ABSTRACT Objective: To describe self-perceived overweight and obesity in university students. Case Medical School, Ecuador. Methodology: The positivist paradigm was used from the quantitative perspective, with a non-experimental design, the type of research is field and descriptive level application of a questionnaire to a group of university students, a questionnaire was structured with the Kobotoolbox tool, which had a total of 27 questions containing socio demographic issues and specific topics to analyze the presence of obesity and overweight. Results: The more class time, the more screen time, the less physical activity. Conclusion: It is shown that being sedentary increases in 2.8 times the probability of being overweight, although it is not significantly significant, it becomes a risk factor to be considered.

RESUMEN Objetivo: Describir el Sobrepeso y obesidad autopercibidos en estudiantes universitarios. Caso: Medicina-Escuela Superior Politécnica de Chimborazo, Ecuador. Metodología: Se empleó el paradigma positivista desde la perspectiva cuantitativa, con un diseño no experimental, el tipo de investigación es de campo y el nivel descriptivo, con aplicación de un cuestionario a un grupo de estudiantes universitarios de Medicina, Escuela Superior Politécnica de Chimborazo, Riobamba, Ecuador; se estructuró un cuestionario con la herramienta Kobotoolbox, misma que contó con un total de 27 preguntas que contenían temas socio demográficos y temas específicos para analizar la presencia de obesidad y sobrepeso. Resultados: Mientras más tiempo de clases más tiempo de pantalla y esto da menos actividad física. Conclusión: Se demuestra que ser sedentario aumenta en 2,8 veces la probabilidad de sufrir sobrepeso, aunque no es determinante, se convierte en un factor de riesgo a ser considerado.

ABSTRACT Objective: The general objective of the research was to describe the evaluation of suicidal risk in university students. Methodology: A quantitative, non-experimental, cross-sectional research was carried out; within the goals set out in this study, the manipulation of the variables to be studied was not contemplated. The study had a descriptive observational scope, with the goal of recording, analyzing and interpreting the current nature of the population studied. The survey was sent through the Google Forms platform. The survey was sent to 77 medical students of the Escuela Superior Politécnica de Chimborazo, Ecuador (ESPOCH). Results: It was found that 66.66% presented low suicidal risk, 14.66% medium risk and 18.66% corresponded to high risk according to the SAD PERSONS scale. In conclusion: The research shows that the population of medical students presents some level of suicidal risk. The problem described should be deepened to clarify the consequences.

RESUMEN Objetivo: El objetivo general de la investigación fue describir la evaluación de riesgo suicida en estudiantes universitarios. Metodología: Se realizó una investigación de tipo cuantitativo, no experimental de corte transversal. Dentro de las metas planteadas en este estudio no se contempla la manipulación de las variables a estudiar. El estudio tuvo un alcance descriptivo observacional, teniendo como meta el registro, análisis e interpretación de la naturaleza actual de la población estudiada. Mediante la plataforma Google Forms se envió la encuesta a 77 estudiantes de Medicina, de la Escuela Superior Politécnica de Chimborazo, Ecuador. (ESPOCH). Resultados: Se obtuvo que el 66.66% presenta riesgo suicida bajo, 14.66% riesgo medio y 18.66% corresponde a riesgo alto según la escala de SAD PERSONS. En conclusión: La investigación muestras que la población de estudiantes de Medicina, presenta algún nivel de riesgo suicida. La problemática descrita debe ser profundizada para esclarecer las consecuencias.

Abstract Annie Ernaux has been the subject of considerable attention in the Brazilian publishing landscape, especially after her 2022 Nobel Prize in Literature and the recent translations of five of her books published by Fósforo. In this essay, I intend to explore the apparently contradictory place that fiction occupies in her work: in a series of interviews (ERNAUX, 2011), Ernaux argues that her literary production involves, at the same time, the incorporation and the questioning of the fictional. To flesh out my argument, I will examine two long excerpts from The Years (2008), proposing a dialogue with Wolfgang Iser, Ivan Jablonka, Luiz Costa Lima, and Pierre Bourdieu. My goal will be to show that the project of a sentence "full of real things" cannot be detached from a certain fictional elaboration; after all, it is the perspectivation through fiction that allows putting life and facts in parentheses in order to better approach them and better think of them.

