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OBJECTIVE: To assess strengths and weaknesses of the methodology of health education programs, carried out in the period 2010-2020, in schools in Serbia. DESIGN: Qualitative study, a thematic analysis approach. SITE: Representatives of Public Health institutions, Serbian biggest nongovernmental organization, Youth organization, Ministry of education and municipality. PARTICIPANTS: Nine professionals working in the field of Public Health and Health education. METHOD: Focus group gathered nine health and non-health professionals in 2022 year. Focus group was recorded, transcribed verbatim, coded and analyzed by three research team members. A coding template evolved through the analysis, providing the expansion of key concepts. Themes were, one by one, extracted, encoded, classified as the smallest units and interpretive, thematic analysis was applied. RESULTS: Although the Focus group in our study identified among other advantages, support of Health sector to Educational sector as crucial, it emphasized as well following weaknesses: Analyzed health education programs were implemented insufficiently as a separate process in schools, did not have the image of programs shared and integrated into community; Health education needs of schoolchildren, parents, and teachers should be examined prior the education implementation; Well-educated interdisciplinary educators have to be strengthened and supported; Parents participation is necessity; Standards and good practice guidelines are needed, and those developed through Health Promoting Schools program could be practiced. CONCLUSION: It is necessary to support cross-curricular competence, where health education should be integrated into all school subjects, and should go far beyond the school, grow into a culture of community life, which will interconnect all stakeholders in strong Public Health network.

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Objective: to compare the number of planned oncotic smear tests and those actually performed in the city of Rio de Janeiro between the years 2013 and 2022 . Methods: using the female population of Rio de Janeiro, an estimate was made of how many tests should be carried out if screening recommended by the Ministry of Health was done in an ideal way and was subsequently compared with the number of tests available in the public database. Results: 1,364,325 were carried out in this period compared to an estimated 7,886,720. After adjustment for the use of supplementary healthcare, the pandemic and exams outside the recommended age, 36% of the ideal was observed. Conclusion: the quantity carried out is far below ideal, even after adjustments, which increases costs for the public health service, making new public policies necessary to improve tracking.

Objetivo: comparar el número de citologías oncóticas planificadas y las realizadas en la ciudad de Río de Janeiro entre los años 2013 y 2022 . Métodos: utilizando la población femenina de Río de Janeiro, se estimó cuántas pruebas se deberían realizar si se recomienda el tamizaje. realizado por el Ministerio de Salud se realizó de manera ideal y luego se comparó con la cantidad de pruebas disponibles en la base de datos pública. Resultados: En este periodo se realizaron 1.364.325 frente a una estimación de 7.886.720. Después del ajuste por el uso de asistencia sanitaria complementaria, la pandemia y los exámenes fuera de la edad recomendada, se observó el 36% del ideal. Conclusión: la cantidad realizada está muy por debajo de lo ideal, incluso después de ajustes, lo que aumenta los costos para el servicio público de salud, haciendo necesarias nuevas políticas públicas para mejorar el seguimiento.

Objetivo: comparar a quantidade de colpocitologias oncóticas ideias e a realmente realizadas no município do Rio de Janeiro entre os anos de 2013 e 2022. Métodos: através da população feminina do Rio de Janeiro, foi feita estimativa de quantos exames deveriam ser realizados caso o rastreio preconizado pelo Ministério da Saúde fosse feito de forma ideal e posteriormente foi comparado com a quantidade de exames disponíveis na base de dados pública. Resultados: foram realizados 1.364.325 nesse período comparado a 7.886.720 estimados. Após ajuste pelo uso de saúde suplementar, pandemia e exames fora da idade recomendada, observou-se 36% do ideal. Conclusão: a quantidade realizada está muito abaixo da ideal, mesmo após os ajustes, o que aumenta custos para o serviço de saúde pública, sendo necessárias novas políticas públicas para melhorar o rastreamento.

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INTRODUCTION AND OBJECTIVES: By 2022, 9 centers had been accredited by the Spanish Society of Cardiology for the atrial fibrillation (AF) process. Our objective was to evaluate the performance of these centers based on the quality indicators (QIs) proposed by the European Society of Cardiology (ESC) in 2020. METHODS: Adults with AF who were attended in the cardiology departments of participating centers during the second week of May 2019 were included in a retrospective registry (n = 797, age 72 ± 11 years, 60% male). Key ESC QIs were assessed. RESULTS: CHA2DS2-VASc, HAS-BLED scores, and serum creatinine levels were documented in 24.9%, 6.1%, and 96.2% of patients, respectively. Anticoagulation was appropriately prescribed in 90.6% of high-risk patients according to the CHA2DS2-VASc score, but was inappropriately prescribed in 57.8% of low-risk patients. Among all patients, 84.1% received high-quality anticoagulation. Inappropriate antiarrhythmic drugs were prescribed in 7.2% of patients with permanent AF, 2.9% of those with structural heart disease, and 0.0% of those with end-stage kidney disease. Catheter ablation was offered to 70% of patients with symptomatic paroxysmal or persistent AF after the failure or intolerance of 1 antiarrhythmic drug. All modifiable risk factors were documented in 59.3% of patients. Rates of all-cause mortality, ischemic stroke or transient ischemic attack, and major bleeding were 8.1, 0.8, and 2.56 per 100 patients/y, respectively. QIs for anticoagulation and outcomes were similar between general cardiology and tertiary referral centers. CONCLUSIONS: Although accredited centers in Spain demonstrated good performance in many of the ESC QIs for AF, there remains room for improvement. These data could serve as a starting point for enhancing the quality of care in this population.

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INTRODUCTION: We analysed the frequency of atrial fibrillation (AF) delayed diagnosis and the factors associated with it in newly diagnosed patients. METHODS: This was a descriptive, cross-sectional, multicentre study. Data were collected from newly diagnosed patients with AF through medical records review and interviews during cardiology, internal medicine, primary care and emergency department consultations in Spain. RESULTS: A total of 201 physicians participated in the study (64.2% cardiologists, 21.4% internists). 948 patients (58% men; mean age 72.8 years) were included. In 41.8% of patients, AF was classified as paroxysmal at diagnosis, 30.9% as persistent and 27.3% as permanent. The diagnosis was coincidental in 37%. It was considered that a delayed diagnosis occurred in 49.3% of patients. This delay was associated with the presence of permanent or persistent AF, older age or valvular disease. 74.8% of patients had some contact with the healthcare system in the preceding year. The diagnosis could have been established between 1 and 6 months earlier in 50.7% of cases and more than six months earlier in 20.1%. 54.4% of the patients had experienced AF compatible symptomatology previously. Of these, 32.6% had a consultation without a diagnosis. CONCLUSIONS: In a significant proportion of AF cases, there is a diagnostic delay. Many people with compatible symptoms neither seek consultations nor contact the healthcare system facilities. Consequently, the opportunity for early diagnosis is lost.

