CHANGES IN FUNCTIONAL CONNECTIVITY FOLLOWING INTENSIVE ATTENTION TRAINING IN PATIENTS WITH TRAUMATIC BRAIN INJURY. A PILOT STUDY.

Objective: To explore functional connectivity after intensive attention training in the chronic phase after traumatic brain injury as clinical evidence indicates that intensive attention training improves attention dysfunction in persons with traumatic brain injury. Design and subjects: A case series study. Two young adults, 13- and 18-months post traumatic brain injury, with traumatic brain injury induced attention deficits were assigned to 20 h of intensive attention training and neuroimaging. Methods: Functional magnetic resonance imaging during a psychomotor vigilance test was conducted pre- and post-intervention. Results: The neuroimaging indicated both increased and decreased connectivity density in frontal, posterior and subcortical brain regions, for some regions with separate change patterns for left and right hemisphere respectively, and an overall reduction in variability in functional connectivity. Conclusion: The changed and decreased variability of functional connectivity in various brain regions, captured by fMRI during a psychomotor vigilance test after direct attention training in a small sample of persons with traumatic brain injury, suggests further studies of functional connectivity changes in neural networks.

Does Non-Immersive Virtual Reality Improve Attention Processes in Severe Traumatic Brain Injury? Encouraging Data from a Pilot Study.

Traumatic brain injury (TBI) is a sudden injury that causes damage to the brain. Rehabilitation therapies include specific training, such as attention process training (APT) programs using either standard or innovative approaches. The aim of this study is to evaluate the effects of a non-immersive virtual reality-based attention training to stimulate attention processes and mood in TBI patients. Thirty subjects with TBI were enrolled at the Neurorehabilitation Unit of the IRCCS Neurolesi Center and divided into either the Conventional Attention Process Training Group (C_APT: n = 15) or the Virtual-Based Attention Processes Training Group (VB_APT: n = 15), treated with the Virtual Reality Rehabilitation System (VRRS-Evo). All of the patients were evaluated with a specific psychometric battery before (T0) and after the end (T1) of each program. We found statistically significant differences between the two groups, in particular concerning global cognitive status (p < 0.02), attention processes (p < 0.03), depression symptoms (p < 0.04) and visual attention (p < 0.01). Experimental intragroup analysis showed great statistical significances in all psychometric tests, i.e., the Montreal Cognitive Assessment (p < 0.0006), Attention Matrices (p < 0.0007), the Hamilton Rating Scale-Depression (p < 0.004), the Trail Making Test-A (p < 0.0007), the Trail Making Test-B (p < 0.0007), and the Trail Making test-BA (p < 0.007). Our results suggest that non-immersive virtual reality may be a useful and effective approach for the attention processes recovery and mood of TBI patients, leading to better cognitive and behavioral outcomes.

The effect of visual attention process and thinking styles on environmental aesthetic preference: An eye-tracking study.

People often form different aesthetic preferences for natural and built environments, which affects their behavioral intention; however, it remains unknown whether this difference in aesthetic preference is due to differences in thinking styles. However, whether tourists' aesthetic preferences differ when using different visual attention processes has not been studied further. This study used eye-tracking and self-reporting to investigate these questions. The results show that natural environment images are more favored visually because they can evoke in tourists larger pupil diameters and longer scan paths, but we found no significant difference in fixation duration and fixation counts. We also found that the scanning path of tourists who predominantly rely on intuitive thinking is modulated by the bottom-up attention process, while the scanning path of tourists who prefer rational thinking is modulated by the top-down attention process. In the bottom-up process, tourists who prefer rational thinking exhibit more positive aesthetic preferences and emotional arousal. In summary, the present study verified that aesthetic preference is more likely to be influenced by both thinking style and visual attention processing. The results of the present work provide preliminary evidence that the aesthetic preference of the environment is not only related to visual attention but also affected by the individual visual attention process and thinking style.

Effect of obesity on inhibitory control in preadolescents during stop-signal task. An event-related potentials study.

