Abstract Introduction: Vascular and neuropathic complications of diabetes cause diabetic foot, being the main risk factor for non-traumatic amputations. Objective: To analyze the available scientific evidence on lifestyle and self-care of patients at risk of diabetic foot. Methodology: Literature review using the preferred reporting items for systematic reviews and meta-analyses methodology; published in EBSCO host, Google academic, PubMed, Scielo and Elsevier; in English and Spanish from 2016 to 2022. Nursing articles were included, mentioning two or more variables of interest: diabetes mellitus, lifestyle, diabetic foot, and self-care; duplicates, no access, and gray literature were eliminated. From a total of 1,080 articles, 14 were included that met the inclusion criteria. Checklists were used to assess the quality of the manuscripts used. Results: Systematic reviews, observational, experimental and qualitative studies showed evidence that self-care can be influenced by culture, context and knowledge deficit, being this a risk factor for the development of diabetic foot. An association was found between the risk of diabetic foot with years of diagnosis, inadequate self-care of the feet and advanced age. Conclusion: The association between the self-care deficit and the risk of diabetic foot in the elderly was evidenced. It is recommended to broaden the search and include people under 40 years of age in order to establish effective preventive measures and reduce the risk of diabetic foot.

Abstrato Introdução: As complicações vasculares e neuropáticas da diabetes causam o pé diabético, sendo o principal fator de risco para amputações não traumáticas. Objetivo: Analisar a evidência científica disponível sobre o estilo de vida e o autocuidado dos doentes em risco de pé diabético. Metodologia: Revisão da literatura utilizando a metodologia preferred reporting items for systematic reviews and meta-analyses; publicada no EBSCO host, Google Scholar, PubMed, Scielo e Elsevier; em inglês e espanhol de 2016 a 2022. Foram incluídos artigos de enfermagem que mencionavam duas ou mais variáveis de interesse: diabetes mellitus, estilo de vida, pé diabético e autocuidado; foram removidos os duplicados, sem acesso e literatura cinzenta. De um total de 1.080 artigos, 14 que preencheram os critérios de inclusão foram incluídos. Foram utilizadas listas de verificação para avaliar a qualidade dos manuscritos utilizados. Resultados: Revisões sistemáticas, estudos observacionais, experimentais e qualitativos mostraram evidências de que o autocuidado pode ser influenciado pela cultura, contexto e défices de conhecimento, que são factores de risco para o desenvolvimento da doença do pé diabético. Foram encontradas associações entre o risco de pé diabético e os anos de diagnóstico, o autocuidado inadequado dos pés e a idade avançada. Conclusão: Verificou-se a associação entre défices de autocuidado e o risco de doença do pé diabético em idosos. Recomendamos o alargamento da pesquisa a pessoas com menos de 40 anos de idade, de forma a estabelecer medidas preventivas eficazes e reduzir o risco de doença do pé diabético.

Resumen Introducción: Las complicaciones vasculares y neuropáticas de la diabetes causan el pie diabético, siendo el principal factor de riesgo para amputaciones no traumáticas. Objetivo: Analizar la evidencia científica disponible sobre el estilo de vida y autocuidado de los pacientes con riesgo de pie diabético. Metodología: Revisión de la literatura mediante la metodología preferred reporting items for systematic reviews and meta-analyses; publicada en EBSCO host, Google académico, PubMed, Scielo y Elsevier; en inglés y español desde 2016 a 2022. Se incluyeron artículos de enfermería, que mencionaran dos o más variables de interés: diabetes mellitus, estilo de vida, pie diabético y autocuidado; se eliminaron duplicados, sin acceso abierto y literatura gris. De un total de 1,080 artículos se incluyeron 14 que reunieron los criterios de inclusión. Se emplearon listas de verificación para evaluar la calidad de los manuscritos utilizados. Resultados: Las revisiones sistemáticas, estudios observacionales, experimentales y cualitativos mostraron evidencias de que el autocuidado puede verse influenciado por la cultura, contexto y déficit de conocimientos, siendo este factor de riesgo para el desarrollo de pie diabético. Se encontró asociación entre el riesgo de pie diabético con años de diagnóstico, autocuidado inadecuado de los pies y edad avanzada. Conclusión: Se evidenció asociación entre déficit de autocuidado y riesgo de pie diabético en el adulto mayor. Se recomienda ampliar la búsqueda e incluir personas menores de 40 años para establecer medidas preventivas eficaces y reducir el riesgo de pie diabético.

