Abstract Introduction: The American Cancer Society (ACS) recommends guidelines to improve the quality of life and survival of cancer survivors, but adherence is low worldwide, and there are no data in Uruguay. Objective: To evaluate the adherence of cancer survivors in Uruguay to the five healthy behavior guidelines recommended by the ACS at the Hospital de Clínicas and the Hospital Departamental de Soriano. Materials and Methods: Observational and prospective study with 288 patients with early-stage cancer (I-III). A questionnaire on healthy habits was used. Patients were classified into low (0-2), moderate (3), and high adherence (4-5). Relationships between adherence and demographic and clinical variables were analyzed using R software. Results: A total of 288 patients were included, 15% consumed enough fruits and vegetables, 63,5% maintained a BMI <30, 32.3% achieved the recommended physical activity, 80.6% did not smoke, and 95,5% did not drink alcohol excessively. Adherence was low in 42%, moderate in 29,5%, and high in 28.5%, being higher among young people (p=0,009), women (p=0,004), patients with higher educational level (p<0,001), and those diagnosed at earlier stages (p=0.009). Conclusions: Most survivors followed the recommendations to abstain from smoking and moderate alcohol consumption, but one-third had a BMI above the recommended level, two-thirds did not reach the recommended level of physical activity, and 85% did not consume the recommended amount of fruits and vegetables. Adherence was lower in older patients, men, those with stage III cancer, and those with lower educational levels, suggesting the need for specific interventions.

Resumo Introdução: A Sociedade Americana do Câncer (ACS) recomenda diretrizes para melhorar a qualidade de vida e a sobrevida dos sobreviventes de câncer, porém a adesão é baixa a nível mundial e não existem dados no Uruguai. Objetivo: Avaliar a adesão dos sobreviventes de câncer no Uruguai às cinco diretrizes de comportamento saudável da ACS no Hospital de Clínicas e no Hospital Departamental de Soriano. Materiais e métodos: Estudo observacional e prospectivo com 288 pacientes com câncer em estágios iniciais (I-III). Foi utilizado um questionário sobre hábitos saudáveis. Os pacientes foram classificados em baixa adesão (0-2), moderada (3) e alta adesão (4-5). Foram analisadas as relações entre a adesão e variáveis demográficas e clínicas utilizando o software R. Resultados: Foram incluídos 288 pacientes, 15% consumiram frutas e vegetais suficientes, 63,5% mantiveram um IMC <30, 32,3% alcançaram o nível recomendado de atividade física, 80,6% não fumavam e 95,5% não consumiam álcool em excesso. A adesão foi baixa em 42%, moderada em 29,5% e alta em 28,5%, sendo maior entre jovens (p=0,009), mulheres (p=0,004), pacientes com maior nível educacional (p<0,001) e em estágios iniciais (p=0,009). Conclusões: A maioria dos sobreviventes seguiu as recomendações para não fumar e moderar o consumo de álcool, mas um terço apresentou IMC superior ao recomendado, dois terços não atingiram o nível de atividade física e 85% não consumiram as frutas e vegetais recomendados. A adesão foi menor em pacientes mais velhos, homens, em estágios III e com menor nível educacional, sugerindo a necessidade de intervenções específicas.

Resumen Introducción: La Sociedad Americana del Cáncer (ACS) recomienda pautas para mejorar la calidad de vida y supervivencia de los sobrevivientes de cáncer, pero la adherencia es baja a nivel mundial y no hay datos en Uruguay. Objetivo: Evaluar la adherencia de los sobrevivientes de cáncer en Uruguay a las cinco pautas de comportamiento saludable de la ACS en el Hospital de Clínicas y el Hospital Departamental de Soriano. Materiales y métodos: Estudio observacional y prospectivo con 288 pacientes de cáncer precoz (I-III). Se utilizó un cuestionario sobre hábitos saludables. Los pacientes fueron clasificados en baja (0-2), moderada (3) y alta adherencia (4-5). Se analizaron relaciones entre adherencia y variables demográficas y clínicas usando el software R. Resultados: Se incluyeron 288 pacientes, 15% consumió suficientes frutas y verduras, 63,5% mantuvo un IMC <30, 32,3% logró la actividad física recomendada, 80,6% no fumaba y 95,5% no bebía alcohol en exceso. La adherencia fue baja en 42%, moderada en 29,5% y alta en 28,5%, siendo mayor entre jóvenes (p=0,009), mujeres (p=0,004), pacientes con mayor nivel educativo (p<0,001) y en estadios tempranos (p=0,009). Conclusiones: La mayoría de los sobrevivientes siguieron las recomendaciones para no fumar y moderar el consumo de alcohol, pero un tercio tenía un IMC superior al recomendado, dos tercios no alcanzaban el nivel de actividad física y el 85% no consumía las frutas y verduras recomendadas. La adherencia fue menor en pacientes mayores, hombres, con estadios III y menor nivel educativo, sugiriendo necesidad de intervenciones específicas.

ABSTRACT Introduction: Spirituality, by providing positive coping or religious/spiritual coping, mobilizes resilience, a positive worldview, and a support network, thereby promoting physical and mental health. Objective: To identify spiritual religious coping by analyzing the association between sociodemographic/educational variables and the level of spiritual guidance among health residents in Recife. Method: This was a cross-sectional, exploratory, and quantitative analytical study. Spirituality was assessed using the Spirituality Self Rating Scale (SSRS), and religious coping was measured by the Brief Religious/Spiritual Coping Scale (RSC-Brief). The collected data were analyzed using Stata 12.1 software, with crude and adjusted prevalence ratios (PR) estimated, and 95% confidence intervals (CI). The study was approved by the Ethics Committee of IMIP under CAAE N. 42807221.2.0000.5201. Result: Of the 107 participants, the majority were aged between 21 and 25 years (45.8%), female (79.4%), enrolled in multidisciplinary residency programs (50.5%), and attending the first year of their course (89.7%). Positive religious coping was identified as medium, high, or very high in 69.2% of participants, while low or no negative religious coping was found in 93.4%, and medium/high spiritual guidance in 57%. Residents with Lato Sensu postgraduate qualifications showed a 40% higher prevalence ratio for having a medium/high level of spiritual guidance compared to those with only undergraduate education, and this ratio was 46% higher in the nursing area when compared to the other fields. Conclusion: Spirituality and religious coping were more prevalent among nursing professionals and those with higher academic qualifications.