Résumé Annie Ernaux s'impose de plus en plus dans le paysage éditorial brésilien, notamment après le Nobel de littérature 2022 et les récentes traductions de cinq de ses livres, publiées par la maison d’édition Fósforo. J'ai l'intention d'explorer dans cet essai la place apparemment contradictoire que la fiction occupe dans son œuvre : dans une série d'entretiens (ERNAUX, 2011), l'auteure soutient que sa production littéraire implique, à la fois, l'incorporation et la mise en question du fictionnel. Pour ce faire, j'examinerai deux longs extraits de Les années (2008), en proposant un dialogue avec Wolfgang Iser, Ivan Jablonka, Luiz Costa Lima et Pierre Bourdieu. Mon objectif sera de montrer que le projet d'une phrase "pleine de choses réelles" ne peut se détacher d'une certaine élaboration fictionnelle, après tout, c'est la mise en perspective par la fiction qui permet de mettre la vie et les faits entre parenthèses pour mieux les approcher et mieux les penser.

Resumo Annie Ernaux vem ganhando um destaque cada vez maior na paisagem editorial brasileira, sobretudo após o Nobel de Literatura 2022 e as recentes traduções de cinco de seus livros pela editora Fósforo. Pretendo explorar, neste ensaio, o lugar aparentemente contraditório que a ficção ocupa em sua obra: em uma série de entrevistas (ERNAUX, 2011), a autora defende que sua produção literária implica, a um só tempo, a incorporação e o questionamento do ficcional. Para dar corpo ao meu argumento, examinarei dois longos trechos de um livro de Ernaux, Os anos (2008), propondo um diálogo com Wolfgang Iser, Ivan Jablonka, Luiz Costa Lima e Pierre Bourdieu. Meu objetivo é mostrar que o projeto de uma frase “cheia de coisas reais” não consegue se desvencilhar de certa elaboração ficcional, afinal, é a perspectivação pela via da ficção que permite colocar a vida e os fatos entre parênteses para melhor se aproximar deles e melhor pensá-los.

ABSTRACT Introduction: Fatigue is an important health concern that requiring appropriate assessment, diagnosis and nursing care planning focused on those who suffer from it. Objective: To validate the content of NANDA-I nursing diagnosis of fatigue (00093) in the version included in a clinical database. Methods: Descriptive and exploratory study of diagnostic content validation by experts following Fehring's proposal. The setting of the study was Spain. Data collection was carried out between June 2019 and March 2020. The participating experts had experience and training in the use of standardized nursing languages. Results: Of the thirteen characteristics that define the diagnosis included in the database, seven were validated as major, five as minor and one was not validated. All sixteen related factors of the diagnosis were validated. The content validity index of the diagnosis was 0.81. Conclusions: The diagnosis obtained a high content validity index. The components of the NANDA-I diagnosis of fatigue (00093) in the clinical database version correspond with those present in the NANDA-I diagnosis of fatigue (00093) in the NANDA-I Classification 2018-2020. The current research is considered to contribute with an increase in diagnostic accuracy by identifying key defining characteristics for the diagnosis. At the same time, it validates related factors that have an influence on the diagnosis but are not incorporated among the components of the NANDA-I diagnosis of fatigue (00093) in the 2018-2020 edition of the NANDA-I Classification.

RESUMEN Introducción: La fatiga constituye un importante problema de salud que precisa de una adecuada valoración, diagnóstico y planificación de cuidados enfermeros centrados en quienes la sufren. Objetivo: Validar el contenido del diagnóstico enfermero NANDA-I Fatiga (00093) en la versión incluida en una base de datos clínica. Métodos: Estudio descriptivo y exploratorio de validación de contenido diagnóstico mediante expertos siguiendo la propuesta de Fehring. El ámbito de estudio fue España. La recogida de datos se realizó entre los meses de junio 2019-marzo 2020. Los expertos participantes disponían de experiencia y formación en el uso de lenguajes estandarizados enfermeros. Resultados: De las 13 Características Definitorias con las que cuenta el diagnóstico incluido en la base de datos, siete fueron validadas como mayores, cinco como menores y una no fue validada. Los 16 Factores Relacionados del diagnóstico fueron validados. El Índice de Validez de Contenido del diagnóstico fue de 0,81. Conclusiones: El diagnóstico obtuvo un Índice de Validez de Contenido elevado. Los componentes del diagnóstico NANDA-I Fatiga (00093) en la versión de la base de datos clínica guardan correspondencia con los presentes en el diagnóstico NANDA-I Fatiga (00093) en la Clasificación NANDA-I 2018-2020. Se considera que la investigación actual contribuye a incrementar la precisión diagnóstica al identificar Características Definitorias claves de la presencia del diagnóstico. Al tiempo valida Factores Relacionados influyentes en el diagnóstico no incorporados en los componentes del diagnóstico NANDA-I Fatiga (00093) en la edición de la Clasificación NANDA-I 2018-2020.