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Resumo O objetivo do artigo é avaliar a prevalência de adesão ao tratamento anti-hipertensivo na população brasileira, com base nos estudos revisados por pares, que utilizaram instrumentos elaborados e/ou adaptados exclusivamente para este fim. Revisão sistemática com meta-análise, baseada nas recomendações do Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A busca foi realizada nas bases BDENF, SciELO, Cuiden, PsycINFOe, CINAHL, Embase, LILACS, MEDLINE, e nos buscadores acadêmicos AgeLine, Google Scholar e ScienceDirect. O protocolo foi registrado no PROSPERO (CRD42021292689). Modelos de efeitos aleatórios foram usados para meta-análise das prevalências obtidas dos estudos individuais. Incluíram-se 104 estudos na meta-análise sobre tratamento anti-hipertensivo na população brasileira, totalizando 38.299 pacientes. O instrumento mais utilizado foi o teste de Morisky-Green de quatro itens (49,5%). A prevalência de adesão estimada pela foi de 44,4% (IC95%: 39,12%-49,94%, I2 = 91,17, p < 0,001), apresentando alta heterogeneidade. A prevalência de adesão ao tratamento anti-hipertensivo encontrada nos estudos nacionais foi insatisfatória, demonstrando que essa problemática continua sendo um grande desafio.

Abstract This article aims to evaluate the adherence to antihypertensive treatment prevalence in the Brazilian population based on peer-reviewed studies which used instruments exclusively designed and/or adapted for this purpose. A systematic review with meta-analysis based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was carried out in the BDENF, SciELO, Cuiden, PsycINFOe, CINAHL, Embase, LILACS, and MEDLINE databases, as well as the AgeLine, Google Scholar and ScienceDirect academic search engines. The protocol was registered with PROSPERO (CRD42021292689). Random effects models were used for a meta-analysis of the prevalence obtained from individual studies. A total of 104 studies were included in the meta-analysis on antihypertensive treatment in the Brazilian population, totaling 38,299 patients. The most used instrument was the four-item Morisky-Green Test (49.5%). The adherence prevalence estimated by the meta-analysis was 44.4% (95%CI: 39.12%-49.94%, I2 = 91.17, p < 0.001), showing high heterogeneity. The adherence to antihypertensive treatment prevalence found in national studies was unsatisfactory, demonstrating that this problem continues to be a major challenge.

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Los programas de estimulación temprana son intervenciones dirigidas a niños con trastornos del desarrollo, como lo es el autismo, estos buscan favorecer la adaptación e integración social, así como mejorar habilidades cognitivas, comunicativas y emocionales. Sin embargo, la pandemia del COVID-19 fue un gran desafío para la continuidad y la efectividad de estos programas, debido a las restricciones de movilidad, el cierre de centros educativos y sanitarios, y el aumento del estrés familiar. En este artículo se revisan los principales estudios que evaluaron el impacto de la pandemia en los programas de estimulación temprana para niños dentro del espectro autista y las estrategias para adaptarlos al contexto actual. Metodología: se realizó una revisión bibliográfica de estudios publicados entre 2020 y 2023 en Scopus, Web of Science, Scielo, Latindex y Google Scholar. Aplicando ecuaciones de búsqueda elaboradas con los descriptores y operadores booleanos: "programas de estimulación temprana", "trastorno del espectro autista", "pandemia COVID-19". Se seleccionaron 29 trabajos que cumplieron con los criterios de inclusión como el aborde de programas de estimulación temprana para niños dentro del espectro autista, producto de investigación empírica o teórica sobre el tema. Los resultados coinciden con los de otras investigaciones que han analizado la misma temática. Se concluye que la pandemia afectó negativamente tanto la calidad como la efectividad de los programas de estimulación temprana, elevando la vulnerabilidad de los niños y niñas con TEA, y que es necesario desarrollar e implementar medidas específicas para garantizar el acceso y la atención adecuada a este colectivo vulnerable.

Early stimulation programs are interventions aimed at children with developmental disorders, such as autism, which seek to promote adaptation and social integration, as well as improve cognitive, communicative and emotional skills. However, the COVID-19 pandemic was a great challenge for the continuity and effectiveness of these programs, due to mobility restrictions, the closure of educational and health centers, and increased family stress. This article reviews the main studies that evaluated the impact of the pandemic on early stimulation programs for children within the autism spectrum and the strategies to adapt them to the current context. Methodology: a bibliographic review of studies published between 2020 and 2023 in Scopus, Web of Science, Scielo, Latindex and Google Scholar was carried out. Applying search equations created with Boolean descriptors and operators: "early stimulation programs", "autism spectrum disorder", "COVID-19 pandemic". 29 works were selected that met the inclusion criteria such as addressing early stimulation programs for children within the autism spectrum, product of empirical or theoretical research on the topic. The results coincide with those of other investigations that have analyzed the same topic. It is concluded that the pandemic negatively affected both the quality and effectiveness of early stimulation programs, increasing the vulnerability of boys and girls with ASD, and that it is necessary to develop and implement specific measures to guarantee access and adequate care for this vulnerable group.

Os programas de estimulação precoce são intervenções dirigidas a crianças com perturbações do desenvolvimento, como o autismo, que procuram promover a adaptação e a integração social, bem como melhorar as competências cognitivas, comunicativas e emocionais. No entanto, a pandemia da COVID-19 representou um grande desafio para a continuidade e eficácia destes programas, devido às restrições de mobilidade, ao encerramento de centros educativos e de saúde e ao aumento do stress familiar. Este artigo revisa os principais estudos que avaliaram o impacto da pandemia nos programas de estimulação precoce para crianças do espectro do autismo e as estratégias para adaptá-los ao contexto atual. Metodologia: foi realizada uma revisão bibliográfica de estudos publicados entre 2020 e 2023 nas bases Scopus, Web of Science, Scielo, Latindex e Google Scholar. Aplicando equações de busca criadas com descritores e operadores booleanos: "programas de estimulação precoce", "transtorno do espectro do autismo", "pandemia de COVID-19". Foram selecionados 29 trabalhos que atenderam aos critérios de inclusão como abordar programas de estimulação precoce para crianças do espectro do autismo, produto de pesquisas empíricas ou teóricas sobre o tema. Os resultados coincidem com os de outras investigações que analisaram o mesmo tema. Conclui-se que a pandemia afetou negativamente tanto a qualidade como a eficácia dos programas de estimulação precoce, aumentando a vulnerabilidade de meninos e meninas com TEA, e que é necessário desenvolver e implementar medidas específicas para garantir o acesso e cuidados adequados a este grupo vulnerável.