Resumo Introdução: A doença renal crônica (DRC) está relacionada à elevada morbimortalidade e perda de qualidade de vida. Igualmente, o hiperparatireoidismo está associado à perda progressiva da função renal, com níveis aumentados de fosfato e diminuição de cálcio, que induzem secreção do paratormônio. Objetivos: Traduzir para língua portuguesa (Brasil), adaptar culturalmente e validar o questionário Parathyroid Symptoms Assessment (PAS), seguindo critérios de confiabilidade e validade em pacientes com DRC e hiperparatireoidismo. Métodos: Estudo metodológico e transversal, realizado no Hospital São Lucas/PUCRS, Porto Alegre, Brasil. O processo de validação do questionário PAS seguiu protocolos de estudos anteriores. Após tradução para o português, aplicou-se a 100 pacientes com hiperparatireoidismo secundário (HPTS) e terciário ou persistente (HPTT). Para dados de validação do PAS, os pacientes responderam ao questionário Short Form Health 36 (SF-36). Critérios de confiabilidade foram avaliados usando coeficiente de correlação intraclasse (CCI) e alfa de Cronbach (α-C). A validade foi avaliada pelo coeficiente de correlação de Spearman entre valores de PAS e SF-36. Resultados: A idade média dos participantes foi 55,6 ± 15,6 anos, 61% eram homens e 68% foram diagnosticados com HPTS. Entre 100 pacientes, 53% realizaram reteste de PAS (CCI = 0,83). A confiabilidade interna por α-C foi 0,86. Observaram-se correlações negativas entre questões do PAS e os domínios físico e mental do SF-36, que variaram de 0,3 a 0,7. Conclusão A versão brasileira do questionário PAS mostrou-se válida e confiável. O questionário PAS pode ser usado para avaliar qualidade de vida em pacientes brasileiros com hiperparatireoidismo que falam português. Introdução (DRC Igualmente cálcio paratormônio Objetivos Brasil, Brasil , (Brasil) (PAS) Métodos transversal LucasPUCRS Lucas PUCRS Lucas/PUCRS Alegre anteriores português aplicouse aplicou se 10 HPTS (HPTS HPTT. HPTT . (HPTT) 3 SF36. SF36 SF (SF-36) CCI αC. αC α C (α-C) 36. SF-36 Resultados 556 55 6 55, 156 15 15, anos 61 68 53 0,83. 083 0,83 0 83 0,83) 086 86 0,86 Observaramse Observaram SF36, 36, 03 0, 07 7 0,7 mostrouse mostrou confiável (Brasil (PAS 1 (HPTT SF3 (SF-36 (α-C SF-3 5 08 0,8 8 (SF-3 SF- (SF- (SF

Abstract Introduction: Chronic kidney disease (CKD) is related to high morbidity and mortality and loss of quality of life. Likewise, hyperparathyroidism is associated to progressive loss of renal function, with increased phosphate and decrease calcium levels, which induce the secretion of parathyroid hormone. Objectives: To translate into Portuguese (Brazil), culturally adapt and validate the questionnaire Parathyroid Symptoms Assessment (PAS), following reliability and validity criteria in patients with chronic kidney disease and hyperparathyroidism. Methods: Methodological and cross-sectional study, carried out at São Lucas Hospital/PUCRS, Porto Alegre, Brazil. The PAS questionnaire validation process followed protocols from previous studies. After translating into Portuguese, it was applied to 100 patients with secondary (SHPT) and tertiary or persistent (THPT) hyperparathyroidism. For PAS validation data, patients responded to the Short Form Health 36 (SF-36) questionnaire. Reliability criteria were evaluated using intraclass correlation coefficient (ICC) and Cronbach’s alpha (α-C). Validity was assessed by Spearman’s correlation coefficient between PAS and SF-36 values. Results: Participant’s mean age was 55.6 ± 15.6 years, 61% was male, and 68% was diagnosed with SHPT. Among 100 patients, 53% performed a PAS retest (ICC = 0.83). The internal reliability by α-C was 0.86. Negative correlations were observed between PAS questions and SF-36 physical and mental domains, which ranged from 0.3 to 0.7. Conclusion: The Brazilian version of the PAS questionnaire was found to be valid and reliable. The PAS questionnaire can be used to evaluate quality of life in Brazilian patients with hyperparathyroidism who speak Portuguese. Introduction CKD (CKD Likewise function levels hormone Objectives Brazil, Brazil , (Brazil) PAS, (PAS) Methods crosssectional cross sectional study HospitalPUCRS Hospital PUCRS Hospital/PUCRS Alegre studies 10 SHPT (SHPT THPT (THPT data 3 SF36 SF (SF-36 ICC Cronbachs Cronbach s αC. αC α C . (α-C) Spearmans Spearman SF-3 values Results Participants Participant 556 55 6 55. 156 15 15. years 61 male 68 53 0.83. 083 0.83 0 83 0.83) 086 86 0.86 domains 03 0. 07 7 0.7 Conclusion reliable (Brazil (PAS 1 SF3 (SF-3 (α-C SF- 5 08 0.8 8 (SF- (SF