RESUMO Introdução: A espiritualidade, ao viabilizar o coping religioso/espiritual positivo ou enfrentamento religioso/espiritual, promove o fortalecimento da resiliência, a construção de uma visão positiva de mundo e a mobilização da rede de apoio social, desempenhando um papel relevante na promoção da saúde física e mental. Objetivo: Este estudo teve como objetivo identificar o coping religioso/espiritual por meio da análise da associação entre variáveis sociodemográficas/educacionais e o nível de orientação espiritual em residentes de saúde do Recife. Método: Trata-se de um estudo transversal, exploratório e quantitativo de caráter analítico. A espiritualidade foi avaliada por meio da Spirituality Self Rating Scale (SSRS) e o coping religioso/espiritual, pela Escala de Coping Religioso/Espiritual Abreviada (CRE-Breve). Os dados coletados foram analisados no software Stata 12.1 com razões de prevalência (RP) brutas e ajustadas estimadas, com intervalos de confiança de 95%. O trabalho foi aprovado pelo Comitê de Ética em Pesquisa (CEP) do Instituto de Medicina Integral Prof. Fernando Figueira (IMIP) com CAAE nº 42807221.2.0000.5201. Resultado: Entre os 107 participantes, predominaram as seguintes características: faixa etária de 21 a 25 anos (45,8%), sexo feminino (79,4%), participação em programas de residência multiprofissional (50,5%) e matrícula no primeiro ano da residência (89,7%). Identificaram-se coping religioso/espiritual positivo médio, alto e altíssimo em 69,2%, coping religioso/espiritual negativo baixo ou nenhum em 93,4% e nível de orientação espiritual média/alta em 57%. Os residentes com pós-graduação lato sensu evidenciaram RP de 40% a mais para terem nível de orientação espiritual média/alta do que os que cursaram apenas a graduação, e na enfermagem essa razão foi 46% maior do que nas outras áreas. Conclusão: Os maiores níveis de orientação espiritual e coping religioso/espiritual positivo mostraram-se mais prevalentes nos profissionais de enfermagem, assim como naqueles com maior formação acadêmica.

RESUMEN Introducción: El síndrome coronario agudo constituye una emergencia médica. Su pronóstico depende de la rapidez en la sospecha diagnóstica y del inicio del tratamiento; de ahí la importancia de detectar y clasificar correctamente a estos pacientes, asignándole una prioridad adecuada, puesto a que con un diagnóstico y tratamiento precoz, se reducen el riesgo de complicaciones y la tasa de morbimortalidad. Objetivo: Evaluar el nivel de conocimientos sobre el actuar de enfermería en pacientes con síndrome coronario agudo. Métodos: Se realizó una investigación de tipo analítico observacional, descriptivo, con enfoque cualicuantitativo y de corte transversal, en la Unidad de Cuidados Intensivos Emergentes del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández, de Matanzas, en el período de enero de 2022 a febrero de 2024. El universo de estudio estuvo conformado por los 15 enfermeros que laboraban de forma física en dicho servicio. Resultados: Predominaron los enfermeros del sexo femenino y el grupo de edades de 20-29 años, así como los enfermeros con nivel medio y superior. Asimismo, prevalecieron los enfermeros con menos de un año de experiencia, sin la obtención de cursos de superación. En cuanto al nivel de conocimientos, predominó la evaluación de mal. Conclusiones: El diagnóstico realizado permitió identificar las insuficiencias sobre el nivel de conocimientos de enfermería para afrontar los cuidados al paciente con síndrome coronario agudo.

ABSTRACT Introduction: Acute coronary syndrome constitutes a medical emergency. Its prognosis depends on the speed of diagnostic suspicion and the start of treatment; hence the importance of correctly detecting and classifying these patients, assigning them an appropriate priority, since with early diagnosis and treatment, the risk of complications and the morbidity and mortality rate are reduced. Objective: To evaluate the level of knowledge about nursing actions in patients with acute coronary syndrome. Methods: An observational, descriptive analytical research, with a qualitative and cross-sectional approach, was carried out in the Emergency Intensive Care Unit of the Clinical Surgical University Hospital Comandante Faustino Perez Hernandez, in Matanzas, in the period of January 2022 to February 2024. The study universe was made up of the 15 nurses who physically worked in this service. Results: Female nurses and the age group of 20-29 years predominated, as well as nurses with intermediate and higher levels. Likewise, nurses with less than one year of experience prevailed, without obtaining courses of improvement. Regarding the level of knowledge, the evaluation of bad predominated. Conclusions: The diagnosis made allowed to identify the insufficiencies in the level of nursing knowledge to face the care of the patient with acute coronary syndrome.

ABSTRACT Introduction: Burnout results from chronic exposure to work-related stress and it is characterized by a reduction in professional efficacy, feelings of lack of energy/exhaustion, and negativity related to work activities. It has a higher incidence in professions with significant interpersonal contact and among caregivers, making doctors a vulnerable population. The Maslach Burnout Inventory questionnaire is considered the gold standard for measuring this disease. In 2014, quinquennial prevention was described, aiming to prevent harm to patients through strategies that reduce Burnout in doctors. Clinical Case: The case describes a 29-year-old woman, a physician in her final year of Residency in General and Family Medicine, who sought an urgent consultation due to feelings of physical and mental exhaustion, hopelessness, irritability, initial and middle insomnia, for the last three months, and hyperphagia, two months ago. She has requested a sick leave from work because “I can't stand working anymore. I need to sleep for a week”. She identified excessive workload at the Clinic, stemming from the demands of her medical residency, as the main cause. She feels unsupported by her colleagues and Training Supervisor and feels pressured to manage the medical agenda without adequate preparation. She reports occasional errors in prescriptions, leading her to feel the need to repeatedly review records and decisions she has made. She denies any appointment with her designated Work physician ever since she started her internship. Upon physical examination, she appeared slaughtered, with a depressed mood, tearful, restless, and with fleeting eye contact. Applying the Maslach Burnout Inventory: Section A- 34 points- high level; Section B- 28 points- high level; Section C- 25 points- high level. A work leave from work was issued, laboratory studies were requested, and fluoxetine 20 mg and trazodone 50 mg were initiated, along with psychotherapy. So far, the patient has been re-evaluated in three consultations, with organic causes ruled out, and in the last re-evaluation, her scores were: Section A- 20 points- moderate level; Section B- 5 points- low level; Section C- 39 points- moderate level. She reports a decrease in medical errors. She maintained the prescribed medication and psychotherapy. She declined to join a Balint group. A new re-evaluation was scheduled in six months. Discussion/Conclusion: This is a case of a General and Family Medicine Resident Physician, diagnosed with Burnout, who has managed to substantially improve her quality of life and job satisfaction, as well as her personal life, following the implementation of both pharmacological and non-pharmacological measures, along with workplace adjustments and the setting of boundaries. She has successfully reduced her perception of making medical errors, thereby improving the quality of healthcare provided to the patients. The long journey of recovery from Burnout makes the monitoring of this illness imperative not only by the patients Family Doctor and Psychologist, but also by the Occupational physician, targeting the improvement of the quality of life of the healthcare professionals in their occupational activity. This clinical case’s purpose is to address and raise awareness among professionals to the prevention of Burnout, particularly in Residents, promoting quinquennial prevention. It is important to note that only professionals who are fulfilled in their biopsychosocial sphere can provide quality care and significantly reduce medical errors.