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El presente estudio investigativo abordó el tema de la inclusión de las gestantes adolescentes en las clases de Educación Física, enfocado al mejoramiento de la salud física y el bienestar de la madre y el feto durante el embarazo. El objetivo principal del trabajo fue proponer un programa de actividades físicas adaptadas para la inclusión de estudiantes en estado de gestación en la clase de Educación Física, en la Unidad educativa fiscal "Pichincha". Se planteó una metodología con enfoque cualitativo, se utilizaron como métodos empíricos la observación científica, la entrevista, la encuesta y la revisión documental que facilitaron la identificación del problema en la parte inicial hasta la realización de la propuesta de ejercicios físicos adaptados, en su etapa final. Se concluye con la aplicación y ejecución de actividades físicas adaptadas, y se obtienen mejoras en la salud cardiovascular, el fortalecimiento de los músculos y las articulaciones, el control del aumento de peso, la reducción del riesgo de complicaciones del embarazo y la mejora del bienestar emocional. Estos resultados fueron comparados con investigaciones de otros autores que corroboran que implementar actividades físicas adaptadas contribuye al mejoramiento de la salud, tanto de la madre como del feto.

A presente pesquisa abordou a questão da inclusão de adolescentes grávidas nas aulas de Educação Física, com foco na melhoria da saúde física e do bem-estar da mãe e do feto durante a gravidez. O objetivo principal do trabalho foi propor um programa de atividades físicas adaptado para a inclusão de estudantes grávidas na aula de Educação Física, na unidade educacional fiscal "Pichincha". Foi proposta uma metodologia com abordagem qualitativa, foram utilizados observação científica, entrevista, levantamento e revisão documental como métodos empíricos que facilitaram a identificação do problema na parte inicial até a realização da proposta de exercícios físicos adaptados, em sua etapa final. . Conclui com a aplicação e execução de atividades físicas adaptadas, obtendo-se melhorias na saúde cardiovascular, fortalecimento de músculos e articulações, controle do ganho de peso, redução do risco de complicações na gravidez e melhora do bem-estar emocional. Esses resultados foram comparados com pesquisas de outros autores que corroboram que a implementação de atividades físicas adaptadas contribui para melhorar a saúde da mãe e do feto.

The present research study addressed the issue of the inclusion of pregnant adolescents in Physical Education classes, focused on improving the physical health and well-being of the mother and fetus during pregnancy. The main objective of the work was to propose a program of physical activities adapted for the inclusion of pregnant students in the Physical Education class, in the "Pichincha" Fiscal Educational Unit. A methodology with a qualitative approach was proposed, scientific observation, interview, survey and documentary review were used as empirical methods that facilitated the identification of the problem in the initial part until the proposal of adapted physical exercises was carried out, in its final stage. It concludes with the application and execution of adapted physical activities, and improvements are obtained in cardiovascular health, strengthening of muscles and joints, control of weight gain, reduction of the risk of pregnancy complications and improvement of well-being. emotional. These results were compared with research by other authors that corroborate that implementing adapted physical activities contributes to improving the health of both the mother and the fetus.

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Los programas de estimulación temprana son intervenciones dirigidas a niños con trastornos del desarrollo, como lo es el autismo, estos buscan favorecer la adaptación e integración social, así como mejorar habilidades cognitivas, comunicativas y emocionales. Sin embargo, la pandemia del COVID-19 fue un gran desafío para la continuidad y la efectividad de estos programas, debido a las restricciones de movilidad, el cierre de centros educativos y sanitarios, y el aumento del estrés familiar. En este artículo se revisan los principales estudios que evaluaron el impacto de la pandemia en los programas de estimulación temprana para niños dentro del espectro autista y las estrategias para adaptarlos al contexto actual. Metodología: se realizó una revisión bibliográfica de estudios publicados entre 2020 y 2023 en Scopus, Web of Science, Scielo, Latindex y Google Scholar. Aplicando ecuaciones de búsqueda elaboradas con los descriptores y operadores booleanos: "programas de estimulación temprana", "trastorno del espectro autista", "pandemia COVID-19". Se seleccionaron 29 trabajos que cumplieron con los criterios de inclusión como el aborde de programas de estimulación temprana para niños dentro del espectro autista, producto de investigación empírica o teórica sobre el tema. Los resultados coinciden con los de otras investigaciones que han analizado la misma temática. Se concluye que la pandemia afectó negativamente tanto la calidad como la efectividad de los programas de estimulación temprana, elevando la vulnerabilidad de los niños y niñas con TEA, y que es necesario desarrollar e implementar medidas específicas para garantizar el acceso y la atención adecuada a este colectivo vulnerable

Early stimulation programs are interventions aimed at children with developmental disorders, such as autism, which seek to promote adaptation and social integration, as well as improve cognitive, communicative and emotional skills. However, the COVID-19 pandemic was a great challenge for the continuity and effectiveness of these programs, due to mobility restrictions, the closure of educational and health centers, and increased family stress. This article reviews the main studies that evaluated the impact of the pandemic on early stimulation programs for children within the autism spectrum and the strategies to adapt them to the current context. Methodology: a bibliographic review of studies published between 2020 and 2023 in Scopus, Web of Science, Scielo, Latindex and Google Scholar was carried out. Applying search equations created with Boolean descriptors and operators: "early stimulation programs", "autism spectrum disorder", "COVID-19 pandemic". 29 works were selected that met the inclusion criteria such as addressing early stimulation programs for children within the autism spectrum, product of empirical or theoretical research on the topic. The results coincide with those of other investigations that have analyzed the same topic. It is concluded that the pandemic negatively affected both the quality and effectiveness of early stimulation programs, increasing the vulnerability of boys and girls with ASD, and that it is necessary to develop and implement specific measures to guarantee access and adequate care for this vulnerable group.

Os programas de estimulação precoce são intervenções dirigidas a crianças com perturbações do desenvolvimento, como o autismo, que procuram promover a adaptação e a integração social, bem como melhorar as competências cognitivas, comunicativas e emocionais. No entanto, a pandemia da COVID-19 representou um grande desafio para a continuidade e eficácia destes programas, devido às restrições de mobilidade, ao encerramento de centros educativos e de saúde e ao aumento do stress familiar. Este artigo revisa os principais estudos que avaliaram o impacto da pandemia nos programas de estimulação precoce para crianças do espectro do autismo e as estratégias para adaptá-los ao contexto atual. Metodologia: foi realizada uma revisão bibliográfica de estudos publicados entre 2020 e 2023 nas bases Scopus, Web of Science, Scielo, Latindex e Google Scholar. Aplicando equações de busca criadas com descritores e operadores booleanos: "programas de estimulação precoce", "transtorno do espectro do autismo", "pandemia de COVID-19". Foram selecionados 29 trabalhos que atenderam aos critérios de inclusão como abordar programas de estimulação precoce para crianças do espectro do autismo, produto de pesquisas empíricas ou teóricas sobre o tema. Os resultados coincidem com os de outras investigações que analisaram o mesmo tema. Conclui-se que a pandemia afetou negativamente tanto a qualidade como a eficácia dos programas de estimulação precoce, aumentando a vulnerabilidade de meninos e meninas com TEA, e que é necessário desenvolver e implementar medidas específicas para garantir o acesso e cuidados adequados a este grupo vulnerável.

