Objective: to associate polypharmacy and medication classes with the risk of falls in the elderly. Method: cross-sectional and quantitative study, carried out in a Specialty Medical Outpatient Clinic in the city of São Paulo – SP, with 117 elderly people, from March to November 2019. Data collection was carried out by fully transcribing the prescriptions into an individual form and the Downton Falls Risk Scale. To compare the risk of falls with polypharmacy and medication classes, the Mann-Whitney and Chi-Square tests were used. In all comparative analyzes a significance level of 5% and a confidence interval of 95% were used. Results: The risk of falls showed a significant correlation with the number of medications, an average of 5.8 per day (p<0.0001) and the medication classes, antihypertensives (p<0.0001), oral antidiabetics (p=0.027), diuretics (p<0.0001) and antidepressants (p=0.042). Conclusion and implications for practice: therefore, the importance of evaluating factors related to the increased risk of falls is highlighted, for subsequent planning and implementation of strategies to deal with adverse reactions and the measures to be taken to ensure the effectiveness and safety of drug treatment.

Objetivo: associar a polifarmácia e as classes medicamentosas com o risco de quedas em idosos. Método: estudo transversal e quantitativo, realizado em um Ambulatório Médico de Especialidades na cidade de São Paulo – SP, com 117 idosos, no período de março a novembro de 2019. A coleta dos dados foi realizada pela transcrição integral dos receituários para um formulário individual e pela Escala de Risco de Quedas de Downton. Para comparar o risco de quedas com a polimedicação e as classes medicamentosas foram utilizados os testes de Mann-Whitney e o Qui-Quadrado. Em todas as análises comparativas foi utilizado um nível de significância de 5% e intervalo de confiança de 95%. Resultados: O risco de quedas apresentou correlação significativa com o número de medicamentos, média de 5,8 ao dia (p<0,0001) e as classes medicamentosas, os anti-hipertensivos (p<0,0001), os antidiabéticos orais (p=0,027), os diuréticos (p<0,0001) e os antidepressivos (p=0,042). Conclusão e implicações para a prática: portanto, ressalta-se a importância da avaliação dos fatores relacionados ao aumento do risco de quedas, para posterior realização de um planejamento e implementação de estratégias no cuidado das reações adversas e nas medidas a serem tomadas para garantir a efetividade e segurança do tratamento medicamentoso.

Abstract Introduction: Sexual violence is a serious problem in Brazilian society whose repercussions on public health make it imperative to address this issue in the context of training in professions. Likewise, comprehensive care for people in situations of sexual violence requires the joint action of different professions, in addition to network integration and articulation of different social facilities. Objective: This study aimed to reflect which competencies - understood as the set of knowledge, skills and attitudes - are permitted for the development of comprehensive care for people in situations of sexual violence, according to the best standards of quality and health safety they. Method: A qualitative study of an exploratory and descriptive nature was carried out, which involved the application of a preliminary form on knowledge about skills, followed by the dynamics of the construction of the human figure, which consists of manufacturing a doll in which the knowledge would be represented by the head, by the skills of the members and by the attitudes of the body, in the creation of an office with 76 participants from different professions. Furthermore, a questionnaire was administered to 32 professionals with experience in the area of sexual violence and with practical experience in caring for people in this situation. Categorical thematic analysis was used. Result: Result: Challenges were identified to be overcome in the three dimensions that constitute competencies, with a clear lack of knowledge for working in a network aiming at the effectiveness and comprehensiveness of care. 15 competencies common to professionals who deal with violence were recognized, and the final product was represented in a radially arranged infographic with the organization of knowledge, skills and attitudes identified as necessary for the development of such competencies. Conclusion: Recognizing common competencies and identifying, separately, which knowledge, skills and attitudes constitute them represent strategies that promote a transversal approach to these contents in the training of professions, especially in health. Proposing a matrix of common competencies for interprofessional practice in care for people in situations of sexual violence can guide the qualification of this care and support interprofessionality in crucial scenarios of collective action to combat the blatant social injustice that sexual violence means.

