Caregiver overload exhausts the person both emotionally and physically, where both negative aspects are perceived that affect their health, therefore, the objective of the study is to determine the level of caregiver overload of patients diagnosed with stroke in a specialized hospital institution in Metropolitan Lima. It is a descriptive, quantitative, cross-sectional study, with a population of 100 family caregivers, who answered a questionnaire of sociodemographic aspects and the Zarit instrument. In their results, 22% (n=22) have an absence of overload, 25% (n=25) light overload and 53% (n=53) intense overload. In conclusion, support systems for family members and caregivers of stroke patients should be strengthened.

By Lucia Asencios-Trujillo, Lida Asencios-Trujillo, Carlos La Rosa-Longobardi, Djamila Gallegos-Espinoza, Livia Piñas-Rivera

The history of the formation of professional competencies in the Bachelor's Degree in Nursing in Cuba is an exciting area of study. However, it is challenging to summarize in a limited space the historical evolution of this topic. The main objective of this study is to describe the process of formation of professional competencies in the Bachelor's Degree in Nursing. To achieve this objective, we carried out an exhaustive documentary and bibliographic review related to the topic, in addition to conducting interviews with professors prominent in the training of nursing professionals. Throughout the paper, the historical evolution of the formation of professional competencies in the Nursing career is presented. It is concluded that professional training in nursing requires both a theoretical and practical construction of the training process. In addition, it must be sensitive to the demands imposed by current social and economic policies. In this context, the commitment to integrate content related to professional competencies in the Bachelor's Degree in Nursing programs, with a focus on patient safety, is highlighted. The training of nurses is oriented towards the maintenance and recovery of health, the prevention of diseases and the rehabilitation of people with sequelae. These approaches will guide the content developed in the curriculum that prepares students to manage patient safety in acute care. In addition, the authors analyze how this training process is congruently adapted to the care model developed in health services.

By Reudis Durán Rodríguez, Raúl Hernández Heredia, Irayma Cazull Imbert, Rosilé Obret Orphee

The main objective of this research is to determine the impact of job performance on workers in textile companies in northern Lima in 2023. The methodology used in the study is basic, with a qualitative approach, non-experimental design and descriptive scope. Two instruments have been used for data collection, the semi-structured interview, which was applied to a group of collaborators who carry out their activities in the production area in three different companies and the documentary analysis, which helped us gather the necessary information, based on studies by other authors that are related to our variable, categories and subcategories. All the information collected has contributed to reach the conclusion that the impact of work performance on workers is favourable, since this directly influences their final performance and the fulfilment of the established goal, allowing them to obtain the monetary and non-monetary incentives provided by the company in which they work. Likewise, the final result is benefits for companies, since by having committed collaborators, thanks to the fact that they feel that their work is well paid, they have the necessary skills and have a leader who always keeps them motivated, they will improve their productivity and the achievement of objectives set as an organization will be much easier to achieve.

By Katherin Janet Tafur Lobato, Delina Lilibeth Rojas Pita, Gustavo Ernesto Zarate Ruiz, Brian Andree Meneses Claudio

Under normal atmospheric conditions, the individual has an optimal state of health, but these conditions alter their physiology and can cause damage to health. Hence, sudden changes in atmospheric pressure generate hearing manifestations and/or injuries because the pressure inside the ear must be equal to that outside. The objective of this study was to determine the prevalence of hearing injuries caused by sudden changes in atmospheric pressure in air and water survival training instructors, during the period 2012-2022. Epidemiological, descriptive cross-sectional research. To collect the information, a documentary review of the clinical records and the work plan was carried out. The population and sample were made up of the 20 instructors of the Department of Physiological Training (DAF). Results: the male sex predominated (85%), the average age and seniority were 36 ± 4.68 and 12 ± 6.59 years respectively, with a work exposure of 6 hours per week. In addition, 15 cases of hearing loss and 01 case of decompression illness with hearing injury were diagnosed, a prevalence of 0,8 cases per year, which indicates that one instructor annually suffers from hearing injury due to Barotrauma. This is why the main prevention measure is in the organization of work, limiting the number and duration of dives. Therefore, it is recommended to implement a hearing conservation program and comply with the morbidity registry of occupational diseases and accidents of the DAF instructor staff related to changes in atmospheric pressure.