ABSTRACT Background: This research addresses two questions: (1) how El Niño Southern Oscillation (ENSO) affects climate variability and how it influences dengue transmission in the Metropolitan Region of Recife (MRR), and (2) whether the epidemic in MRR municipalities has any connection and synchronicity. Methods: Wavelet analysis and cross-correlation were applied to characterize seasonality, multiyear cycles, and relative delays between the series. This study was developed into two distinct periods. Initially, we performed periodic dengue incidence and intercity epidemic synchronism analyses from 2001 to 2017. We then defined the period from 2001 to 2016 to analyze the periodicity of climatic variables and their coherence with dengue incidence. Results: Our results showed systematic cycles of 3-4 years with a recent shortening trend of 2-3 years. Climatic variability, such as positive anomalous temperatures and reduced rainfall due to changes in sea surface temperature (SST), is partially linked to the changing epidemiology of the disease, as this condition provides suitable environments for the Aedes aegypti lifecycle. Conclusion: ENSO may have influenced the dengue temporal patterns in the MRR, transiently reducing its main way of multiyear variability (3-4 years) to 2-3 years. Furthermore, when the epidemic coincided with El Niño years, it spread regionally and was highly synchronized.

Resumen Introducción: En las últimas décadas se está produciendo un envejecimiento progresivo de nuestra población, lo cual conlleva que el deterioro cognitivo sea uno de los principales problemas a abordar. La enfermera comunitaria juega un rol crucial en el cribado del deterioro cognitivo, y para ello cuenta con numerosos cuestionarios para tal valoración, como el Eurotest, el Pfeiffer, o el Fototest, entre otros. El más usado en Atención Primaria es el Mini-Examen Cognoscitivo (MEC-35). Objetivo: Valorar la fiabilidad del cuestionario MEC-35 aplicado por enfermeras a pacientes en el ámbito de la Atención Primaria. Material y Métodos: Estudio de fiabilidad inter-intra enfermeras del MEC-35 en su empleo en el contexto de la Atención Primaria. Resultados: La concordancia bruta global entre enfermeras fue del 77(69-83) % y la libre de azar según la kappa de Cohen del 49(30-68) % (p<0,001). La concordancia global bruta intra enfermeras fue del 72(68-83) % y la libre de azar del 55(27-83) % (p=0,002). En la valoración de la fiabilidad entre-enfermeras 5 ítems (14%) obtuvieron una concordancia nula según el criterio de Landis-Koch y en la intra-enfermeras 8 (23%). Discusión: A pesar de unificar criterios entre las enfermeras que aplicaron esta herramienta, y teniendo en cuenta los resultados del estudio, se propone la eliminación de algunos ítems con muy baja concordancia y la modificación del enunciado de otros para mejorar esa fiabilidad en su empleo por enfermeras comunitarias. Tal transformación requiere de la prueba de validez y fiabilidad de esta versión del MEC-35. Conclusión: El MEC-35, a pesar de ser una herramienta de cribado ampliamente empleada entre las enfermeras, presenta unos valores de fiabilidad insuficientes.

Abstract Introduction: In recent decades, a progressive aging of our population has been taking place, which means that cognitive deterioration is one of the main problems to be addressed. The community nurse plays a crucial role in screening for cognitive impairment, and for this it has numerous questionnaires for such assessment, such as the Eurotest, the Pfeiffer, or the Fototest, among others. The most used in our environment is the Mini-Examen Cognoscitivo (MEC-35). Aim: To assess the reliability of the MEC-35 questionnaire applied by nurses to patients in the Primary Care setting. Material and methods: Inter-intra nurse reliability study of the MEC-35 in its use in the context of Primary Care. Results: The overall gross concordance between nurses was 77 (69-83) % and the random agreement according to Cohen's kappa was 49 (30-68) % (p <0.001). The gross global concordance within nurses was 72 (68-83) % and the free of chance 55 (27-83) % (p = 0.002). In the inter-nurse reliability assessment, 5 items (14%) obtained null concordance according to the Landis-Koch criterion, and 8 (23%) in intra-nurses reliability. Conclusions: The MEC-35, despite being a widely used screening tool among nurses, has insufficient confidence values. Discussion: Despite unifying criteria among the nurses who applied this tool, and taking into account the results of the study, it is proposed to eliminate some items with very low concordance and modify the wording of others to improve reliability in their use by community nurses. Such transformation requires the validity and reliability test of this version of the MEC-35.