Resumo Introdução: A violência sexual é um grave problema na sociedade brasileira cujas repercussões no âmbito da saúde pública tornam imperativa a abordagem dessa questão no contexto da formação das suas profissões. Igualmente, a integralidade do cuidado destinado às pessoas em situação de violência sexual requer a atuação conjunta de diversas profissões, além da integração em rede e articulação de diferentes equipamentos sociais. Objetivo: Este estudo teve como objetivo reconhecer quais competências - entendidas como o conjunto de conhecimentos, habilidades e atitudes - são necessárias para o desenvolvimento do cuidado integral destinado às pessoas em situação de violência sexual, segundo os melhores padrões de qualidade e segurança para a saúde delas. Método: Realizou-se um estudo qualitativo de caráter exploratório e descritivo que envolveu a aplicação de um formulário prévio sobre os conhecimentos acerca das competências, seguido da dinâmica da construção da figura humana, que consiste na confecção de um boneco no qual os conhecimentos estariam representados pela cabeça, as habilidades pelos membros e as atitudes pelo corpo, na realização de uma oficina com 76 participantes de diferentes profissões. Adicionalmente, aplicou-se um questionário a 32 profissionais com reconhecida expertise na área de violência sexual e com experiência prática no atendimento às pessoas nessa situação. Foi empregada a análise temática categorial. Resultado: Identificaram-se desafios a serem superados nas três dimensões constituintes das competências, com nítida deficiência de conhecimentos para a atuação em rede visando à efetividade e à integralidade do cuidado. Reconheceram-se 15 competências comuns aos profissionais que lidam com a violência, e o produto final foi representado num infográfico de disposição radial com a organização dos conhecimentos, das habilidades e das atitudes identificados como necessários para o desenvolvimento de tais competências. Conclusão: Reconhecer competências comuns e identificar, separadamente, quais conhecimentos, habilidades e atitudes as constituem representa estratégias promotoras da abordagem transversal desses conteúdos na formação das profissões, sobretudo da saúde. A proposição de uma matriz de competências comuns para prática interprofissional no cuidado destinado às pessoas em situação de violência sexual pode orientar a qualificação desse cuidado e alicerçar a interprofissionalidade em cenários cruciais de atuação coletiva para o enfrentamento da flagrante injustiça social que a violência sexual significa.

BACKGROUND: With about 55% of operating costs in manufacturing organisations coming from costs of supply chains, coupled with a 6% increase in supply chain costs incurred by a manufacturing organisation during the financial year 2021-2022, supply chain managers need to ascertain factors contributing to high supply operating cost and ascertain suitable strategies to lower supply chain management cost. OBJECTIVES: The purpose of this study is to unveil the factors and the solutions to poor supply chain quality in a steel product manufacturing organisation. METHOD: A qualitative approach conducted via an interview guide was used in this study. Perceptions of key supply chain stakeholders within a steel product manufacturing organisation formed the basis of the exploring factors contributing to poor supply chain quality and the solutions thereof. The Pareto chart was created to ascertain the critical factors that contribute to poor supply chain quality. RESULTS: The study revealed that inventory stock-out, management decisions, process deviations, longer lead times, suppliers and unreliable enterprise resource planning (ERP) system issues contributed to poor supply chain quality CONCLUSION: Supply chain managers should make use of strategies such as safety and consignment stock policy, just-in-time (JIT) system, supplier evaluation exercise for supplier selection, localisation of the sourcing of raw materials, customised ERP systems, job rotation and dashboards, with a view to improve visibility and efficiency of supply chain processes. CONTRIBUTION: The study serves as a knowledge advisor to supply chain managers, on the critical factors contributing to poor supply chain quality, and the solutions thereof.

Resumo Esta pesquisa tem interesse particular de identificar a motivação e os recursos estratégicos que suportam o projeto de expansão de uma cooperativa de crédito localizada no estado do Rio Grande do Sul para o estado de Minas Gerais. Foi realizada coleta de dados com Diretores e Gerentes que lideraram o processo de expansão, os quais responderam ao questionário elaborado à luz da literatura, e os dados analisados quantitativa e qualitativamente. Os dados apontaram que a motivação para expansão respaldou-se na possibilidade de aumentar a área de atuação, expansão da marca, diversificação e aumento da segurança de operação; os fatores de localização incluíram a utilização de índices econômicos e demográficos municipais, similaridade das áreas de atuação. Os recursos estratégicos, em sua maioria, denotam paridade competitiva, destacando-se com sustentáveis o nível de confiança, captação de recursos e sistemas informatizados, considerando os recursos intangíveis são mais difíceis de serem imitados pelos concorrentes do que os tangíveis. Em termos de localização em Minas Gerais, a cooperativa priorizou a expansão de associados, área de atuação e estratégias diferenciadas dos concorrentes. Dessa forma, a pesquisa suscita ampliação, especialmente quando considerado o protagonismo exercido pelas cooperativas de crédito e sua proeminência no crescimento e desenvolvimento econômico do Brasil. Gerais literatura qualitativamente respaldouse respaldou se marca operação municipais maioria competitiva destacandose destacando confiança informatizados tangíveis associados forma ampliação Brasil

