Ganhos em saúde com a implementação de programas de reabilitação respiratória nos utentes com DPOC: uma scoping review / Health gains with the implementation of respiratory rehabilitation programs in patients with COPD: a scoping review

A tendência global da saúde e o envelhecimento demandam uma expansão significativa dos serviços de reabilitação. A Enfermagem de Reabilitação é portadora de um corpo de conhecimentos e procedimentos específicos que permitem atuar e ajudar as pessoas portadoras de patologias agudas, crónicas ou que apresentem sequelas, a maximizar o seu potencial funcional e a sua independência. Assim, foi realizado um Estágio de Natureza Profissional com o objetivo de desenvolver competências no âmbito da Enfermagem de Reabilitação em contexto comunitário. Este apresenta uma análise crítica fundamentada sobre as competências profissionais desenvolvidas, enquanto Enfermeiro Especialista e Enfermeiro Especialista em Enfermagem de Reabilitação. Para orientar este percurso foi tido em conta o modelo teórico de Afaf Meleis com a sua Teoria das Transições. Relativo à prática de investigação trata-se de um estudo de revisão, uma scoping review, que tem como objetivo: Mapear a evidência científica disponível para identificar quais os ganhos em saúde obtidos através da implementação de um Programa de Reabilitação Respiratória pelo Enfermeiro Especialista em Enfermagem de Reabilitação aos portadores de Doença Pulmonar Obstrutiva Crónica. Sustentado na metodologia de Joanna Briggs Institute e que obedece aos critérios de inclusão segundo a estratégia Participantes, Conceito e Contexto. Elaborada a frase boolenana e realizada pesquisa nas seguintes bases de dados: CINAHL complete (via EBSCO), COCHRANE Databases of Sistematic Reviews, MEDLINE (Via PUBMED), OPENGREY, MEDLATINA e SCIELO. Foram incluídos sete artigos, sendo três estudos randomizados controlados, um estudo randomizado não controlado, uma meta-análise, um estudo retrospetivo-correlacional de natureza quantitativa e um estudo quase experimental. Os resultados apontam para os ganhos na capacidade respiratória, na capacidade motora, na saúde mental e na qualidade de vida. Este estágio permitiu, enquanto mestranda, o desenvolvimento de conhecimentos e competências variadas. Para a unidade onde decorreu teve um impacto positivo através da sensibilização para uma referenciação mais precoce para o Enfermeiro Especialista em Enfermagem de Reabilitação e para os utentes a possibilidade de uma prestação de cuidados cada vez mais diferenciada, célere e adequada as suas reais necessidades

The global health trend and aging demand a significant expansion of rehabilitation services. Rehabilitation Nursing is the bearer of a body of knowledge and specific procedures that allow acting and helping people with acute, chronic pathologies or those with sequelae, to maximize their functional potential and independence. Thus, a Professional Internship was carried out with the aim of developing skills in the field of Rehabilitation Nursing in a community context. This presents a grounded critical analysis of the professional skills developed as a Specialist Nurse and Specialist Nurse in Rehabilitation Nursing. Toguide this path, the theoretical model of Afaf Meleis was taken into account with his Theory of Transitions. Regarding research practice, this is a review study, a scoping review, which aims to: Map the scientific evidence available to identify the health gains obtained through the implementation of a Respiratory Rehabilitation Program by the Nurse Specialist in Nursing of Rehabilitation for patients with Chronic Obstructive Pulmonary Disease. Supported by the methodology of the Joanna Briggs Institute and which complies with the inclusion criteria according to the Participants, Concept and Context strategy. The Boolean phrase was elaborated and a search was carried out in the following databases: CINAHL complete (via EBSCO), COCHRANE Databases of Systematic Reviews, MEDLINE (via PUBMED), OPENGREY, MEDLATINA and SCIELO. Seven articles were included, three randomized controlled studies, one randomized uncontrolled study, one meta-analysis, one retrospective correlational quantitative study and one quasi-experimental study. The results point to gains in respiratory capacity, motor capacity, mental health and quality of life. This internship allowed, as a Master's student, the development of varied knowledge and skills. For the unit where it took place it had a positive impact through raising awareness of an earlier referral for the Specialist Nurse in Rehabilitation Nursing and for users the possibility of providing increasingly differentiated care, faster and adequate to their real needs.

