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In the United States, the system for special pathogen patient care incorporates a network of federally funded US biocontainment units that maintain operational readiness to care for patients afflicted by high-consequence infectious diseases (HCIDs). This network has expanded in number of facilities and in scope, serving as a regional resource for special pathogen preparedness. Lessons learned for maintaining these units are shared with the intent of informing new and existing biocontainment units.

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Multi-tiered systems of behavioral supports offer teachers tools to implement positive, antecedent- or consequence-based interventions for all students (i.e., Tier 1), and for those who need additional support (i.e., Tier 2), such as students with ADHD. Because these interventions may be challenging to use, targeted, theory-driven implementation strategies may assist teachers in implementing them with fidelity. This exploratory study examined teachers' intended and self-reported use of specific Tier 1 and Tier 2 behavioral classroom interventions. Sixty-five K-8 teachers from five urban public schools completed an online survey about their intentions to use and self-reported use of four Tier 1 and Tier 2 behavioral classroom interventions. Teachers' intentions varied by intervention, with the weakest intentions for using a daily behavior report (Tier 2), and weaker intentions for using high rates of specific praise than for other Tier 1 interventions. Teacher's self-reported use was significantly lower than intended use for Tier 1 interventions, but not Tier 2 interventions. Results were generally similar whether the referent group was students with ADHD symptoms or the entire class. These results suggest specific factors to target to support teachers' use of behavioral classroom interventions.

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INTRODUCTION: The Drinking Motives Questionnaire-Revised Short Form (DMQ-R-SF) is widely used among alcohol researchers studying adolescents and young adults. The psychometric properties of the DMQ-R-SF have been examined among university students in many countries, but to our knowledge, not in Australia, New Zealand or Argentina. We sought to examine the reliability and endorsement of the items on the DMQ-R-SF, and test the associations between the DMQ-R-SF subscales and alcohol use, and negative alcohol consequences between university students from Australia, New Zealand and Argentina. METHOD: University students (N = 820) in Australia (n = 315), New Zealand (n = 265) and Argentina (n = 240) completed a confidential online alcohol survey which included the DMQ-R-SF, the Daily Drinking Questionnaire and the Brief Young Adult Alcohol Consequences Questionnaire. RESULTS: Using the alignment method, support for the four-factor model on the DMQ-R-SF emerged and the factor loadings for 11 of the 12 items were invariant across sites. Most items (8 out of 12) on the DMQ-R-SF were fully invariant across all sites, but some small differences in item reliability for one item, and endorsement for three items emerged between the sites. Across the three countries, coping motives were positively correlated with negative alcohol consequences. Enhancement motives were positively associated with both alcohol use and negative alcohol consequences among students from Australia and New Zealand. DISCUSSION AND CONCLUSIONS: Most items on the DMQ-R-SF were comparably reliable among the university students sampled from Australia, New Zealand and Argentina. Our preliminary findings suggest that the DMQ-R-SF can be reliably used with university students from these countries.

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ABSTRACT Background The COVID-19 pandemic has brought substantial challenges for current practices in treating hereditary neuromuscular disorders (hNMDs). However, this infection has not been the only concern for these patients. Social distancing has compromised multidisciplinary assistance and physical activity, and has brought about several mental health issues. We presented a follow-up on 363 patients with hNMDs at a Brazilian tertiary center during the peak of the COVID-19 pandemic. Objective We aimed to show the frequency and severity of SARS-CoV-2 infection among hNMD patients and to demonstrate the effects of the pandemic on life habits, disease progression and multidisciplinary supportive care status. Methods Three hundred and sixty-three patients (58% male and 42% female) were followed for three months through three teleconsultations during the peak of the COVID-19 pandemic in Brazil. Results There were decreases in the numbers of patients who underwent physical, respiratory and speech therapies. For several patients, their appetite (33%) and sleep habits (25%) changed. Physical exercises and therapies were interrupted for most of the patients. They reported new onset/worsening of fatigue (17%), pain (17%), contractions (14%) and scoliosis (7%). Irritability and sleep, weight and appetite changes, and especially diminished appetite and weight loss, were more frequent in the group that reported disease worsening. There was a low COVID-19 contamination rate (0.8%), and all infected patients had a mild presentation. Conclusion The isolation by itself was protective from a COVID-19 infection perspective. However, this isolation might also trigger a complex scenario with life habit changes that are associated with an unfavorable course for the NMD.