Abstract This research is particularly interested in identifying the motivation and strategic resources that support the expansion project of a credit union located in the state of Rio Grande do Sul to the state of Minas Gerais. Data collection was carried out with Directors and Managers who led the expansion process, who answered the questionnaire elaborated in the light of the literature, and the data analyzed quantitatively and qualitatively. The data showed that the motivation for expansion was supported by the possibility of increasing the area of operation, brand expansion, diversification and increased operational safety; location factors included the use of municipal economic and demographic indices, similarity of areas of operation. Strategic resources, for the most part, denote competitive parity, standing out as sustainable the level of trust, fundraising and computerized systems, considering that intangible resources are more difficult to be imitated by competitors than tangible ones. In terms of location in Minas Gerais, the cooperative prioritized the expansion of members, area of operation and differentiated strategies from competitors. In this way, the research raises expansion, especially when considering the role played by credit unions and their prominence in the growth and economic development of Brazil. Gerais process literature qualitatively safety indices part parity trust systems ones members way Brazil

Abstract Objective To understand the challenges faced in terms of permanent education in health, for achieving quality improvements and patient safety at a public hospital undergoing hospital accreditation. Methods This was a descriptive, cross-sectional study with a qualitative approach. Semi-structured interviews were conducted with 22 professionals, lasting an average of 22 minutes. The interviews were subsequently analyzed and interpreted using Bardin’s thematic content analysis. The software Iramuteq was used to analyze the textual corpus, and BioEstat 5.3 was used to analyze the profile of the participants. The data collection took place in June 2022, following approval by the Research Ethics Committees. Results The descending hierarchical classification analysis, generated by Iramuteq, was applied, resulting in three categories: Challenges of Permanent Education through the Continuous Improvement Process, Permanent Education for the Promotion of Quality and Patient Safety in the Context of Hospital Accreditation, and Educational Strategies for Improving Quality and Patient Safety. Conclusion Challenges inherent to the actions of permanent education in health were identified, such as resistance to cultural change, adherence to activities, high turnover of professionals, and difficulty in releasing the nursing team to participate in activities, due to work demand.

Resumen Objetivo Comprender los desafíos enfrentados por la educación permanente para lograr mejorar la calidad y la seguridad del paciente en un hospital público sometido a acreditación hospitalaria. Métodos Estudio descriptivo, transversal y con enfoque cualitativo. Se realizaron entrevistas semiestructuradas a 22 profesionales, con duración promedio de 22 minutos, que luego se analizaron e interpretaron mediante el análisis de contenido temático de Bardin. Se utilizaron los softwares Iramuteq para el análisis de corpus textual y BioEstat 5.3 para el análisis del perfil de los participantes. La recopilación de datos se llevó a cabo en junio de 2022, después de la aprobación de los Comités de Ética en Investigación. Resultados Se aplicó el análisis de clasificación jerárquica descendente, generado por Iramuteq. Se obtuvieron tres categorías: Desafíos de la educación permanente mediante el proceso de mejora continua, Educación permanente para la promoción de la calidad y de la seguridad del paciente en el contexto de la acreditación hospitalaria, y Estrategias educativas para la mejora de la calidad y la seguridad del paciente. Conclusión Se identificaron desafíos inherentes a las acciones de educación permanente en salud, tales como resistencia a cambios de cultura, adherencia a las actividades, alta rotación de profesionales y dificultad de autorizar al equipo de enfermería para participar en las actividades relacionadas con la demanda de trabajo.

