Diseño metodológico para desarrollar un procedimiento de gestión de comunicación interna en el Ministerio de Salud Pública de Cuba

Introducción: La gestión de la comunicación interna en las organizaciones de salud representa una herramienta sistémica y organizativa que impacta en el nivel de satisfacción y compromiso de los trabajadores con la organización y se extiende hasta beneficiar a los pacientes como usuarios de los servicios. Su implementación constituye una política de la Administración Central del Estado Cubano que la dirección del Ministerio de Salud Pública prioriza, al considerarla imprescindible para el logro de los objetivos de trabajo. Esto condujo a diseñar un procedimiento que permitiera gestionar la comunicación interna en la institución. Objetivo: Exponer los métodos, las técnicas y los procedimientos empleados para diseñar un procedimiento para la gestión de la comunicación interna en el Ministerio de Salud Pública de Cuba. Resultados: Se plantea una investigación de desarrollo tecnológico, de tipo mixta, aplicada en dos fases y desarrolladas con técnicas cuantitativas y cualitativas. Conclusiones: El empleo de técnicas cuantitativas y cualitativas permitió identificar los elementos que componen un procedimiento para gestionar la comunicación interna en el Ministerio de Salud Pública. El procesamiento de los datos obtenidos desde el nivel individual hasta el colectivo facilitó la integración de conocimientos para organizar el diseño del procedimiento por etapas. La metodología empleada permitió obtener un procedimiento actualizado y válido por expertos y el público interno.

Introduction: The management of internal communication in health organizations represents a systemic and organizational tool that impacts the level of satisfaction and commitment of workers with the organization and it extends to benefit patients as users of services. Its implementation constitutes a policy of the Central Administration of the Cuban State that the management of the Ministry of Public Health prioritizes, considering it essential for the achievement of work objectives. This led to designing a procedure that would allow managing internal communication in the institution. Objective: To present the methods, techniques and procedures used to design a procedure for the management of internal communication in the Ministry of Public Health of Cuba. Results: A mixed type technological development research is proposed, applied in two phases and developed with quantitative and qualitative techniques. Conclusions: The use of quantitative and qualitative techniques allowed to identify the elements that make up a procedure to manage internal communication in the Ministry of Public Health. The processing of the data gained from the individual to the collective level facilitated the integration of knowledge to organize the design of the procedure in stages. The methodology used allowed to obtain an updated and valid procedure by experts and the internal public.

Diseño Óptimo de Estudios en Rehabilitación: Importancia del Tamaño Muestra / Optimal Design of Rehabilitation Studies: Importance of Sample Size

Este artículo aborda los principios esenciales para la estimación del tamaño muestral en estudios cuantitativos de ciencias de la rehabilitación y movimiento humano. Además, proporciona una guía práctica y accesible sobre el diseño de investigaciones rigurosas, abordando conceptos clave como la precisión, nivel de confianza, nivel de significancia y potencia estadística, fundamentales para obtener resultados válidos y confiables. También se explora cómo estos parámetros influyen en la generalización de hallazgos y la detección de diferencias significativas, así como la importancia de un tamaño muestral adecuado para que los futuros investigadores mejoren la calidad de sus estudios en campos de la rehabilitación y el movimiento humano.

This article addresses the essential principles for sample size estimation in quantitative studies of rehabilitation sciences and human movement. In addition, it provides a practical and accessible guide on the design of rigorous investigations, addressing key concepts such as precision, confidence level, significance level and statistical power, essential to obtain valid and reliable results. It also explores how these parameters influence the generalization of findings and the detection of significant differences, as well as the importance of an adequate sample size for future researchers to improve the quality of their studies in the fields of rehabilitation and human movement.

Principales dificultades de los proyectos de investigación de la especialidad Medicina General Integral / Main Difficulties of Research Projects of the General Comprehensive Medicine Specialty