SUMMARY BACKGROUND: Cancer-related fatigue is a pervasive symptom, affecting up to 90% of cancer patients throughout their illness, and can persist well after treatment has ended. Despite its prevalence, no definitive evidence-based treatment exists, leading to an abundance of proposed alternatives, including natural supplements. To further explore the potential effects of guaraná on cancer-related fatigue, a systematic review with meta-analysis was conducted and registered on the International Prospective Register of Systematic Reviews (CRD42023484144). METHODS: A thorough search of PubMed/MEDLINE and Cochrane Library was conducted using MeSH terms and related keywords for cancer-related fatigue and guaraná. Eligible studies were selected according to predetermined criteria and assessed for quality in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. Data extraction was independently performed by two reviewers, with any discrepancies resolved by a third researcher. RESULTS: In total, 4 full articles and 1 abstract, encompassing a total of 229 patients from 2009 to 2023, were included in the meta-analysis. Despite high heterogeneity between studies (I2=78%, ꭓ2=18.51, df=4, p=0.0010), the analysis revealed a significant benefit of using guaraná to alleviate cancer-related fatigue, with a standard mean difference of −0.77 (95%CI −1.34, −0.21) and a test for the overall effect of Z=2.68 (p=0.007). CONCLUSION: This meta-analysis provides support for the use of guaraná in the treatment of cancer-related fatigue. However, further investigation through larger prospective randomized controlled trials is necessary to validate these findings. BACKGROUND Cancerrelated Cancer symptom 90 illness ended prevalence evidencebased evidence based exists alternatives supplements cancerrelated metaanalysis meta CRD42023484144. CRD42023484144 CRD . (CRD42023484144) METHODS PubMedMEDLINE PubMed MEDLINE Interventions reviewers researcher RESULTS abstract 22 200 2023 metaanalysis. analysis. I2=78%, I278 I I2 78 (I2=78% ꭓ21851 ꭓ ꭓ2 18 51 ꭓ2=18.51 df4 df df=4 p=0.0010, p00010 p p=0.0010 , 0 0010 p=0.0010) 077 77 −0.7 95%CI 95CI CI 95 134 34 −1.34 −0.21 021 21 Z268 Z 2 68 Z=2.6 p=0.007. p0007 p=0.007 007 (p=0.007) CONCLUSION However findings 9 CRD4202348414 (CRD42023484144 20 202 I2=78% I27 7 (I2=78 ꭓ2185 5 ꭓ2=18.5 df= p0001 p=0.001 001 07 −0. 13 3 −1.3 −0.2 02 Z26 6 Z=2. p000 p=0.00 00 (p=0.007 CRD420234841 (CRD4202348414 I2=78 (I2=7 ꭓ218 ꭓ2=18. −0 −1. Z2 Z=2 p00 p=0.0 (p=0.00 CRD42023484 (CRD420234841 I2=7 (I2= ꭓ21 ꭓ2=18 − −1 Z= p0 p=0. (p=0.0 CRD4202348 (CRD42023484 I2= (I2 ꭓ2=1 p=0 (p=0. CRD420234 (CRD4202348 (I ꭓ2= p= (p=0 CRD42023 (CRD420234 (p= CRD4202 (CRD42023 (p CRD420 (CRD4202 CRD42 (CRD420 CRD4 (CRD42 (CRD4 (CRD

Abstract Introduction: Demographic changes, technological advancements, and new recommendations in resident education necessitate a review the characteristics of obstetrics and gynecology specialization programs in our country. Objective: To evaluate whether the quality standards required by national and international entities are being met by our programs. Method: A Google Forms survey was sent to 18 program coordinators of the 14 universities offering the specialization, including the five campuses of the University of Chile, yielding 16 responses. The survey collected demographic data and relevant characteristics of the training centers. Results: The analyzed programs are quite heterogeneous in most of the items evaluated items, and not all of the nationally and internationally suggested quality criteria are universally met. There are significant differences among training centers regarding residents’ opportunities to perform relevant surgical procedures in our specialty. Conclusions: Coordination and collaboration among program directors are essential to achieve the comprehensive training of specialists with high-quality standards. The use of clinical simulation will also enable adequately expose of residents to procedures that may be less accessible in their hospital practice.

Resumen Introducción: Los cambios demográficos, los avances tecnológicos y las nuevas recomendaciones en docencia de residentes hacen necesario revisar las características de los programas de especialización en obstetricia y ginecología de nuestro país. Objetivo: Evaluar si nuestros programas de especialización cumplen los estándares de calidad exigidos por entidades nacionales e internacionales. Método: Se envió una encuesta de Google Forms a 18 encargados de programas de las 14 universidades que imparten la especialidad, incluyendo las cinco sedes de la Universidad de Chile, obteniéndose 16 respuestas. La encuesta recolectó datos demográficos y características de interés de los centros formadores. Resultados: Los programas analizados son bastante heterogéneos en la mayoría de los ítems evaluados, y no todos los criterios de calidad sugeridos nacional e internacionalmente se cumplen de forma universal. Existen diferencias importantes entre centros formadores en relación con la oportunidad de los residentes de realizar procedimientos quirúrgicos relevantes en nuestra especialidad. Conclusiones: Es esencial la coordinación y colaboración entre jefes de programa para lograr la formación de especialistas integrales y con altos estándares de calidad. El uso de simulación clínica también nos permitirá una adecuada exposición de los residentes a procedimientos que puedan estar menos accesibles en su práctica hospitalaria.

Abstract Introduction: Nursing, as a science and discipline, faces the challenge of missed care and omissions that affect the safety and quality of care. Objective: to analyze the scientific evidence related to missed care in nursing, highlighting its impact on safety and quality of care. Methodology: A systematic review of articles was conducted between 2018 and 2023, with a descriptive design, following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) flowchart. The study was conducted between September and December 2023, collecting articles related to lost care in nursing from open-access indexed journals in the following repositories: Scielo, Redalyc, PubMed, Wos, Scopus, and CINAHL. Selection and exclusion criteria were applied, and original qualitative and quantitative articles were chosen with a maximum validity of 6 years. The review focused on literature in English, Spanish, and Portuguese. Ethical standards were rigorously respected, guaranteeing confidentiality and treating sensitive information ethically. Results: 7 articles were included, which revealed disparities in lost care between public and private hospitals, highlighting the gap in resources, in addition to emphasizing the relationship between lost care and professional burnout, omissions in primary nursing care such as handwashing, along with the importance of planning care through the nursing process, to ensure compliance and recording of this care. Conclusion s: Strategies such as humanizing care, developing plans for resource scarcity, and maintaining an adequate nurse-patient relationship are essential to address the issue of lost care.