Resumo Objetivo Compreender os desafios enfrentados pela educação permanente para o alcance da melhoria da qualidade e da segurança do paciente em um hospital público submetido à acreditação hospitalar. Métodos Estudo descritivo, transversal e com abordagem qualitativa. Realizaram-se entrevistas semiestruturadas com 22 profissionais, durando, em média, 22 minutos, as quais posteriormente foram analisadas e interpretadas por meio da análise de conteúdo temática de Bardin. Adotaram-se os softwares Iramuteq para a análise de corpus textual, e o BioEstat 5.3, para análise do perfil dos participantes. A coleta de dados ocorreu em junho de 2022, após aprovação nos Comitês de Ética em Pesquisa. Resultados Aplicou-se a análise de classificação hierárquica descendente, gerada pelo Iramuteq. Obtiveram-se três categorias: Desafios da Educação Permanente mediante o Processo de Melhoria Contínua; Educação Permanente para a Promoção da Qualidade e da Segurança do Paciente no Contexto da Acreditação Hospitalar; e Estratégias Educativas para a Melhoria da Qualidade e da Segurança do Paciente. Conclusão Identificaram-se desafios inerentes às ações de educação permanente em saúde, tais como resistência à mudança de cultura, adesão às atividades, alta rotatividade de profissionais e dificuldade para liberação da equipe de enfermagem para participar das atividades relacionadas à demanda de trabalho.

RESUMEN: Los laboratorios de simulación quirúrgica permiten perfeccionar las habilidades y disminuir las brechas de aprendizaje en la enseñanza de las ciencias quirúrgicas porque se logra disminuir el tiempo de formación y mejorar la calidad, sin estrés en los profesionales y con mayor seguridad para los pacientes. El uso de los simuladores permite minimizar el conflicto ético entre la seguridad del paciente y la enseñanza, lograr mayor eficiencia en el proceso de enseñanza aprendizaje, al disminuir los costos por concepto de insumos y complicaciones de los pacientes. Es propósito del autor comunicar sobre la importancia de los laboratorios de simulación quirúrgica en la docencia médica y motivar a las Universidades de Ciencias Médicas en Cuba para que, a través de proyectos de desarrollo, puedan obtener con estas estrategias de aprendizaje, alternativas útiles, ante las afectaciones económicas que provoca el bloqueo.

ABSTRACT: Surgical simulation laboratories make it possible to perfect skills and reduce learning gaps in the teaching of surgical sciences because it is possible to reduce training time and improve quality, without stress for professionals and with greater safety for patients. The use of simulators allows minimizing the ethical conflict between patient safety and teaching, achieving greater efficiency in the teaching-learning process, by reducing costs for supplies and patient complications. It is the author's purpose to communicate about the importance of surgical simulation laboratories in medical teaching and to motivate the Universities of Medical Sciences in Cuba so that, through development projects, they can obtain useful alternatives with these learning strategies before the economic effects caused by the blockade.

BACKGROUND: Final-year nursing students are actively involved in the delivery of public immunisation programmes as part of workplace-based learning, and require adequate knowledge, clinical skills, and attitudes regarding vaccines. This study investigated the knowledge, attitudes and perceptions regarding vaccines of final year nursing students at a South African University METHODS: This cross-sectional study, through the use of an online survey questionnaire, assessed the knowledge, attitudes and perceptions regarding vaccines and the Expanded Programme of Immunization of final-year nursing students registered at a South African University during the 2021-2022 academic year RESULTS: There were 68 participants enrolled in the study (85% response rate). Participants displayed good knowledge regarding vaccines (average score of 52.54/70 ± 5.01 standard deviation [s.d.]), and overall positive perceptions of their training on vaccines and its safety. Knowledge gaps were identified in the mechanisms through which vaccines confer immunity in the human body and the cold chain requirements for the storage of vaccines. Of concern was the prevalent misconception among 78% of participants that vaccines are not effective CONCLUSION: The findings of this study indicate that final year nursing students at the University of KwaZulu-Natal, South Africa have good knowledge regarding vaccines. However, an improved understanding of the mechanism of vaccines will aid nursing students to confront and address misperceptions by clients thereby reducing improving vaccine uptake. Curriculum planners should also consider the inclusion of communication strategies to address vaccine hesitancy CONTRIBUTION: The study contributes to data on nurse education regarding vaccines in the African context, and identifies areas to improve vaccine uptake