Preadolescence is a period in which structural and functional changes occur in brain network reorganization that relate to the development of executive control functions, particularly in the areas of attention and cognitive inhibition. Obesity has been associated with a deficit in executive functions and behavioral and electrophysiological differences using the go/no-go task (proactive inhibition), but no study has assessed brain-electrical activity using the stop-signal task (reactive inhibition) in this population. Therefore, we hypothesized that obese preadolescents would show less efficiency in reactive inhibition than their same-age non-obese peers. To test this hypothesis, event-related potentials (ERPs) were collected during a stop-signal task and compared between 27 obese preadolescents (mean BMI = 25.9; 9.65 years old) and 29 normal-weight preadolescents (mean BMI = 17.5; 9.60 years old). No significant differences between groups were observed in behavioral responses. As for ERPs, the obese group had an electrophysiological pattern associated with less efficient conflict monitoring during the "no-go" condition (i.e., less modulation of N200 latency based on the experimental condition), differences in attentional allocation in the "go" condition (less modulation of P300a latency based on experimental condition), and difficulties in rule retrieval from working memory associated with the trial-type in both experimental conditions (smaller P300b amplitude). We conclude that obese preadolescents displayed less ability to modulate conflict-monitoring in the "no-go" condition and attention allocation in the "go" condition, evidencing differences between groups in the development of attention and inhibitory control.

Investigating music-based cognitive rehabilitation for individuals with moderate to severe chronic acquired brain injury: A feasibility experiment.

BACKGROUND: Acquired brain injuries often cause cognitive impairment, significantly impacting participation in rehabilitation and activities of daily living. Music can influence brain function, and thus may serve as a uniquely powerful cognitive rehabilitation intervention. OBJECTIVE: This feasibility study investigated the potential effectiveness of music-based cognitive rehabilitation for adults with chronic acquired brain injury. METHODS: The control group participated in three Attention Process Training (APT) sessions, while the experimental group participated in three Music Attention Control Training (MACT) sessions. Pre-and post- testing used the Trail Making A & B, Digit Symbol, and Brown-Peterson Task as neuropsychological tests. RESULTS: ANOVA analyses showed no significant difference between groups for Trail A Test, Digit Symbol, and Brown-Peterson Task. Trail B showed significant differences at post-test favouring MACT over APT. The mean difference time between pre-and post-tests for the Trail B Test was also significantly different between APT and MACT in favour of MACT using a two-sample t-test as well as a follow-up nonparametric Mann Whitney U-test. CONCLUSIONS: The group differences found in the Trail B tests provided preliminary evidence for the efficacy of MACT to arouse and engage attention in adults with acquired brain injury.

Is a structured work task application for the assessment of work performance in a constructed environment, useful for patients with attention deficits?

BACKGROUND: The purpose of our study was to develop a Structured Work Task application for the Assessment of Work Performance for patients with attention deficits. MATERIAL AND METHODS: We developed a computer-based registration task titled the Attention-demanding Registration Task. It had a structured administrative procedure with additional scoring regarding time and accuracy, also linked to the original scoring of the Assessment of Work Performance. We evaluated the Attention-demanding Registration Task for content validity. Furthermore, we investigated it concerning sensitivity and specificity in patients with attention deficits due to acquired brain injury (n = 65) against a comparison group of healthy people (n = 47). RESULTS: Our investigation on content validity using the Assessment of Work Characteristics confirmed that the Attention-demanding Registration Task sets high demands on process skills, especially on energy, temporal organization, and adaptation. The Attention-demanding Registration Task showed high sensitivity and specificity in differing between patients with attention deficits and a healthy working group; nine out of ten participants were placed in the correct group. CONCLUSIONS: To assess work performance, the use of a Structured Work Task application, the Attention-demanding Registration Task, linked with the Assessment of Work Performance, proved to be sensitive to attention deficits.Implications for rehabilitationA Structured Work Task application for the Assessment of Work Performance was developed for use in people with attention deficits and showing a high degree of sensitivity and specificity.Linking performance time and accuracy to the Assessment of Work Performance scoring and providing a guide for linking task performance to the Assessment of Work Performance skills in addition to the usual observations performed, may increase scoring accuracy.Reference data for a comparison group of healthy subjects are provided.The use of the Attention demanding Registration Task, while using the Assessment of Work Performance within clinical practice ensures a more accurate description of process skills in performance.