Resumen Introducción: la enfermería, como ciencia y disciplina, se enfrenta al desafío de los cuidados perdidos y omisiones que afectan la seguridad y calidad de la atención. Objetivo: analizar las evidencias científicas relacionadas con los cuidados perdidos en enfermería, destacando su impacto en la seguridad y calidad asistencial. Metodología: se realizó una revisión sistemática de artículos entre 2018-2023, con diseño descriptivo, siguiendo el flujograma Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). El estudio se llevó a cabo entre septiembre y diciembre de 2023, recopilando artículos de revistas indexadas de acceso abierto en; Scielo, Redalyc, PubMed, Wos, Scopus y CINAHL, relacionados con los cuidados perdidos en enfermería. Se aplicaron criterios de selección y exclusión, eligiendo artículos originales cualitativos y cuantitativos con una vigencia máxima de 6 años. La revisión se centró en literatura en inglés, español y portugués. Se respetaron rigurosamente las normas éticas, garantizando la confidencialidad y tratando éticamente la información sensible. Resultados: se incluyeron 7 artículos, los que revelaron disparidades en el cuidado perdido entre hospitales públicos y privados, resaltando la brecha en recursos, además de enfatizar en la relación entre el cuidado perdido y el agotamiento profesional, omisiones en cuidados básicos de enfermería como el lavado de manos, junto con la importancia de planificar el cuidado mediante el proceso de enfermería, a fin de garantizar su complimiento y registro de este cuidado. Conclusiones: estrategias como la humanización de la atención, desarrollo de planes ante escasez de recursos y mantener una adecuada relación enfermero-paciente, son esenciales para enfrentar los inconvenientes que representan los cuidados perdidos.

Resumen En Cuba, la falta de equipos de medición, el alto costo de las estaciones de contaminación atmosférica y las limitantes para acceder a nuevas tecnologías, dificultan el monitoreo continuo de la calidad del aire. Por tales motivos, la presente investigación tuvo como objetivo, caracterizar contaminantes criterio empleando el modelo System for Integrated modeLling of Atmospheric coMposition. Se obtuvo una serie diaria de concentraciones estimadas de contaminantes criterio en La Habana durante el año 2021. Se realizó una caracterización del comportamiento de los contaminantes analizando las concentraciones medias diarias y medias mensuales. Se realizó una revisión de los días en que las concentraciones sobrepasaban los valores de las concentraciones máximas admisibles establecidas en la Norma Cubana. Además, se compararon estos resultados con los Valores Guías de Calidad del Aire recomendados por la Organización Mundial de la Salud. De forma general, los valores diarios estimados de las concentraciones de los contaminantes se correspondieron con los patrones de distribución espacial y temporal característicos observados en estudios precedentes en la ciudad con monitoreo automático y activo. Se reafirma así la utilidad de la herramienta de las salidas del modelo System for Integrated modeLling of Atmospheric coMposition para brindar información de calidad del aire en La Habana.

Abstract In Cuba, the lack of measurement equipment, the high cost of air pollution stations and the limitations to access new technologies make continuous monitoring of air quality difficult. For these reasons, the objective of this research was to characterize criterion pollutants using the System for Integrated modeling of Atmospheric coMposition model. A daily series of estimated concentrations of criteria pollutants was obtained in Havana during the year 2021. A characterization of the behavior of the pollutants was carried out by analyzing the average daily and average monthly concentrations. A review was carried out of the days in which concentrations exceeded the values of the maximum admissible concentrations established in the Cuban Standard. In addition, these results were compared with the Air Quality Guide Values recommended by the World Health Organization. In general, the estimated daily values of pollutant concentrations corresponded to the characteristic spatial and temporal distribution patterns observed in previous studies in the city with automatic and active monitoring. Thus, the usefulness of the tool of the outputs of the System for Integrated modelLing of Atmospheric coMposition model to provide air quality information in Havana is reaffirmed.

Abstract Context: Female Sexual Dysfunctions (FSD) are prevalent conditions, can occur in any stage of life and can severely affect women’s quality of life. The etiology of FSD is often multifactorial, including biologic, psychological, interpersonal and sociocultural factors. Objectives: To evaluate FSD in a Portuguese population and what factors can influence the female sexual function. Methods: A cross-sectional study was conducted between August and September of 2023. Participants filled an anonymous online survey, including a demographic questionnaire and the Female Sexual Function Index (FSFI) for evaluation of sexual function. Inclusion criteria: age between 18 and 75 years old, residence in Portugal and being in a heterosexual relationship. The total score FSFI and domain scores (desire, arousal, lubrification, orgasm, satisfaction and discomfort) were analyzed using SPSS 22®. Results: A total of 401 women completed the questionnaire, 393 fulfilled the inclusion criteria. Women had a mean age of 41,6 years (range: 20-71 years). From these, 48% of women reported being moderately satisfied or very satisfied with their sex life and 9,6% reported no sexual intercourse in the past 4 weeks. Among sexually active women, the mean total FSFI score was 27.37 (range: 7.5-34.5±4.99) and 36% met the criteria for sexual dysfunction (FSFI score ≤ 26.55). Post-menopausal participants, when compared to women in reproductive age, had a lower mean total score and also had lower mean scores across all domains, except for discomfort (p<0.05). Women with children or a BMI ≥ 25 had lower mean total score and lower mean scores for desire, arousal and satisfaction domains (p<0.05). Conclusions: The prevalence of FSD was 36%. These findings highlight the importance of addressing FSD as a significant concern for women health and quality of life and the need for training and awareness among healthcare professionals.