Introducción: El residente de Medicina General Integral, una vez graduado, ejecutará investigaciones en correspondencia con las necesidades actuales del Sistema Nacional de Salud y a partir de los problemas de salud predominantes en su comunidad. Objetivo: Describir las principales dificultades en los proyectos de investigación de los residentes de la Especialidad de Medicina General Integral. Métodos: Se realizó un estudio observacional descriptivo transversal en la Facultad de Ciencias Médicas de Sagua la Grande en el período 2020-2021. La población objeto de análisis quedó constituida por un total de 69 proyectos de investigación provenientes de 5 policlínicos docentes de 3 municipios del territorio (Corralillo, Quemado de Güines y Sagua la Grande). Se revisó el proyecto de investigación, se confeccionó un modelo para la recogida de datos extraídos de los mismos y se elaboró una base de datos para su almacenamiento. Resultados: Las principales dificultades estuvieron dadas en no sustentar adecuadamente la investigación, en la redacción del problema científico, específicamente la relación entre el problema y el tipo de investigación, la conceptualización y/o operacionalización de las variables, la selección y elaboración de los métodos, técnicas e instrumentos para la recogida de la información y la acotación de la bibliografía por normas de Vancouver. Conclusiones: Resulta de vital importancia que los residentes de esta especialidad desarrollen habilidades investigativas desde el primer año de formación, lo que contribuirá a un mejor desempeño profesional a partir de la aplicación del método científico en la solución de los problemas de salud que se presenten en su quehacer diario(AU)

Introduction: The family medicine resident, once graduated, will do research in correspondence with the current needs of the national health system and considering the predominant health problems in her/his community. Objective: To describe the main difficulties in the research projects of residents in the General Comprehensive Medicine specialty. Methods: A cross-sectional, descriptive and observational study was carried out in the medical school of Sagua la Grande Municipality, in the period 2020-2021. The population under analysis consisted of a total of 69 research projects from five teaching polyclinics in three municipalities of the territory (Corralillo, Quemado de Güines and Sagua la Grande). Each research project was reviewed, a model was prepared for collecting the data extracted from them, and a database was elaborated for their storage. Results: The main difficulties were not supporting the research adequately, as well as in writing the scientific problem, specifically the relation between the problem and the type of research; also, the conceptualization or operationalization of variables, the selection and elaboration of methods, the techniques and instruments for the collection of information, and the bibliographical adjustment by the Vancouver norms. Conclusions: It is of vital importance that residents of this specialty develop research skills from the first year of training, which will contribute to better professional performance from the application of the scientific method in the solution of health problems that appear in their daily work(AU)

Nurses' professional values scale‒three: Validation and psychometric appraisal among Saudi undergraduate student nurses.

Objectives: Since the nursing professional values have garnered attention as a principal criterion for safe‒quality nursing practice, it was measured using the Nurses Professional Values Scale‒three. We aimed to validate and ascertain the psychometric indicators of the Arabic version of the Nurses Professional Values Scale-three among Saudi student nurses. Method: This methodological study recruited student nurses using convenience sampling from two nursing colleges at KSA. About 438 valid questionnaires were returned out of 500 questionnaires which were distributed over students in a formal day class time; representing a response rate of 87.6%. A 2‒fold cross‒validation process was adopted. A transcultural process was conducted. Face, content, and construct validity using exploratory and confirmatory factor analyses were used. Convergent and discriminant validity were also assessed. The reliability of the scale was assessed using Cronbach's alpha. Results: Face validity was achieved. The content validity of items ranged from .83 to 1.00, while it was .96 for the overall scale. The exploratory factor analysis yielded a scale containing 28 items with a three‒factor model, explaining 74.5% of the total variance. Confirmatory factor analysis confirmed that three‒factor solution had an adequate model fit (CMIN/df = 1.98; RMSEA = .065; SRMR = .039, CFI = .972, and GFI = .968). Convergent validity and discriminant validity were achieved. Cronbach's alpha values were .89, .90, .90, and .96 for activism, caring, professionalism, and the overall scale, respectively. Conclusion: Adequate levels of reliability and validity of the Arabic version of the Nurses Professional Values Scale-three were established, indicating the appropriateness of using this version to assess the professional values among Saudi and other Arabic‒speaking nurses.

Difficulties experienced by endodontics researchers in conducting studies and writing papers.

Objectives: The study investigated the difficulties experienced by endodontics researchers around the world in conducting studies and writing papers. Materials and Methods: A survey consisting of 18 questions on the difficulties experienced by endodontics researchers in performing studies and writing papers was e-mailed to academics in the field of endodontics working at 202 universities. The independent risk factors were analyzed using binary logistic regression at a significance level of 0.05. Results: A total of 581 individuals (10.7%) agreed to participate in the study. Almost half the participants (48.2%) reported that they had received some type of training in conducting studies and writing papers. In response to the question, "Do you get help from a statistician to perform the statistical analyses of your studies?," 77.1% answered "yes." Around 40% of the participants stated that the need to obtain ethical approval negatively affected their desire to conduct studies. The participants' regions had no effect on the reported difficulties associated with writing papers in English or conducting statistical analyses (p > 0.05). Most participants (81.8%) reported difficulties in writing the Discussion section, regardless of their region, academic degrees, or years of experience. Conclusions: The participants stated they experienced difficulties in many areas, such as conducting statistical analyses, finding new ideas, and writing in English. Engaging in a detailed examination of ethics committee rules, expanding biostatistics education, increasing the number of institutions providing research funding, and increasing the number of endodontics journals can increase the enthusiasm of endodontics researchers to publish papers.