The effects of adapted physical exercise during rehabilitation in patients with traumatic brain injury.

OBJECTIVES: This study aims to investigate the effects of adapted physical exercise on the level of muscular ability and attention process in patients with traumatic brain injury (TBI). PATIENTS AND METHODS: Between September 2018 and November 2018, a total of 25 male patients with TBI (mean age: 41.1±9.7 years; range, 30 to 50 years) that occurred two years ago were included in this randomized-controlled study. The patients were divided into two groups as the experimental group (n=13) and the control group (n=12). The experimental group implemented a regular rehabilitation program and an additional program of adapted physical exercise. The control group implemented only a regular rehabilitation program (morning gymnastics and gymnastics for the brain). Motor and functional abilities were assessed by a Senior Fitness battery and Berg's balance scale. Attention process was assessed by a standardized d2 test. RESULTS: A significant improvement in physical abilities (strength, flexibility and balance) and attention process was observed in both groups (p<0.01). The improvement was greater in the experimental group (p<0.01). CONCLUSION: Traumatic brain injury causes difficulties in the memory and executive functions of the body and impairs working ability. The short-term adapted physical exercise program can yield a positive change in working abilities of patients with TBI.

Neural mechanism of attention control in long-term preksha meditation.

Meditation is a complex mental process-practiced widely for stress management and promotion of health- exerts beneficial effects on physical and mental health, and cognitive performance. However, until now, few theoretical neural mechanisms of meditation had been proposed, still not completely elucidated. We have previously evaluated the brain activity during Preksha meditation using an innovative 18FDG-PET methodological approach. Based on our previous study observations, we proposed here the neurophysiological framework of long-term and regular practice of preksha meditation. This mechanism will provide the scientific evidence to understand the attention control mechanisms resulting from the advanced state of preksha meditation. This might have multiple clinical applications as well as effective in a healthy population for attention-related tasks. Also, it is expected that the present neural model will provide a scientific platform for future clinical studies of meditation.

Daily management of attention dysfunction two-four years after brain injury and early cognitive rehabilitation with attention process training: a qualitative study.

The evaluation of intensive cognitive training is usually based on neuropsychological tests and questionnaires. A study of the subjective experience of cognitive training would provide another type of valuable information concerning the effects of rehabilitation. We used grounded theory methods to explore the experience and management of attention dysfunction in daily life two-four years after brain injury. Data were collected by in-depth interviews of 14 adults with moderate-to-mild attention dysfunction after stroke or traumatic brain injury, and working part time or full time at the time of the interviews. The group received 20 hours of attention process training within the context of multidisciplinary rehabilitation early after brain injury. Data were analysed by open coding with constant comparison. The management of attention dysfunction was described by the informants as a dynamic process where strategies are continuously refined and flexibly adjusted as awareness and metacognitive knowledge increases. This process is regulated by situation-dependent factors. Attention process training might provide a suitable starting point for the identification of problem areas, improved specific goalsetting and stimulated self-training. The model describes the dynamic nature of the process, the ongoing struggle, self-training and search for feedback.

Memorias del Simposio de Salubristas del Caribe y las Américas / Memories of the Caribbean and America Public Health Symposium i: en

El Simposio de Salubristas del Caribe y las Américas presentó 3 ediciones (2017, 2018 y 2019) y estuvo auspiciado por la Sociedad Cubana de Salud Pública, el Capítulo Provincial de Salud Pública, la Dirección Provincial de Salud, la Universidad de Ciencias Médicas, el Consejo Provincial de Sociedades Científicas de la Salud, el Policlínico Docente Camilo Torres Restrepo, así como la Asociación Nacional de Economistas y Contadores. Conjuntamente con este evento se desarrollaron los talleres de ética y valores y de Economía de la Salud. En la tercera edición se celebró también la Jornada de residentes en Medicina General Integral. Se intercambiaron experiencias, que en el marco de la proyección salubrista, han tenido impacto en las esferas económica, social y científica. Por su importancia y acuerdo de los presentes, las conclusiones tomadas en sesión plenaria fueron enviadas a los decisores provinciales para contribuir a mejorar la calidad de los procesos atencionales, docentes e investigativos.

