015 / Hospitalizations and deaths associated with Influenza, Honduras. 2011-2015

La carga de enfermedad por influenza está bien documentada en países de clima templado, pero hasta la fecha en Honduras solo se ha realizado un estudio, siendo este el segundo con respecto a la carga médica asociada a influenza. Objetivo: Estimar el número de hospitalizaciones y defunciones, debidos a la influenza, como causante de las infecciones respiratorias agudas en la población. Material yMétodos: Se realizó un estudio descriptivo retrospectivo. Seutilizó tres fuentes de datos secundarias:registros de todos los egresos hospitalarios, resultados de detección viral por influenza y proyecciones de población por grupos de edad. Se estimó la tasa de incidencia y su intervalo de confianza al 95%, combinando las tres fuentes de datos. Resultados: Las hospitalizaciones en las infecciones respiratorias agudas graves (IRAG) J09-J18 asociadas a influenza en el 2011-2015 son mayores en los menores de cinco años, en donde las hospitalizaciones son mayores en los años 2013 con 68.2 (IC 95%: 64.2-72.1) casos por 100, 000 habitantes. En el periodo 2011-2015. Las tasas de incidencia en las defunciones de IRAG asociadas a influenza1.Doctor(a) en medicina y cirugía.2.Doctor(a) en Pediatría3.Nivel Básico de Epidemiologia de Campo del FETP4.MSc.Epidemiólogo del FETP, coordinador de las enfermedades Transmisibles de la unidad devigilancia de la salud, Secretaria de Salud de HondurasAutor de correspondencia: Hommer Mejía, homams2003@yahool.comRecibido: Aprobado: (J09-J18) fueron mayores en el año 2014 con 1 caso (IC 95%: 0.4-1.6) por 100 000 habitantes. La circulación por influenza comenzó a incrementarse a partir de agosto del 2011 luego en los años 2012-2015 con picos altos durante los meses de octubre y noviembre. Conclusión: La carga médica asociada a influenza representa un impacto para los servicios de salud de Honduras, siendo los grupos de población en edades extremas, los que más hospitalizaciones y muertes presentaron. Se sugiere promover la vacunación contra influenza con la composición de cepas circulantes en el país y en temporada apropiada, enfatizando en los grupos más vulnerables de la población...(AU)

Medio siglo de gestión de la información para el desarrollo de la salud villaclareña / Half a century of information management for the health development in Villa Clara province

RESUMEN Arribar a medio siglo de existencia representa para cualquier institución la expresión de una fructífera vida profesional y la oportunidad de meditar sobre el camino transitado. El sistema nacional de información de ciencias médicas surgió en 1965, y la primera institución fuera de la capital del país fue el Centro Provincial de Información de Ciencias Médicas de Villa Clara, que se constituyó en 1969. En estos años de labor el Centro ha crecido en: recursos humanos, instalaciones, medios tecnológicos y servicios que se brindan a los usuarios; sus proyecciones se han revolucionado en sintonía con el desarrollo científico-tecnológico. El crecimiento de la red de bibliotecas, la atención técnica y metodológica realizada, la creciente labor de superación profesional desplegada, la inserción de las tecnologías en la actividad científico-informativa y la producción de numerosos recursos y servicios digitalizados, son elementos que caracterizan la historia de esta institución.

ABSTRACT Reaching half a century of existence represents for any institution the expression of a successful professional life and the opportunity to meditate on the road traveled. The national information system of medical sciences emerged in 1965, and the first institution outside the capital of the country was the Provincial Information Center of Medical Sciences of Villa Clara, which was constituted in 1969. In these years of work the Center has grown in: human resources, facilities, technological means and services that are offered to the users; its projections have been revolutionized along with the scientific-technological development. The growth of the network of libraries, the technical and methodological assistance, the growing work of professional improvement, the insertion of technologies in the scientific-informative activity and the production of numerous resources and digitalized services, are elements that characterize the history of this institution.

El componente informacional en el currículo de la carrera de Medicina / The informational component in the study programme of the Medicine career

RESUMEN Introducción: la competencia y desempeño de los futuros egresados de la carrera de Medicina en el uso de la información científica en cualquier tipo de soporte, tiene relación con la presencia del componente informacional en el currículo de la carrera. Objetivos: diagnosticar qué niveles de representatividad tiene el componente informacional en el currículo de la carrera de Medicina, y en qué medida prepara a los estudiantes en el proceso de su formación para ser competentes informacionalmente. Métodos: se emplearon métodos del nivel empírico y del nivel teórico para diagnosticar en qué medida los contenidos de información científica presentes en el currículo de la carrera de Medicina contribuyen a formar estudiantes competentes informacionalmente. Resultados: se obtuvo un diagnóstico del nivel de competencia informacional de los estudiantes de 2do a 5to año de la carrera de Medicina de la Universidad de Ciencias Médicas de Villa Clara. Se realizó una evaluación interna de la presencia del componente informacional en el currículo de la carrera de Medicina. Conclusiones: el diagnóstico realizado reveló que son insuficientes los contenidos y actividades docentes incluidos en el currículo de Medicina dirigidos a formar un estudiante competente informacionalmente, y que los estudiantes alcanzan una deficiente preparación en el uso de los recursos informativos especializados en ciencias de la salud en el transcurso de su carrera.