RESUMO Introdução: O Burnout resulta da exposição crónica ao stress laboral e caracteriza-se por redução da eficácia a nível profissional, sentimentos de falta de energia/exaustão e negatividade relacionados com a atividade laboral. Tem maior incidência em profissões de elevado contacto com pessoas e em prestadores de cuidados, tornando os médicos uma população vulnerável. O questionário Maslach Burnout Inventory é considerado gold standard para a medição desta patologia. Em 2014 foi descrita a prevenção quinquenária, que pretende evitar o dano para o paciente, atuando no médico através de estratégias que visem a diminuição do Burnout. Caso Clínico: Descreve-se uma mulher de 29 anos, médica, no último ano da especialização em Medicina Geral e Familiar, que recorreu a consulta aberta por sensação de exaustão física e mental, sentimentos de desesperança, irritabilidade, insónia inicial e intermédia, com três meses de evolução e hiperfagia há dois meses. Solicitou certificado de incapacidade temporária para o trabalho, porque “já não aguento mais trabalhar. Preciso de dormir uma semana”. Aponta como principal etiologia o trabalho excessivo no Centro de Saúde, decorrente da exigência do internato médico. Sente-se pouco apoiada pelos colegas de equipa e orientador de formação e considera-se pressionada a gerir a agenda médica sem ter preparação para tal. Relata erros pontuais na prescrição médica, pelo que sente necessidade de rever várias vezes os registos efetuados e as atitudes tomadas. Nega ter sido convocada para qualquer consulta de Medicina do Trabalho desde que ingressou na especialidade. Ao exame objetivo, apresentava-se cabisbaixa, com humor deprimido, chorosa, inquieta e com contacto ocular fugaz. Aplicando o questionário atrás mencionado: Secção A - 34 pontos - nível elevado; Secção B - 28 pontos - nível elevado; Secção C - 25 pontos - nível elevado. Foi emitido o certificado de incapacidade temporária para o trabalho, solicitado estudo analítico e iniciada fluoxetina 20mg e trazodona 50mg, bem como psicoterapia. Até à data, a doente foi reavaliada em três consultas, foi excluída patologia orgânica e na última reavaliação apresentava os seguintes valores: Secção A- 20 pontos- nível moderado; Secção B- 5 pontos- nível baixo; Secção C- 39 pontos- nível moderado. Refere diminuição dos erros médicos. Manteve a medicação instituída, bem como a psicoterapia. Recusou o grupo Balint. Foi programada nova reavaliação em seis meses. Discussão/Conclusão: Trata-se de uma doente, Médica Interna em Medicina Geral e Familiar com o diagnóstico de Burnout, que conseguiu melhorar substancialmente a sua qualidade de vida e satisfação no trabalho e vida pessoal, após a implementação de medidas farmacológicas e não farmacológicas e também após alterações a nível laboral e imposição de limites. Conseguiu diminuir a perceção de erro médico, melhorando assim os cuidados de saúde prestados aos utentes. O longo percurso de recuperação desta doença torna fulcral o acompanhamento destes utentes pela equipa de Medicina do Trabalho, e não só pelo Médico de Família e Psicólogo, visando melhorar a qualidade de vida e saúde dos profissionais no âmbito da sua atividade laboral. Com este caso clínico pretende-se abordar e sensibilizar os profissionais para a prevenção do Burnout, em particular nos médicos internos, fomentando a prevenção quinquenária. De ressalvar que apenas profissionais realizados na sua esfera biopsicossocial conseguem proporcionar cuidados de qualidade e reduzir de forma importante o erro médico.

Resumen Introducción: la lepra afecta a millones de personas deteriorando la salud física y mental, generando complicaciones como síntomas depresivos que pueden afectar la calidad de vida. Objetivo: estimar la prevalencia de síntomas depresivos en una agremiación de pacientes y expacientes con enfermedad de Hansen de una ciudad del Caribe colombiano. Materiales y métodos: estudio descriptivo con muestreo no probabilístico en miembros de una agremiación de pacientes y ex-pacientes con enfermedad de Hansen de una ciudad del Caribe colombiano. Los síntomas depresivos fueron estimados mediante test de Beck I y los resultados se contrastaron con variables sociodemográficas y clínicas mediante análisis bivariado. Resultados: participaron 51 personas, con una edad promedio de 52 años (IC 35,7-68,5), y predominio del sexo masculino (57%). El 39% de la población cursó bachillerato, el 25% se encontraban en tratamiento al momento de la encuesta y el 33% presentaban algún grado de discapacidad. El 27%, 16% y 2% de la población presentó depresión leve, moderada y severa respectivamente. El síntoma depresivo más frecuentemente descrito fue la fatiga (13%) seguido de cambios en el apetito (84,2%), llanto (81,6%), y tristeza (79%). No se encontró relación estadísticamente significativa entre presencia de síntomas depresivos y características sociodemográficas, el tratamiento y la discapacidad. Conclusiones: el 35% de los encuestados con el test de Beck I obtuvo calificaciones compatibles con depresión, se recomienda incluir manejo especializado en salud mental dentro del abordaje integral del paciente y expaciente con enfermedad de Hansen.