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OBJECTIVE: To analyze the experiences regarding the implementation of COVID-19 vaccination strategies, emphasizing the opportunities and challenges identified during its implementation. DESIGN: A systematic review of the literature published between 2020 and 2022. DATA SOURCES: The study was conducted across four databases: PubMed, ScienceDirect, Scielo, and Lilacs. SELECTION OF STUDIES: Publications selection followed the PRISMA methodology (Preferred Reporting Items for Systematic Review and Meta-Analysis). DATA EXTRACTION: A database was created where key elements of the selected study were identified and recorded, such as results, discussion, and conclusions. In addition, analysis categories were created such as: stages of the implementation plan, challenges identified and opportunity areas. RESULTS AND CONCLUSIONS: 292 publications were found, of which 25 were selected for analysis. Of these, 64% came from high-income countries and 32% from upper-middle-income countries. According to the stages of the implementation plan, 20% of the studies focused on regulations, planning and coordination; 28% in prioritization of the population to be vaccinated; 16% in acceptance, demand, and risk communication; and 16% in administration and information systems. Reflection on the response to the pandemic invites us to consider various aspects, such as the organization and function of health systems, the importance of collaborative work, efforts to achieve equity, communication strategies, as well as ethical dilemmas when seeking preserve health.

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Objective. This work sought to develop the Actuasalud platformas a useful tool for nursing that permits assessing health, in term of frailty, in population over 65 years of age. Methods. For the design and development of Actuasalud, two working groups were formed: one from nursing with different profiles, to identify the scientific content and a computer science group responsible for the software programming and development. Both teams adapted the scientific content to the technology so that the tool would allow for population screening with detection of health problems and frailty states. Results. The software was developed in three large blocks that include all the dimensions of frailty: a) sociodemographic variables, b) comorbidities, and c) assessment tools of autonomy-related needs that evaluate the dimensions of frailty. At the end of the evaluation, a detailed report is displayed through bar diagram with the diagnosis of each of the dimensions assessed. The assessment in the participating elderly showed that 44.7% (n = 38) of the population was considered not frail, and 55.3%; (n = 47) as frail. Regarding associated pathologies, high blood pressure (67.1%; n = 57), osteoarthritis and/or arthritis (55.3%; n = 47), diabetes (48.2%; n = 41) and falls during the last year (35.3%; n = 30) were highlighted. Conclusion.Actuasalud is an application that allows nursing professionals to evaluate frailty and issue a quick diagnosis with ordered sequence,which helps to provide individualized care to elderly individuals according to the problems detected during the evaluation.

Objetivo. Desarrollar la plataforma Actuasalud como una herramienta útil para enfermería que permita evaluar la salud, en términos de fragilidad, en población mayor de 65 años. Métodos. Para el diseño y desarrollo de Actuasalud,se constituyeron dos grupos de trabajo: uno de enfermería con diferentes perfiles para identificar el contenido científico y uno informático que se responsabilizó de la programación y desarrollo del software. Ambos equipos adaptaron el contenido científico a la tecnología de manera que la herramienta permitiese hacer un cribado poblacional con detección de problemas de salud y estados de fragilidad. Resultados. Se desarrolló el software en tres grandes bloques que incluyen todas las dimensiones de fragilidad: a) variables sociodemográficas, b) comorbilidades y c) herramientas de evaluación de necesidades relacionadas con la autonomía que evalúan las dimensiones de fragilidad. Al finalizar la evaluación, se visualiza un informe detallado mediante diagrama de barras con el diagnóstico de cada una de las dimensiones evaluadas. La evaluación en los mayores participantes mostró que el 44.7% (n = 38) de la población se consideró como no frágil, y un 55.3%; (n = 47) como frágiles. En cuanto a las patologías asociadas, destacaron hipertensión arterial (67,1 %; n = 57), artrosis y/o artritis (55.3%; n = 47), diabetes (48.2 %; n = 41) y caídas en el último año (35,3 %; n = 30). Conclusión.Actuasalud es una aplicación que permite a los profesionales de enfermería evaluar fragilidad y emitir un diagnóstico de forma ágil con secuencia ordenada que ayuda a brindar cuidados individualizados a personas mayores de acuerdo los problemas detectados en la evaluación.

Objetivo. Desenvolver a plataforma Actuasalud como uma ferramenta útil para a enfermagem que permite avaliar a saúde, em termos de fragilidade, numa população com mais de 65 anos. Métodos. Para a concepção e desenvolvimento do Actuasalud foram formados dois grupos de trabalho: um grupo de enfermagem com perfis diferentes, para identificar o conteúdo científico, e um grupo de informática que foi responsável pela programação e desenvolvimento do software. Ambas as equipas adaptaram o conteúdo científico à tecnologia para que a ferramenta permitisse o rastreio da população para detectar problemas de saúde e estados de fragilidade. Resultados. O software foi desenvolvido em três grandes blocos que incluem todas as dimensões da fragilidade: a) variáveis sociodemográficas, b) comorbidades ec) instrumentos de avaliação de necessidades relacionadas à autonomia que avaliam as dimensões da fragilidade. Ao final da avaliação é apresentado um relatório detalhado através de um diagrama de barras com o diagnóstico de cada uma das dimensões avaliadas. A avaliação nos idosos mostrou que 44.7% (n=38) da população foi considerada não frágil e 55.3%; (n=47) como frágil. Quanto às patologias associadas, destacaram-se a hipertensão arterial (67.1%; n=57), a osteoartrite e/ou artrite (55.3%; n=47), a diabetes (48.2%; n=41) e as quedas no último ano (35.3%; n=30). Conclusão. Actuasalud é um aplicativo que permite ao profissional de enfermagem avaliar a fragilidade e emitir um diagnóstico de forma ágil e com sequência ordenada que auxilia no atendimento individualizado ao idoso de acordo com os problemas detectados na avaliação.

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Objective.To evaluate the pedagogical skills of third-year nursing students at Yangzhou University (China). Methods. A multisite quasi-experimental design was used in this study. Fifty-five participants were selected by convenience sampling. The Objective Structured Teaching Evaluation (OSTE) scale was used to assess teaching skills. The evaluation included four different stages: Teaching Background Analysis (E1), Lesson Plan Presentation (E2), Original article Mock Class (E3) and Teaching Reflection (E4). Prior to the assessment, the teachers assigned homework to the students to complete at the four stations. Results. Fifty-five nursing students with an average age of 21.3±0.7 years participated in the study, with a predominance of female students (78.2%). The highest mean score was achieved in E1 (83.1), followed by E2 and E3 (82.5 and 82.3 respectively), while the lowest mean score was found in E4 (79.6). In E3, instructors gave lower scores for class organisation, class characteristics and overall performance compared to the self-reported scores of the standardised students (p<0.05). More than 80% of the students strongly agreed and recommended the OSTE as the primary method for assessing teaching skills in the classroom.Conclusion. Deficits in teaching skills were identified in the participating students; this information will allow specific interventions to improve the situation. The OSTE instrument was a useful method for assessing the pedagogical skills of undergraduate nursing students.