Stakeholders' perceived achievements and challenges after the safe motherhood project in Northern Uganda

The Japanese Red Cross Society (JRCS) and the Uganda Red Cross Society (URCS) implemented the Safe Motherhood project topromote mother-friendly society in northern Uganda from 2010 to 2016. The follow-up study has not been conducted and the information on achievements and challenges after the project were limited. To review the safe motherhood project in northern Uganda, the purpose of the study was to explore the stakeholders' perceived achievements and challenges after the project. Study design was qualitative content analysis using interview guides. After the approval of Institutional Review Board Clearance, the study was started (Approval Number: 2017-034). The subjects were informed about the ethical considerations (informed consent, participation on free will, confidentiality, and anonymity) in participating in the research, and they participated after signing the consent form. Six volunteers, 2 health center staff, and 2 former Uganda Red Cross staff were interviewed. Achievements were the acquisition of knowledge, attitudes changes, behavioural changes, linkage of all stakeholders, and positive influence on Safe Motherhood in community. Challenges of sociocultural barriers, attitudes toward women, accessibility and human resources, incentives and facilities, and sustainability of the project were derived from the interview. The study revealed that the project linked all stakeholders to achieve Safe Motherhood in community and all the developed registration systems were taken over. Long-term support is necessary for Safe Motherhood to take root

A vigilância do utente com HTA - A construção da consulta de enfermagem numa unidade de saúde familiar / Surveillance of users with hypertension - The construction of the nursing consultation in a family health unit

A Hipertensão Arterial é uma das doenças mais prevalentes a nível mundial e o principal fator de risco para os eventos cérebro e cardiovasculares: em Portugal estima-se uma prevalência de 36% na população entre os 25-74 anos, sendo que cerca de um terço das mortes têm causa atribuída a doenças do aparelho circulatório. O presente relatório, realizado no âmbito do Curso de Mestrado em Enfermagem, na área de especialização em Enfermagem Comunitária e de Saúde Pública, pretende plasmar o percurso do estágio final realizado entre 16 de setembro de 2019 a 31 de janeiro de 2020, o qual, baseado nas necessidades referidas pela equipa de enfermeiros de uma USF foi para esta e com esta, estruturada uma consulta de Enfermagem de Hipertensão Arterial, com recurso à Metodologia do Planeamento em Saúde. A mesma, tem como objetivos a promoção de estilos de vida saudáveis, providenciar vigilância e follow-up neste grupo e capacitar para o autocuidado na doença. O projeto revelou-se exequível perante os objetivos institucionais e da equipa, e foi avaliado através da satisfação de requisitos definidos pelos enfermeiros para o mesmo. Trará a mais valia de produzir ganhos em saúde na doença HTA e suas complicações.

High Blood Pressure is one of the most prevalent diseases worldwide and also a major risk factor for cerebral e cardiovascular events: it´s estimated a prevalence of 36% among adults aged between 25-74 in Portugal, and, a third of all deaths have cause attributed to circulatory diseases. The present report aims to demonstrate the path taken as a student of the Masters in Community and Public Health Nursing, between September the 16th of 2019 and January the 31st of 2020, which, based on needs identified by the nurses team, a Nurses Lead Consultation was created, with them and for them, in the local Family Health Care Unit, resourcing to Health Planning Methodology. The consultation main goals are promotion of healthy lifestyles, to provide regular surveillance and follow-up, and empower patients for self-care. The project revealed feasible according to institutional and the nurse's team goals and was submitted to evaluation according to previous requirements dictated by nurses. It is predicted to bring health gains in the High Blood Pressure disease and it`s complications.

Las ganas de vivir como expresión del bienestar de las personas mayores / Will to live as an expression of the well-being of older people

INTRODUCCIÓN: Las ganas de vivir, concepto central en las teorías del bienestar, representa un componente actitudinal positivo hacia la propia vida. Se ha identificado como un mediador entre la autopercepción del envejecimiento y la longevidad y la salud. El objetivo de este estudio es caracterizar a las personas mayores que tienen elevados niveles de ganas de vivir en las principales dimensiones de la psicología positiva. MÉTODO: Participaron de forma voluntaria 165 adultos mayores con edades comprendidas entre 54 y 89 años, usuarios de centros de mayores de la Comunidad de Madrid. Se evaluaron las ganas de vivir y otras dimensiones del bienestar y la salud. Se analizaron las correlaciones entre las distintas dimensiones evaluadas, se establecieron comparaciones entre ellas en función de distintos niveles de ganas de vivir, y se analizó qué dimensiones contribuyen en mayor medida a las ganas de vivir. RESULTADOS: Las correlaciones entre variables han resultado estadísticamente significativas en su mayor parte; se ha observado una disminución de los coeficientes al controlar el efecto de las ganas de vivir. En las comparaciones de medias, se hallaron diferencias significativas entre los 3grupos con diferente nivel de ganas de vivir en prácticamente todas las dimensiones de la psicología positiva. Gratitud, afecto positivo y depresión son las dimensiones que mejor predicen las ganas de vivir. CONCLUSIÓN: Los adultos mayores que conforman el grupo con elevadas ganas de vivir se caracterizan por tener mayores niveles de optimismo, gratitud, resiliencia, afecto positivo, sentido de la vida, prosperidad psicológica, felicidad y satisfacción con la vida y menores niveles de depresión y autopercepción del envejecimiento negativa. Las implicaciones de estos resultados apuntan hacia la relevancia de las ganas de vivir en el envejecimiento con éxito