ABSTACT Introduction: Leprosy affects millions of people, impairing both physical and mental health and giving rise to complications such as depressive symptoms that can impact the quality of life. Objective: To estimate the prevalence of depressive symptoms in an association of patients and former patients with Hansen's disease in a city in the Colombian Caribbean. Materials and methods: A descriptive study with non-probabilistic sampling was conducted among members of an association of patients and former patients with Hansen's disease in a city in the Colombian Caribbean. Depressive symptoms were assessed using the Beck Depression Inventory, and the results were compared with sociodemographic and clinical variables through bivariate analysis. Results: Fifty-one individuals participated, with an average age of 52 years (CI 35.7-68.5), and a male predominance (57%). Thirty-nine percent of the population had completed high school, 25% were undergoing treatment at the time of the survey, and 33% had some degree of disability. Twenty-seven percent, 16%, and 2% of the population exhibited mild, moderate, and severe depression, respectively. The most frequently reported depressive symptom was fatigue (13%), followed by changes in appetite (84.2%), crying (81.6%), and sadness (79%). No statistically significant relationship was found between the presence of depressive symptoms and sociodemographic characteristics, treatment, or disability. Conclusions: It is evident that 35% of respondents scored in the range indicative of depression on the Beck Depression Inventory. Specialized mental health management is recommended to be included in the comprehensive care of patients and former patients with Hansen's disease.

RESUMEN Introducción: Las alteraciones posturales en las escuelas constituyen un problema de salud pública emergente, asociado al uso inadecuado de mochilas. Estas disfunciones predisponen a trastornos musculo esqueléticos, y afecta la salud física y el rendimiento académico. Objetivo: Evaluar la postura y determinar los factores asociados a alteraciones de la columna vertebral en escolares que utilizan mochila diariamente. Materiales y Métodos: Estudio observacional analítico transversal en 192 escolares de 6-14 años de una institución educativa privada de San Lorenzo, Paraguay. Se realizó evaluación postural mediante método Kendall estandarizado. Se identificaron escolares con alteraciones posturales y sin ellas para analizar factores asociados. Se recolectaron datos sociodemográficos, antropométricos y sobre uso de mochilas mediante cuestionario validado. Se realizó análisis bivariado y regresión logística multivariada Resultados: La prevalencia de alteraciones posturales fue del 25% (n=48). Se identifica: escoliosis-cifosis combinada (12,5%), escoliosis aislada (8,3%) y cifosis (4,2%). El sexo masculino mostró mayor prevalencia (OR=4.8; IC95%:2.3-9.9; p<0.001). El 65% transportaba peso superior al 10% corporal. El uso incorrecto de mochila se afecta significativamente con alteraciones posturales (OR=2.3; IC95%:1.5-3.5; p<0.001). Las principales repercusiones fueron: necesidad de medicación (OR=13.0; IC95%:5.3-32.0), consulta médica (OR=11.0; IC95%:6.3-26.4) y ausentismo escolar (OR=5.3; IC95%:3.9-9.0). Conclusiones: La prevalencia de alteraciones posturales fue significativa, predominando en varones. El uso inadecuado de mochila y lesiones previas constituyen factores de riesgo importantes. Se requiere de programas preventivos enfocados en educación postural y uso correcto de mochilas escolares.

ABSTRACT Introduction: Postural alterations in schoolchildren constitute an emerging public health problem associated with improper backpack use. These dysfunctions predispose to musculoskeletal disorders, affecting children's physical health and academic performance. Objective: To evaluate posture and determine factors associated with spinal alterations in schoolchildren who use backpacks daily. Materials and Methods: Observational analytical cross-sectional study in 192 schoolchildren aged 6-14 years from a private educational institution in San Lorenzo, Paraguay. Postural evaluation was performed using standardized Kendall method. Students with and without postural alterations were identified to analyze associated factors. Sociodemographic, anthropometric, and backpack use data were collected through a validated questionnaire. Bivariate analysis and multivariate logistic regression were performed. Results: The prevalence of postural alterations was 25% (n=48). Combined scoliosis-kyphosis (12.5%), isolated scoliosis (8.3%), and kyphosis (4.2%) were identified. Male sex showed higher prevalence (OR=4.8; 95%CI:2.3-9.9; p<0.001). Sixty-five percent carried weight exceeding 10% of body weight. Incorrect backpack use was significantly associated with postural alterations (OR=2.3; 95%CI:1.5-3.5; p<0.001). Main repercussions were: need for medication (OR=13.0; 95%CI:5.3-32.0), medical consultation (OR=11.0; 95%CI:6.3-26.4), and school absenteeism (OR=5.3; 95%CI:3.9-9.0). Conclusions: The prevalence of postural alterations was significant, predominantly in males. Improper backpack use and previous injuries constituted important risk factors. Preventive programs focused on postural education and proper backpack use are required.

Abstract Introduction: Stress is a contemporary phenomenon that affects the world population and university students, this factor could be one of those involved in the quality of sleep, which is important to take care of, especially in students because of its relevance in the learning process, and on the other hand physical activity can affect both how to manage stress levels or prevent sleep disorders, which is why this study aims to relate stress levels with sleep quality and physical activity in medical students. Methods: A descriptive, correlational, and cross-sectional study was developed based on different studies. the responses of 116 Medicine students from the University of Magallanes were analyzed using three evaluations: The perceived Stress Scale, the International Physical Activity Questionnaire (IPAQ), and the Pittsburgh Test). Results: Medicine students presented a positive correlation (p=0.64, p<0.001) between the Perceived Stress Scale (PSS) and Pittsburgh (Pitts). One of the PSS variables (unable to control things) and the student's dysfunction in performing their essential daily tasks (dysfunction during the day) have a positive correlation (p=0.54, p<0.001). Physical activity averaged 930 METs, and no significant correlation was found with the PSS and Pitts variables. Conclusion: The relationship between stress and sleep quality is inversely proportional; therefore, the higher the level of stress perceived, the lower the student's sleep quality, which is not related.