RESUMO Antecedentes: A Pandemia por COVID-19 tem trazido desafios subtanciais para a prática clínica no tratamento das doenças neuromusculares hereditárias (DNMh). A infecção não tem sido a única preocupação para os pacientes. O distanciamento social tem comprometido a assistência multidisciplinar, atividade física e tem trazido problemas mentais em decorrência do próprio isolamento. Nós apresentamos aqui um seguimento de 363 pacientes com DNMh de um centro terciário Brasileiro durante o pico da Pandemia de Covid-19. Objetivos: Mostrar a frequência e gravidade da infecção por Sars-Cov-2 em pacientes com DNMh e demonstrar os efeitos da pandemia nos hábitos de vida, na progressão da doença e no cuidado multidisciplinary. Métodos Trezentos e sessenta e três pacientes (58% homens and 42% mulheres) foram acompanhados por 3 meses através de 3 teleconsultas durante o pico da Pandemia de Covid-19 no Brasil. Resultados Houve um decréscimo no número de pacientes que faziam terapia física, respiratória e fonoaudiológica. Em muitos pacientes, o apetite (33%) e hábitos do sono (25%) se alteraram. Exercícios físicos e terapias foram interrompidas pela maioria dos pacientes. Physical exercises and therapies were interrupted for most of the patients. Eles relataram piora ou aparecimento de fadiga (17%), dor (17%), retrações (14%), e escoliose (7%). Irritabilidade, mudanças no sono, peso e apetite, sendo principalmente diminuição do apetite e peso foram mais frequentemente encontrados em pacientes que apresentaram piora clinica da doença. Houve uma baixa taxa de contaminação por Covid-19 (0.8%), e todos os pacientes infectado apresentaram quadro clinico leve. Conclusão O isolamento por si só se mostrou protetor na perspectiva de infecção por Covid-19, mas pode desencadear um cenário complexo com mudanças nos hábitos de vida e curso desfavorável da doença de base.

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Esta revisión narrativa describe el daño colateral de la pandemia de COVID-19, tanto en aspectos de la salud, como también sociales, educativos o económicos. Comunicamos el impacto mundial y local. Consideramos que varias de estas consecuencias eran inevitables, especialmente las sucedidas durante los primeros meses de una pandemia que se difundió a gran velocidad y con graves consecuencias directas en la morbimortalidad de la población. Sin embargo, luego de seis meses de su llegada a la Argentina, es oportuno revaluar la situación y replantearse si no se debería cambiar el enfoque para balancear la minimización del impacto directo de COVID-19 junto con la del daño colateral que las medidas para paliarlo produjeron. Es un desafío que no debe limitarse al sistema de salud. Debe encararse con un abordaje intersectorial amplio y con participación activa de la sociedad. Así como aplanamos la curva de COVID-19, cuanto más nos demoremos en aplanar las otras curvas de problemas sanitarios y sociales que se están generando, mayor será su impacto, tanto en el corto como en el largo plazo. (AU)

This narrative review shows the collateral damage of the COVID-19 pandemic, whether in health, social, educational or economic aspects. We report on the impact at the global and local levels. Many of these consequences were inevitable, especially in the first months of a pandemic that spread at great speed and with serious direct consequences on the morbidity and mortality of the population. However, six months after the arrival in our country, it is an opportunity to reassess the situation and rethink whether the approach should not be changed to balance the minimization of the direct impact of COVID-19 with that of the collateral damage that mitigation measures produced. This is a challenge that should not be limited to the health system. It must be addressed with a broad intersectoral approach and active participation of society. Just as we flatten the COVID-19 curve, the longer we delay in flattening the other curves of health and social problems that are being generated, the greater the impact, both in the short and long term. (AU)