Resumen Referencia del documento de práctica clínica basada en la evidencia: Tiantian Z, Xiaohong W, Gangyi P, Qian Z, Lianhua C, Zehua C, Huanzhen O. Effectiveness of Standardized Nursing Terminologies for Nursing Practice and Healthcare Outcomes: A Systematic Review. International Journal of Nursing Knowledge. Int J Nurs Knowl. 2021; (1): 1-9.

Abstract Video consultation (VC) represents a novel method of healthcare interaction in the context of a coronavirus pandemic. To carry out VC it is necessary to have specific technology: a program to generate virtual meetings, a computer, tablet and/or mobile phone with an integrated camera and microphone. Training is key for the process to be successful and it is not without its difficulties. This article describes the concept of VC, its use in Primary Care (PC), the role of nurses in its use, as well as an experience of implementation in PC in Tenerife.

Resumen La videoconsulta (VC) representa un método novedoso de interacción asistencial en el contexto de pandemia por coronavirus. Para realizar la VC es necesario contar con tecnología específica: un programa para generar reuniones virtuales, ordenador, tableta y/o móvil con cámara y micrófono integrados. La formación es clave para que el proceso sea exitoso y éste no está exento de dificultades. Este artículo describe el concepto de VC, su uso en Atención Primaria (AP), el rol de las enfermeras en su utilización, así como una experiencia de implantación en AP de Tenerife.

Abstract Adaptative grieving is a natural and self-limiting adjustment to a new reality that arises after a significant loss, real or perceived, with a wide range of manifestations that impact the health of the bereaved. Research on grief has modified the way we understand its processes so that its classification has drastically changed. The different types of grief can be grouped into two categories: adaptive grieving and maladaptive grieving. The latter group includes a pool of processes, including traumatic grievieng, complicated grieving and spiritual grieving. The specialized literature gathers different scales and measuring instruments that help toassess the course and risk of complications throughout grief. There is an increasing number of research associated with the continuity of bonds. And there is also a need to evaluate the effectiveness of this connection and its adaptive capacity.

Resumen El duelo es un proceso de adaptación natural y autolimitado a una nueva realidad que surge tras una pérdida significativa, real o percibida, con un amplio abanico de manifestaciones que producen un impacto en la salud del doliente. Las investigaciones en torno al duelo, han modificado el modo de entender sus procesos, con lo que su clasificación ha variado drásticamente. Los diferentes tipos de duelo pueden agruparse en dos grandes categorías: duelo adaptativo y duelo no adaptativo, incluyendo en este último conjunto un conglomerado de procesos que incluyen el duelo traumático, el duelo complicado y el duelo espiritual. La literatura especializada, recoge diferentes escalas e instrumentos de medida que ayudan a evaluar el curso y el riesgo de complicaciones en el transcurso del duelo. Cada vez son más numerosas las investigaciones asociadas a la continuidad de vínculos, siendo necesaria una evaluación de la efectividad de esta conexión y de su capacidad de adaptación.

Resumo Fundamento A intervenção percutânea em pacientes com disfunção de prótese biológica mitral apresenta-se como uma alternativa ao tratamento cirúrgico convencional. Objetivo Relatar a primeira experiência brasileira de implante transcateter de bioprótese valve-in-valve mitral via transeptal (TMVIV-via transeptal). Métodos Foram incluídos pacientes portadores de disfunção de bioprótese cirúrgica submetidos ao TMVIV-transeptal em 12 hospitais brasileiros. Foram considerados estatisticamente significativos valores de p<0,05. Resultados Entre junho/2016 e fevereiro/2019, 17 pacientes foram submetidos ao TMVIV-via transeptal. A mediana de idade foi 77 anos (IIQ,70-82), a mediana do escore STS-PROM foi 8,7% (IIQ,7,2-17,8). Todos os pacientes tinham sintomas limitantes de insuficiência cardíaca (CF≥III), tendo 5 (29,4%) sido submetidos a mais de uma toracotomia prévia. Obteve-se sucesso do TMVIV-via transeptal em todos os pacientes. A avaliação ecocardiográfica demonstrou redução significativa do gradiente médio (pré-intervenção, 12±3,8 mmHg; pós-intervenção, 5,3±2,6 mmHg; p<0,001), assim como aumento da área valvar mitral (pré-intervenção, 1,06±0,59 cm2; pós-intervenção, 2,18±0,36 cm2; p<0,001) sustentados em 30 dias. Houve redução significativa e imediata da pressão sistólica de artéria pulmonar, com redução adicional em 30 dias (pré-intervenção, 68,9±16,4 mmHg; pós-intervenção, 57,7±16,5 mmHg; 30 dias, 50,9±18,7 mmHg; p<0,001). Durante o seguimento, com mediana de 162 dias (IIQ, 102-411), observou-se marcada melhora clínica (CF≤II) em 87,5%. Um paciente (5,9%) apresentou obstrução de via de saída de ventrículo esquerdo (VSVE), evoluindo para óbito logo após o procedimento, e outro morreu aos 161 dias de seguimento.Conclusão: A primeira experiência brasileira de TMVIV-transeptal demonstra a segurança e a efetividade dessa nova técnica. A obstrução da VSVE é uma complicação potencialmente fatal, reforçando a importância da seleção dos pacientes e do planejamento do procedimento. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