Resumen Introducción: el estrés es un fenómeno contemporáneo que afecta a la población mundial y a los estudiantes universitarios, este factor pudiese ser uno de los que interviene en la calidad de sueño, la cual es importante de cuidar sobre todo en los alumnos debido a su relevancia en el proceso de aprendizaje, y por otro lado la actividad física puede afectar tanto en cómo manejar los niveles de estrés o prevenir trastornos del sueño, es por ello que este estudio tiene como objetivo relacionar los niveles de estrés con la calidad del sueño y la actividad física en estudiantes de medicina. Métodos: se desarrolló un estudio descriptivo, correlacional y transversal basado en diferentes estudios. Se analizaron las respuestas de 116 estudiantes de Medicina de la Universidad de Magallanes mediante tres evaluaciones: Escala de Estrés Percibido, Cuestionario Internacional de Actividad Física (IPAQ) y Test de Pittsburgh. Resultados: los estudiantes de Medicina presentaron una correlación positiva (p=0.4, p<0.001) entre la Escala de Estrés Percibido (EEP) y la de Pittsburgh (Pitts). Una de las variables EEP (incapaz de controlar las cosas) y la disfunción del estudiante en la realización de sus tareas esenciales diarias (disfunción durante el día) tienen una correlación positiva (p=0.54, p<0.001). La actividad física tuvo un promedio de 930 MET's, y no se encontró correlación significativa con las variables EEP y Pitts. Conclusión: la relación entre el estrés y la calidad del sueño es inversamente proporcional; por lo tanto, a mayor nivel de estrés percibido, menor calidad de sueño del estudiante, lo cual no está relacionado.

ABSTRACT Education in older adults is a powerful tool for transforming themselves and their environment; through it, it is possible to change beliefs and attitudes that allow for deep and meaningful learning, enabling this age group to transmit what they have learned to their peers. Aim: To describe the perceived benefits six months after completing the Senior-FITT Peer Instructors Diploma, a pioneering virtual educational program in Chile. Materials and Methods: A qualitative study was conducted based on a theoretical, methodological approach that derives from grounded theory. The 28 graduates of the Diploma were invited to participate in a focus group and telephone interviews. This program, implemented during the pandemic context, aimed to train leaders in physical activity and health among older people to generate an impact on their health centers and communities. Results: Benefits such as changes in body weight, muscle strengthening, independence, and physical mobility were described. Also, community and psycho-emotional benefits, such as transmitting knowledge and strengthening emotional bonds. All participants continued to engage in physical activity and transmit the knowledge learned six months after the program, and 50% guided other groups of older people. Conclusion: Virtual educational programs can be an effective tool to improve the physical and mental well-being of older adults. These programs provide useful knowledge and skills for daily life, promote physical independence, and strengthen emotional bonds. In addition, participants become agents of change in their communities by transmitting the knowledge acquired.

RESUMEN La educación en las personas mayores es una poderosa herramienta de transformación en sí mismos y en su entorno; a través de ella es posible cambiar creencias y actitudes que permiten crear aprendizajes profundos y significativos permitiendo a este grupo etario transmitir a sus pares lo aprendido. Objetivo: Describir los beneficios percibidos a los seis meses de finalización del Diploma de Instructores Pares Senior-FITT, un programa educativo virtual pionero en Chile. Material y Métodos: Se realizó un estudio cualitativo que sigue un enfoque teórico metodológico que deviene de teoría fundamentada. Se invitó a participar a los 28 egresados del Diploma en un grupo focal y entrevistas telefónicas. Este programa, implementado durante el contexto de la pandemia, tenía como objetivo formar líderes en actividad física y salud entre las personas mayores, con el fin de generar un impacto en sus centros de salud y comunidades. Resultados: Se describieron como beneficios los cambios en el peso corporal, fortalecimiento muscular, independencia y movilidad física. También beneficios comunitarios y psicoemocionales, como la transmisión de conocimientos y fortalecimiento de vínculos afectivo. Todos los participantes continuaron realizando actividad física y transmitiendo los conocimientos aprendidos seis meses después del programa y el 50% guio otros grupos de personas mayores. Conclusión: el programa educativo virtual pueden ser una herramienta efectiva para mejorar el bienestar físico y mental de las personas mayores. Este tipo de programas no solo proporcionan conocimientos y habilidades útiles para la vida diaria, sino que también promueven la independencia física y fortalecen los vínculos emocionales. Además, los participantes se convierten en agentes de cambio en sus comunidades al transmitir los conocimientos adquiridos.

Resumo Introdução: O sono é uma das necessidades primordiais do ser humano, cujo papel fundamental é relaxar e restabelecer o organismo para um novo ciclo. A privação de sono e o trabalho por turnos podem agravar as condições de saúde física e mental dos enfermeiros que trabalham por turnos. Objetivo: Analisar a qualidade do sono de enfermeiros de um serviço de urgência de um hospital da região norte de Portugal e a sua relação com o trabalho por turnos. Metodologia: Estudo descritivo-correlacional, transversal e quantitativo. Aplicou-se o Índice de Qualidade de Sono de Pittsburgh, amostra constituída por 60 enfermeiros. Tratamento de dados foi elaborado com recurso à estatística descritiva e inferencial. Resultados: A maioria dos participantes foram enfermeiras (68,3%), idade entre 31 e 40 anos (61,7%). Verificámos, quer os enfermeiros do sexo feminino quer os com a categoria profissional de enfermeiros de cuidados gerais percecionaram uma má qualidade de sono. Os participantes com horário fixo, que trabalham em turnos noturnos e que têm até dois turnos noturnos por semana apresentaram uma qualidade de sono mais baixa, (80%) dos enfermeiros evidenciaram dificuldade em adormecer e percecionaram má qualidade de sono. Conclusão: É necessário intervir a nível individual e organizacional, para adoção de medidas que visem melhorar a qualidade de sono de enfermeiros que trabalham por turnos. Importa sensibilizar a adoção de estratégias de higiene do sono, promovendo hábitos de vida saudáveis, tendo em vista melhorar a qualidade do sono dos enfermeiros, o que se traduzirá numa melhoria dos cuidados saúde prestados.