By Elisa Leon, Carmen Rodriguez, María Del Carmen Martínez, Misael Ron

Introduction: bibliometric studies allow us to assess the current state of research, the contributions of authors and countries in the fields of knowledge. An investigation was carried out with the objective of describing the visibility and impact of scientific production on health policies published in Scopus.
Method: a bibliometric study of the subject was carried out in Scopus, from 2018 to 2022, variables such as total documents, number of citations, authors, most productive journals and countries, Field-Weighted Citation Impact, Quartile of journals, were analyzed. Source Normalized Impact per Paper, CiteScore, SCImago Journal Rank.
Results: the highest number of articles was found in 2022 (n=30553), the highest number of citations in 2018 (n=277749) with a weighted citation impact index per field of 1,04; 10,9 was the highest annual average number of citations per article. More than half of the articles were in journals of the first and second quartile. Among the main keywords were COVID-19, primary care, health care, health policies, health insurance. The United States stands out as the country with the most productive institutions with 6 of the top 10, with an FWCI of 2,14, the University of Oxford stands out. The BMJ Global Health magazine had a SNIP of 2,164 and an SJR of 2,376.
Conclusions: scientific production is abundant, the analysis of bibliometric indicators shows that a large part of the research is found in high-impact journals; with high levels of productivity and quality of your documents.

By Javier Gonzalez-Argote

The objective of this research is to determine the relationship between leadership styles and the organizational climate of employees in the retail sector, with a quantitative approach and a correlational scope, 81 employees were sampled, using the statistical formula of finite population sampling, obtained from a population of 100 employees in the retail sector, the data were collected using the Likert scale. Likewise, 2 measurement instruments were used, one for each variable, for the Organizational Climate variable the Evaluation of Organizational Climate in Health (ECOS-S) was used, for the Leadership variable and its dimensions the questionnaire of description of the leader's behavior was used (L. B.D.Q. - Form XII), for data analysis processing the SPSS statistical package was used, with which the reliability statistics of the leadership instrument was taken and gave as a result a Cronbach's Alpha = .966, and for the climate instrument a Cronbach's Alpha = .983. The correlational result for general leadership and organizational climate showed that there is a significant relationship between the two variables with Rho .603, thus taking the alternate hypothesis and rejecting the null hypothesis, for the dimension Laissez Faire leadership and organizational climate the correlational result is Rho = . 625 indicates that the relationship is also significant, for the dimension Autocratic Leadership and organizational climate the correlational result is Rho = .568 which is also significant, the third dimension Transformational Leadership and Organizational Climate the correlational result is Rho = .729 which is also significant. Therefore, it is concluded that there is a significant relationship between leadership styles and organizational climate among employees in Metropolitan Lima in the retail sector in the year 2023.

By Jose Christopher Chávez Cantaro, Juan De La Cruz Huamani Tello, Gustavo Ernesto Zarate Ruiz, Brian Andree Meneses Claudio

The present study focuses on the evaluation of the satisfaction of users and subjects of care in a hospital service. A simple cross-sectional descriptive research design was used and data were collected through a questionnaire with 15 questions addressing dimensions such as empathy, responsibility, technical capacity, communication and tangible goods. The results show that the majority of respondents are satisfied with the service, with no significant differences according to sociodemographic variables. However, lower satisfaction is observed among accompanying persons in the dimensions of responsibility and tangible goods. It is concluded that satisfaction is high in several dimensions of nursing care, but a lack of tangible resources is noted due to the shortage of personnel during data collection. It is recommended that similar studies be conducted in other hospitals to obtain a more complete representation of the perception of nursing care in different hospital settings.