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Resumo Este estudo objetiva identificar e discutir dilemas bioéticos na assistência médica a gestantes adolescentes. Trata-se de revisão integrativa, a partir de artigos indexados na Biblioteca Virtual em Saúde entre 2010 e 2015. Foram selecionados dois artigos que abordam a temática. De acordo com os estudos, houve queda significativa no número de partos entre jovens nos últimos cinco anos. Contudo, os índices ainda são preocupantes. Em consequência disso, encontraram-se dois eventos na relação médico-gestante adolescente: ética médica e aborto induzido, constando a autonomia e a não maleficência como dilemas bioéticos. A bioética proporciona reflexões sistemáticas ao envolver profissionais de saúde e educação na promoção da saúde sexual e ao dar assistência imediata às adolescentes, incluindo medidas preventivas de gravidez indesejada, com o intuito de evitar incidência de aborto e submissão das jovens a serviços clandestinos.

Abstract The aim of this study is to identify and to discuss some bioethical aspects involved in medical assistance to pregnant teenagers. Through Integrative Review, it was selected two articles tackling the same chosen theme, contained in the Biblioteca Virtual em Saúde (Virtual Health Library) and published between 2010 and 2015. Based on researches, there was a significant decrease in the number of births among adolescents in the last five years. However, the indices are still worrying. As a result, it was found two alternatives in the relationship between doctor and pregnant teenagers: medical ethics and induced abortion, it having the autonomy and not-malfeasance as bioethical dilemmas. The Bioethics provides systematic reflections in the sense of involving the professionals of health and education in sexual and reproductive health and providing assistance tothe young woman, in which preventive measures of an unwanted pregnancy avoid the Incidence of unsafe abortion and, consequently, avoid them to look for clandestine services.

Resumen Este estudio tiene como objetivo identificar y discutir algunos dilemas bioéticos en la asistencia médica a adolescentes embarazadas. Se trata de una revisión integradora, a partir de artículos indexados en la Biblioteca Virtual en Salud, entre los años 2010 y 2015. Se seleccionaron dos artículos que abordan esta temática. Según los estudios, hubo reducción significativa en el número de partos de las jóvenes en los últimos cinco años. Sin embargo, los niveles siguen siendo preocupantes. Como consecuencia de esto, se encontraron dos eventos en la relación entre el médico y las adolescentes embarazadas: ética médica y aborto inducido, considerando la autonomía y la no maleficencia como dilemas bioéticos. La bioética ofrece reflexiones sistemáticas al involucrar a los profesionales de la salud y de la educación en el fomento de la salud sexual y al proporcionar asistencia inmediata a las adolescentes, lo cual incluye medidas preventivas de un embarazo no deseado, con el objetivo de evitar la incidencia del aborto y la sumisión de las jóvenes a los servicios clandestinos.

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This study aimed to describe the consequences experienced in the life of a person with kidney transplantation. This is a descriptive and qualitative approach, using the Critical Incident Technique, in which the interview content was analyzed, in an attempt to isolate the consequences of the kidney transplantation, showing positive and/or negative references. When confronted with what kidney transplantation provided to people's life, the independence from the hemodialysis machine, the existence of a quiet and normal life, the sensation of well-being, and the possibility of performing activities were demonstrated. In compensation, the transplantation provided changes that led them to another reality. Although some changes in the life of these people occurred, the process of transplantation did not represent significant change, which could install suffering.

Este estudio tuvo como objetivo analizar las consecuencias provocadas en la vida de las personas con trasplante de riñón. Tiene un enfoque cualitativo, descriptivo, utilizando la Técnica de Incidentes Críticos, que analizó el contenido de las entrevistas, con el objetivo de aislar las consecuencias positivas y negativas que surgen después de un trasplante de riñón. Así con todo lo que el proceso de trasplante proporcionó en las vidas de las personas, se destacaron la independencia de la hemodiálisis, la existencia de una vida tranquila y normal y la sensación de bien-estar. Aúnque, promovido cambios que llevaron a una nueva realidad. Aúnque se han producido cambios en la vida de uno, el trasplante renal no representó cambios significativos que llevarían al sufrimiento.