Abstract Background Percutaneous intervention in patients with bioprosthetic mitral valve dysfunction is an alternative to conventional surgical treatment. Objectives To report the first Brazilian experience with transseptal transcatheter bioprosthetic mitral valve-in-valve implantation (transseptal-TMVIV). Methods Patients with surgical bioprosthetic dysfunction submitted to transseptal-TMVIV in 12 Brazilian hospitals were included. The significance level adopted was p<0.05. Results From June/2016 to February/2019, 17 patients underwent transseptal-TMVIV. Their median age was 77 years (IQR,70-82) and median Society of Thoracic Surgeons predicted risk of mortality (STS-PROM) score was 8.7% (IQR,7.2-17.8). All patients had limiting symptoms of heart failure (FC≥III) and 5 (29.4%) had undergone more than one previous thoracotomy. Transseptal-TMVIV was successful in all patients. Echocardiographic assessment showed a significant reduction in mean mitral valve gradient (pre-intervention, 12±3.8 mmHg; post-intervention, 5.3±2.6 mmHg; p<0.001), in addition to an increase in mitral valve area (pre-intervention, 1.06±0.59 cm2; post-intervention, 2.18±0.36 cm2; p<0.001) sustained for 30 days. There was a significant and immediate reduction in the pulmonary artery systolic pressure, with an additional reduction in 30 days (pre-intervention, 68.9±16.4 mmHg; post-intervention, 57.7±16.5 mmHg; 30 days, 50.9±18.7 mmHg; p<0.001). During follow-up (median, 162 days; IQR, 102-411), significant clinical improvement (FC≤II) was observed in 87.5% of the patients. One patient (5.9%) had left ventricular outflow tract (LVOT) obstruction and died right after the procedure, and another died at 161 days of follow-up. Conclusion The first Brazilian experience with transseptal-TMVIV shows the safety and effectivity of the new technique. The LVOT obstruction is a potentially fatal complication, reinforcing the importance of patients’ selection and of procedural planning. (Arq Bras Cardiol. 2020; [online].ahead print, PP.0-0)

RESUMO: A perfusão regional intravenosa (PRI) em membros de equinos é um método comprovadamente eficiente para o tratamento de infecções sinoviais, porém ainda existem lacunas quanto à dose, volume e intervalos de administração a serem utilizados. Neste estudo, objetivou-se avaliar a concentração intra-articular da gentamicina administrada por PRI em equinos, ao longo de 24 horas pós-administração, bem como avaliar a influência do volume total perfundido. Vinte equinos foram distribuídos em dois grupos experimentais, Grupo Gentamicina 60 (G60) e Grupo Gentamicina 250 (G250), representados por 10 equinos em cada grupo que receberam, por PRI, 6,6 mg/kg de gentamicina diluída em Ringer lactato para um total de 60 ml (G60) ou 250 ml (G250). As colheitas de líquido sinovial foram realizadas, na articulação metacarpo-falangeana, antes do início do experimento e após 4, 8, 12, 16, 20, e 24 horas. Difusão em ágar foi o método para doseamento das concentrações de gentamicina. Quatro horas após a PRI, a concentração intra-articular da gentamicina era de 47,58±49,21 µg/ml no G60 e 10,92±6,11 µg/ml no G250. Durante as 24 horas de colheita, a concentração intra-articular de gentamicina permaneceu acima da concentração inibitória mínima (CIM) (2 μg/ml) em ambos os grupos experimentais. No G60, as concentrações de gentamicina no líquido sinovial atingiram a concentração máxima e mantiveram-se 8 a 10 vezes mais elevadas que a CIM (Cmáx: 16 a 20 μg/ml) durante 12 horas após a PRI. Conclui-se que a PRI em membros, com 6,6 mg/kg de gentamicina diluída para o volume de 60 ml, promove concentrações intra-articulares mais elevadas que o volume de 250 ml, permanecendo acima da CIM durante 24 horas e em concentração máxima durante 12 horas.