INTRODUCTION: Will-to-live, a central concept in well-being theories, represents a positive attitudinal component towards one's own life. It has been identified as a mediator between the self-perception of aging and longevity and health. The objective of this study is to characterise elderly people with high levels of will-to-live in the main dimensions of positive psychology. METHOD: The study included the voluntary participation of 165 adults, aged between 54-89 years, users of senior centres in the Community of Madrid. Will-to-live and other dimensions of well-being and health were evaluated. The correlations between the different evaluated dimensions were analysed, and comparisons made in terms of different levels of will-to-live, as well as an analysis of the dimensions that contribute most to the will-to-live. RESULTS: Correlations among the majority of variables were statistically significant, with a decrease in the coefficients being observed when controlling the effect of the will-to-live. When groups with different levels of will-to-live are compared with well-being and health, there are statistically significant differences in practically all of the dimensions. Gratitude, positive affect, and depression are the dimensions that best predict will-to-live. CONCLUSION: Older adults that make up the group with high will-to-live are characterised by higher levels of optimism, gratitude, positive affect, sense of life, psychological prosperity, resilience, happiness, and satisfaction with life, as well as lower levels of depression and negative self-perception of aging. The implications of these results point towards the relevance of will-to-live in successful aging

O papel do enfermeiro especialista na implementação do transitional care model na comunidade / The role of the nurse specialist in implementing the transitional care model in the community

As admissões hospitalares têm aumentado, sendo que a taxa de reinternamento hospitalar aumentou aproximadamente 8%. É fundamental adotar medidas que visem diminuir estes valores e consolidem uma transição efetiva entre cuidados de saúde primários e hospitalares. Este trabalho tem como objetivo promover o empowerment no idoso e família para reduzir o internamento e reinternamento hospitalar dos utentes de uma Unidade de Saúde em Lisboa. O trabalho é de natureza descritiva, de abordagem quantitativa, segundo a metodologia do processo de planeamento em saúde com enfoque no Transitional Care Model (TCM), modelo do Empowerment e Teoria das Transições de Afaf Meleis, aplicação no domicílio da Edmonton Frail Scale, Escala de Quedas de Morse e ainda a aplicação de questionário sociodemográfico. A amostra é de 37 utentes, 78,4% mulheres, 100% reformados, 67,6% de classe baixa, 91,8% tiveram, pelo menos, uma ida ao serviço de urgência hospitalar, 97,3% apresentam baixo a alto risco de queda, 63% com fragilidade moderada a severa. Como resultados releva-se a inexistência de episódios de quedas bem como a redução dos acessos ao serviço de urgência. Teremos assim a prevenção de complicações e melhoria da gestão da doença crónica, processos liderados pelo Enfermeiro Especialista em Enfermagem Comunitária, com aplicação das competências reguladoras previstas bem como respondendo aos Descritores de Dublin. Como limitações destacam-se o tamanho reduzido da amostra bem como a inexistência de internamentos no decorrer do trabalho. Considerando a elevada fragilidade do idoso no domicílio, a aplicação deste modelo permitirá reduzir as barreiras existentes entre os níveis de cuidados, com ganhos em saúde bem como custo-efetividade.

Hospital admissions have increased, with the rate of hospital readmission rising by approximately 8%. It is essential to adopt measures that aim to reduce these values and consolidate an effective transition between primary and hospital health care. This work aims to promote empowerment in the elderly and family to reduce hospitalization and rehospitalization of users of a Health Unit in Lisbon. The work is descriptive and quantitative, according to the methodology of the health planning process with a focus on the Transitional Care Model (TCM), Empowerment model and Afaf Meleis Transition Theory, application at the Edmonton Frail Scale home, Scale Morse Falls and the use of a sociodemographic questionnaire. The sample is made up of 37 users, 78.4% women, 100% retired, 67.6% low class, 91.8% had at least one visit to the hospital emergency service, 97.3% have low to high risk of falling, 63% with moderate to severe fragility. As a result, there is a lack of falls' episodes as well as a reduction in access to emergency service. We will thus have the prevention of complications and improvement in the management of chronic disease, processes led by the Specialist Nurse in Community Nursing, with the application of the regulatory powers provided for as well as responding to the Dublin Descriptors. As limitations, we highlight the small sample size as well as the absence of hospitalizations during the work. Considering the high fragility of the elderly at home, the application of this model will allow reducing the existing barriers between the levels of care, with gains in health as well as cost-effectiveness.