Methodological Aspects in Randomized Clinical Trials of Nutritional Interventions.

Nutrition is an essential component when promoting human health. Without a doubt, improving the quality of one's diet can improve one's quality of life as a whole and help postpone the onset or control of many chronic diseases. The volume of publications in this field has increased in recent years, in line with increased awareness of the importance of nutrition in health; however, the quality of the evidence on which most nutritional guidelines are based remains low, due to errors in conducting nutritional interventions or because the information is primarily derived from observational studies. To enhance the evidence supporting clinical guidelines in nutrition, the quality of randomized clinical trials (RCT) based on nutritional interventions must be improved; nevertheless, due to their heterogeneous nature and a lack of specific guidelines for designing, performing, documenting, and reporting on this type of intervention, conducting a nutritional intervention is a real challenge. Following a review of the literature on the methodological and ethical standards, as well as four extensions of the CONSORT (Consolidated Standards of Reporting Trials) guidelines that should be considered when implementing a nutritional intervention, seven essential aspects were identified. The current narrative review includes definitions, examples, diagrams, and algorithms regarding aspects of the appropriate study design, the intervention of the control group, the randomization and blinding processes, the study population selection, as well as a description of the type of intervention and the personnel involved in carrying out the study in order to make the implementation of a nutritional intervention easier.

Caracterización preliminar de los protocolos de investigación de residentes de Ciencias Médicas / Preliminary characterization of research protocols of residents in Medical Sciences

Introducción: El conocimiento científico se caracteriza por ser racional, sistemático y verificable, lo que requiere una correcta estructura del protocolo de investigación. La finalidad de un protocolo es la correcta planificación y ejecución del estudio mediante la organización del trabajo de forma lógica, enfocada y eficiente. Objetivo: Describir los protocolos de tesis de los residentes de ciencias médicas. Métodos: Se realizó una investigación descriptiva de corte retrospectivo para la caracterización de 61 protocolos de tesis de los estudiantes de las disciplinas de Medicina general integral y Estomatología general integral del curso 2019-2020. Se confeccionó una planilla para la recolección de los datos extraídos de los protocolos revisados y se elaboró una base de datos para su almacenamiento. Resultados: Del total de protocolos revisados, 36 (59 por ciento) fueron de Medicina general integral y 25 (41 por ciento) de Estomatología general integral. El 90 por ciento de los protocolos de Medicina general integral son estudios observacionales, de estos el 97 por ciento estudios transversales, y de ellos casi el 90 por ciento estudios descriptivos. Los protocolos de Estomatología general integral presentaron resultados similares: el 96 por ciento son estudios observacionales, de estos 92 por ciento transversales y de ellos el 95 por ciento de tipo descriptivo. Acápites tan importantes como la operacionalización de las variables, la descripción de los métodos para la recolección de datos y las consideraciones éticas para el trabajo con humanos se consideran en menos del 25 por ciento de todos los protocolos revisados. Conclusiones: Se demuestra una marcada insuficiencia en la redacción de los protocolos de investigación por parte de los residentes de Medicina general integral y Estomatología general integral(AU)

Introduction: Scientific knowledge is characterized by being rational, systematic and verifiable, for this an adequate initial planning of the research work is required, which is achieved through the correct structure of the research protocol. The planning of a protocol is the correct planning and execution of the study by organizing the work in a logical, focused and efficient way. Objective: To characterize the thesis protocols of the students of the disciplines of comprehensive general medicine and comprehensive general stomatology of the 2019-2020 academic year. Methods: A retrospective descriptive investigation was carried out for the characterization of 61 thesis protocols of the students of the integral general medicine and integral general stomatology disciplines of the 2019-2020 academic year. A spreadsheet was prepared to collect the data extracted from the revised protocols and a database was prepared for storage. Results: Of the total protocols reviewed: 36 (59 percent) from integral general medicine and 25 (41 percent) from integral general stomatology. 90 percent of integral general medicine protocols are observational studies, of these 97 percent cross-sectional studies, and of them almost 90 percent descriptive studies. Regarding the integral general stomatology protocols, the results are similar: 96% are observational studies, of these 92 percent are cross-sectional and 95 percent of them are descriptive. In all, sections as important as the operationalization of the variables, the description of the methods for data collection, and the ethical considerations for working with humans are considered in less than 25 percent of all the protocols reviewed. Conclusions: A marked insufficiency in the writing of the research protocols by the residents of integral general medicine and integral general stomatology is demonstrated(AU)