The Caribbean and America Public Health Symposium presented 3 editions (2017, 2018 and 2019) and was sponsored by the Cuban Society of Public Health, the Provincial Chapter of Public Health, Health Provincial Management, the University of Medical Sciences, the Provincial Council of Health Scientific Societies, Camilo Torres Restrepo Teaching Polyclinic, as well as the National Association of Economists and Accountants. Along with this event Ethics and Values and Health Economy workshops were developed. In the third edition the Day of residents in Comprehensive General Medicine also took place. Experiences were exchanged that in the mark of the public health projection, have had impact in the economic, social and scientific spheres. Due to its importance and agreement of the present people, the conclusions taken in plenary session were sent to the provincial decision makers to contribute in the improvement of quality in the care giving, teaching and investigative processes.

Diseño de procesos para reducir tiempo en lista de espera traumatológica no garantizada, Hospital público Chileno / Design processes to reduce time in under guaranteed traumatological waiting list, Chilean Public Hospital

Resumen: resolver el alto tiempo de espera de las consultas de especialidad en un Hospital público, desde el momento de solicitud de interconsulta, hasta la resolución de ésta tienen directa relación con la satisfacción de los usuarios. Se rediseñaron los procesos administrativos en el departamento de gestión del usuario para reducir el tiempo de permanencia de los usuarios en la lista de espera de especialidad traumatológica no garantizada. Para ello se identificaron los nudos críticos del proceso administrativo y mediante metodología de rediseño de procesos se logró una propuesta que implicó la definición de diagramas de flujo para reducir el tiempo de espera entre las distintas etapas del proceso, lo que fue coherente con los objetivos sanitarios 2011-2020 y los compromisos de gestión definidos para la disminución de tiempos de espera para consultas de especialidad e intervenciones quirúrgicas.

Abstract: resolving the high waiting time of the specialist consultations in a public hospital, from the time an application for consultation is entered until the resolution of this one is in direct relation with the user dissatisfaction. This reality was faced by redesigning the administrative processes in the user management department to reduce the time of permanence of the users in the waiting list of non-guaranteed traumatological specialty. To this end, the critical nodes of the administrative process were identified to achieve a redesign proposal, through a process redesign methodology. This involved the design of flow diagrams that allowed the waiting time to be reduced between the different stages of the process was consistent with the health objectives 2011-2020 and the management commitments defined for the reduction of waiting times for specialist consultations and surgical interventions.

Aplicación del proceso de atención de enfermería por estudiantes, un estudio desde la experiencia vivida / Nursing attention process application by students, a study from the lived experience / Aplicação do processo de atenção de enfermagem pelos estudantes, um estudo desde a experiência vivida

El proceso de atención de enfermería es un método que promueve la asistencia reflexiva, individualizada y dirigida a los resultados. Su uso en contextos educativos se asocia al fomento del desarrollo profesional, sobre todo si se acompaña por teorías disciplinares y la guía docente. Sin embargo, en Costa Rica no se sabe con seguridad cómo se aplica, pues no hay suficientes estudios del tema. Con el fin de aportar información a este marco de referencia se efectuó una investigación que tuvo las siguientes características. Objetivos: Determinar el sentido otorgado por estudiantes de enfermería de la Universidad de Costa Rica a la aplicación del método, así como distinguir la manera de cómo lo empleaban. Método: Se realizó un estudio cualitativo fenomenológico en el que se analizaron documentos y entrevistas de una muestra de estudiantes que cursaban el 5.o año de la Licenciatura en Enfermería, en el 2014. Resultados: En la narrativa, el sentido del fenómeno se estableció con base en tres categorías: conocimientos, experiencias y enseñanzas. En los documentos, se evidenció variación del uso del proceso de enfermería en todas las fases y mediante ambas técnicas, se identificaron limitantes de uso de carácter conceptual, docente y laboral. Conclusiones: Con esta investigación se pudo comprender el significado de las vivencias de la aplicación, así como modo y dificultades de hacerlo. Aun así se considera imprescindible incorporar líneas formales de indagación que continúen explorando el fenómeno en Costa Rica.