Objetivo. Evaluar las habilidades pedagógicas de los estudiantes de tercer curso de enfermería de la Universidad de Yangzhou (China). Métodos. En este estudio se empleó un diseño cuasi-experimental multisitio. Por muestreo por conveniencia se seleccionaron 55 participantes. Se empleó la escala Examen Objetivo Estructurado de la enseñanza(OSTE- Objective Structured Teaching Evaluation, en inglés) para evaluar las habilidades pedagógicas. La evaluación abarcó cuatro estaciones distintas: Análisis de los antecedentes de la enseñanza (E1), Presentación del plan de la lección (E2), Clase simulada (E3) y Reflexión sobre la enseñanza (E4). Antes de la evaluación, los instructores asignaron tareas a los estudiantes que debían realizar en las cuatro estaciones. Resultados. Participaron en la investigación 55 estudiantes de enfermería con un promedio de edad fue de 21.3±0.7 años y predominó el sexo femenino (78.2%). La puntuación media más alta se alcanzó en la E1 (83.1), seguida por E2 y E3 (82.5 y 82.3, respectivamente, mientras que la puntuación media más baja se registró en la E4 (79.6). En la E3 los instructores asignaron puntuaciones más bajas en comparación a las autorreportadas por los estudiantes estandarizados en términos de organización de la enseñanza, características de la enseñanza y rendimiento general (p<0.05). Más del 80% de los estudiantes se mostraron totalmente de acuerdo y recomendaron el OSTE como método principal para evaluar las habilidades docentes en el aula. Conclusión. Se identificaron en los estudiantes participantes las deficiencias en las habilidades pedagógicas; esta información permitirá realizar intervenciones específicas para mejorar situaciones específicas de la situación encontrada. El instrumento OSTE fue un método útil para la valoración de las habilidades pedagógicas de los estudiantes universitarios de enfermería.

Objetivo. Avaliar as competências pedagógicas dos estudantes do terceiro ano de enfermagem da Universidade de Yangzhou (China). Métodos. Um desenho quase-experimental multisite foi utilizado neste estudo. Por amostragem de conveniência, foram selecionados 55 participantes. A escala Objective Structured Teaching Evaluation (OSTE) foi utilizada para avaliar as competências pedagógicas. A avaliação abrangeu quatro estações distintas: Análise do percurso docente (E1), Apresentação do plano de aula (E2), Aula simulada (E3) e Reflexão sobre o ensino (E4). Antes da avaliação, os instrutores atribuíram tarefas aos alunos, que deveriam completar as quatro estações consecutivamente. Resultados. Participaram da pesquisa 55 estudantes de enfermagem com idade média de 21.3±0.7 anos e predominou o sexo feminino (78.2%). A maior pontuação média foi alcançada em E1 (83.1), seguida de E2 e E3 (82.5 e 82.3, respectivamente, enquanto a menor pontuação média foi registrada em E4 (79.6). Em E3 os instrutores atribuíram pontuações mais autorrelatado por alunos padronizados em termos de organização do ensino, características de ensino e desempenho geral (p<0.05). Mais de 80% dos alunos concordaram fortemente e recomendaram o OSTE como principal método para avaliar habilidades de ensino em sala de aula. Conclusão. Foram identificadas deficiências nas competências pedagógicas dos alunos; esta informação permitirá realizar intervenções específicas para melhorar situações específicas da situação encontrada. O instrumento OSTE foi um método útil para avaliar as competências pedagógicas de estudantes universitários de enfermagem.

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Lucía Vivanco Muñoz es terapeuta ocupacional, egresada de la Universidad de Chile en 1983 y una de las primeras en incursionar en la Terapia Ocupacional social y comunitaria en Chile. En esta entrevista, realizada por su colega Débora Grandón, analiza el desarrollo de la Terapia Ocupacional social y comunitaria a través de su incursión, a finales de la década de 1980 y durante los años 90, en áreas no tradicionales de la Terapia Ocupacional, como el acompañamiento a personas viviendo con VIH-SIDA, la desinstitucionalización de niñeces vulneradas y la reinserción en sus familias y comunidades. También, colaboró en el diseño de políticas públicas para la superación de la pobreza desde el Estado chileno y en otros países, en su rol de consultora para el Banco Mundial. Actualmente, es académica de la Escuela de Terapia Ocupacional en la Universidad de Santiago de Chile -USACH. Esta experiencia como iniciadora de áreas de práctica hoy instituidas en el ejercicio de la profesión tiene un relevante valor histórico y constituye un aporte significativo al desarrollo de estos campos y a la formación de nuevas generaciones.

Lucía Vivanco Muñoz is an occupational therapist who graduated from the University of Chile in 1983 and is one of the pioneers in the development of a social and community Occupational Therapy in Chile. In this interview, conducted by her colleague Débora Grandón, she analyzes the development of a social and community Occupational Therapy throughout her involvement at the end of the 1980s and during the 1990s in non-traditional areas such as accompanying people living with HIV/AIDS, the deinstitutionalization of vulnerable children, and their reintegration into their families and communities. She also participated in designing public policies for overcoming poverty within the Chilean government and other countries in her role as a consultant for the World Bank. She is currently an academic at the School of Occupatio-nal Therapy at the University of Santiago de Chile -USACH. This experience as an initiator of areas of practice established today in the exercise of the profession has a relevant historical value and constitutes a significant contribution to the development of these fields and the training of new generations

Lucía Vivanco Muñoz é terapeuta ocupacional, formada pela Universidade do Chile em 1983, e uma das primeiras a se aventurar na Terapia Ocupacional social e comunitária no Chile. Nesta entrevista, conduzida por sua colega Débora Grandón, se analisa o desenvolvimento da Terapia Ocupacional social e comunitária por meio de sua incursão no final dos anos 80 e durante os anos 90, em áreas não tradicionais da Terapia Ocupacional, como o acompanhamento de pessoas vivendo com HIV-AIDS, a desinstitucionalização de crianças em situação de vulnerabilidade e a reintegração em suas famílias e comunidades. Além disso, colaborou no desenho de políticas públicas para a superação da pobreza no Estado chileno e em outros países, atuando como consultora para o Banco Mundial. Atualmente, é professora na Escola de Terapia Ocupacional da Universidade de Santiago do Chile - USACH. A experiência da professora como pioneira em áreas de prática, hoje instituídas no exercício da profissão, tem um valor histórico relevante e constitui uma contribuição significativa para o desenvolvimento desses campos e para a formação de novas gerações

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INTRODUCTION: This study aimed to present real-life data on the use, efficacy, and safety of administering antibiotic therapy through portable elastomeric pumps (pEP) in the outpatient setting. METHODS: This retrospective observational cohort study was conducted from January 2020 to May 2023 in a large academic hospital in Rome, Italy. All patients receiving antibiotic therapy via pEP were included up to a follow-up period of 90 days after the end of antibiotic therapy. The primary outcome was the treatment response. Secondary endpoints were adverse events attributable to the drug administered, the vascular catheter, or the infection itself. RESULTS: Of the 490 patients referred to our outpatient parenteral antibiotic therapy (OPAT) unit, 94 (19.2%) received antibiotic therapy via pEP and were included in the final analysis. The most frequently treated infections were those involving bone and prosthetics, including spondylodiscitis (n=27; 28.8%). Most infections were due to Pseudomonas aeruginosa (n=55; 48.3%). Cefepime (n=32; 34.0%), piperacillin/tazobactam (n=29; 30.9%), ceftolozane/tazobactam (n=7; 7.5%), and oxacillin (n=7; 7.5%) were the most frequently administered antibiotics. The infection cure rate reached 88.3% (n=83). 12 patients (12.8%) reported adverse events, of which half (6.4%) were drug-related and half (6.4%) were line-related. CONCLUSIONS: OPAT through portable elastomeric infusion pumps proved to be safe and effective. It also contributed to the reduction of healthcare costs, fully respecting the principles of personalized medicine. This strategy has emerged as a promising tool for antibiotic stewardship and infection control.