ABSTRACT Introduction: the competence and performance of future medical graduates in the use of scientific information in any type of material media is related to the presence of the informational component in the study programme. Objective: to diagnose what levels of representativeness do the informational component has in the medicine programme and to what extent does it prepare students in their training process to be informationally competent. Methods: empirical and theoretical methods were used to diagnose to what extent the contents of scientific information included in the medicine programme contribute to the formation of competent students from the informational point of view. Results: a diagnosis of the level of informational competence of 2nd to 5th year medicine students at the University of Medical Sciences in Villa Clara was obtained. An internal evaluation of the presence of the informational component in the study programme of the Medicine career was conducted. Conclusions: the diagnosis showed that contents and teaching activities included in the study programme aimed at training a competent student informationally are insufficient and students achieve poor preparation in the use of specialized health science information resources throughout their careers.

A Rare Case of Isolated and Idiopathic Spontaneous Renal Artery Dissection in a Female Patient on Multiple Medications.

Constituting less than 25% of all renal artery dissections (RAD), isolated spontaneous renal artery dissection (SRAD) is a rare diagnosis that can cause subsequent renal infarction with impairment. The majority of SRAD cases are idiopathic. Management ranges from conservative, medical to endovascular, and surgical repair. We report a case of a young female on multiple medications who presented with SRAD. She presented with acute abdominal pain and was found to have isolated spontaneous renal artery dissection. The etiology of this patient's isolated SRAD could possibly be pinned down to her multiple stimulant medications used after the major known causes were ruled out.

Trimethoprim-sulfamethoxazole Induced Pancytopenia: A Common Occurrence but A Rare Diagnosis.

Trimethoprim-sulfamethoxazole (TMP-SMX) is a bacteriostatic antimicrobial medication used for the treatment of a variety of infections and has many reported skin and hematologic side effects. Due to the easy availability and cost effectiveness, TMP-SMX is one of the medications commonly used for treatment of skin and soft tissue in patients with methicillin-resistant Staphylococcus aureus (MRSA) infection. One of the rare hematologic manifestations of TMP-SMX is pancytopenia, which is a reduction in all cell lines. In this case report, we are documenting a case of pancytopenia due to severe drug reaction to TMP-SMX in a 70-year-old female after two weeks of medication use. Upon initial stabilization she underwent a thorough workup and was subsequently diagnosed with severe drug-induced pancytopenia. Detailed history, early diagnosis, prompt discontinuation of the offending medication along with supportive care remain the mainstay of treatment in the management of TMP-SMX induced pancytopenia.

Assessing electronic immunization registries: the Pan American Health Organization experience.

OBJECTIVE: To develop a methodology to assess electronic immunization registries (EIRs) in low- and middle-income countries (LMICs) in Latin America and the Caribbean. METHODS: A team from the Immunization Unit at the Pan American Health Organization (PAHO) reviewed existing methodologies to evaluate health information systems, particularly the Performance of Routine Information System Management (PRISM) framework and methodologies used to assess information systems. In 2014, the PAHO team convened a small working group to develop an evaluation approach to be added to the existing World Health Organization immunization data quality self-assessment (DQS) tool. The resulting DQS with an added EIR component was named "DQS Plus." The DQS Plus methodology was used in Panama in May 2014 and in Honduras in November 2015. RESULTS: The DQS Plus tool proved feasible and easy to implement in Panama and Honduras, including by not adding much time or resources to those needed for a usual DQS. The information obtained from the DQS Plus assessment was practical and helped provide health authorities with recommendations to update and improve their EIR, strengthen the use of the registry, and enhance the data the assessment produced, at all levels of the health system. These recommendations are currently being implemented in the two countries. CONCLUSIONS: The DQS Plus proved to be a practical and useful approach for assessing an EIR in an LMIC and generating actionable recommendations. Further work on defining operational and related EIR functional standards in LMICs will help develop an improved EIR assessment tool for Latin America and the Caribbean, and potentially elsewhere.