The nursing attention process is a method which promotes the reflexive, individualized and results-oriented assistance. Its application in educational contexts is linked to the advancement of the professional development, in particular, if this process is accompanied by discipline-related theories and teaching guides. Nevertheless, in Costa Rica, it is not known with certainty, how this process is applied because there aren't enough studies on the topic. With the aim of providing information to this reference frame, an investigation was conducted with the following characteristics. Objectives: To determine the sense given by University of Costa Rica students to the application of this nursing method, and also to distinguish the forms in which these students particularly applied it. Method: A qualitative and phenomenological study was used to analyze documents and interviews on a sample of students enrolled into the 5 th year of the Nursing Baccalaureate Program en 2014. Results: Regarding narrative, the sense of the phenomenon was established on the base of three categories: knowledge, experiences, and teachings. In relation to the documents, variations in the use of the nursing process were found in all phases, and conceptual-related, teaching-related, and working-related limitations were also identified. Conclusions: As a result of this study, it was possible to understand the meaning of the lived experiences related to the application of this nursing process including the difficulties to enact it. Therefore, it is considered necessary to continue the efforts on the exploration and investigation of this phenomenon in Costa Rica.

O processo de atenção de enfermagem é um método que promove a assistência reflexiva, individualizada e dirigida aos resultados. Seu uso em contextos educativos associa-se ao fomento de desenvolvimento profissional, sobre tudo si se acompanhar por teorias disciplinares e a guia docente. Porém, na Costa Rica não se sabe com seguranca como se aplica, pois não tem suficientes estudos do tema. Com o fim de aportar informacão para este marco de referência efetuou-se uma pesquisa que teve as seguintes características. Objetivos: Determinar o sentido concedido pelos estudantes de enfermagem da Universidade de Costa Rica à aplicação do método, assim como, distinguir a forma que o empregavam. Método: Realizou-se um estudo qualitativo fenomenológico onde se analisaram documentos e entrevistas de uma amostra de estudantes que cursavam o 5.o ano da Licenciatura em Enfermagem, em 2014. Resultados: Na narrativa, o sentido do fenômeno estabeleceu-se com base em 3 categorias: conhecimentos, experiências e ensinos. Nos documentos, evidenciou-se variação do uso do processo enfermeiro em todas as fases e mediante ambas as técnicas, identificaram-se limitantes de uso de caráter conceitual, docente e laboral. Conclusões: Com esta pesquisa conseguiu-se compreender o significado das vivencias da aplicação, assim como o modo e as dificuldades de fazê-lo. Ainda assim considera-se imprescindível incorporar linhas formais de indagação que continuem explorando o fenômeno na Costa Rica.

Evaluation of the short-term executive plus intervention for executive dysfunction after traumatic brain injury: a randomized controlled trial with minimization.

OBJECTIVE: To determine whether the Short-Term Executive Plus (STEP) cognitive rehabilitation program improves executive dysfunction after traumatic brain injury (TBI). DESIGN: Randomized, waitlist controlled trial with minimization and blinded outcome assessment. SETTING: Community. PARTICIPANTS: Participants with TBI and executive dysfunction (N=98; TBI severity 50% moderate/severe; mean time since injury ± SD, 12±14y; mean age ± SD, 45±14y; 62% women; 76% white). INTERVENTION: STEP program: 12 weeks (9h/wk) of group training in problem solving and emotional regulation and individual sessions of attention and compensatory strategies training. MAIN OUTCOME MEASURES: Factor analysis was used to create a composite executive function measure using the Problem Solving Inventory, Frontal Systems Behavior Scale, Behavioral Assessment of the Dysexecutive Syndrome, and Self-Awareness of Deficits Interview. Emotional regulation was assessed with the Difficulties in Emotion Regulation Scale. The primary attention measure was the Attention Rating and Monitoring Scale. Secondary measures included neuropsychological measures of executive function, attention, and memory and measures of affective distress, self-efficacy, social participation, and quality of life. RESULTS: Intention-to-treat mixed-effects analyses revealed significant treatment effects for the composite executive function measure (P=.008) and the Frontal Systems Behavior Scale (P=.049) and Problem Solving Inventory (P=.016). We found no between-group differences on the neuropsychological measures or on measures of attention, emotional regulation, self-awareness, affective distress, self-efficacy, participation, or quality of life. CONCLUSIONS: The STEP program is efficacious in improving self-reported post-TBI executive function and problem solving. Further research is needed to identify the roles of the different components of the intervention and its effectiveness with different TBI populations.