Resumo Introdução: As disfunções sexuais femininas (DSF) são condições prevalentes. Estas podem ocorrer em qualquer fase da vida e podem afetar negativamente a qualidade de vida de muitas mulheres. A etiologia das DSF é frequentemente multifatorial, incluindo fatores biológicos, psicológicos, interpessoais e socioculturais. Objetivos: Avaliar as DSF em mulheres portuguesas e identificar possíveis fatores que possam influenciar a sexualidade feminina. Métodos: Estudo transversal observacional realizado entre agosto e setembro de 2023, através do preenchimento de questionário online anónimo, que incluía um questionário demográfico e o Female Sexual Function Index (FSFI) para avaliação da resposta sexual. A pontuação total e dos domínios (desejo, excitação, lubrificação, orgasmo, satisfação e desconforto) foram analisados utilizando o SPSS 22®. Resultados: De um total de 401 mulheres que completaram o questionário, 393 preenchiam os critérios de inclusão no estudo. A idade média das inquiridas foi de 41,6 anos (20-71 anos). Quando questionadas, 74% das mulheres referiram estar moderadamente satisfeitas ou muito satisfeitas com a sua vida sexual e 9,6% das mulheres referiu ausência de relações sexuais nas últimas quatro semanas. Entre as mulheres sexualmente ativas, a pontuação média total do FSFI foi de 27,37 (7,5-34,5±4,99) e 36% preenchiam os critérios para disfunção sexual (Pontuação FSFI ≤ 26,55). As participantes na pós-menopausa, em comparação com as mulheres em idade reprodutiva, apresentaram uma pontuação média total inferior, assim como pontuações médias inferiores em todos os domínios, exceto no desconforto (p<0,05). Mulheres com filhos ou com IMC ≥25 tiveram uma pontuação média total e pontuações médias inferiores nos domínios do desejo, excitação e satisfação (p<0,05). Conclusões: A prevalência de problemas sexuais na população em estudo foi de 36%. Estes achados destacam a importância de abordar as DSF como uma preocupação na saúde e qualidade de vida das mulheres e da necessidade de formação e sensibilização dos profissionais de saúde.

Abstract Objectives: characterize, in a sociodemographic and clinical perspective, pacients who underwent videoendoscopy of swallowing and had oropharyngeal dysphagia during their hospital stay. Furthermore, it is also intended to find strategies to improve the quality of the response to pacientes in need of videoendoscopy of swallowing. Case study: this study is based on a sample collected in Centro Hospitalar Universitário Santo António, between january 2019 and september 2021, including. Materials and Methods: the clinical data and image studies from 157 pacients were retrospectively analyzed. After careful selection, all cases that did not meet the inclusion criteria were excluded from the study. Thus, 143 patients were selected for analysis. Results and conclusions: this study identifies determining factors of FOIS level variability, detecting severe patients in a preliminary, pre-VED phase, reducing waiting time by over 70%, and consequently improving service quality in all its dimensions.

Resumo Objetivos: caracterizar, do ponto de vista sociodemográfico e clínico, os doentes submetidos a videoendoscopia da deglutição que, no decurso do seu internamento, apresentaram quadro de disfagia orofaríngea; encontrar estratégias para melhorar a qualidade da resposta aos doentes que necessitem de recorrer a videoendoscopia da deglutição. Desenho do Estudo: este estudo tem por base uma amostra recolhida no Centro Hospitalar Universitário Santo António, entre janeiro de 2019 e setembro de 2021, inclusive. Material e Métodos: foram analisados retrospetivamente os processos clínicos e estudos imagiológicos de 157 doentes. Após seleção cuidada, foram excluídos do estudo todos os casos que não cumpriram os critérios de inclusão. Assim, obtiveram-se para análise 143 doentes. Resultados e Conclusões: este estudo identifica fatores determinantes da variabilidade do nível FOIS, detetando doentes graves numa fase preliminar, pré-VED, diminuindo o tempo de espera em mais de 70%, e, consequentemente, melhorando a qualidade do serviço em todas as suas dimensões.

Resumen La autoevaluación de los programas de maestría impartidos total o parcialmente en entornos virtuales permite la mejora de estos y favorece la toma de decisiones basada en evidencias. La eficacia de la autoevaluación depende de los indicadores utilizados por lo que es indispensable determinar el valor de estos. El objetivo del trabajo fue implementar un instrumento de evaluación de los indicadores para la autoevaluación de la calidad de los programas virtuales de maestría. Se realizó la identificación y análisis de artículos científicos, guías de diseño y normas técnicas que abordan la evaluación de indicadores. Se empleó el motor de búsqueda de Google y Google Académico con las palabras clave: indicadores, sistemas de indicadores, evaluación de indicadores. Como resultado del análisis se identificaron seis criterios de calidad de los indicadores utilizados en la autoevaluación de los programas virtuales de maestría. Se elaboró un instrumento para medir estos seis criterios mediante una escala de Likert de cinco niveles. La prueba piloto del instrumento diseñado permitió su validación y mejorar los indicadores utilizados en la autoevaluación de los programas virtuales de maestría en la Cátedra de Calidad, Metrología y Normalización de la Universidad de La Habana.