ABSTRACT: Intravenous regional limb perfusion (IRLP) is an efficient method to treat horses with synovial infections. However, information on the dose, volume, and intervals of administration is lacking. The aim of this study was to evaluate the intra-articular concentration of gentamicin administered by IRLP in horses over 24 h post-administration and evaluate the influence of the total perfused volume. Twenty horses were assigned to two treatment groups. Gentamicin 60 group (G60, n=10) and Gentamicin 250 group (G250, n=10) received IRLP of 6.6 mg/kg of gentamicin diluted in Ringer’s lactate for a total volume of 60 ml (G60) and 250 ml (G250), respectively. Synovial fluid harvests were performed in the metacarpophalangeal joint before (0) and 4, 8, 12, 16, 20, and 24 hours after IRLP. Agar diffusion was the assay for measuring gentamicin concentrations. Four hours after IRLP, the intra-articular concentration of gentamicin was 47.58±49.21 μg/ml in G60 and 10.92±6.11 μg/ml in G250. During the 24 h of harvest, the intra-articular concentration of gentamicin remained above the minimum inhibitory concentration for horses (MIC; 2 μg/ml) in both experimental groups. In G60, the concentration of gentamicin in synovial fluid reached the maximal concentration and remained 8 to 10-fold higher than the MIC (Cmax: 16 to 20 μg/ml) during 12 h after IRLP. These findings support that IRLP with 6.6 mg/kg of gentamicin diluted to a volume of 60 ml promotes intra-articular concentrations higher than 250 ml, remaining above the MIC for 24 h and at the maximum concentration for 12 h.

Abstract This study presents the results of a prioritization exercise of standardized nursing languages, belonging to the psychosocial area, carried out in the context of a 20-hour training program. A total of 15 nurses participated, most of them from specialized care, with work experience, regular users of these languages, with previous training in this regard and a favorable attitude. The following NANDA-I diagnoses were prioritized: 00146 Anxiety, 00054 Risk for loneliness, 00150 Risk for suicide, 00053 Social isolation and 00214 Discomfort. Among the NOC outcome criteria, the following were prioritized: 1205 Self-esteem, 0300 Self-care: activities of daily living, 1209 Motivation, 1204 Emotional balance and 1211 Anxiety level. And among the NIC interventions: 4920 Active listening, 5270 Emotional support, 5250 Decision-making support, 7040 Support for the main caregiver and 7140 Support for the family. Subsequently, the main diagnostic and outcome indicators were selected, describing the degree of overlap between them. Likewise, for the interventions, the activities prioritized by the working group were related to the available evidence.

Resumen En este estudio se presentan los resultados de un ejercicio de priorización de lenguajes enfermeros estandarizados, pertenecientes al área psicosocial, realizado en el contexto de un programa formativo de 20 horas. Participaron un total de 15 enfermeras, la mayoría del ámbito de atención especializada, con experiencia laboral, utilizadoras habituales de estos lenguajes, con formación previa al respecto y actitud favorable. Se priorizaron los siguientes diagnósticos de NANDA-I: 00146 Ansiedad, 00054 Riesgo de soledad, 00150 Riesgo de suicidio, 00053 Aislamiento social y 00214 Disconfort. Entre los criterios de resultado NOC, se priorizaron: 1205 Autoestima, 0300 Autocuidados: actividades de la vida diaria, 1209 Motivación, 1204 Equilibrio emocional y 1211 Nivel de ansiedad. Y entre las intervenciones NIC: 4920 Escucha activa, 5270 Apoyo emocional, 5250 Apoyo en la toma de decisiones, 7040 Apoyo al cuidador principal y 7140 Apoyo a la familia. Posteriormente, se seleccionaron los principales indicadores diagnósticos y de resultado, describiendo el grado de solapamiento entre ellos. Asimismo, para las intervenciones, se relacionaron las actividades priorizadas por el grupo de trabajo con la evidencia disponible.