Resumen Introducción: El sueño es una de las necesidades primordiales del ser humano, cuyo papel fundamental es relajar y restablecer el organismo para un nuevo ciclo. La falta de sueño y el trabajo por turnos pueden empeorar las condiciones de salud física y mental de las enfermeras que trabajan por turnos. Objetivo: Analizar la calidad del sueño de las enfermeras que trabajan en urgencias de un hospital del norte de Portugal y su relación con el trabajo por turnos. Metodología: Estudio descriptivo-correlacional, transversal y cuantitativo. Se aplicó el Índice de Calidad del Sueño de Pittsburgh, muestra compuesta por 60 enfermeras. El tratamiento de los datos se elaboró mediante estadística descriptiva e inferencial. Resultados: La mayoría de los participantes eran enfermeras (68,3%), con edades entre los 31 y 40 años (61,7%). Observamos que tanto las enfermeras como las que tienen la categoría profesional de enfermeras de cuidados generales perciben uma mala calidad del sueño. Los participantes con horario fijo, que trabajan en turnos nocturnos y que tienen hasta dos turnos nocturnos por semana tuvieron una menor calidad de sueño, (80%) dos enfermeras tuvieron dificultad para conciliar el sueño y percibieron mala calidad del sueño. Conclusión: Es necesario intervenir a nivel individual y organizacional de forma a adoptar medidas que mejoren la calidad del sueño de los enfermeros que trabajan por turnos. Del mismo modo es importante generar conciencia sobre la adopción de estrategias de higiene del sueño, para que se puedan promover hábitos de vida saludables, y así mejorar la calidad del sueño de las enfermeras, lo que se traducirá en una mejora de la atención médica brindada.

Abstract Introduction: Sleep is one of the primordial needs of human beings, and plays a fundamental role in relaxing and reestablishing the body for a new cycle. Sleep deprivation and shift work can have negative consequences for the physical and mental health of nurses working shifts. Objective: To analyze the sleep quality of nurses in an emergency department at a hospital in the north of Portugal and its relationship with shift work. Methodology: Descriptive-correlational, cross-sectional and quantitative study. The Pittsburgh Sleep Quality Index was applied to a sample of 60 nurses. Data processing was performed using descriptive and inferential statistics. Results: The majority of participants were nurses (68.3%), aged between 31 and 40 years old (61.7%). We found that both female nurses and those with the professional category of general care nurses perceived poor sleep quality. Participants with a fixed schedule, who work night shifts and who work up to two-night shifts per week had a lower quality of sleep, (80%) of nurses had difficulty falling asleep and perceived poor quality of sleep. Conclusion: It is necessary to intervene at an individual and organizational level to promote the adoption of measures to improve the quality of sleep of nurses who work shifts. It is important to raise awareness about the adoption of sleep hygiene strategies, promoting healthy lifestyle habits, with the aim of improving the quality of sleep of nurses, which will translate into an improvement in the health care provided.

Resumen Antecedentes: Los adultos mayores tienen tasas de envejecimiento heterogéneas. Objetivo: Explorar la asociación entre edad biológica (EB) y envejecimiento acelerado (EA) con fragilidad en adultos mayores. Material y métodos: Análisis de 735 adultos mayores de la Cohorte de Coyocán. Se estimó EB con AnthropoAge, EA con AnthropoAgeAccel y fragilidad con el fenotipo de Fried y el índice de fragilidad (IF). Se exploró la asociación de EB y EA (AnthropoAgeAccel ≥ 0) con fragilidad; se caracterizó su presencia simultánea sobre fenotipos de composición corporal y función física. Se determinó el riesgo de EA para progresión del fenotipo de fragilidad a tres años de seguimiento. Resultados: Los adultos mayores con EA presentaron mayor prevalencia de fragilidad e IF, menor fuerza de prensión y velocidad de marcha. Los resultados de AnthropoAgeAccel se asociaron a IF (β = 0.0053, IC 95 % = 0.0027-0.0079) y al fenotipo de fragilidad (RM = 1.16, IC 95 % = 1.09-1.25). Existieron diferencias por sexo en composición corporal y función física relacionadas con EA solo en participantes no frágiles. El EA en la evaluación basal se asoció con progresión de la fragilidad con el tiempo (RM = 1.74, IC 95 % = 1.11-2.75). Conclusiones: A pesar su asociación, el EA es independiente de la fragilidad en adultos mayores que viven en la comunidad.

Abstract Background: Older adults have highly heterogeneous aging rates. Objective: To explore the association of biological age (BA) and accelerated aging with frailty in community-dwelling older adults. Material and methods: We assessed 735 community-dwelling older adults from the Coyocan Cohort. BA was measured using AnthropoAge, accelerated aging with AnthropoAgeAccel, and frailty using Fried’s phenotype and the frailty index. We explored the association of BA and accelerated aging (AnthropoAgeAccel ≥ 0) with frailty at baseline and characterized the body composition and physical function phenotype of accelerated aging in non-frail/frail participants. We also explored accelerated aging as a risk factor for frailty progression after 3-years of follow-up. Results: Older adults with accelerated aging have higher frailty prevalence and indices, lower handgrip strength and gait speed. AnthropoAgeAccel was associated with higher frailty indices (β = 0.0053, 95 % CI = 0.0027-0.0079), and increased odds of frailty at baseline (OR = 1.16, 95 % CI = 1.09-1.25). We observed sex-based differences in body composition and physical function linked to accelerated aging in non-frail participants; however, these differences were absent in pre-frail/frail participants. Accelerated aging at baseline was associated with higher risk of frailty progression over time (OR = 1.74, 95 % CI = 1.11-2.75). Conclusions: Despite being intertwined, biological accelerated aging is largely independent of frailty in community-dwelling older adults.