Resumen (Introducción): La contaminación, la exposición y el riesgo a enfermar por mercurio (Hg) son un tema fundamental en la definición de estrategias para la mejora de la salud ambiental, especialmente en Latinoamérica, donde la problemática se ha relacionado más con la informalidad en la minería de oro artesanal y a pequeña escala, y con la escasez de medidas tanto de seguridad como de protección ambiental. Se realizó una revisión bibliográfica sin metaanálisis de investigaciones científicas publicadas entre los años 2015 y 2021, en revistas recuperadas de Scopus y Science Direct. (Objetivo): Aportar evidencia científica sobre la exposición al mercurio y sus efectos en la salud, a partir de investigaciones científicas publicadas. (Metodología): Se siguieron los pasos estandarizados de búsqueda referentes a la guía de la Asociación Española de Enfermería en Cuidados Paliativos (AECPAL), se verificó la validez y la precisión de cada artículo, haciendo uso complementario de una versión adaptada de GRADE a estudios observacionales. (Resultados): Se encontraron concentraciones de Hg en sangre muy altos, en trabajadores de la industria del oro y de lámparas fluorescentes, que oscilan entre 13.16 µg/L y 54.05 µg/L. Se señalan efectos teratógenos asociados a muerte fetal, anomalía congénita, parto espontáneo y restricción en el crecimiento; en la población ocupacionalmente expuesta, el deterioro cognitivo, la hipercolesterolemia, infertilidad, autismo y defectos en el tubo neural. Conclusiones): Las concentraciones de Hg en sangre y sus efectos en la salud son notablemente variables entre los estudios, pero se ha evidenciado las principales actividades sociales que implican exposición y sus efectos.

Abstract (Introduction): The contamination, exposure, and risk of mercury (Hg) are a fundamental issue in the definition of research strategies for the improvement of environmental health, especially in Latin America where the problem has been mostly related to the informality of artisanal and small-scale gold mining and the scarcity of safety and environmental protection measures. A bibliographic review was carried out without meta-analysis of scientific research published between 2015 and 2021, in journals retrieved from Scopus and Science Direct. (Objective): To provide scientific evidence on exposure to mercury and its effects on health from published scientific research. (Methodology): The standardized search steps referring to the guide of the Spanish Association of Nursing in Palliative Care (AECPAL) were followed; In addition, the validity and precision of each article was verified, making complementary use of a version adapted from GRADE to observational studies. (Results): Very high blood mercury concentrations were found in workers in the gold industry and fluorescent lamps, ranging from 13.16 µg/L to 54.05 µg/L. Teratogenic effects associated with fetal death, congenital anomaly, spontaneous delivery and growth restriction are indicated, and in the occupationally exposed population they were cognitive deterioration, hypercholesteremia, infertility, autism and neural tube defects. (Conclusions): The concentration values of mercury in blood and its effects on health are notably variable among the studies, but the main social activities that involve exposure and its associated effects have been evidenced.

ABSTRACT Objective: Determine the characteristics of ocular trauma in patients diagnosed with traumatic cataract. Methods: A cross-sectional descriptive observational study was carried out with 335 patients diagnosed with traumatic cataract. The variables included age, sex, affected eye, location of trauma occurrence, use of protection in the work environment, type of ocular trauma, associated damage, cataract morphology and area of injury. Results: The average age of the patients was 52.2 ± 14.8 years. A predominance of males was observed (75.5%) and the majority of cases presented blunt ocular trauma (70.4%). The right eye was more affected (64.8%). Regarding the place of occurrence of ocular trauma, 49.9% of cases occurred in the work context, and the majority of patients who experienced open ocular trauma did not use eye protection. The most common associated injuries were increased intraocular pressure, capsule rupture and synechiae, iris dialysis. Regarding the morphology of the cataracts, it was observed that total opacity predominated. Conclusions: This study highlights the importance of preventive strategies, especially in work environments prone to eye injuries. The lack of eye protection in cases of open eye trauma emphasizes the need to raise public awareness about the importance of adequate safety measures. These findings may guide clinical interventions and public health policies to reduce the incidence and sequelae of traumatic cataract.