RESUMO A implantação de novas políticas públicas de provimento de profissionais de saúde para a atenção básica demandou a oferta de oportunidades educacionais. O objetivo é apresentar a iniciativa do Sistema Universidade Aberta do SUS (UNA-SUS) na oferta de cursos de especialização em atenção básica aos profissionais dos programas de provimento. Participaram das ofertas 15 instituições públicas de ensino superior do Sistema UNA-SUS. Foram estudantes 41.100 profissionais de todo o Brasil, entre eles, médicos, dentistas e enfermeiros. Foram analisados os dados provenientes da Plataforma Arouca do Sistema UNA-SUS, sendo selecionados como indicadores quantitativos para análise o número de profissionais que concluíram o curso, de profissionais aguardando ingresso no curso, de estudantes cursando, de estudantes falecidos, de estudantes inativados sem ingresso e de estudantes reprovados ou que abandonaram o curso. Foi realizada ainda a análise de 2163 Trabalhos de Conclusão de Curso (TCC) que estavam disponíveis no Acervo de Recursos Educacionais em Saúde do Sistema UNA-SUS entre os meses de maio e outubro de 2017. Foi possível realizar uma análise quantitativa e qualitativa seguindo as orientações do pensamento hermenêutico-dialético. Os resultados mostraram que até o momento 20.437 profissionais dos programas de provimento concluíram os cursos de especialização em atenção básica e ainda há 8.201 cursando. Em relação ao TCC, observou-se que as doenças crônicas não transmissíveis, os tumores e os problemas relacionados à gravidez, parto e puerpério, assim como aspectos relacionados à saúde infantil e saúde do idoso foram os mais evidentes nos projetos dos profissionais. Concluiu-se que a utilização de estratégias pedagógicas inovadoras pelas instituições de ensino provocou a reflexão sobre a prática, a mudança no processo de trabalho e a troca de saberes e experiências. Os cursos ofertados prepararam os participantes dos programas de provimento para a atuação na atenção básica e demonstraram melhor conhecimento sobre o Sistema Único de Saúde e letramento digital, especialmente, os estrangeiros e os intercambistas.

ABSTRACT The implementation of new public policies in Brazil to make up the shortfall of primary health care workers requires the provision of educational opportunities as part of the core strategy. This study presents the case of the provision of specialization courses for professionals in primary health care through the Open University of the Unified Health System (UNA-SUS) in the context of two federal programs: Valuing Primary Care (Provab) and More Doctors (PMMB). The vacancies were offered by fifteen public higher education institutions of the UNA-SUS System. Forty-one thousand professionals from all over Brazil, including doctors, dentists and nurses, where enrolled as students. Quantitative data about the courses and students was collected from the Arouca Platform - the information system of UNA-SUS. The qualitative indicators selected for analysis were: the numbers of professionals waiting to enroll on the course, of students who died, of professionals who failed to enroll, and of students who enrolled, graduated and dropped out of the course. The students were also required to write a course conclusion work, and these are published in the UNA-SUS open access repository (Ares). A sample of 2163 course conclusion works where reviewed using the hermeneutic-dialectic approach. Results: It was found that to date, 20,437 graduated from basic health care specialization courses and a further 8,201 are currently taking courses. The man themes chosen for the course conclusion work were: chronic non-communicable diseases, tumors and pregnancy, childbirth and the puerperium, children’s health and health of the elderly. It was concluded that the use of innovative pedagogical strategies by educational institutions led the professionals to reflect on their practice, review their work processes, and sometimes change those processes, and a broader sharing of knowledge and experiences. It seems that the courses prepared the participants for their professional activities in primary health care, improved their specific knowledge about Brazil’s Unified Health System, and provided digital literacy, especially for foreign students.

Abstract Introduction: lifestyle habits can influence the welfare of children and an unsuitable management approach can result in a health status imbalance. The available evidence points out that nursing educational interventions in school environments positively influence the acquisition of healthy lifestyle habits to tackle issues such as childhood obesity. Objective: To assess the impact of an educational intervention carried out by primary care nurses in the school setting, with children aged 10 to 12 years old, on the improvement of eating habits, physical activity and sleep quality. Material and methodology: Quasi-experimental study to measure the efficiency of a community nurse intervention in the school setting, with pre and post-intervention surveys, prospective, descriptive, observational and without control or randomization. Results: 150 students from five schools in Tenerife took part in the study. Regarding the reach of impact pre-post intervention, significant differences were observed in the allocation of the problems Sedentary lifestyle and Deterioration of the sleep pattern. Item-to-item differences were corroborated in cases of pre-post dysfunction, using the Cochran Q value and statistical significance. For 28 of the 32 items compared, there was a decrease in the number of children with dysfunctional habits between before and after the intervention, although they were only notable in six of the statements. Conclusión: It seems that the incorporation of these three workshops in the school year of these children decreased the problems diagnosed by the nurses as Ineffective feeding pattern of the child, Sedentary lifestyle and Deterioration of the sleep pattern, although without significance in the first of those mentioned. However, a community nurse intervention in education as outlined above seems beneficial so that, embracing other ongoing parallel initiatives and considering other factors and variables, children's lifestyle habits regarding the nutritional value in their food, physical activity and sleep pattern can be enhanced at an early age.