RESUMEN Antecedentes: Las enfermedades cardiovasculares en México, representan el 23.5% del total de las muertes. Los trabajadores de unidades médicas no están exentos de padecer eventos cardiovasculares. Objetivo: Estimar el riesgo cardiovascular en trabajadores de una unidad médica con tablas de predicción no basadas en laboratorio de Gaziano. Material y métodos: Estudio transversal descriptivo con recolección de datos de octubre a noviembre de 2021. Participaron trabajadores de todas las categorías y turnos laborales que otorgaron consentimiento informado. Se excluyeron aquellos con incapacidad temporal de trabajo, licencia o comisión para no laborar. El riesgo cardiovascular se estimó con las tablas de predicción no basadas en laboratorio de Gaziano, que incluyen sexo, edad, diabetes, antecedente de tabaquismo, presión arterial sistólica e índice de masa corporal, y clasifican el riesgo en bajo (< 5% a 10%), moderado (> 10 a 20%) y alto (> 20%). Las variables categóricas se presentan como frecuencias y proporciones, y las cuantitativas con medidas de tendencia central y dispersión. Se realizó la prueba de ji al cuadrado para comparar la distribución de las diferentes categorías laborales por riesgo cardiovascular. Resultados: Participaron 186 trabajadores de la unidad médica. Presentaron obesidad de grado I el 35.5%, hipertensión arterial el 18.8%, diagnóstico previo de diabetes el 11.8%, tabaquismo el 9.7% y actividad física de intensidad baja el 51.1%. El riesgo cardiovascular fue bajo en el 87.6%, moderado en el 8.6% y alto en el 3.8. Conclusiones: Estimar el riesgo cardiovascular en los trabajadores de las unidades médicas permitirá establecer acciones en el ámbito laboral, para disminuir o eliminar factores de riesgo.

ABSTRACT Background: Cardiovascular diseases in Mexico, represents 23.5% of total deaths. Workers in medical units are not exempt from suffering cardiovascular events. Objective: Estimate cardiovascular risk in workers of a medical unit with prediction tables not based on Gaziano's laboratory. Materials and methods: Descriptive Cross-sectional study carried out from October to November 2021. Workers from all work shifts participated and provided informed consent. Those with temporary incapacity for work, license or commission not to work were excluded. Cardiovascular risk was estimated with Gaziano's non-laboratory-based prediction tables, which include sex, age, diabetes, smoking history, systolic blood pressure, and body mass index, classifying the risk as low (< 5% to 10%), moderate (> 10% to 20%) and high (> 20%). Frequencies and proportions were calculated in qualitative variables, and measures of central tendency and dispersion were calculated in quantitative variables. The chi-square test was performed to compare the distribution of the different job categories by cardiovascular risk. Results: 186 workers from the medical unit participated, 35.5% had grade I obesity, 18.8% had high blood pressure, 11.8% had a previous diagnosis of diabetes, 9.7% smoked and 51.1% had low-intensity physical activity. Low cardiovascular risk was observed in 87.6%, moderate in 8.6% and high in 3.8%. Conclusions: Estimating the cardiovascular risk in medical unit workers will allow for establishing actions in the workplace to reduce or eliminate risk factors.

ABSTRACT Introduction: suicidal behavior is a health problem that results in a high risk for the physical and psychological integrity of the individual. Objective: to characterize suicidal behavior in the Province of Villa Clara in the period from January 2016 to December 2020. Methods: an observational, descriptive, cross-sectional study was carried out. 5,700 patients who had suicidal behavior in the province during the period studied were studied. To obtain the necessary information, the notifiable disease cards were reviewed. The quantitative variables were described using absolute frequencies, relative frequencies and rates. Results: the year 2016 showed a higher incidence of suicide attempts, with a rate of 160x100,000 inhabitants. The mortality rate from suicide was higher in males and in patients 80 years of age and older, including both sexes. Suicide attempts were recorded at a higher rate in female patients between 25 and 59 years old. The highest rate per 100,000 inhabitants of suicide attempts was recorded in the Municipality of Camajuaní (163.6) and the highest mortality rate due to suicide in the Municipality of Corralillo (29.4). Conclusions: more than half of those who died by suicide had premature mortality and the rate of years of potential life lost was lower than the national rate. The municipalities with the highest mortality from suicide and the highest mortality from suicide attempts were those with the greatest number of rural areas.

RESUMEN Introducción: la conducta suicida es un problema de salud que trae como resultado un alto riesgo para la integridad física y psicológica del individuo. Objetivo: caracterizar la conducta suicida en la Provincia de Villa Clara en el período de enero de 2016 a diciembre de 2020. Métodos: se realizó un estudio observacional, descriptivo, transversal. Se estudiaron 5 700 pacientes que tuvieron conducta suicida en la provincia en el período estudiado. Para obtener la información necesaria se revisaron las tarjetas de enfermedad de declaración obligatoria. Se realizó la descripción de las variables cuantitativas mediante frecuencias absolutas, frecuencias relativas y tasas. Resultados: el año 2016 mostró mayor incidencia de intento suicida, con una tasa de 160x100 000 habitantes. La tasa de mortalidad por suicidio fue mayor en el sexo masculino y en pacientes de 80 y más años de edad, incluidos ambos sexos. El intento suicida registró mayor tasa en pacientes femeninas entre 25 y 59 años. La mayor tasa por 100 000 habitantes de intento suicida se registró en el Municipio de Camajuaní (163,6) y la mayor de mortalidad por suicidio en el de Corralillo (29,4). Conclusiones: más de la mitad de los fallecidos por suicidio tuvieron mortalidad prematura y la tasa de años de vida potenciales perdidos fue menor a la nacional. Los municipios con mayor mortalidad por suicidio y mayor letalidad de los intentos suicidas fueron los que tienen mayor cantidad de áreas rurales.

Abstract Suicide is a public health problem. Prevention requires training actions at an emotional level, the scientific treatment of suicidal risk situations and a sensitive management by the media. Following the commemorations of the World Suicide Prevention Day and the World Mental Health Day, this is an opportunity to reconceptualize how the of illness as a process facilitates the approach to mental disorders. Understanding the life history of each patient allows for an adequate biographical contextualization that explains the complex interaction between early life stress, vulnerability, epigenetics and vital, social and environmental circumstances. Consistent with this clinical view, medical actions must also focus on the participation in continual medical education programs and at the school of medicine, and on the design of promotion/prevention actions that consider the vision of the health-disease continuum and that conceives physical and mental health as a unit. The above is strengthened with the development of health professionals own introspective abilities to detect burnout syndrome as a mechanism of loss of empathy.