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RESUMO As Práticas Corporais e Atividades Físicas (PCAF) têm sido incorporadas no Sistema Único de Saúde (SUS), tendo o Programa Academia da Saúde como principal expoente. Contudo, ainda não foi investigado o planejamento, que expressa as responsabilidades dos gestores quanto à saúde da população, para efetivação dessas práticas como políticas públicas de saúde. Assim, o presente artigo teve o objetivo de analisar a formulação e o desenvolvimento da agenda de promoção das PCAF a partir dos instrumentos de planejamento do âmbito federal do SUS - Plano Nacional de Saúde, Programação Anual de Saúde e Relatório Anual de Gestão, de 2004 a 2023. Por meio de estudo de caráter analítico-descritivo, pautado em pesquisa documental, foi realizada a busca de termos como: (in)atividade física; fisicamente ativo; exercício físico; práticas corporais; entre outros. A formulação e o desenvolvimento da referida agenda estiveram principalmente relacionados com o enfrentamento das doenças crônicas não transmissíveis, e houve importante disparidade entre o que foi planejado e o executado, em desfavor da expansão do Academia da Saúde. Com o resgate histórico da agenda das PCAF no SUS apresentado, são permitidos debates e iniciativas com vistas a efetivá-las enquanto política pública de saúde.

ABSTRACT Body Practices and Physical Activities (BPPA) have been incorporated into the Unified Health System (SUS), with the Health Academy Program as its main exponent. However, planning, which expresses the responsibilities of managers regarding the population's health, has not yet been investigated to make these practices effective as public health policies. Thus, the aim of this article was to analyze the formulation and development of the agenda for BPPA promotion from the planning instruments of the federal level of the SUS - National Health Plan, Annual Health Programming, and Annual Management Report, from 2004 to 2023. Through an analytical-descriptive study based on documentary research, a search was carried out for terms such as: physical (in)activity; physically active; physical exercise; body practices; among others. The formulation and development of the BPPA promotion agenda were mainly related to facing chronic noncommunicable diseases, and there was an important disparity between what was planned and what was executed, to the detriment of the expansion of Health Academy. With the historic rescue of the BPPA agenda presented in the SUS, debates and initiatives are allowed with a view to making them effective as a public health policy.

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Relatar a experiência vivenciada por enfermeiras mestrandas e docente de disciplina eletiva de universidade pública do interior de Minas Gerais. Método: estudo descritivo, do tipo relato de experiência, a fim de relatar reflexões críticas acerca da Política Nacional de Humanização (PNH) realizadas em disciplina de Programa de Pós-graduação stricto sensu ministrada entre agosto e novembro de 2023. Resultados: participaram sete enfermeiras, todas do sexo feminino, com vivências em instituições de saúde públicas e privadas. Foi possível compreender sobre diversos aspectos, e duas categorias foram elaboradas: Repercussões e entraves referentes à implantação plena da PNH; Humanização e ensino teórico-prático nas instituições formadoras. Também foi produzido um mapa mental sobre a temática. Conclusão: destaca-se a importância de discutir sobre humanização nas instituições de ensino para o aprofundamento do tema e disseminação do conhecimento associado ao olhar prático humanizado.(AU)

To report on the experience of master's degree nurses and a lecturer in an elective course at a public university in the interior of Minas Gerais. Method: this is a descriptive, experience-report type study, aimed at reporting critical reflections on the National Humanization Policy (NHP) carried out in a stricto sensu postgraduate program course taught between August and November 2023. Results: Seven nurses took part, all female, with experience in public and private healthcare institutions. It was possible to understand various aspects, and two categories were created: Repercussions and obstacles regarding the full implementation of the PNH; Humanization and theoretical-practical teaching in training institutions. A mind map on the subject was also produced. Conclusion: The importance of discussing humanization in educational institutions is highlighted in order to deepen the subject and disseminate knowledge associated with a practical humanized approach.(AU)

Relatar la experiencia de enfermeros de maestría y de un profesor en un curso electivo de una universidad pública del interior de Minas Gerais. Método: se trata de un estudio descriptivo, de tipo experiencia-informe, con el objetivo de relatar reflexiones críticas sobre la Política Nacional de Humanización (PNH) realizadas en una asignatura del programa de posgrado stricto sensu impartida entre agosto y noviembre de 2023. Resultados: Participaron siete enfermeras, todas del sexo femenino, con experiencia en instituciones de salud públicas y privadas. Se pudieron conocer diversos aspectos y se desarrollaron dos categorías: repercusiones y obstáculos en la plena implantación de la PNH; humanización y enseñanza teórico-práctica en las instituciones de formación. También se elaboró un mapa mental sobre el tema. Conclusión: Se destaca la importancia de discutir la humanización en las instituciones de enseñanza para profundizar el tema y difundir el conocimiento asociado a un abordaje humanizado práctico.(AU)

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Objetivo: desarrollar un panel de indicadores para monitorizar la actividad de los programas de optimización del uso de antimicrobianos en los servicios de urgencias. Métodos: un grupo multidisciplinar formado por expertos en el manejo de la infección en urgencias y en la implantación de programas de optimización de uso de antimicrobianos (PROA) evaluó una propuesta de indicadores utilizando una metodología Delphi modificada. En una primera ronda, cada uno de los expertos clasificó la relevancia de cada indicador propuesto en 2 dimensiones (repercusión asistencial y facilidad de implantación) y 2 atributos (nivel de priorización y periodicidad de medida). La segunda ronda se realizó a partir del cuestionario modificado de acuerdo con las sugerencias planteadas y nuevos indicadores sugeridos por los participantes. Los expertos efectuaron modificaciones en el orden de priorización y calificaron los nuevos indicadores propuestos de la misma manera que en la primera ronda. Resultados: se propusieron un total de 61 potenciales indicadores divididos en 4 grupos: indicadores de consumo, microbiológicos, de proceso y de resultado. Tras el análisis de las puntuaciones y los comentarios realizados en la primera ronda, 31 indicadores fueron clasificados como de alta prioridad, 25 de prioridad intermedia y 5 de baja prioridad. Además se generaron 19 nuevos indicadores. Tras la segunda ronda, se mantuvieron los 61 indicadores inicialmente propuestos y adicionalmente se incorporaron 18 nuevos: 11 como de alta prioridad, 3 como de intermedia y 4 como de baja prioridad. Conclusiones: los expertos consensuaron un panel de indicadores PROA adaptado a los servicios de urgencias priorizados por nivel de relevancia como un elemento de ayuda para el desarrollo de estos programas, que contribuirá a monitorizar la adecuación del uso de antimicrobianos en estas unidades.(AU)