By Horacio Alen, Daniel Ernesto Gutiérrez Raina

Introduction: Skin-to-skin contact (COPAP) on the maternal thorax allows the preterm newborn to experience tactile, auditory, and proprioceptive stimuli, heart rate, the sound of the flow of the great vessels and maternal caresses while being held; this stimulates the self-regulation necessary for the survival of these infants.
Aim: to describe the experiences in the implementation of a protocol of family integration and skin-to-skin contact with the newborn in order to favor the recovery of the patient hospitalized.
Methods: A non-experimental, analytical study was carried out in health systems and services. The study alternatively used secondary source data from technical documentation of the sector and statistical records of the service.
Results: Regarding the characteristics of the puerperal women who participated in the skin-to-skin contact protocol, those aged between 25 and 30 years predominated, with an interperiod growth of 21.9%. The most frequent pathologies were Severe Eclampsia and Pre-Eclampsia; only 4 pathologies were found with negative growth. Finally, according to the distribution of RN admission according to the mother's hospitalization day, we found a growth in hospitalizations longer than 4 days, and a decrease in those that were 3 days, this indicator remained in general with growth.
Conclusions: It can be affirmed that skin-to-skin contact is a recommended, beneficial, and safe practice. The availability of a protocol agreed upon by the services involved makes it possible to apply it as a routine care procedure.

By Mariela Quintana-Honores, Paola Corvalán, Johanna Gironda-Durán

Self-medication is defined as the use of medicinal products on own account or on the recommendation of other persons outside the medical profession. This practice is quite common, and adolescents are a vulnerable group to the effects that it can cause. Material and methods: A descriptive and retrospective cross-sectional observational study was conducted. The sample included schooled adolescents, of both sexes, between 15 and 18 years who attended 4th, 5th and 6th year of secondary school (EES Nº7, EES Nº1 Manuel Dorrego, EES Nº9 (Normal), EES N19, EESA Nº1 "Florencio Molina Campos") in establishments in the city of Junín, Province of Buenos aires. The data collection tool was a voluntary, anonymous, multiple-choice survey open through a Google form. The data was captured and interpreted in tables and graphs in Excel. Results: This work determined that 72.9% (84) of the adolescents enrolled in school engage in the practice of self-medication, therefore 20.8% (22) did not. 86.9% (73) of the adolescents who self-medicated did so for headache, 56% (47) for fever, 50% (42) for sore throat. 86.9% (73) of the adolescents studied consumed ibuprofen, being the most chosen according to their answers. Second, paracetamol is found at 81% (68. The 63.1% (53) responded that they did not know the risk of the drugs they consumed, 23.8% (20) indicated that they had little knowledge about it, while 13.1% (11) responded that they did. Conclusion: It can be concluded from the previously presented information that most of the adolescents surveyed do not make a responsible use of drugs and have biases for a correct decision making when addressing their medical problem. From a very early age it can be seen that adolescents have been implementing the practice of them. When practiced with such prematurity, they may incur unknown risks by not knowing the specific uses of medicines and consequently obtain a counterproductive result when using them.

By Lucia Micaela Vargas, Aníbal Danilo Farias

Objective: The objective of this research was to determine the thermal stress conditions generated by low temperatures in the refrigerated warehouses of a plant in Venezuela; it was carried out between 2022 and 2023.
Methods: it was carried out within the positivist paradigm, quantitative approach, under a field study, observational design, descriptive level and cross-sectional. The population was made up of 13 workers who worked the day shift, being the census sample. Environmental parameters such as temperature, humidity and air speed were measured in different areas, using calibrated instruments. With the data obtained, the localized cooling index was calculated and the metabolic load was evaluated by observing the tasks, as well as the thermal insulation of the workers' clothing.
Results: the sample studied had an average age of over 50 years and a work experience of over 8 years; 35 % of the sample reported a cardiovascular history. Most of the jobs had thermal comfort conditions according to the WCI; 15.38 % of the workers felt cold; where a potential risk was identified in one of the workplaces due to excessive air speed and in another due to insufficient thermal insulation of clothing.
Conclusion: Therefore, it was concluded that it is necessary to complement the evaluation with medical checks for workers, due to the possible impact of prolonged exposure to cold on their health.