Resumen El suicidio es un problema de salud pública. La prevención requiere de acciones formativas a nivel emocional, del tratamiento científico de las situaciones de riesgo suicida y de un manejo sensible por parte de los medios de comunicación. A raíz de las efemérides del día mundial de la prevención del suicidio y del día mundial de la salud mental, conviene hacer una reflexión sobre cómo la conceptualización de la enfermedad como proceso facilita el abordaje de los trastornos mentales. La comprensión de la historia de vida de cada paciente permite realizar una adecuada contextualización biográfica que explica la compleja interacción entre estrés temprano en la vida, vulnerabilidad, epigenética y circunstancias vitales, sociales y ambientales. Congruente con este trabajo clínico, la labor médica debe centrarse también en la participación en programas de educación médica continua y desde la escuela de medicina y en el diseño de acciones de promoción/prevención que consideren esta visión del continuum salud-enfermedad y que entiendan la salud física y mental como unidad. Lo anterior se fortalece con el desarrollo de las propias capacidades introspectivas para la detección del desgaste profesional como mecanismo de pérdida de la empatía.

Resumen Antecedentes: La malnutrición es un problema mundial que afecta a niños escolares, capaz de incrementar el riesgo de enfermedades en la edad adulta. Adultos yaquis han presentado graves problemas de salud, por lo que los escolares podrían encontrarse en una situación similar. Objetivo: Evaluar el estado nutricional, el perfil lipídico y los factores asociados en una muestra de escolares yaquis. Material y métodos: Se estudiaron 109 escolares habitantes de los pueblos originarios, en quienes se realizaron mediciones antropométricas, se extrajo una muestra de sangre venosa en condición de ayuno y se aplicaron cuestionarios. Resultados: La prevalencia de sobrepeso/obesidad fue de 38.5 %, sin que se registraran casos de desnutrición crónica; 38.6 % de los escolares presentó dislipidemia. El consumo de fibra resultó ser un factor protector contra sobrepeso/obesidad y el consumo de grasa constituyó un factor de riesgo. La puntuación de actividad física resultó ser un factor protector contra dislipidemia y los factores de riesgo fueron puntuaciones Z del índice de masa corporal/edad, circunferencia de cintura, historia familiar de dislipidemias, nivel educativo y empleo permanente. Conclusiones: Los escolares yaquis padecen por igual alta proporción de sobrepeso/obesidad y dislipidemia. Los factores asociados pueden resultar útiles para el diseño de intervenciones contextualizadas para esta población.

Abstract Background: Malnutrition is a global problem that affects schoolchildren and can increase the risk of diseases in adulthood. Adult members of the Yaqui Indigenous group have been shown to have serious health problems, and Yaqui schoolchildren could therefore find themselves in a similar situation. Objective: To evaluate the nutritional status, lipid profile and associated factors in a sample of Yaqui schoolchildren. Material and methods: A total of 109 Yaqui schoolchildren who lived in their localities of origin were recruited. Anthropometric measurements were carried out, a venous blood sample was extracted in fasting conditions, and several questionnaires were applied. Results: The prevalence of overweight/obesity was 38.5%, with no cases of chronic malnutrition being recorded; 38.6% of the children had dyslipidemia. Fiber consumption was a protective factor against overweight/obesity, while fat intake was a risk factor. The physical activity score was found to be a protective factor against dyslipidemia, and the risk factors were BMI-for-age Z-scores, waist circumference, family history of dyslipidemia, educational level, and permanent employment. Conclusions: Yaqui schoolchildren equally suffer from a high proportion of overweight/obesity and dyslipidemia. The associated factors may be useful for the design of contextualized interventions for this population.

RESUMEN Objetivos: identificar y sintetizar, a partir de la literatura, los impactos de la discapacidad física causada por la lepra en la calidad de vida de los individuos atendidos en la Red de Atención a la Salud. Métodos: se trata de una revisión de alcance, realizada de acuerdo con las recomendaciones del JBI. Las bases de datos utilizadas en la búsqueda fueron el Sistema de Análisis y Recuperación de Literatura Médica en Línea, la Biblioteca Cochrane, Web of Science, Lilacs, el Índice Cumulativo de Literatura en Enfermería y Ciencias Afines, Scopus, Embase, Leprosy Information Services y Google Scholar. Resultados: se identificaron 1690 documentos, de los cuales 36 fueron parte de la revisión. La discapacidad física causada por la lepra afecta la calidad de vida en términos de actividades de la vida diaria, socioeconómicas, psicológicas, dolor y bienestar general. Conclusiones: se identificaron los compromisos causados por la discapacidad física en la calidad de vida, indicando la necesidad de acciones de prevención, promoción y rehabilitación, como el seguimiento, el acompañamiento de los casos y la educación en salud.

RESUMO Objetivos: identificar e sintetizar, a partir da literatura, os impactos da incapacidade física causada pela hanseníase na qualidade de vida dos indivíduos atendidos na Rede de Atenção à Saúde. Métodos: trata-se de uma revisão de escopo, realizada de acordo com as recomendações do JBI. As bases de dados utilizadas na busca foram Medical Literature Analysis and Retrieval System Online, Cochrane library, Web of Science, Lilacs, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Leprosy Information Services e Google Scholar. Resultados: foram identificados 1690 documentos, dos quais 36 compuseram a revisão. A incapacidade física causada pela hanseníase impacta na qualidade de vida no âmbito de atividades de vida diária, socioeconômico, psicológico, da dor e no bem-estar geral. Conclusões: foram identificados os comprometimentos causados pela incapacidade física na qualidade de vida, indicando a necessidade de ações de prevenção, promoção e reabilitação, como rastreamento, acompanhamento dos casos e educação em saúde.

ABSTRACT Objectives: to identify and synthesize, from the literature, the impacts of physical disability caused by leprosy on the quality of life of individuals receiving care within the Health Care Network. Methods: this is a scoping review conducted following the JBI recommendations. The databases used in the search included the Medical Literature Analysis and Retrieval System Online, Cochrane Library, Web of Science, Lilacs, Cumulative Index to Nursing and Allied Health Literature, Scopus, Embase, Leprosy Information Services, and Google Scholar. Results: 1690 documents were identified, of which 36 were included in the review. Physical disability caused by leprosy affects the quality of life in the areas of daily activities, socioeconomic aspects, psychological well-being, pain, and overall well-being. Conclusions: we identified the impairments caused by physical disability in the quality of life, highlighting the need for prevention, promotion, and rehabilitation actions, such as screening, case management, and health education.