Características presentes en escolares de secundaria que no fuman o no tienen intención de hacerlo / Characteristics present in secondary school students who do not smoke and who have no intention to smoke

Objetivo: Conocer las variables presentes en escolares de primero y segundo de secundaria que no consumen tabaco o no tienen intención de fumar desde un modelo de salud positiva. Métodos: Estudio transversal con 482 estudiantes en Andalucía y Cataluña usando un cuestionario validado (proyecto ESFA y PASE). Se realizaron análisis de regresión logística binaria. Resultados: Quienes no tenían intención de fumar presentaron una actitud desfavorable al tabaco y una alta autoeficacia (p <0,001). En los/las no consumidores/as las variables más asociadas fueron la actitud, el modelo social (p <0,001) y la autoeficacia (p = 0,005). Conclusiones: Los resultados reflejan factores motivacionales presentes en escolares que no fuman ni pretenden hacerlo. La actitud y la autoeficacia se asocian fuertemente con la intención y con el comportamiento. Esta información puede ser útil para desarrollar estrategias positivas de promoción de la salud desde un modelo salutogénico

Objective: To know the variables present in primary and secondary school students who do not smoke or intend to smoke from a positive health model. Methods: Cross-sectional study with 482 students from Andalusia and Catalonia using a validated questionnaire (ESFA and PASE project). Binary logistic regression analysis was performed. Results: Those who did not intend to smoke viewed smoking unfavourably and had high self-efficacy (p <0.001). In non-consumers, the most associated variables were attitude, social model (p <0.001), and self-efficacy (p =0.005). Conclusions: The results show motivational factors present in students who do not smoke and do not intend to do so. Attitude and self-efficacy are strongly associated with intention and behaviour. This information might be useful for developing positive health promotion strategies from a salutogenesis approach

O impacto económico da prevenção de úlceras de pressão num hospital universitário / The economic impact of pressure ulcers prevention in a university hospital

Objetivo: As úlceras de pressão constituem uma condição evitável que se traduz numa diminuição da qualidade de vida do doente. Simultaneamente representam um acréscimo nos custos para os serviços de saúde, associados ao aumento do tempo de internamento. A investigação é fundamental para justificar a prevenção enquanto medida de sustentabilidade e melhoria dos cuidados de saúde. O estudo visa estimar o efeito individual das diferentes categorias das úlceras de pressão no incremento do tempo de internamento hospitalar e os ganhos em saúde que derivam da intervenções autónomas e independentes dos enfermeiros do domínio da prevenção das UP. Métodos: A determinação do impacto incremental das diferentes categorias das UP no tempo de internamento é obtida por uso de um modelo econométrico concebido para esse fim. Os ganhos em saúde são determinados com o uso da equação preconizada pela ordem profissional dos enfermeiros (OE). Resultados: O impacto incremental das diferentes categorias de UP no internamento hospitalar é por ordem crescente de severidade clínica da UP de 1,05 dias; 1,64 dias; 3,53 dias e 10,29 dias. Estima-se que tenha sido prevenido o incremento de 2977,61 dias de internamento hospitalar, em resultado da prevenção das úlceras de pressão. Conclusão: É possível incrementar os ganhos em saúde e contribuir na redução do impacto das UP no internamento hospitalar ao clinicamente indispensável através da maximização na efetividade diagnóstica.

Objective: Pressure ulcers are an avoidable condition that results in a decrease in the health related quality of life of the client. At the same time, they represent an increase in costs for health services associated with an increase in length of hospital stay. Research in this area is fundamental to justify prevention as a measure of sustainability and improvement of health care. The study aims to estimate the individual effect of the different categories of pressure ulcers on the increase of hospitalization time and the health gains derived from autonomous and independent interventions of nurses in the field of PU prevention. Methods: The determination of the incremental impact of the different UP categories in the length of stay is obtained by using an econometric model designed for this purpose. Health gains are determined using the equation recommended by the professional order of nurses (OE). Results: The incremental impact of the different categories of PU on hospital admission is in ascending order of clinical severity of PU of 1.05 days; 1.64 days; 3.53 days and 10.29 days. It is estimated that an increase of 2977.61 days of hospitalization was prevented, as a result of the prevention of pressure ulcers. Conclusion: It is possible to increase the health gains and contribute in reducing the impact of PUs in hospital admission to the clinically indispensable by maximizing the diagnostic effectiveness.

Horacio Ferrer Díaz, médico, combatiente y escritor matancero / Horacio Ferrer Díaz, physician, fighter and writer from Matanzas

El estudio descriptivo de personalidades de la provincia debe formar parte de un proyecto para enriquecer el conocimiento de todos los profesionales matanceros vinculados con las ciencias médicas y la historia, que a su vez serán los que preparen a los estudiantes de las ciencias médicas para su formación integral. Esta es la razón fundamental por la que seleccionamos al eminente médico Horacio Ferrer Díaz, que en el siglo xix prestigió el terruño. Fue un notable galeno, especializado en oftalmología, quien combinó su desempeño profesional con las actividades revolucionarias en defensa de la independencia de Cuba. Fue inventor de un aparato para estudiar la retina y otro para extraer la catarata al vacío y de una mesa giratoria de reconocimiento única en el mundo. Publicó "La Fonometría antes y después de la operación de catarata", y fue el primero que operó un paciente con desprendimiento de retina en Cuba. Hijo de la tierra unionense, Ferrer Díaz debe ser recordado por siempre por sus aportes médicos y su gran activismo político en las filas mambisas, donde adquiere grados militares, y en contra del gobierno de Machado y la dictadura de Batista después. El recuento de la historia en las guerras independentistas queda plasmado para todos los cubanos en su obra Con el rifle al hombro, escrita en su ancianidad (AU).