By María Medina-Reverón, Ariel Pérez-Galavís, Misael Ron, Mauro Páramo-Colmenares

Introduction: Work-life balance has a positive impact on work, family and quality of services. The aim of this study was to propose an intervention through workshops as a contribution to work-life balance as a determinant of the quality of stomatological services.
Methods: An intervention study was carried out using non-probability sampling based on selection criteria. The study universe included 10 female stomatologists, five female managers and their respective partners. The proposal was evaluated by experts and workshops were designed to integrate theoretical and practical knowledge, taking as a starting point the experiences of the participants, promoting reflection and collective transformation of the problems.
Results: The experts evaluated the proposal as applicable, feasible, generalizable, relevant, valid and original. Six conference sessions and 27 group discussion sessions were held, distributed in three workshops: workshop 1, focused on the action plan as a key factor for the transformation of the current state towards the desired state; workshop 2, focused on conciliation as a determining factor in the quality of stomatological services; and workshop 3, oriented to the systematic follow-up of the tasks of the action plan. The intervention evaluated and implemented allowed contributing to the reconciliation of work and family life through the incorporation of new knowledge and active participation in the processes of organizational change.

By Yamilé Rodríguez Sotomayor, Alfredo Pardo Fernández, Ileana Elena Castañeda Abascal, Héctor Manuel Verdecia Rodríguez

Resilience is a capacity for adaptation and coping that nursing students have during their pre-professional training period, therefore, the objective of the study is to determine the level of resilience in nursing students doing their pre-professional internship at a university in North Lima. It is a quantitative, descriptive, cross-sectional and non-experimental study, with a population of 80 nursing students, who completed a questionnaire of sociodemographic data and the Connor-Davidson resilience scale. In their results, 14% (n=11) of the students have low resilience, 21% (n=17) medium resilience and 65% (n=52) high resilience. In conclusion, it is necessary the implementation of psychoemotional support programs when students perform their pre-professional internships, since this allows the strengthening of well-being generates and thus strengthens their resilience.

By Lucia Asencios-Trujillo, Lida Asencios-Trujillo, Carlos La Rosa-Longobardi, Djamila Gallegos-Espinoza, Livia Piñas-Rivera

The main objective of this research work is to analyze the impact of transformational leadership in the companies belonging to the Association of traders in the shoe store sector of San Pedro de Icho - Caquetá, 2023. For this purpose, the impact of categories such as: idealized influence, inspirational motivation, intellectual stimulation and individual consideration has been identified. The research had a qualitative approach of basic type, which will be developed through a case study design, using semi-structured interviews through a questionnaire of open questions, this instrument allows obtaining data from the participants, who are 3 store managers and 3 collaborators who work within the Association of merchants. The results show that the managers and collaborators interviewed also have a clear opinion of what transformational leadership is, and can highlight that both the direct leaders and their followers feel that they are somehow heard and considered in the opinions that may arise at the time, in the same way that transformational leadership can be used to implement strategies that lead to improve the company to achieve objectives. It is concluded that the impact of transformational leadership is transcendental and positive in the companies located in the Association of traders in the area of shoe stores, since their own management of this type of leadership has led to the companies to last in time and be positioned in the market, in turn this has generated that their employees and customers are loyal to the company for the good quality of service and empathy that has with them, this finally affects the achievement of the objectives set.