Este estudo objetivou analisar as consequências acarretadas na vida da pessoa com o transplante renal. Possui abordagem qualitativa, do tipo descritivo, utilizando a Técnica dos Incidentes Críticos, em que analisou o conteúdo das entrevistas, almejando isolar as consequências positivas e negativas advindas após o transplante renal. Diante do que o processo de transplantação proporcionou na vida das pessoas, destacaram a independência do tratamento hemodialítico, a existência de uma vida tranquila e normal e a sensação de bem-estar. Em compensação, promoveu alterações que conduziram a uma nova realidade. Embora tenham acontecido mudanças na vida da pessoa, o transplante renal não representou alterações significativas que levassem ao sofrimento.

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O presente artigo objetiva explicitar autopesquisa da autora sobre aspectos relacionadosao erro, incluindo origens, mecanismos, consequências e o círculo vicioso doerro, quando não reciclado. Apresenta uma proposta de espiral da autopesquisa doerro para oportunizar o aprendizado decorrente da autovivência. A metodologia utilizadafoi o estudo bibliográfico do tema e da autopesquisa da autora. Traz técnicasconscienciológicas para a análise, a autopesquisa e a autorretratação cosmoética doserros. Como resultados observou-se a desdramatização, a reparação e a profilaxia doserros além da higiene mental sobre deslizes passados e superação de erros evolutivos.Na conclusão, ressalta a importância de analisar as autovivências enquanto ferramentade autopesquisa, de reciclagens intraconscienciais e de aprimoramento da intencionalidadecosmoética(AU)

The present article aims at to explicit the author's self-research on aspects relatedto mistake, including origins, mechanisms, consequences and the vicious circle ofmistake, when not recycled. It presents a proposal of self-research mistake spiral toproportionate the learning due to self-experience. The used methodology was the bibliographicalstudy of the theme and the author's self-research. She brings conscientiologicaltechniques for the analysis, the self-research and the cosmoethical self-retrac -tion of mistakes. As results it was observed the removal of dramatization, therepairing and the prophylaxis of the mistakes, besides the mental hygiene on passedlapses and overcoming of evolutionary mistakes. In the conclusion, it emphasizes theimportance of analyzing self-experiences as self-research tool, intraconsciential recyclingsand improvement of cosmoethical intentionality(AU)

El presente artículo objetiva explicitar la auto-investigación de la autora sobre aspectosrelacionados al error, incluyendo orígenes, mecanismos, consecuencias y círculovicioso del error, cuando no es reciclado. Presenta una propuesta de espiral de laauto-investigación del error para oportunizar el aprendizaje proveniente de la autovivencia.La metodología utilizada fue el estudio bibliográfico del tema y de la autoinvestigaciónde la autora. Se ofrecen técnicas concienciológicas para el análisis, laauto-investigación y la auto-retractación cosmoética de los errores. Como resultado,se observó la desdramatización, la reparación y la profilaxis de los errores, más alláde la higiene mental sobre deslices pasados y la superación de errores evolutivos. Enla conclusión, se resalta la importancia de analizar las autovivencias cual herramientade auto-investigación, de reciclajes intraconcienciales y de primoreo de la intenciona -lidad cosmoética(AU)

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The treatment of pseudoarthrosis is often long and with great financial and social cost. The aim of this study was to analyze the costs and consequences of stem cells application in patients with pseudoarthrosis. Methodology: This study is an economic analysis of costs and consequences. It was undertaken in a University Hospital from September 2008 to December 2010. The direct costs and time to fracture healing of eight patients were raised. Results: The follow up of patients after the procedure was for six months. From eight patients, seven were healed. The healing time was an average of 14.7 weeks. The direct costs of hospital treatment was R$ 1,207.75. Conclusion: The results of this study are encouraging. The future challenge will be to increase the sample and evaluate the effectiveness of this procedure.