WASP (Write a Scientific Paper): Interpretative phenomenological analysis: Its attraction and relevance to the medical field.

This paper describes the use of Interpretative Phenomenological Analysis (IPA) in qualitative research and its adaptability to medical research. Whilst presenting the main tenets of the approach, it also highlights its' strengths in helping medical professionals gain rich information about their service users' needs, symptoms and experiences, via research. It discusses the application of IPA on various levels such as by contextualising quantitative data or gaining insight into patients' understanding of clinical guidelines. The paper also describes methodological choices of the approach and the reasoning behind them. It outlines the sample, data collection tools and method of analysis utilised in IPA. To help researchers locate the particular use of this approach on the qualitative research landscape, this paper also compares its' use to that of other qualitative approaches. Finally, it discusses ways of evaluating IPA studies and hence, to ensure that such studies respect the philosophical roots of qualitative research in general, and those of IPA in particular.

The Progress of Tobacco Control Research in Sub-Saharan Africa in the Past 50 Years: A Systematic Review of the Design and Methods of the Studies.

Over one billion of the world's population are smokers, with increasing tobacco use in low- and middle-income countries. However, information about the methodology of studies on tobacco control is limited. We conducted a literature search to examine and evaluate the methodological designs of published tobacco research in Sub-Saharan Africa (SSA) over the past 50 years. The first phase was completed in 2015 using PubMed, Embase, CINAHL, and Cochrane Central Register of Controlled Trials. An additional search was completed in February 2017 using PubMed. Only tobacco/smoking research in SSA countries with human subjects and published in English was selected. Out of 1796 articles, 447 met the inclusion criteria and were from 26 countries, 11 of which had one study each. Over half of the publications were from South Africa and Nigeria. The earliest publication was in 1968 and the highest number of publications was in 2014 (n = 46). The majority of publications used quantitative methods (91.28%) and were cross-sectional (80.98%). The commonest data collection methods were self-administered questionnaires (38.53%), interviews (32.57%), and observation (20.41%). Around half of the studies were among adults and in urban settings. We conclud that SSA remains a "research desert" and needs more investment in tobacco control research and training.

Heritability of social anxiety disorder: a systematic review of methodological designs

Abstract Background The investigation of heritability stands out as an important means to establish the weight of genetic and environmental factors in the development of social anxiety disorder. Objective This study aims to make a critical review of methodological designs used in the investigation of the social anxiety disorder (SAD) heritability. Methods We reviewed 31 research articles published until October 2015 and found through the electronic search bases PubMed, Web of Science, and Scopus and manual searches in the reference lists of the selected references. Most of the investigations involved adult samples and twins to assess heritability. Results There was great variability in the screening and diagnostic instruments used in the studies, leading to different outcomes. Structural equation models proved to be the most adequate to assess SAD heritability, allowing better estimates of this aspect of the disorder. SAD heritability rates varied between 13% and 76% in the articles reviewed. Discussion We discuss methodological aspects that may affect the quality and the development of improved studies to investigate SAD heritability such as sample size, quality of screening instruments, and use of diagnostic interviews. More homogeneous investigations involving larger samples and standardized instruments and methods are desirable and opportune.

El diseño metodológico de las investigaciones evaluativas relacionadas con la calidad en salud / The methodological design of the evaluative investigations related to health quality

Se realizó una revisión bibliográfica de los conceptos de calidad y evaluación de la calidad de la atención médica o calidad en salud. Se constató la diversidad de conceptos según diferentes autores, pero el más aceptado es del modelo de Avedis Donabedian que en 1986 expuso los resultados de su investigación que se ha convertido en un paradigma, al crear los componentes de la calidad: estructura, proceso y resultados, y es la metodología que actualmente establece la Escuela Nacional de Salud Pública de Cuba (ENSAP). Después de abordar los elementos teóricos e históricos del tema se señalan las dificultades detectadas en investigaciones realizadas en Santiago de Cuba y se emiten algunas recomendaciones metodológicas al respecto, para mejorar los resultados reales del informe final de dichas investigaciones.

