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

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).

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).

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).

Historia de la salud en Colón. Etapa Revolucionaria / The history of public health in Colón. Revolucionary period

En artículos anteriores se había abordado la historia de la salud en la ciudad de Colón en la etapa colonial y en la etapa neocolonial. El presente contiene la tercera parte y final de la historia de la salud en el municipio. Su objetivo es dar a conocer los avances que ha alcanzado la municipalidad en el sector de la salud después del triunfo revolucionario (AU).

The history of the public health in the city of Colón during the colonial and neo-colonial period has been treated in previous articles. The current one covers the third and final part of the history of public health in the municipality. Its aim is to let people know about the advances achieved by the municipality in this sector after the revolutionary triumph (AU).

Rosa Alba Salas Mora: Una investigadora integral / Rosa Alba Salas Mora: An integral researcher

Presentamos una breve semblanza de la vida y obra de la Doctora Rosa Alba Salas Mora, viróloga venezolana que consolidó la vigilancia virológica de laboratorio, dando un aporte invaluable a la Salud Pública en nuestro país. Resaltamos algunos aspectos de su destacada actuación profesional

We present a brief biography of Rosa Alba Salas Mora, a venezuelan virologist who consolidated virological laboratory surveillance, giving an invaluable contribution to Public Health in our country. We highlight some aspects of her outstanding professional performance