The descriptive study of the province's personalities should be a part of a project to enhance the knowledge of all Matanzasan professional related with the medical sciences and the history, who are in their turn the ones who are going to train the medical sciences students for their comprehensive education. That is the main reason of choosing the personality of the eminent doctor Horacio Ferrer Díaz, who gave prestige to our native province. He was a notable physician, specialized in Ophthalmology, who combined his professional performance with the revolutionary activities in defense of the Cuban independence. He was the inventor of a device to study the retina and another to vacuum extract the cataract, and a rotating table of examination that was unique in the world. He published "Photometry before and after the cataract surgery" and was the first one who operated a patient with retinal detachment in Cuba. A son of the region of Union, Ferrer Díaz should be recollected forever because of his medical contributions and his great political activism at the service of the independence fighters against the Spanish colonialism, where he obtained military ranks, and against the government of Gerardo Machado and Batista's dictatorship later. The recount of independent wars was reflected in his work With the rifle on the shoulder, written in his old age (AU).

Horacio Ferrer Díaz, médico, combatiente y escritor matancero / Horacio Ferrer Díaz, physician, fighter and writer from Matanzas

El estudio descriptivo de personalidades de la provincia debe formar parte de un proyecto para enriquecer el conocimiento de todos los profesionales matanceros vinculados con las ciencias médicas y la historia, que a su vez serán los que preparen a los estudiantes de las ciencias médicas para su formación integral. Esta es la razón fundamental por la que seleccionamos al eminente médico Horacio Ferrer Díaz, que en el siglo xix prestigió el terruño. Fue un notable galeno, especializado en oftalmología, quien combinó su desempeño profesional con las actividades revolucionarias en defensa de la independencia de Cuba. Fue inventor de un aparato para estudiar la retina y otro para extraer la catarata al vacío y de una mesa giratoria de reconocimiento única en el mundo. Publicó "La Fonometría antes y después de la operación de catarata", y fue el primero que operó un paciente con desprendimiento de retina en Cuba. Hijo de la tierra unionense, Ferrer Díaz debe ser recordado por siempre por sus aportes médicos y su gran activismo político en las filas mambisas, donde adquiere grados militares, y en contra del gobierno de Machado y la dictadura de Batista después. El recuento de la historia en las guerras independentistas queda plasmado para todos los cubanos en su obra Con el rifle al hombro, escrita en su ancianidad (AU).

The descriptive study of the province's personalities should be a part of a project to enhance the knowledge of all Matanzasan professional related with the medical sciences and the history, who are in their turn the ones who are going to train the medical sciences students for their comprehensive education. That is the main reason of choosing the personality of the eminent doctor Horacio Ferrer Díaz, who gave prestige to our native province. He was a notable physician, specialized in Ophthalmology, who combined his professional performance with the revolutionary activities in defense of the Cuban independence. He was the inventor of a device to study the retina and another to vacuum extract the cataract, and a rotating table of examination that was unique in the world. He published "Photometry before and after the cataract surgery" and was the first one who operated a patient with retinal detachment in Cuba. A son of the region of Union, Ferrer Díaz should be recollected forever because of his medical contributions and his great political activism at the service of the independence fighters against the Spanish colonialism, where he obtained military ranks, and against the government of Gerardo Machado and Batista's dictatorship later. The recount of independent wars was reflected in his work With the rifle on the shoulder, written in his old age (AU).

Los valores como núcleo de la gestión de las instituciones de salud en Cuba / The values like nucleus of management of the institutions of health in Cuba

Se realizó una revisión de los conceptos más conocidos dentro del ámbito organizacional que abordan al valor como categoría científica. Se analizan y se destacan sus principales aportes al mundo laboral. Se logra concretar un conjunto de ideas y reflexiones que guían investigaciones y nuevos juicios acerca de este proceso psicológico con importante peso en la legitimación y alineación del comportamiento. Se muestra la importancia de su gestión en instituciones de salud en Cuba (AU).

We carried out a review of the most commonly known concepts of the organizational field, approaching value as a scientific category. Their contribution to the occupational world were analyzed and highlighted. It allowed summing up ideas and reflections to direct research and judgments about this psychological process with important weight in the behavior legitimating and adjustment. The importance of its management in Cuban health institutions is shown (AU).