RESUMEN Objetivo: Determinar las características del trauma ocular en pacientes diagnosticados con catarata traumática. Métodos: Se realizó un estudio observacional descriptivo de corte transversal con 335 pacientes diagnosticados con catarata traumática. Las variables incluyeron edad, sexo, ojo afectado, lugar de ocurrencia del trauma, uso de protección en el entorno laboral, tipo de trauma ocular, daños asociados, morfología de la catarata y zona de lesión. Resultados: La edad promedio de los pacientes fue de 52,2 ± 14,8 años. Se observó un predominio del sexo masculino (75,5 %) y la mayoría de los casos presentaron un trauma ocular cerrado (70,4 %). El ojo derecho fue más afectado (64,8 %). En cuanto al lugar de ocurrencia del traumatismo ocular, el 49,9 % de los casos se produjo en el contexto laboral, y la mayoría de los pacientes que experimentaron un trauma ocular abierto no utilizaban protección ocular. Las lesiones asociadas más comunes fueron el aumento de la presión intraocular, la ruptura de la cápsula y las sinequias, la diálisis del iris. En cuanto a la morfología de las cataratas, se observó que predominaba la opacidad total. Conclusiones: Este estudio subraya la importancia de estrategias preventivas, especialmente en entornos laborales propensos a lesiones oculares. La falta de protección ocular en casos de trauma ocular abierto enfatiza la necesidad de concienciar a la población sobre la importancia de medidas de seguridad adecuadas. Estos hallazgos pueden guiar intervenciones clínicas y políticas de salud pública para reducir la incidencia y las secuelas de la catarata traumática.

Resumo Por meio deste estudo, procurou-se analisar o comportamento do cliente em relação aos aplicativos de pedidos de comida, bem como comparar o comportamento dos usuários de dois níveis para sugerir estratégias para startups de entrega de comida. Para atingir esse objetivo, primeiro a literatura é revisada para desenvolver um modelo construtivo e, em seguida, os dados primários são coletados de usuários de aplicativos de comida nas cidades indianas de Chandigarh e Bhubaneswar para verificar as suposições sobre os fatores que afetam seu comportamento. O resultado mostrou que a segurança financeira e de saúde, juntamente com a entrega flexível e a facilidade de uso, são determinantes significativos da satisfação do cliente no serviço de alimentação digital e o comportamento dos clientes em dois níveis diferentes mostrou semelhança, exceto a importância das opções de variedade e poucos aspectos de descontos e entrega flexível. Este estudo é significativo para os stakeholders na entrega de alimentos, como investidores, fundadores de startups, e fornecedores para criar estratégias para seus serviços de acordo com as preferências do cliente final encontradas neste estudo. procurouse procurou se objetivo seguida saúde uso semelhança alimentos investidores

Abstract Through this study, we tried to analyze customer behavior towards food delivery apps as well as make a comparison of behavior by users from two tiers which is made to suggest strategies for food delivery startups. To accomplish this objective, first the literature is reviewed to develop a constructive model, and then primary data is collected from food app users in the Indian cities of Chandigarh and Bhubaneswar to verify the assumptions on factors affecting their behavior. The results show that financial and health safety, along with flexible delivery and ease of use are significant determinants of customer satisfaction in digital food service and the behavior of customers in two different tiers is shown to be similar, except in the significance of variety options and few aspects of discounts and flexible delivery. This study is significant for food delivery stakeholders such as investors, founders of startups, and vendors to strategize their service as per preferences of the end customer found in this study. startups objective model safety similar investors

Resumen La guía práctica de nutrición enteral domiciliaria de la Sociedad Europea de Nutrición Clínica y Metabolismo (ESPEN) publicada en 2020 incluye 61 recomendaciones. Un número relevante de ellas está referido a parámetros de seguridad, prevención de las complicaciones, estrategias de control y calidad de vida de los pacientes y familiares. Estas son las mismas razones por las que se tiende a las unidades monodosis en todos los medicamentos en general. La nutrición enteral es de los pocos tratamientos a los que todavía no ha llegado la monodosis y la mayor parte de los pacientes con nutrición enteral intermitente por sonda gástrica tienen indicada una dosis diferente a la presentación farmacéutica. Este hecho provoca riesgo de complicaciones derivadas de errores en la administración que no deben ser olvidados y que afectan en mayor medida a población anciana y con alto grado de dependencia. La innovación consistente en la creación de envases monodosis de 375 ml para nutrición enteral respetando los horarios fisiológicos de las tomas puede solucionar la mayor parte de ellos y cumple con los requerimientos proteico-energéticos y con las recomendaciones sobre dosificación elaboradas por las sociedades científicas para pacientes con mayor riesgo.