El tratamiento de pseudartrosis es, muchas veces, largo y con gran costo financiero y social. El objetivo de este estudio fue analizar los costos y las consecuencias de la aplicación de células-tronco en pacientes con pseudartrosis. Metodología: Se trata de un análisis económico de costo y consecuencias. Éste fue realizado en un Hospital Universitario en el período de septiembre de 2008 a diciembre de 2010. Fueron presupuestados los costos directos y el tiempo para la consolidación de la fractura de ocho pacientes. Resultados: El tiempo de acompañamiento de los pacientes después del procedimiento fue de seis meses, siendo que, de los ocho pacientes tratados, siete están curados. El tiempo de consolidación fue en media de 14,7 semanas. Los costos directos del tratamiento hospitalario fue de R$ 1.207,75. Consideraciones finales: Los resultados de este estudio son animadores. El desafío futuro será aumentar la muestra e analizar la efectividad de este procedimiento.

O tratamento de pseudoartroses é, muitas vezes, longo e com grande custo financeiro e social. O objetivo deste estudo foi analisar os custos e as consequências da aplicação de células-tronco em pacientes com pseudartrose. Metodologia: Trata-se de uma análise econômica de custo e consequências. Este foi realizado em um Hospital Universitário no período de setembro de 2008 a dezembro de 2010. Foram levantados os custos diretos e o tempo para consolidação da fratura de oito pacientes. Resultados: O tempo de acompanhamento dos pacientes após o procedimento foi de seis meses, sendo que, dos oito pacientes tratados, sete estão curados. O tempo de consolidação foi em média de 14,7 semanas. Os custos diretos do tratamento hospitalar foi de R$ 1.207,75. Considerações finais: Os resultados deste estudo são animadores. O desafio futuro será aumentar a amostra e avaliar a efetividade deste procedimento.

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El presente estudio pretende determinar la frecuencia, evitabilidad y consecuencias de los Eventos Adversos (EA) ocurridos en los servicios de hospitalización basándose en las fichas epidemiológicas e historias clínicas de pacientes que hayan tenido un evento durante este periodo. Como resultados se encontró con mayor frecuencia los Eventos Adversos (EA) son debidos a algún procedimiento (63%): suspensión quirúrgica (38%), seguido de otras complicaciones R/C intervención quirúrgica o procedimiento (13.3%), viéndose mayormente afectada la población masculina (61%), en edades de 10 a 29 años (37%). El servicio donde se presentan más frecuentemente estos eventos es cirugía (52%). Esta problemática produce deterioro físico en un 100% en el paciente, además de aumentar la estancia hospitalaria de 1-2 días (91.7%), siendo el mayor factor causal el tipo de asistencia sanitaria que recibe el paciente. Estos eventos pudieron haber sido evitados en un 74% de los casos. En conclusión el presente estudio mostró que los eventos adversos ocurridos con mayor frecuencia fueron los relacionados con algún procedimiento y/o cuidados, siendo de estos, los más comunes la cancelación de turnos quirúrgicos y quemaduras, erosiones y contusiones (incluyendo fracturas consecuentes) respectivamente. Lo que produjo una prolongación de los días de estancia, lo cual no ocasionó directamente situaciones de gravedad o repercusiones importantes en el estado de salud del paciente; pero la aparición de estos Eventos Adversos (E.A) son completamente prevenibles, puesto que tiene que ver directamente con las prácticas de cuidado impartidas por el personal de salud, que requieren mayor concentración al momento de realizar cualquier procedimiento, si se toman en cuenta las medidas necesarias para garantizar la seguridad del paciente.