A literature review on the quality concepts and medical care quality evaluation or health quality was carried out. The diversity of concepts was verified according to different authors, but the most accepted is the Avedis Donabedian pattern that in 1986 exposed the results of his investigation that has become a paradigm, when creating the components of the quality: structure, process and results, and it is the methodology that at the moment establishes the Cuban Public Health National School (ENSAP) Spanish abbreviation. After approaching the theoretical and historical elements of the topic the difficulties detected in investigations carried out in Santiago de Cuba are pointed out and some methodological recommendations in this respect are announced in order to improve the final report actual results of these investigations.

Can you see it too? Observed and self-rated participation in mainstream schools in students with and without autism spectrum disorders.

OBJECTIVES: To examine the degree to which observations can capture perception of participation, observed and self-rated levels of interactions for students with and without autism spectrum disorders (ASD) were explored. METHODS: Frequencies and levels of involvement in interactions with classmates were observed and compared in 22 students with ASD and 84 of their classmates in mainstream schools, using a standardized protocol. Self-reported participation measurements regarding interactions with classmates and teachers from five questionnaire items were correlated with the observations. In total, 51,516 data points were coded and entered into the analyses, and correlated with 530 questionnaire ratings. RESULTS: Only one weak correlation was found in each group. Compared with classmates, students with ASD participated less frequently, but were not less involved when they actually did. CONCLUSIONS: Observations alone do not capture the individuals' perception of participation and are not sufficient if the subjective aspect of participation is to be measured.

Conocimiento de los especialistas y residentes de Medicina Natural y Tradicional sobre los ensayos clínicos / Knowledge of the specialist and residents of Natural and Traditional Medicine on the clinical researches

La Medicina Natural y Tradicional ha entrado en una nueva etapa de desarrollo con el incremento en la demanda de sus alternativas terapéuticas. Se realizó una investigación descriptiva transversal, mediante la cual se identificaron las necesidades de aprendizaje de 20 médicos, entre especialistas y residentes de Medicina Natural y Tradicional, acerca de los aspectos básicos de ensayos clínicos. Existe desconocimiento acerca de las fases y pilares fundamentales de un ensayo clínico y los aspectos éticos importantes al ser una investigación en seres humanos, por lo que demuestra la falta de capacitación que existe sobre el tema. Es imprescindible fomentar una cultura de ensayos clínicos en los médicos que se desempeñan en el área de la Medicina Natural y Tradicional. Esto permitiría elevar la calidad y rapidez con que se desarrollan estos estudios en Cuba.

The Natural and Traditional Medicine has entered a new developmental stage with the increase in the requests of its therapeutic alternatives. We carried out a crossed descriptive research, through which we identified the learning necessities of 20 doctors, between specialist and residents of Traditional and Natural Medicine, about the main aspects of clinical researches. There is a lack of knowledge on the main phases and bases of a clinical research and on the important ethical aspects for being a research in human beings, showing the lack of knowledge on the theme. It is unavoidable to promote a culture of clinical researches among the doctors working in the area of Traditional and Natural Medicine. This will allow increasing the quality and speed of these researches development in Cuba.

PsychDisclosure.org : Grassroots Support for Reforming Reporting Standards in Psychology.

There is currently an unprecedented level of doubt regarding the reliability of research findings in psychology. Many recommendations have been made to improve the current situation. In this article, we report results from PsychDisclosure.org, a novel open-science initiative that provides a platform for authors of recently published articles to disclose four methodological design specification details that are not required to be disclosed under current reporting standards but that are critical for accurate interpretation and evaluation of reported findings. Grassroots sentiment-as manifested in the positive and appreciative response to our initiative-indicates that psychologists want to see changes made at the systemic level regarding disclosure of such methodological details. Almost 50% of contacted researchers disclosed the requested design specifications for the four methodological categories (excluded subjects, nonreported conditions and measures, and sample size determination). Disclosed information provided by participating authors also revealed several instances of questionable editorial practices, which need to be thoroughly examined and redressed. On the basis of these results, we argue that the time is now for mandatory methods disclosure statements for all psychology journals, which would be an important step forward in improving the reliability of findings in psychology.