Cesación tabáquica en San José de las Lajas. Quinquenio 2011-2016 / Tobacco stopping in San José de las Lajas. Quinquennium 2011-2016

Introducción: el tabaquismo es considerado por la Organización Mundial de la Salud como una enfermedad crónica de naturaleza adictiva que reúne elementos biológicos, psicológicos, sociales y tiene determinantes claramente establecidos. Existe un gran desafío pues es necesario ser más efectivos en el abordaje de estos pacientes. Objetivo: determinar la eficacia de la consulta de cesación tabáquica en San José de las Lajas. Métodos: se realizó un estudio descriptivo longitudinal prospectivo, según variables seleccionadas de los pacientes atendidos en la consulta de cesación tabáquica del Policlínico Docente Luis Augusto Turcios Lima, de San José, desde enero de 2012 a diciembre de 2016. El universo estuvo constituido por el total de pacientes que acudieron a la misma, siendo 255 fumadores, se utilizaron métodos empíricos y teóricos, como la entrevista, y la revisión documental, se evaluó la eficacia según criterios establecidos al efecto. Resultados: predominó el sexo femenino, más de la mitad perteneció al grupo de edad de 40 a 59 años, con nivel de escolaridad secundario casi el 50 por ciento, las afecciones más frecuentes asociadas fueron la hipertensión y las enfermedades pulmonares, siendo la vía de acceso más frecuente la remisión médica, al evaluar la estrategia resulto en una eficacia alta. Conclusiones: la consulta posee una estrategia adecuada, pero es susceptible de ser perfeccionada sobre todo en el momento en que debe ser referido el paciente y el seguimiento que debe hacerse al lograr la abstinencia (AU)

Introduction: tobacco addiction is considered by the World Health Organization as a chronic disease of addictive nature that gathers biologic, psychological, and social elements and it has clearly established determinants. There is a great challenge because it is necessary to be more effective in the facing of these patients. Objective: to determine the efficacy of the consultation of tobacco stopping in San José de las Lajas. Methods: a descriptive, longitudinal, prospective study was carried out, according to the selected variables of the assisted patients in the consultation of tobacco stopping in San José de las Lajas at Luis Augusto Turcios Lima Teaching Policlinic, from January, 2012 to December, 2016. The universe was formed by the total of patients who attended that consultation, being 255 smokers, empiric and theoretical methods were used such as interviews document revision; the efficacy according to the established criteria for the study was evaluated. Results: female sex prevailed, more than the half of the patients belonged to the 40 to 59 age group, with a secondary scholarship, almost the 50 por cent, the most frequent associated affections were hypertension and pulmonary diseases and the most frequent access way was the medical referral, when the strategy was evaluated it showed a high efficacy. Conclusions: this consultation has an adequate strategy, but it can be improved, most of all in the moment that the patient should be referred and the follow-up that should be done to get abstinence (AU)

Assessing electronic immunization registries: the Pan American Health Organization experience

[ABSTRACT]. Objective. To develop a methodology to assess electronic immunization registries (EIRs) in low- and middle-income countries (LMICs) in Latin America and the Caribbean. Methods. A team from the Immunization Unit at the Pan American Health Organization (PAHO) reviewed existing methodologies to evaluate health information systems, particularly the Performance of Routine Information System Management (PRISM) framework and methodologies used to assess information systems. In 2014, the PAHO team convened a small working group to develop an evaluation approach to be added to the existing World Health Organization immunization data quality self-assessment (DQS) tool. The resulting DQS with an added EIR component was named “DQS Plus.” The DQS Plus methodology was used in Panama in May 2014 and in Honduras in November 2015. Results. The DQS Plus tool proved feasible and easy to implement in Panama and Honduras, including by not adding much time or resources to those needed for a usual DQS. The information obtained from the DQS Plus assessment was practical and helped provide health authorities with recommendations to update and improve their EIR, strengthen the use of the registry, and enhance the data the assessment produced, at all levels of the health system. These recommendations are currently being implemented in the two countries. Conclusions. The DQS Plus proved to be a practical and useful approach for assessing an EIR in an LMIC and generating actionable recommendations. Further work on defining operational and related EIR functional standards in LMICs will help develop an improved EIR assessment tool for Latin America and the Caribbean, and potentially elsewhere.