Proceso de atención de Enfermería a pacientes con gangrena de Fournier / Nursing attention process in a Fournier gangrene patient

La gangrena de Fournier es un complejo no muy común y potencialmente letal descrito por Baurienne en 1764, y posteriormente por A. L. Fournier en 1883, como un proceso gangrenoso de causa desconocida; ha adoptado varios nombres como: gangrena idiopàtica, erisipela gangrenosa y gangrena estreptocócica del escroto. Es una patología que ha sido descrita en hombres y mujeres, con alta morbimortalidad especialmente entre los pacientes de 40 a 70 años, que tienen factores predisponentes como (diabetes mellitus y alcoholismo crónico), su incidencia es de 1 en 7,500 casos. Se caracteriza por el inicio abrupto de una infección necrotizante de los tejidos blandos de la región genital y perirectal, progresiva, que compromete tejidos circundantes. El personal de Enfermería en el desarrollo de su función asistencial y en búsqueda de resolver las necesidades humanas de los pacientes, emplean una metodología propia como el Proceso Atención de Enfermería (PAE) y la implementación del Plan de Cuidados de Enfermería (PLACE), como método sistemàtico y organizado para brindar cuidado individualizado y holístico, este proporciona una directriz en el cual se utilizan las competencias, el conocimiento y habilidades. El objetivo fue identificar las necesidades humanas afectadas de un paciente con gangrena de Fournier a través de la valoración de los patrones funcionales, y mejorar la calidad del cuidado empleando la taxonomía NANDA, NOC , NIC.

Fournier gangrene is a complex, not common, but potentially fatal necrotizing infection which was first described by Baurienne in 1764, and later by J. A. Fournier in 1883 as a gangrenous process of unknown etiology. It has been named also as idiopathic gangrene, gangrenous erysipelas, and scrotum streptococcal gangrene. It is both a male and female pathology with a high mortality rate, especially among patients over 40 years old with predisposing factors such as diabetes mellitus and chronic alcoholism. Its incidence is 1 in 7 500 cases. It is characterized by a sudden necrotizing infection of the soft tissues of the genital and perirectal areas, which progressively compromises other surrounding tissues. The nursing staff in the development of their caring role and solve human needs of patients have a right to use a proprietary methodology as the Nursing Care Process (SAP), and the implementation of the Nursing Care Plan (PLACE by its Spanish initials), as organized, systematic approach to provide individualized, holistic care, this provides a guideline that uses the skills, knowledge and abilities. Objective: To identify human needs of a patient affected with Fournier's gangrene through the assessment of functional patterns and improve the quality of care using the taxonomy NANDA, NOC, NIC.

