Background: Identifying effective methods for safeguarding the efficient functioning of the healthcare system contributes significantly towards establishing a successful healthcare organization. Consequently, quality management programs are currently being implemented in healthcare as a vital strategy for patient care. Quality management encompasses protocols and guidelines in decision-making and in the evaluation of processes and treatment flowcharts, data analysis and health indicators, and addresses improvement in the interaction between different health professionals. Qualifying health professionals to perform quality management has represented a barrier to implementing a well-structured management system. Indeed, the pathway to qualifying health managers is often poorly outlined, with clear gaps in the definition of their competencies, training and career plans. Therefore, studies and education-related actions aimed at qualifying health professionals in management are vital if health services of excellence are to be established. The present study aimed to plan, develop, implement and evaluate a management specialization course in oncology using blended learning. Methods: Following approval by the institution's internal review board, the study was conducted at the Instituto de Medicina Integral Prof. Fernando Figueira (IMIP). The Analysis, Design, Development, Implementation and Evaluation (ADDIE) model was used to plan, develop, implement and evaluate the course. Data were collected as the course participants who had concluded all the modules evaluated the program. Results: A management course in oncology, consisting of ten sequential modules, was developed and implemented between March 2018 and February 2019. The course consisted of monthly face-to-face encounters, each with 12 h of activities, and distance education using a virtual learning environment. Each module was presented by a specialist on the subject in question. After the end-of-course conclusion work had already been handed in and evaluated by the tutors, the participants completed a form to assess the course using Kirkpatrick's training evaluation model. Conclusions: A management course in oncology was developed using the ADDIE model. A high degree of satisfaction was found among the participants regarding improvements in their management skills and their professional behavior. The expectation is that this initiative will ultimately improve healthcare and reduce costs, as well as encourage further innovative educational actions for health professionals.

A double blind randomized clinical trial of sufentanil as an adjunct in spinal anesthesia for cesarean section and, thereby, be able to reduce the dose of bupivacaine, a local anesthetic, with the same result of an anesthetic block with higher doses but with fewer perioperative side effects, such as hypotension.

A double blind randomized clinical trial of sufentanil as an adjunct in spinal anesthesia for cesarean section and, thereby, be able to reduce the dose of bupivacaine, a local anesthetic, with the same result of an anesthetic block with higher doses but with fewer perioperative side effects, such as hypotension.

Objective: To evaluate the frequency of pressure injuries and associated factors in the older pacients with gastrointestinal cancer. Methods: Cross-sectional study of 212 individuals aged 60 years and older and diagnosed with untreated gastrointestinal cancer confirmed by histology, cytology or immunohistochemistry. Patients who had undergone previous cancer treatment, except surgical ones, were excluded. The variables studied were: pressure injury, nutritional status, weight loss in the three months prior to the assessment, functionality, level of physical activity, presence of comorbidities and laboratory variables. For media comparisons, Student's test and categorical variables or square test or Fisher's exact test were used. In the multivariate analysis using logistic regression, the Wald test was used to evaluate the independent effects of factors with p <0.20 and applied to the Hosmer-Lemesho test. Results: The frequency of LP was 68/212 (32.1%). In the multivariate analysis, variables that may remain associated with the presence of LP were: hypertension and cerebrovascular disease. The final model presents an adequate fit to the data (Hosmer-Lemeshow test (p = 0.736). Conclusion: these findings can guide future research and can serve as a guide in health care services decisions about the use of pressure injury prevention strategies.

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