This study aims to determine the frequency, preventability and consequences of adverse events (AEs) occurring in hospital services based on epidemiologic and clinical records of patients who have had an event during this period. As a result of this most frequently encountered adverse events (AE) it was found that they were due to procedure (63%)as surgical suspension (38%), followed by other complications R / C surgery or procedure (13.3%). the most affected population are male (61%), aged 10 to 29 years (37%). The service in which these events occur more frequently is surgery (52%). This problem causes physical damage by 100% in the patient, moreover it will increase the hospital stay of 1-2 days (91.7%), it is the largest causing factor the type of health care to the patient. These events could have been avoided in 74% of cases. In conclusion this study showed that adverse events occurred most frequently were related to any procedure and / or care. They were the most common; surgical termination of turns and burns, abrasions and contusions (including resulting fractures) respectively. It produced prolongation of the days of stay, which not directly causes serious situations or significant impact on patient health status, but the occurrence of these adverse events (AEs) are completely preventable, since they are related to the practices of care given by health personnel, who require more concentration when performing any procedure, if one takes into account the measures necessary to ensure patient safety

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Antecedentes: La severidad de los efectos que la violación provoque en una adolescente dependerá de una serie de variables tanto personales, familiares, variables relacionadas con la violación misma, pero un elemento importante para aliviar el daño causado a la víctima y ayudar a su tratamiento es efectuar la denuncia y lograr con esto la sanción para el agresor. Objetivo: Determinar los factores asociados al proceso de denuncia de la violación en un grupo de mujeres que sufrieron violación en su niñez o adolescencia atendidas en un Centro Universitario de Atención en Salud Sexual y Reproductiva. Material y método: Se estudió un grupo de 225 adolescentes con antecedente de violación. A todas ellas se les aplicó un cuestionario al ingreso y entrevistas y visitas domiciliarias posteriores. Se estudiaron variables personales y familiares seleccionadas. Se realizo análisis uni, bivariado y OR para explicar las variables seleccionadas y denuncia efectuada. Se utilizo los software EPI-INFO 6.0 y STATA 8.0. Resultados: La violación intrafamiliar se asocio a: violación reiterada, que ocurriera en el hogar de la adolescente y el agresor, rabia y odio como reacción a la violación, amenaza o intimidación como factor asociado a la violación, amenaza del agresor como razón de denuncia tardía, y como razón para no denunciar que el agresor sea un familiar. La violación extrafamiliar se asoció a que la violación fuera única, que ocurra en el trayecto entre la casa y el colegio, que el temor a enfrentar a los padres y tutores sea la razón para que la denuncia sea tardía y desconfianza de la justicia como razón de no denuncia. Las variables asociadas con la no denuncia fueron: no estudiante, antecedente de maltrato, y reacción de rabia y odio contra el agresor. Al estratificar por tipo de violación la diferencia es mas marcada para la violación extrafamiliar.

Background: The severity of the effects caused by rape will depend on a serie of personal, family variables as others related to rape itself, but an important element to relieve damage caused to the victim and support her treatment is to make a formal complaint and thus to get the aggressor punishment. Aim: To determine the factors related to the formal complaint process of the rape in a group of women who suffered rape during childhood or adolescence. Material and methods: A group of 225 adolescent women with rape record was studied. A questionnaire was applied to all of them at the first visit to CEMERA and interviews and home visit were performed after wards. Uni, bivariate and OR analysis to explain the selected variables and the formal complaint were performed. EPI-INFO 6.0 and STATA 8.0 softwares were used. Results: Intrafamilial rape was associated to: repetitive rape, that take place at adolescent and aggressor home, rage and hate as an after-rape reaction, threat and intimidation as a factor related to rape, delayed formal complaint due to aggressor threat and, also the fact that the abuser is a relative is a reason for not making the formal complaint. Extrafamilial rape was associated to: unique, that happens during the home-school way, fear to parents is a reason for the delay of the formal complaint. Variables related to the non making formal complaint were: victim was not a student, she has maltreatment record and she expresses rage and hate against aggressor. This difference was more relevant for the extrafamilial rape.

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