Abstract Systematic self-assessment of master's programs taught totally or partially in virtual environments allows the improvement of these and favors evidence-based decision making. Self-assessment effectiveness is to a large extent due to indicators that are defined to carry it out. Value determination of these indicators for the self-assessment´s objectives achievement is the first step to the realization of this. Given the above, the objective of this work was to implement an instrument for evaluating the self-assessment´s indicators for quality of virtual programs master's. It was carried out identification and analysis of scientific articles, design guides and technical standards that address the evaluation of indicators. The Google and Google Scholar search engine was used with the keywords: indicators, indicator systems, indicator evaluation. As a result of the analysis, six indicators’ quality criteria used in the master's virtual programs self-assessment were identified. An instrument was developed to measure these six criteria through a five-level Likert scale. Pilot test of designed instrument allowed its validation and improve the indicators used in master's virtual programs self-assessment in the Chair of Quality, Metrology and Standardization of the University of Havana.

Abstract Wood is a material widely used in construction, furniture, and other applications. Technologies are used to protect its quality and durability against biological damage and the effects of water, temperature and radiation that affect its physical and mechanical properties. The present work reviews the available treatments, evaluates their advantages and disadvantages, and defines the criteria for their use. The theme was divided into two sections: (I) Wood degrading agents, and (II) A classification of protection technologies that included both the traditional methods and novel approaches such as nanotechnology. The conclusions obtained with this approach point to the fact that several traditional chemical treatments substantially reduce biological damage and moisture absorption in wood. However, potential health and environmental effects should be considered. On the other hand, the dimensional stability of the wood is improved through the use of heat treatments. The use of nanometric composites for wood protection is a very promising technique that is under increasing development. However, it is a technology that requires special care because the nanomaterials must be toxic to the agents causing biodeterioration, but harmless or less hazardous to humans and the environment.

Resumen La madera es un material ampliamente usado en construcción, muebles, entre otras aplicaciones. Para mantener su calidad y durabilidad se emplean tecnologías de protección contra daños biológicos y los efectos del agua, la temperatura y la radiación que afectan sus propiedades físicas y mecánicas. En el presente trabajo se realizó una revisión de los tratamientos disponibles y se evaluaron sus ventajas e inconvenientes, además se definieron los criterios para su utilización. La temática se dividió en dos secciones: (I) los agentes degradadores de la madera, y (II) una clasificación de tecnologías de protección que incluyó tanto métodos tradicionales, como enfoques novedosos, tal es el caso de la nanotecnología. Bajo este enfoque, las conclusiones obtenidas apuntan a que diversos tratamientos químicos tradicionales reducen, sustancialmente, el daño biológico y la absorción de humedad en la madera. No obstante, deben considerarse los posibles efectos a la salud y al ambiente. Por otra parte, si se emplean tratamientos térmicos, la estabilidad dimensional de la madera mejora. El uso de compuestos nanométricos para la protección de la madera es una técnica muy prometedora y en creciente desarrollo. Sin embargo, es una tecnología de especial cuidado porque los nanomateriales tienen que ser tóxicos para los agentes causantes del biodeterioro, pero inocuos o menos peligrosos para los humanos y el ambiente.

Abstract For twenty-six years, the priest of Los Llanos, Don Cándido Sotomayor, carried out a task of organizing and classifying the priesthood that is surprising given the dynamics of constant change that characterized that community towards the end of the colonial period. In this sense, it seems that his work did not consist of a mere reclassification of the population, but rather a personal and consistent categorization based on the implicit criteria of quality perception. The categories used by Sotomayor reveal both the values rooted in his position in the social hierarchy and the changes in the current racial imaginaries and their resignification towards the end of the colonial era. It is important to highlight, in line with what the authors expressed, the opportunities that the analysis of Sotomayor's work provides to examine the approaches through which the census takers observed reality. Likewise, it allows contrasting perceptions, consistency and reinforcements of certain implicit attributes of quality over time. This detailed look at the religious’ work and classification criteria offers us a unique window to understand how quality was constructed and perceived at that time, as well as to analyze the changes and continuities in social and racial evaluations throughout the colonial period.

Resumen Durante veintiséis años, el cura de Los Llanos, don Cándido Sotomayor, llevó a cabo una labor de ordenamiento y clasificación del curato que resulta sorprendente dada la dinámica de cambio constante que caracterizaba a esa comunidad hacia finales del período colonial. En este sentido, pareciera que su labor no consistió en una mera reclasificación de la población, sino más bien en una categorización personal y consistente basada en los criterios implícitos de percepción de la calidad. Las categorías utilizadas por Sotomayor revelan tanto los valores arraigados en su posición en la jerarquía social como los cambios en los imaginarios raciales vigentes y su resignificación hacia el final de la era colonial. Es importante resaltar, en sintonía con lo expresado por las autoras, las oportunidades que el análisis de la labor de Sotomayor brinda para examinar los enfoques a través de los cuales los censistas observaban la realidad. Asimismo, permite contrastar percepciones, consistencias y reforzamientos de ciertos atributos implícitos de la calidad a lo largo del tiempo. Esta mirada detallada sobre el trabajo y los criterios de clasificación del religioso nos ofrece una ventana única para comprender cómo se construía y percibía la calidad en esa época, así como para analizar los cambios y continuidades en las valoraciones sociales y raciales a lo largo del periodo colonial.