By Ada Séfora Díaz Velasco, Fanny Luz Mamani Ccama, Brian Andree Meneses Claudio, Gustavo Ernesto Zarate Ruiz

Introduction: The paper discusses the historical evolution and importance of vaccines in public health. The key role of vaccines and drinking water in preventing infectious diseases since the 19th century is highlighted. It mentions how epidemics such as poliomyelitis in Argentina boosted vaccine research and development. In addition, the shared responsibility between scientists, vaccine developers and the population is emphasized, highlighting the importance of public health policies and awareness.
Methods: A qualitative study was conducted with a systematic review of scientific literature. Sources included data from WHO, the Argentine Ministry of Health, scientific papers, and surveys, with a focus on sociodemographic parameters and living conditions. The analysis focused on a historical-logical approach to interpret the data.
Results: The results show significant advances in the Argentine vaccination program, especially in the pediatric population. There was a notable reduction in the number of unvaccinated children from 2021 to 2022, and increases in DTP and HPV vaccine coverage. There was a historic decrease in the incidence of influenza and in the infant mortality rate since 1990. The measles outbreak in 2020 was associated with low vaccination coverage in 2019. During the COVID-19 pandemic, there was a low post-vaccination infection rate and zero deaths in fully vaccinated individuals. In addition, an increase in life expectancy since 1990 was noted.
Conclusions: Vaccines are fundamental in public health, evidenced by the improvement in vaccination coverage and the decrease in the prevalence of infectious diseases and infant mortality in Argentina. Awareness campaigns and public health policies have been crucial. However, misinformation remains a challenge. Global collaboration, such as that of WHO, is key to improving vaccination coverage and addressing emerging challenges such as COVID-19 and Ebola. Immunization remains an essential tool to prevent disease and save lives worldwide.

By Malena Garros, Agustín Leandro Rolando, Jesica Ponce, Sebastián Ovejero, Héctor Arnaldo Toranzos

Patient satisfaction has become a crucial indicator of quality of care, influencing treatment compliance and patient loyalty. Key factors, such as communication, empathy, and nursing staff safety, play an essential role in user satisfaction. Dimensions affecting user satisfaction include tangibility of facilities, reliability of care, and responsiveness. This article also examines the relationship between user satisfaction and socioeconomic variables such as gender, age, academic level, and length of hospitalization. It highlights the importance of collecting patient feedback through surveys and evaluations to identify areas for improvement and promote innovation in health care delivery. In summary, user satisfaction is a crucial indicator in modern health care that drives continuous improvement in the quality of care in Latin America and around the world.

By Horacio Alen, Daniel Ernesto Gutiérrez Raina

This paper explores ten hidden challenges in healthcare leadership and provides practical strategies to address them. These challenges include a lack of self-awareness, ineffective communication, empathy deficiency, resistance to change, delegation issues, overconfidence, accountability shortcomings, cognitive biases, time management problems, and issues related to pride and ego. Leaders in healthcare must first focus on self-awareness by regularly reflecting on their values and seeking honest feedback from colleagues. Effective communication skills are crucial, and leaders must convey information clearly, adapt to their audience, and foster open and honest communication. Empathy is essential for healthcare leaders, as it helps build strong relationships and fosters a collaborative work environment. Leaders should actively listen, show genuine interest in concerns, and seek to understand perspectives beyond differences of opinion. Resistance to change can limit growth, so leaders must adopt an open mindset, surround themselves with diverse perspectives, and be willing to learn and adapt. Delegation is crucial, and leaders should trust their team and assign tasks based on individual skills. Overconfidence can lead to poor decisions, so leaders must practice humility, consult with colleagues, and conduct reviews before important decisions. Accountability is essential, and leaders must acknowledge their responsibility and be transparent about their actions. Cognitive biases can influence decision-making, so leaders should develop emotional intelligence and awareness of their biases. Effective time management involves setting realistic goals and prioritizing tasks. Finally, pride and ego can hinder collaboration, so leaders must practice self-control and connect their leadership to a higher purpose. In conclusion, healthcare leaders must address these challenges to ensure quality healthcare and patient safety. By focusing on self-improvement and building collaborative teams, leaders can play a pivotal role in delivering quality healthcare and promoting patient well-being.

By Carlos Oscar Lepez