Las políticas públicas en la educación médica y su influencia en el reajuste curricular / Public politics in medical education and their influence on the curricular readjustment

Los desafíos del mundo actual exigen otorgar a la salud una prioridad dentro de las políticas sociales y en este proceso la universidad asume una posición de principios. En los últimos años, diversos países de la región latinoamericana y del mundo han mostrado el resultado del trabajo de reajuste de los currículos de formación. Se advierte el interés de acercar más al profesional a la atención primaria de salud y se implementan nuevas disciplinas, para lograr cumplir con las metas de Salud para Todos de la Organización Mundial de la Salud. Cuba por su parte, se ha caracterizado por mantener desde 1959 una línea coherente de trabajo para lograr la calidad de los servicios de salud. La formación de médicos ha sido desde entonces una tarea estratégica y una serie de planes de estudio han permitido en cada momento histórico enfrentar estos retos. Disímiles son los criterios publicados en estos últimos años con respecto a la manera en que hoy se conduce la formación básica del futuro galeno, lo que ha generado debates entre los interesados y al fin motivado reformas, aunque estas aún insuficientes. Actualmente se implementa un nuevo plan de estudios en la carrera de medicina, verdadera tarea para los docentes que llevan a cabo esta labor. El propósito es promover una reflexión acerca del tratamiento de las políticas públicas en salud de la región y en particular el de Cuba, haciendo hincapié en la educación médica como eje formador y sostenedor de la misma (AU).

The challenges of the current world require conferring to health care a priority among the social politics, and in this process the medical university assumes a position of principles. During the last years, several countries of the Latin American area and around the world have showed the results of the readjustment of the training curriculums. It is noticed the interest of approaching professionals to the primary health care, and new subjects are implemented, to reach the aims of "Health for everyone", the program of the World Health Organization (WHO). Cuba, for its part, has been characterized for keeping up a coherent line of work to achieve the quality of health services since 1959. Since them the training of physicians has been a strategic task, and a series of study plans have allowed to affront these challenges in each historical moment. Several criteria have been published in the last years with respect to the way the basic training of the futures physicians is led; it has generated disputes among the interested factors, motivating reforms at the end that are still insufficient. Currently, a new study plan is implemented in the medicine studies, a true task for the teaching staff carrying this task out. The aim is promoting reflections on the treatment of public health politics in the region and particularly in Cuba, making emphasis in medical education as its training and sustaining axis (AU).

Los valores como núcleo de la gestión de las instituciones de salud en Cuba / The values like nucleus of management of the institutions of health in Cuba

Se realizó una revisión de los conceptos más conocidos dentro del ámbito organizacional que abordan al valor como categoría científica. Se analizan y se destacan sus principales aportes al mundo laboral. Se logra concretar un conjunto de ideas y reflexiones que guían investigaciones y nuevos juicios acerca de este proceso psicológico con importante peso en la legitimación y alineación del comportamiento. Se muestra la importancia de su gestión en instituciones de salud en Cuba (AU).

We carried out a review of the most commonly known concepts of the organizational field, approaching value as a scientific category. Their contribution to the occupational world were analyzed and highlighted. It allowed summing up ideas and reflections to direct research and judgments about this psychological process with important weight in the behavior legitimating and adjustment. The importance of its management in Cuban health institutions is shown (AU).

Las políticas públicas en la educación médica y su influencia en el reajuste curricular / Public politics in medical education and their influence on the curricular readjustment

Los desafíos del mundo actual exigen otorgar a la salud una prioridad dentro de las políticas sociales y en este proceso la universidad asume una posición de principios. En los últimos años, diversos países de la región latinoamericana y del mundo han mostrado el resultado del trabajo de reajuste de los currículos de formación. Se advierte el interés de acercar más al profesional a la atención primaria de salud y se implementan nuevas disciplinas, para lograr cumplir con las metas de Salud para Todos de la Organización Mundial de la Salud. Cuba por su parte, se ha caracterizado por mantener desde 1959 una línea coherente de trabajo para lograr la calidad de los servicios de salud. La formación de médicos ha sido desde entonces una tarea estratégica y una serie de planes de estudio han permitido en cada momento histórico enfrentar estos retos. Disímiles son los criterios publicados en estos últimos años con respecto a la manera en que hoy se conduce la formación básica del futuro galeno, lo que ha generado debates entre los interesados y al fin motivado reformas, aunque estas aún insuficientes. Actualmente se implementa un nuevo plan de estudios en la carrera de medicina, verdadera tarea para los docentes que llevan a cabo esta labor. El propósito es promover una reflexión acerca del tratamiento de las políticas públicas en salud de la región y en particular el de Cuba, haciendo hincapié en la educación médica como eje formador y sostenedor de la misma (AU).