Estudio de caso a una adolescente con dependencia en la necesidad de seguridad y protección, por deficiencia de proteína C / Case Study on a teenage over-dependent on security and protection due to protein "C" deficiency

Los problemas de salud de la población infantil constituyen un reto diario para otorgar los cuidados especializados de enfermería conforme a las particularidades biológicas, psicológicas y sociales de este grupo de edad. Para afrontarlo es preciso tener conocimiento de los diferentes factores que influyen en el proceso salud-enfermedad, así como compartir con el gremio las acciones que enfermería implementa para cubrir las demandas específicas de atención. Objetivo: Dar a conocer el estudio de caso, de una adolescente femenina con deficiencia de proteína "C" con dependencia en la necesidad de seguridad y protección. Metodología: Se utilizó el Proceso Atención de Enfermería, orientado con la propuesta filosófica de Virginia Henderson, la recolección de la información se realizó mediante fuentes primarias y secundarias, se realizaron valoraciones focalizadas obteniéndose 15 diagnósticos enfermeros de los cuales 5 están en dependencia, 5 en riesgo y 5 en independencia; la realización de los mismos se hizo apoyándose en la taxonomía de la NANDA versión 2009-2011 y en el formato PES. Se detectó el grado y nivel de dependencia de acuerdo a la escala propuesta por Margot Phaneuf, y se planearon las estrategias a realizar para que ella alcanzara su independencia. Resultados: Con las intervenciones que se propusieron en el plan así como las acciones de enfermería se logró que la paciente y su cuidador primario (mamá) identificaran como enfrentar los problemas principales derivados de la pérdida de la visión y el embolismo de tal forma que se evitaron complicaciones futuras. Cabe mencionar que la participación del cuidador primario fue fundamental para mejorar el nivel de dependencia de las necesidades alteradas.

Objective: divulge the study case of a female adolescent with protein "C" deficiency and over-dependency to security and protection. Methodology: The Virginia Henderson philosophy oriented Nursing Attention Process was used. Data were collected from primary and secondary sources. Based on the NANDA 2009-2011 and the PES format, fifteen nurse assessments were made; 5 turned out to be; in dependence, 5; in risk, and 5; in independence. The degree and level of dependency was assessed according to the Margot Phaneuf proposed scale. Strategies to help the adolescent reach her independence were planned. Results: From the proposed interventions and the nursing actions, the patient and her primary care supporter (her mother) identified how to face the principal problems derived from the loss of vision and embolism, and thus future complications were avoided. The primary health supporter role was fundamental to improve the patient's dependency level.

Reflexiones interacadémicas sobre el proceso de atención de enfermería / Inter-academical reflexions on the nursing process

El desarrollo de actividades interacadémicas en espacios de investigación sin lugar a dudas reporta la posibilidad de un intercambio de visiones sobre la disciplina y una experiencia en pro de la cultura de la Inter-multidisciplina. En el marco de la Unidad de Investigación la ENEO-UNAM, ha instituido los jueves académicos, escenario donde se diserta sobre temas relevantes para el cuidado a la salud, tal fue el caso del Proceso de Atención de Enfermería (PAE). En una jornada de cuatro sesiones se abordó por representantes de las diversas Academias de Enfermería e Investigadores en el tema, los diferentes escenarios en los que se evidencia el proceso, así como la problemática y forma de aproximarse al PAE. De dicha actividad se reconocieron tres aspectos nodales en torno al PAE a saber: Aspectos semánticos-nominales, los Teóricos conceptuales y los Instrumentales; todos de gran trascendencia e impostergable abordaje. Lo anterior inserto en una visión filosófica sobre el cuidado a partir de la aprehensión de persona y naturaleza, que lleven a considerar el verdadero humanismo con que se ha investido a la profesión de enfermería.

The development of interacademic activities in investigation spaces without doubt reports the possibility of an interchange of visions on the discipline and a experience for the culture of the Inter-discipline. Within the framework of the Unit of Investigation the ENEO-UNAM, has instituted academic thursdays, scene where dissert on excellent subjects for the care to the health, so was the case of the Nursing Process Attention (PAE by abbreviations in for Spanish) . In cycle of four sessions one approached by representatives of the diverse Academies of Nursing and Investigators in the subject, the different scenes in which the process is demonstrated, as well at the problematic and forms to come near to the PAE. We´re acknowledge of this activity, three aspects around the PAE : Aspects semantic-nominal, the conceptual theoreticians and Instrumentation; all of great importance and urgent boarding. All inserted in a philosophical vision on the care from the apprehension of person and the nature, who take to consider the true humanist whereupon she has been invested to the Nursing profession.