Objective: To develop a panel of indicators to monitor antimicrobial stewardship programs activity in the emergency department. Methods: A multidisciplinary group consisting of experts in the management of infection in emergency departments and the implementation of antimicrobial stewardship programs (ASP) evaluated a proposal of indicators using a modified Delphi methodology. In the first round, each expert classified the relevance of each proposed indicators in two dimensions (healthcare impact and ease of implementation) and two attributes (prioritization level and frequency). The second round was conducted based on the modified questionnaire according to the suggestions raised and new indicators suggested. Experts modified the prioritization order and rated the new indicators in the same manner as in the first round. Results: 61 potential indicators divided into four groups were proposed: consumption indicators, microbiological indicators, process indicators, and outcome indicators. After analyzing the scores and comments from the first round, 31 indicators were classified as high priority, 25 as intermediate priority, and 5 as low priority. Moreover, 18 new indicators were generated. Following the second round, all 61 initially proposed indicators were retained, and 18 new indicators were incorporated: 11 classified as high priority, 3 as intermediate priority, and 4 as low priority. Conclusions: The experts agreed on a panel of ASP indicators adapted to the emergency services prioritized by level of relevance. This is as a helpful tool for the development of these programs and will contribute to monitoring the appropriateness of the use of antimicrobials in these units.(AU)

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Objetivo: desarrollar un panel de indicadores para monitorizar la actividad de los programas de optimización del uso de antimicrobianos en los servicios de urgencias. Métodos: un grupo multidisciplinar formado por expertos en el manejo de la infección en urgencias y en la implantación de programas de optimización de uso de antimicrobianos (PROA) evaluó una propuesta de indicadores utilizando una metodología Delphi modificada. En una primera ronda, cada uno de los expertos clasificó la relevancia de cada indicador propuesto en 2 dimensiones (repercusión asistencial y facilidad de implantación) y 2 atributos (nivel de priorización y periodicidad de medida). La segunda ronda se realizó a partir del cuestionario modificado de acuerdo con las sugerencias planteadas y nuevos indicadores sugeridos por los participantes. Los expertos efectuaron modificaciones en el orden de priorización y calificaron los nuevos indicadores propuestos de la misma manera que en la primera ronda. Resultados: se propusieron un total de 61 potenciales indicadores divididos en 4 grupos: indicadores de consumo, microbiológicos, de proceso y de resultado. Tras el análisis de las puntuaciones y los comentarios realizados en la primera ronda, 31 indicadores fueron clasificados como de alta prioridad, 25 de prioridad intermedia y 5 de baja prioridad. Además se generaron 19 nuevos indicadores. Tras la segunda ronda, se mantuvieron los 61 indicadores inicialmente propuestos y adicionalmente se incorporaron 18 nuevos: 11 como de alta prioridad, 3 como de intermedia y 4 como de baja prioridad. Conclusiones: los expertos consensuaron un panel de indicadores PROA adaptado a los servicios de urgencias priorizados por nivel de relevancia como un elemento de ayuda para el desarrollo de estos programas, que contribuirá a monitorizar la adecuación del uso de antimicrobianos en estas unidades.(AU)

Objective: To develop a panel of indicators to monitor antimicrobial stewardship programs activity in the emergency department. Methods: A multidisciplinary group consisting of experts in the management of infection in emergency departments and the implementation of antimicrobial stewardship programs (ASP) evaluated a proposal of indicators using a modified Delphi methodology. In the first round, each expert classified the relevance of each proposed indicators in two dimensions (healthcare impact and ease of implementation) and two attributes (prioritization level and frequency). The second round was conducted based on the modified questionnaire according to the suggestions raised and new indicators suggested. Experts modified the prioritization order and rated the new indicators in the same manner as in the first round. Results: 61 potential indicators divided into four groups were proposed: consumption indicators, microbiological indicators, process indicators, and outcome indicators. After analyzing the scores and comments from the first round, 31 indicators were classified as high priority, 25 as intermediate priority, and 5 as low priority. Moreover, 18 new indicators were generated. Following the second round, all 61 initially proposed indicators were retained, and 18 new indicators were incorporated: 11 classified as high priority, 3 as intermediate priority, and 4 as low priority. Conclusions: The experts agreed on a panel of ASP indicators adapted to the emergency services prioritized by level of relevance. This is as a helpful tool for the development of these programs and will contribute to monitoring the appropriateness of the use of antimicrobials in these units.(AU)

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Introducción: Los programas de optimización de antimicrobianos (PROA) son herramientas clave en la adecuación de estos fármacos. La información disponible sobre la aplicación e indicadores para monitorizar estos programas en urgencias es limitada. El objetivo del estudio es conocer el grado de implantación de programas PROA en los servicios de urgencias, así como el uso de antimicrobianos en estas unidades. Material y métodos. Estudio multicéntrico retrospectivo. Se envió una invitación a todos los participantes del grupo de trabajo de farmacéuticos de urgencias REDFASTER-SEFH. Se utilizó un cuestionario de 21 ítems, contestado por un equipo formado por especialistas en los servicios de farmacia hospitalaria, urgencias, enfermedades infecciosas y microbiología. Resultados. 18 hospitales completaron la encuesta. Catorce (77,8%) disponían de un responsable PROA en la unidad. El valor de DDD por 1000 ingresos osciló entre 36,5 y 400,5 (mediana 100,4 [RIQ:57,2-157,3]). El grupo de carbapenémicos y macrólidos presentó una amplia variabilidad. Únicamente seis (33,3%) hospitales disponían de informe anual de resistencias específico para urocultivos y hemocultivos en urgencias. El porcentaje de multirresistentes en urocultivos fue del 12,5% y en hemocultivos del 12,2%. El porcentaje de adecuación en bacteremia de acuerdo con el resultado del hemocultivo fue del 81,0% (RIQ:74,6-85,0%), y en infección urinaria del 78,0% (RIQ:71,5-88,0%). Conclusiones. Pese a la existencia de responsables PROA, actividades formativas y guías de tratamiento en urgencias, la información sobre el uso de antimicrobianos y el perfil de resistencias en estas unidades es limitado. Futuras actividades han de ir encaminadas a mejorar la información sobre los resultados PROA propios para estas unidades. (AU)