The challenges of the current world require conferring to health care a priority among the social politics, and in this process the medical university assumes a position of principles. During the last years, several countries of the Latin American area and around the world have showed the results of the readjustment of the training curriculums. It is noticed the interest of approaching professionals to the primary health care, and new subjects are implemented, to reach the aims of "Health for everyone", the program of the World Health Organization (WHO). Cuba, for its part, has been characterized for keeping up a coherent line of work to achieve the quality of health services since 1959. Since them the training of physicians has been a strategic task, and a series of study plans have allowed to affront these challenges in each historical moment. Several criteria have been published in the last years with respect to the way the basic training of the futures physicians is led; it has generated disputes among the interested factors, motivating reforms at the end that are still insufficient. Currently, a new study plan is implemented in the medicine studies, a true task for the teaching staff carrying this task out. The aim is promoting reflections on the treatment of public health politics in the region and particularly in Cuba, making emphasis in medical education as its training and sustaining axis (AU).

Momentos históricos del Policlínico Universitario Pedro Borrás Astorga / Historical moments of the University Hospital Pedro Borrás Astorga

Introducción: los momentos históricos vivenciados por las áreas de salud, adquieren una connotación especial en su desarrollo evolutivo. Objetivo: describir los momentos históricos del Policlínico Universitario "Pedro Borrás Astorga". Materiales y métodos: se realizó una investigación pedagógica sobre dicha área de salud ubicada en la ciudad de Pinar del Río, en el período comprendido entre septiembre y noviembre del 2016, empleando el método materialista dialéctico, el cual permitió el empleo de métodos teóricos, empíricos y estadístico (descriptivo). Resultados: en la clasificación de los momentos históricos por año, predominaron los de carácter provincial con 55,6%, así como el año 2016 como el período de mayor actividad histórica con 44,4%. Respecto al tipo de momento histórico, se destacan los reconocimientos y galardones (138), seguido de la colaboración médica (83), con ascenso significativo en el 2016. Conclusiones: al describir dichas páginas memorables, se fortalece el arsenal de conocimientos históricos, así como constituye un estímulo de trabajo y anécdotas para las presentes y futuras generaciones (AU).

Introduction: the historical moments health areas have went through adopt a special connotation in their evolutive development. Objective: to describe historical moments of the University Policlinic "Pedro Borrás Astorga". Materials and methods: a pedagogical research on the health area located in the city of Pinar del Rio, in the period from September to November 2016, using the dialectic materialist method that allowed the employment of theoretical, empiric and statistic (descriptive) methods. Results: in the classification of the historical moments per year, the ones with provincial character predominated with 55.6 %, and 2016 was the period of higher historical activity with 44 %. According to the kind of historical moment, acknowledgments and awards stood out (138), followed by medical collaboration (83), with significant growth in 2016. Conclusions: to describe memorable moments strengthens the arsenal of historical knowledge, being also a work stimulus and anecdote for the current and future generations (AU).

Intervención educativa sobre prevención de cardiopatías congénitas en mujeres en edad fértil, consultorios médicos 8 y 9. Policlínico Samuel Fernández. Municipio de Matanzas; 2015-2016 / Educative intervention on congenital heart diseases prevention in fertile aged women. Medical Consultations 8 and 9. Policlinic “Samuel Fernández”. Municipality of Matanzas; 2015-2016

Introducción: las cardiopatías congénitas son los defectos más frecuentes y primera causa de muerte en menores de un año, su etiología es multifactorial y los factores de riesgo diversos y muchos prevenibles. Objetivo: implementar un programa educativo para el desarrollo de conocimientos sobre prevención de cardiopatías congénitas en mujeres en edad fértil de dos consultorios médicos del Policlínico Docente "Samuel Fernández "del municipio Matanzas, entre enero 2015 a marzo 2016. Material y métodos: se realizó un estudio de intervención, se diagnosticó el nivel de conocimientos y necesidades educativas sentidas a través de un cuestionario al universo de mujeres en edad fértil de los consultorios médicos declarados. Para determinar la existencia de asociación entre ambas variables, se calculó el Chi cuadrado, para una confiabilidad de 99%. Se aplicó la prueba de la t de Student para comparar las medias aritméticas de la variable conocimiento antes y después de la intervención, para una confiabilidad de 99%. Resultados: el nivel de conocimiento de las féminas fue regular y las necesidades educativas sentidas altas antes de la intervención, modificándose a bien después de implementada la misma, con diferencias estadísticamente altamente significativas. Conclusiones: Se comprueba la eficacia del producto elaborado al constatarse el desarrollo de conocimientos sobre el tema (AU).

Introduction: congenital heart diseases are the most frequent defects and the first cause of death in children aged less than a year. Its etiology is multifactorial and the risk factors are diverse and many of them preventable. Objective: to put into practice an educative program for the development of knowledge on congenital heart diseases in fertile aged women from two medical consultations of the Teaching Policlinic "Samuel Fernández", municipality of Matanzas, from January 2015 to March 2016. Materials and methods: an intervention was carried out. It was diagnosed the level of knowledge and the educative necessities using an questionnaire filled in by the universe of fertile aged women from the declared medical consultations. To determine the existence of association between both variables chi-square was calculated for a reliability of 99 %. The T student test was applied to compare the arithmetic average of knowledge variable before and after the intervention, for a 99 % of reliability. Results: the women´s level of knowledge was regular and the perceived educative necessities were high before the intervention; the level of knowledge turned to good after the intervention, with significantly high statistical differences. Conclusions: the efficacy of the elaborated product was proved when development of knowledge on the theme was stated (AU).