Resumen Introducción : Los adultos mayores con enfermedades crónicas avanzadas y necesidad de cuidados paliativos están más expuestos a la polifarmacia y a consumir medicación potencialmente inapropiada, la cual genera un alto riesgo de eventos adversos y alteración de la calidad de vida. El objetivo de este estudio fue describir la frecuencia de consumo de medicación potencialmente inapropiada de adultos mayores con necesidad de cuida dos paliativos que ingresaron a cuidados domiciliarios luego de una hospitalización. Métodos : Estudio de corte transversal observacional de registros de dispensación e historias clínicas electró nicas, de adultos mayores en un sistema de cuidados domiciliarios y con necesidades de cuidados paliativos según el rastreo con la herramienta NECPAL, los índices PROFUND y/o PALIAR. Se analizó el consumo de fárma cos durante los 180 días posteriores al ingreso a cuidados domiciliarios. Se clasificaron los fármacos como poten cialmente inapropiados según criterios de LESS-CHRON. Resultados : Se incluyeron 176 pacientes, edad prome dio 87.4 años, 67% mujeres; 78% eran pluripatológicos y 22% presentaban una enfermedad única crónica progre siva. La mortalidad a los 6 meses fue 73%. La mediana de consumo de fármacos por paciente fue 9.1 (RIC = 4-9.7). El 87% consumía medicación potencialmente inapropia da, principalmente antihipertensivos, benzodiacepinas y antipsicóticos. Conclusión : Este estudio observó que los adultos ma yores, con necesidad de cuidados paliativos en cuidados domiciliarios, tienen un alto consumo de medicación potencialmente inapropiada. Esto refuerza la necesidad de implementar intervenciones efectivas centradas en el paciente, para prevenir la prescripción inadecuada y estimular la de-prescripción.

Abstract Introduction : Older adults with advanced chronic diseases and palliative care needs are more exposed to polypharmacy and use of potentially inappropriate medication, which generates a high risk of adverse events and impaired quality of life. The objective of this study was to describe the frequency of potentially inappropriate medication use among older adults with palliative care needs receiving home care services after hospital discharge. Methods : Observational cross-sectional study of pharmacy dispensing and electronic health records, of older adults in a home care system and with palliative care needs according to the screening with the NECPAL tool or the PROFUND and/or PALIAR indexes. Dispensed medications during 180 days after admission to home care were analyzed. Medications were classified as po tentially inappropriate according to the LESS-CHRON criteria. Results : We included 176 patients, mean age 87.4 years, 67% were women; 73% were pluripathologic pa tients and 22% had one chronic progressive disease. Mortality at 6 months was 73%. Median frequency of dispensed medications per patient was 9.1 (IQR = 4-9.7). The frequency of potentially inappropriate medication dispensation among patients was 87%, mainly antihy pertensives, benzodiazepines and antipsychotics. Conclusion : This study observed that dispensation of potentially inappropriate medication among older adults with palliative care needs and home care services is very high. This emphasizes the need for effective patient-centered interventions to prevent inadequate prescription and stimulate de-prescription.

RESUMO Introdução: este artigo foi elaborado a partir da detecção de insuficiências teórico-metodológicas e práticas no processo de preparação técnica da natação artística escolar. Objetivo: desenvolver uma concepção teórica com ma nova forma de reestruturação do conteúdo para o treinamento de figuras, a partir da sua periodização, que favoreça o aumento do desempenho esportivo em nadadores artísticos da categoria escolar. Materiais e métodos: métodos analítico-sintéticos e sistêmicos estrutural-funcionais foram utilizados como métodos teóricos de pesquisa científica. Análise empírica, documental e parecer pericial. Como métodos matemático-estatísticos, estatística descritiva e inferencial, com Teste W de Kendall. Resultados: a qualidade da concepção teórica foi corroborada pela avaliação emitida pelos 15 especialistas selecionados, que tiveram relação direta quer com o treino desportivo, quer de forma articular com o treino da natação artística cubana. Conclusões: os especialistas na avaliação dos indicadores destacam a sua funcionalidade, relevância e viabilidade.

ABSTRACT Introduction: This article was carried out based on identifying theoretical, methodological, and practical shortcomings in the technical preparation process of school artistic swimming. Objective: To develop a theoretical concept with a new way of restructuring the content for the training of figures, based on theirs periodization, which favors the increase of sports performance in school-age artistic wimmers. Materials and Methods: The theoretical methods of scientific research used were analytical-synthetic and systemic-functional. Empirical methods included documentary analysis and expert criteria. Mathematical-statistical methods involved descriptive and inferential statistics, using the Kendall's W Test. Results: The quality of the theoretical concept was confirmed by the evaluation issued by the 15 selected experts, who had a direct relationship either with sports training or in a particular way in the training of Cuban artistic swimming. Conclusions: Experts evaluating the indicators emphasize their functionality, relevance, and feasibility.