Resumen Introducción: Los hábitos de vida determinan el bienestar de los niños y una inadecuada gestión puede producir un desequilibrio en el estado de salud. La evidencia disponible apunta que las intervenciones enfermeras educativas en ámbito escolar influyen positivamente en la adquisición de hábitos de vida saludables para combatir problemas como el sobrepeso y la obesidad infantil. Objetivo: Evaluar el impacto de una intervención educativa realizada por enfermeras de Atención Primaria en el ámbito escolar, con niños de 10 a 12 años, sobre la mejora de los hábitos alimentarios, de actividad física y de sueño-descanso. Material y método: Estudio cuasiexperimental para la medida de la efectividad de una intervención enfermera comunitaria en el ámbito escolar, con encuestas pre y post-intervención, de tipo prospectivo, descriptivo, observacional y sin grupo control ni aleatorización. Resultados: Participaron 150 escolares de cinco colegios de Tenerife. Respecto a la medida del impacto pre-post intervención se comprobaron diferencias significativas en la asignación de los problemas Estilo de vida sedentario y Deterioro del patrón de sueño. Se comprobaron ítem a ítem las diferencias de casos en cuanto a la disfuncionalidad pre-post, empleando el valor de la Q de Cochran y la significación estadística. Para 28 de los 32 ítems comparados, hubo un descenso en el número de niños con hábitos disfuncionales entre el antes y el después de la intervención, aunque solamente fueron significativas en seis de los enunciados. Conclusión: Parece que la incorporación de estos tres talleres en el año escolar de estos niños disminuyó los problemas diagnosticados por las enfermeras como Patrón de alimentación Ineficaz del niño, Estilo de vida sedentario y Deterioro del patrón del sueño, aunque sin significación en el primero de los mencionados. No obstante, una intervención enfermera comunitaria en ámbito educativo como la descrita parece favorable para que, tomando otras iniciativas paralelas y que consideren otros factores y variables, se mejoren a edades tempranas los hábitos de los niños a nivel alimentario, de actividad-ejercicio y de sueño-descanso.

Abstract NANDA-I suggests the development and proposal of new syndrome type diagnoses. An observational, descriptive, transversal and analytical study was designed. The study was conducted with 188 patients from primary health care nursing practice that were assessed and diagnosed in the psychosocial area administering the Psycho-Social Nursing Diagnosis Questionnaire (PSndQ). Objective: to describe sociodemographic and clinical factors associated with the PSndQ diagnoses "Emotional Shock Syndrome" (ESS) and "Social Disruption Syndrome" (SDS) and to classify these aspects as related factors, risk population or associated condition. And proposing interventions according to the NIC classification. The ESS diagnosis was assigned to 25% of the sample, while the SDS was assigned to 16.5%. For the ESS, 28 related factors were found, 13 population groups at risk and 5 associated conditions. For the SDS, 36 related factors, 8 risk population groups and 5 associated conditions were found. In addition, 23 possible interventions for ESS and 21 for SDS were identified. The main conclusion is the need to incorporate both diagnostic proposals into the NANDA-I classification in an area of such a complex assessment and approach as the psychosocial one. It is expected that new studies will corroborate our findings and allow, along the same line, to improve the level of evidence of the international classification of nursing diagnoses.

Resumen NANDA-I sugiere el desarrollo y propuesta de nuevos diagnósticos de tipo síndrome. Se diseñó un estudio observacional, descriptivo, transversal y de corte analítico. Realizado con 188 pacientes de consultas enfermeras de Atención Primaria que fueron valorados y diagnosticados en el área psicosocial con ayuda del Cuestionario para el diagnóstico enfermero Psico-Social (CdePS). Objetivo: describir factores sociodemográficos y clínicos asociados a los diagnósticos CdePS “Síndrome de Shock Emocional” (SSE) y “Síndrome de Disrupción Social” (SDS) y clasificar dichos aspectos como factores relacionados, población de riesgo o condición asociada, además de realizar una propuesta de intervenciones acorde a la clasificación NIC. El diagnóstico SSE se asignó a un 25% de la muestra, mientras que el SDS, a un 16,5%. Para el SSE se hallaron 28 factores relacionados, 13 grupos de población en riesgo y 5 condiciones asociadas. Para el SDS, 36 factores relacionados, 8 grupos de población de riesgo y 5 condiciones asociadas. Se identificaron, además, 23 posibles intervenciones para el SSE y 21 para el SDS. Como conclusión principal se puede destacar el interés de incorporar ambas propuestas diagnósticas a la clasificación de NANDA-I en un área de tan compleja valoración y abordaje como es la psicosocial. Se espera que nuevos estudios corroboren nuestros hallazgos y permitan, en esta misma línea, mejorar el nivel de evidencia de la clasificación internacional de diagnósticos enfermeros.