Intervención educativa sobre prevención de cardiopatías congénitas en mujeres en edad fértil, consultorios médicos 8 y 9. Policlínico Samuel Fernández. Municipio de Matanzas; 2015-2016 / Educative intervention on congenital heart diseases prevention in fertile aged women. Medical Consultations 8 and 9. Policlinic "Samuel Fernández". Municipality of Matanzas; 2015-2016

Introducción: las cardiopatías congénitas son los defectos más frecuentes y primera causa de muerte en menores de un año, su etiología es multifactorial y los factores de riesgo diversos y muchos prevenibles. Objetivo: implementar un programa educativo para el desarrollo de conocimientos sobre prevención de cardiopatías congénitas en mujeres en edad fértil de dos consultorios médicos del Policlínico Docente "Samuel Fernández "del municipio Matanzas, entre enero 2015 a marzo 2016. Material y métodos: se realizó un estudio de intervención, se diagnosticó el nivel de conocimientos y necesidades educativas sentidas a través de un cuestionario al universo de mujeres en edad fértil de los consultorios médicos declarados. Para determinar la existencia de asociación entre ambas variables, se calculó el Chi cuadrado, para una confiabilidad de 99%. Se aplicó la prueba de la t de Student para comparar las medias aritméticas de la variable conocimiento antes y después de la intervención, para una confiabilidad de 99%. Resultados: el nivel de conocimiento de las féminas fue regular y las necesidades educativas sentidas altas antes de la intervención, modificándose a bien después de implementada la misma, con diferencias estadísticamente altamente significativas. Conclusiones: Se comprueba la eficacia del producto elaborado al constatarse el desarrollo de conocimientos sobre el tema (AU).

Introduction: congenital heart diseases are the most frequent defects and the first cause of death in children aged less than a year. Its etiology is multifactorial and the risk factors are diverse and many of them preventable. Objective: to put into practice an educative program for the development of knowledge on congenital heart diseases in fertile aged women from two medical consultations of the Teaching Policlinic "Samuel Fernández", municipality of Matanzas, from January 2015 to March 2016. Materials and methods: an intervention was carried out. It was diagnosed the level of knowledge and the educative necessities using an questionnaire filled in by the universe of fertile aged women from the declared medical consultations. To determine the existence of association between both variables chi-square was calculated for a reliability of 99 %. The T student test was applied to compare the arithmetic average of knowledge variable before and after the intervention, for a 99 % of reliability. Results: the women´s level of knowledge was regular and the perceived educative necessities were high before the intervention; the level of knowledge turned to good after the intervention, with significantly high statistical differences. Conclusions: the efficacy of the elaborated product was proved when development of knowledge on the theme was stated (AU).

Momentos históricos del Policlínico Universitario Pedro Borrás Astorga / Historical moments of the University Hospital Pedro Borrás Astorga

Introducción: los momentos históricos vivenciados por las áreas de salud, adquieren una connotación especial en su desarrollo evolutivo. Objetivo: describir los momentos históricos del Policlínico Universitario "Pedro Borrás Astorga". Materiales y métodos: se realizó una investigación pedagógica sobre dicha área de salud ubicada en la ciudad de Pinar del Río, en el período comprendido entre septiembre y noviembre del 2016, empleando el método materialista dialéctico, el cual permitió el empleo de métodos teóricos, empíricos y estadístico (descriptivo). Resultados: en la clasificación de los momentos históricos por año, predominaron los de carácter provincial con 55,6%, así como el año 2016 como el período de mayor actividad histórica con 44,4%. Respecto al tipo de momento histórico, se destacan los reconocimientos y galardones (138), seguido de la colaboración médica (83), con ascenso significativo en el 2016. Conclusiones: al describir dichas páginas memorables, se fortalece el arsenal de conocimientos históricos, así como constituye un estímulo de trabajo y anécdotas para las presentes y futuras generaciones (AU).

Introduction: the historical moments health areas have went through adopt a special connotation in their evolutive development. Objective: to describe historical moments of the University Policlinic "Pedro Borrás Astorga". Materials and methods: a pedagogical research on the health area located in the city of Pinar del Rio, in the period from September to November 2016, using the dialectic materialist method that allowed the employment of theoretical, empiric and statistic (descriptive) methods. Results: in the classification of the historical moments per year, the ones with provincial character predominated with 55.6 %, and 2016 was the period of higher historical activity with 44 %. According to the kind of historical moment, acknowledgments and awards stood out (138), followed by medical collaboration (83), with significant growth in 2016. Conclusions: to describe memorable moments strengthens the arsenal of historical knowledge, being also a work stimulus and anecdote for the current and future generations (AU).