RESUMEN Introducción: el presente artículo se realizó a partir de detectar insuficiencias teórico-metodológicas y prácticas en el proceso de preparación técnica de la natación artística escolar. Objetivo: elaborar una concepción teórica con una nueva forma de reestructurar el contenido para el entrenamiento de las figuras, sobre la base de su periodización, que favorezca el incremento del rendimiento deportivo en nadadores artísticos categoría escolar. Materiales y métodos: se emplearon como métodos teóricos de la investigación científica el analítico-sintético y el sistémico estructural funcional. De los empíricos, el análisis documental y el criterio de expertos. Como métodos matemático-estadísticos, la estadística descriptiva e inferencial, con la Prueba de W de Kendall. Resultados: la calidad de la concepción teórica quedó corroborada por la evaluación emitida por los 15 expertos seleccionados, que tuvieran relación directa ya sea con el entrenamiento deportivo o de modo particular en el entrenamiento de la natación artística cubana. Conclusiones: los expertos en la evaluación de los indicadores, resaltan su funcionabilidad, pertinencia y factibilidad.

RESUMEN Objetivo: Determinar la influencia de los determinantes sociales de la salud en la resistencia antibiótica, en los países de América Latina. Metodología: Estudio documental de tipo revisión sistemática, con análisis interpretativo de la información, se incluyeron a artículos publicados entre 2018 y 2023 de las bases de datos: PubMed, ScienceDirect, Cochrane, Dialnet, Google académico, BVS, LilaCs, Scielo, Epistemonikos, CUIDEN, TripDatabase, BASE Search, Jurn, WorldWideScience, Refseek, Redalyc, EbscoHost y CONRICYT; en los idiomas español, inglés y portugués, que tuvieran como población comunidades y países de América Latina; se excluyeron aquellos con enfoque veterinario o agropecuario. Resultados: Se obtuvieron 4,625 en la búsqueda inicial y posterior a la aplicación de criterios de selección, se analizaron 28 artículos analizó la calidad metodológica, la bibliometría y el análisis temático a través de la interpretación de la información contenida. Conclusión: Los determinantes sociales de la salud estructurales asociados con la resistencia antimicrobiana fueron las políticas públicas, el género, los factores macroeconómicos, el nivel socioeconómico familiar, educativo y la gobernanza.

ABSTRACT Objective: Determine the influence of social determinants of health on antibiotic resistance in Latin American countries. Methodology: Systematic review type documentary study with interpretive analysis of the information, articles published between 2018 and 2023 from the following databases were included: PubMed, ScienceDirect, Cochrane, Dialnet, Google scholar, BVS, LilaCs, SciELO, Epistemonikos, CUIDEN, TripDatabase, BASE Search, Jurn, WorldWideScience, Refseek, Redalyc, EbscoHost and CONRICYT; in the Spanish, English and Portuguese languages, which had Latin American communities and countries as their population; Those with a veterinary or agricultural focus were excluded. Results: 4,625 were obtained in the initial search and after the application of selection criteria, 28 articles were analyzed that analyzed the methodological quality, bibliometrics and thematic analysis through the interpretation of the information contained. Conclusion: The social determinants of structural health associated with antimicrobial resistance were public policies, gender, macroeconomic factors, family socioeconomic level, education, and governance.

Abstract Background Molecularly targeted therapies, such as monoclonal antibodies (mAbs) and Janus Kinase inhibitors (JAKis), have emerged as essential tools in the treatment of dermatological diseases. These therapies modulate the immune system through specific signaling pathways, providing effective alternatives to traditional systemic immunosuppressive agents. This review aims to provide an updated summary of targeted immune therapies for inflammatory skin diseases, considering their pathophysiology, efficacy, dosage, and safety profiles. Methods The review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A systematic search was conducted on PubMed over the past 10 years, focusing on randomized clinical trials, case reports, and case series related to targeted immune therapies in dermatology. Eligibility criteria were applied, and data were extracted from each study, including citation data, study design, and results. Results We identified 1360 non-duplicate articles with the initial search strategy. Title and abstract review excluded 1150, while a full-text review excluded an additional 50 articles. The review included 143 studies published between 2012 and 2022, highlighting 39 drugs currently under investigation or in use for managing inflammatory skin diseases. Study limitations The heterogeneity of summarized information limits this review. Some recommendations originated from data from clinical trials, while others relied on retrospective analyses and small case series. Recommendations will likely be updated as new results emerge. Conclusion Targeted therapies have revolutionized the treatment of chronic skin diseases, offering new options for patients unresponsive to standard treatments. Paradoxical reactions are rarely observed. Further studies are needed to fully understand the mechanisms and nature of these therapies. Overall, targeted immune therapies in dermatology represent a promising development, significantly improving the quality of life for patients with chronic inflammatory skin diseases. mAbs (mAbs JAKis, JAKis , (JAKis) diseases pathways agents pathophysiology efficacy dosage profiles Metaanalyses Meta PRISMA (PRISMA guidelines 1 years trials reports applied design 136 nonduplicate non duplicate strategy 1150 fulltext full text 5 14 201 2022 3 emerge treatments observed Overall development (JAKis 13 115 20 202 11 2