[RESUMEN]. Objetivo. Formular una metodología para evaluar los registros de inmunización electrónicos en los países de ingresos bajos y medianos de América Latina y el Caribe. Métodos. Un equipo de la Unidad de Inmunizaciones de la Organización Panamericana de la Salud (OPS) examinó las metodologías existentes para evaluar los sistemas de información de salud, en particular el marco Performance of Routine Information System Management (PRISM), que analiza la gestión de la información sistemática, así como otras metodologías empleadas para evaluar los sistemas de información. En el 2014, el equipo de la OPS reunió a un pequeño grupo de trabajo para idear una estrategia de evaluación que se le agregaría a la herramienta existente de la Organización Mundial de la Salud para autoevaluación de la calidad de los datos (DQS) relativos a la inmunización. La herramienta DQS resultante, con un componente añadido de registros de inmunización electrónicos, se denominó “DQS Plus”. La metodología de DQS Plus se usó en Panamá en mayo del 2014 y en Honduras en noviembre del 2015. Resultados. Se demostró que la herramienta DQS Plus fue factible y fácil de aplicar en Panamá y Honduras, entre otras cosas por no requerir mucho tiempo ni recursos adicionales a los necesarios para la DQS ordinaria. La información obtenida mediante la evaluación con DQS Plus fue práctica y contribuyó a proporcionar a las autoridades sanitarias las recomendaciones para actualizar y mejorar sus registros de inmunización electrónicos, fortalecer el uso del registro y mejorar los datos que arrojó la evaluación, a todos los niveles del sistema de salud. En la actualidad están poniéndose en práctica dichas recomendaciones en los dos países. Conclusiones. Se demostró que DQS Plus es una estrategia práctica y útil para evaluar un registro de inmunización electrónico en los países de ingresos bajos y medianos y generar recomendaciones aplicables. El trabajo ulterior para definir las normas operativas y funcionales de los registros de inmunización electrónicos en los países de ingresos bajos y medianos contribuirá a crear una mejor herramienta de evaluación de dichos registros en América Latina y el Caribe, y posiblemente en otros sitios.

[RESUMO]. Objetivo. Elaborar uma metodologia para avaliar os registros eletrônicos de vacinação em países de baixa e média renda na América Latina e no Caribe. Métodos. Uma equipe da Unidade de Imunização da Organização Pan-Americana da Saúde (OPAS) analisou as metodologias existentes para avaliação dos sistemas de informação em saúde, em particular a estructura de Desempenho da Gestão Rotineira dos Sistemas de Informação (PRISM) e as metodologias usadas para avaliação de sistemas de informação. Em 2014, a equipe da OPAS formou um pequeno grupo de trabalho com a incumbência de desenvolver um método de avaliação a ser integrado à ferramenta existente de autoavaliação da qualidade dos dados de imunização (DQS) da Organização Mundial da Saúde (OMS). A ferramenta DQS com o novo componente de registros eletrônicos de vacinação foi denominada “DQS Plus”. A metodologia DQS Plus foi empregada no Panamá, em maio de 2014, e em Honduras, em novembro de 2015. Resultados. A ferramenta DQS Plus provou ser viável e fácil de ser implementada no Panamá e em Honduras, principalmente por não despender mais tempo ou recursos aos já necessários com a habitual ferramenta DQS. As informações obtidas na avaliação com a ferramenta DQS Plus foram práticas e contribuíram com recomendações às autoridades sanitárias de atualizar e melhorar os registros eletrônicos de vacinação, reforçar o uso do registro e aprimorar os dados produzidos com a avaliação em todos os níveis do sistema de saúde. Essas recomendações estão atualmente em fase de implementação nos dois países. Conclusões. A ferramenta DQS Plus é comprovadamente um método prático e útil para avaliar os registros eletrônicos de vacinação em países de baixa e média renda e gerar recomendações executáveis. Outros estudos com o objetivo de definir os padrões operacionais e funcionais relacionados aos registros eletrônicos de vacinação nos países de baixa e média renda devem contribuir para o desenvolvimento de uma versão aprimorada da ferramenta de avaliação de registros eletrônicos de vacinação para a América Latina e o Caribe e possivelmente para outras regiões.

La autoeficacia docente: un reto en el accionar del profesor universitario de las ciencias médicas / Teacher self-efficacy: a challenge in the actions of the university professor of medical sciences

Se realizó una revisión bibliográfica con el objetivo de indagar sobre la autoeficacia docente y su influencia en la calidad de la docencia universitaria. Se describe la evolución histórica del concepto enunciado por Bandura (1999) a partir de la Teoría Social Cognitiva de Rotter, que constituye un aporte para la comprensión de la adaptación y cambio humano; su desarrollo teórico-metodológico la ha posicionado como válida y confiable para explicar cómo sus componentes (mecanismos, fuentes y procesos) se encuentran mediados por la autoeficacia. Niveles de autoeficacia positivos o negativos marcan profundas consecuencias en el desempeño personal y/o profesional; es un reto para la academia motivar al claustro de profesores para asumir este concepto como factor determinante en su accionar sistemático en aras de incrementar la calidad del proceso docente educativo.

A bibliographic review was carried out with the objective of researching about the teaching self-efficacy and its influence on the quality of university teaching. The historical evolution of the concept enunciated by Bandura (1999) is described from the Social Cognitive Theory of Rotter, which constitutes a contribution for the understanding of adaptation and human change; Its theoretical-methodological development has positioned it as valid and reliable to explain how its components (mechanisms, sources and processes) are mediated by self-efficacy. Levels of positive or negative self-efficacy have profound consequences on personal and / or professional performance; it is a challenge for the academy to motivate the teaching staff to assume this concept as a determining factor in their systematic action in order to increase the quality of the teaching-learning process.