Introduction: Antimicrobial stewardship programs (ASP) have become a key tool in the adaptation of these drugs to the health system. The information available on the application and indicators used in these programs in emergency departments is scarce. The objective of this study is to know theextent of ASP implementation in the emergency departments, as well as the use of antimicrobials in these units. Material and methods. Multicenter retrospective study. An invitation was sent to all participants of the REDFASTER-SEFH emergency pharmacist working group. A questionnaire was used consisting of 21 items, answered by a team made up of a pharmacist, emergency room specialist, infectious disease specialist and microbiologist. Results. Eighteen hospitals completed the survey. Fourteen (77.8%) had an ASP manager. The DDD value per 1000 admissions ranged between 36.5 and 400.5 (median: 100.4 [IQR:57.2-157.3]). Both carbapenem and macrolide group presented wide variability in use. Six (33.3%) hospitals had an annual report on the specific resistance profile for urine and blood cultures. The percentage of multi-drug resistant strains in urine cultures was 12.5% and in blood cultures 12.2%. The percentage of adequacy in the bacteremia treatment was 81.0% (IQR:74.6-85.0%), while in urinary tract infections was 78.0% (IQR:71.5-88.0). Conclusions: Despite the existence of ASP members in emergency services, as well as the training activity and local guidelines is common. knowledge of the use of antimicrobials and resistances is limited. Future activities must be aimed at improving information about the ASP results in these units. (AU)

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En la actualidad ha aumentado el desarrollo de programas de entrenamiento en habilidades socioemocionales en la infancia, debido a que se los considera como una herramienta válida para la adaptación y afrontamiento de una gran variedad de situaciones, tanto académicas como personales. Sin embargo, son escasos los estudios que aporten una visión integral de las evidencias disponibles en el contexto de educación primaria. Se presenta una revisión sistemática de tipo paraguas basada en el método PRISMA, que incluye revisiones sobre programas de desarrollo socioemocional aplicados en educación primaria, con el objetivo de sintetizar sus características y recopilar los principales resultados reportados. Se utilizaron las bases de datos: ERIC, WOS, PSYCINFO, SCOPUS y COCHRANE. Tras un proceso por pares ciegos se seleccionaron y analizaron 15 revisiones. Utilizando las herramientas AMSTAR-2 y SANRA se encontró que el 60% de los estudios secundarios presenta una calidad críticamente baja o baja. Se identificaron 39 programas reportados en revisiones de buena calidad, un 51.2% presentaron evidencias moderadas o fuertes e informaron efectos significativos principalmente en ajuste del comportamiento, competencia social y emocional y habilidades académicas. Se discute el impacto de la calidad metodológica encontrada y las evidencias reportados en la interpretación y generalización de los hallazgos.(AU)

Currently, the development of training programs in socioemo-tional skills in childhood has increased because they are considered as a valid tool for adaptation and coping with a variety of situations, both aca-demic and personal. However, there are few studies that show a compre-hensive view of available evidences. This research presents an umbrella re-view based on PRISMA method guidelines. It includes reviews on socio-emotional development programs applied in Primary Education with the aim of synthesizing their characteristics and compiling the main results on their effectiveness. The following databases were used: ERIC, WOS, PSYCINFO, SCOPUS and COCHRANE. After a blind peer process, 15 reviews that met the inclusion criteria were selected and analysed. Using the AMSTAR-2 and SANRA tools, it was found that 60% of secondary studies have critically low or low quality. Thirty nine programs reported in good quality reviews were identified, 51.2% presented moderate or strong evidence and reported significant effectsmainly on behavioral adjustment, social and emotional competencies and academic skills. The impact of the methodological quality found and the evidences on the interpretation and generalization of the findings is discussed.(AU)

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Introducción: La tasa de cesárea es un motivo de controversia y la clasificación de Robson es un método de estandarización que evalúa las causas de esta. En nuestro trabajo analizamos si las medidas de mejora de manejo prenatal e intraparto implementadas tras la revisión de Robson suponen un descenso de índice de cesáreas sin incrementar los de morbimortalidad neonatal y materna. Material y método: Estudio cuasi experimental antes-después, entre 2019 y 2020, con un total de 2.181 pacientes con parto en el Hospital Universitario de Valme (1.027 en el grupo 2019 y 1.154 en el de 2020). Resultados: Observamos que se produjo una disminución estadísticamente significativa de la tasa de cesárea entre 2019 y 2020 (21 vs. 15,8%; p = 0,001) sin ser relevante la reducción en ningún subgrupo de estudio. Hubo un menor índice de parto inducido (29,3 vs. 24,6%; p = 0.01), un aumento en la tasa de parto vaginal (79 vs. 84,2%; p = 0,001) tanto de eutócicos como instrumentales (57,9 vs. 60,3%; 21 vs. 23,9%; p = 0.005) y una baja estadísticamente significativa de la de cesáreas por fallo de inducción o no progresión del parto (NPP) (34,7 vs. 20,9%; p = 0,008). En las inducciones mediante balón de Cook observamos una disminución del índice de cesárea (45,3 vs. 22,2% p = 0,001). Hallamos que redujo el porcentaje de ingreso en la Unidad de Cuidados Intensivos Neonatales (UCIN) (10,5 vs. 7.6%; p = 0,016) y la morbilidad neonatal global (11,4 vs. 8,2%; p = 0,013) sin encontrar diferencia en los resultados maternos. Conclusiones: La aplicación de la clasificación de Robson puede ser un método útil para identificar grupos que requieran de medidas específicas destinadas a estandarizar el manejo de las pacientes, con lo que se permite reducir la tasa de cesáreas.(AU)

Background: Cesarean section rate is controversial and the Robson classification is a method for standardizing the evaluation of the causes of cesarean section. The aim of this study was to evaluate whether the measures to improve prenatal and intrapartum management implemented after the Robson classification evaluation lead to a decrease in the rate of cesarean sections without increasing the rates of neonatal and maternal morbidity and mortality. Material and method: Quasi-experimental study before-after,between-2019 and 2020, including a total of 2181 patients with delivery at Hospital-Universitario-Valme(1027 patients in Group-2019, and 1154 patients in group-2020).Results: We observed that there was a statistically significant decrease in the cesarean section rate between 2019 and 2020 (21.0% vs 15.8%; p = 0.001) without the decrease being significant in any study subgroup. There was a lower rate of induced labor(29.3% vs 24.6%; p = 0.01), an increased rate of vaginal delivery (79.0% vs 84.2%; p = 0.001), both eutocic and instrumental deliveries (57.9% vs 60.3%; 21% vs 23.9%; p = 0.005) and a statistically significant decrease in the rate of cesarean sections due to failure of induction or non-progression of labor(34.7% vs 20.9%;p = 0.008). In inductions using the balloon-Cook we observed a decrease in the rate of cesarean section (45.3% versus 22.2% p = 0.001). We found a decrease in the percentage of admission to the Neonatal ICU (10.5% vs 7.6%; p = 0.016) and global neonatal morbidity(11.4% vs 8.2%; p = 0.013) without observing a difference in maternal outcomes. Conclusions: The application of the Robson classification can be a useful method to identify groups that require the application of specific measures aimed at standardizing the management of these patients, thus allowing to reduce the rate of cesarean sections.(AU)

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