Abstract The home enteral nutrition practical guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) published in 2020 includes 61 recommendations. A significant number of them are related to safety parameters, prevention of complications, control strategies and quality of life of patients and family members. These are the same reasons why single-dose units are usually used on all medicines. Enteral feeding is one of the few treatments that has not yet reached the single dose and most patients with intermittent enteral nutrition by gastric tube have a dose which differs from pharmaceutical presentation. This leads to the risk of complications arising from errors in the administration that should not be forgotten and that affect mostly elderly and highly dependent populations. The innovation that consists in the creation of 375 ml single-dose containers for enteral feeding following the physiological schedules of the takes can solve most of them and meets the energy protein requirements and recommendations on dosage developed by scientific societies for patients at higher risk.

ABSTRACT Inflammatory bowel disease (IBD) is a chronic condition that affects the digestive tract and can lead to inflammation and damage to the intestinal lining. IBD patients with cancer encounter difficulties since cancer treatment weakens their immune systems. A multidisciplinary strategy that strikes a balance between the requirement to manage IBD symptoms and the potential effects of treatment on cancer is necessary for effective care of IBD in cancer patients. To reduce inflammation and avoid problems, IBD in cancer patients is often managed by closely monitoring IBD symptoms in conjunction with the necessary medication and surgical intervention. Anti-inflammatory medications, immunomodulators, and biologic therapies may be used for medical care, and surgical options may include resection of the diseased intestine or removal of the entire colon. The current study provides a paradigm for shared decision-making involving the patient, gastroenterologist, and oncologist while considering recent findings on the safety of IBD medicines, cancer, and recurrent cancer risk in individuals with IBD. We hope to summarize the pertinent research in this review and offer useful advice. (IBD lining systems problems intervention Antiinflammatory Anti inflammatory medications immunomodulators colon decisionmaking decision making patient gastroenterologist medicines advice

Abstract Vaccine hesitancy is a phenomenon with the potential to reduce vaccination coverage rates, as observed with the yellow fever vaccine (YFV), leading to epidemics and the reintroduction of controlled immunopreventable diseases. This study, together with the scientific literature, aims to map the relationship among the lack of information, vaccine safety and adverse events, and vaccine hesitancy concerning YFV. A scoping review was conducted in the Virtual Health Library (VHL), National Library of Medicine (PubMed), SCOPUS, Embase, and Web of Science databases, using controlled (DeCS/MeSH) and uncontrolled descriptors. In this work, we selected eleven articles, published in English, Spanish, and Portuguese, with no time limits, which met the inclusion criteria. False information, inadequate knowledge about the immunizer, lack of time to take a vaccination, acceptance of the vaccine, vaccine safety, and fear of adverse events were related to vaccine hesitancy. This study reinforces the importance of access to adequate information, provides guidance on YFV safety and adverse events, and can aid in the development of public health strategies to mitigate hesitancy.

Resumo A hesitação vacinal é um fenômeno com potencial para reduzir as taxas de cobertura vacinal, como observado na vacina contra febre amarela (VFA), propiciar epidemias e a reintrodução de doenças imunopreveníveis controladas. O objetivo deste estudo é mapear junto à literatura científica a relação entre a falta de informação, a segurança da vacina e os eventos adversos e a hesitação vacinal da VFA. Foi realizada uma revisão de escopo nas bases Biblioteca Virtual em Saúde (BVS), National Library of Medicine (PubMed), SCOPUS, Embase e Web of Science utilizando descritores controlados (DeCS/MeSH) e não controlados. Foram selecionados 11 artigos publicados nos idiomas inglês, espanhol e português, sem delimitação de tempo e que atenderam aos critérios de inclusão. Estiveram relacionados à hesitação vacinal da VFA informações falsas, conhecimento inadequado sobre o imunizante, falta de tempo para se vacinar, aceitação da vacina, insegurança na vacina e medo dos eventos adversos. Este estudo reforça a importância do acesso a informações adequadas, orientações sobre a segurança e os eventos adversos da VFA e pode auxiliar na elaboração de estratégias de saúde pública para mitigar a hesitação vacinal.

Resumen Antecedentes: Se han implementado distintas estrategias de contención desde el inicio de la pandemia de COVID-19. Objetivo: Evaluar el impacto de medidas de seguridad en la tasa de infecciones durante un encuentro académico. Métodos: Estudio observacional retrospectivo. Se utilizó una encuesta y los datos se analizaron posteriormente. Resultados: Cincuenta y ocho (edad media 34, 67% hombres) participantes completaron la encuesta; 34 (57%) eran personal médico, 8 (14%) trabajadores de industria farmacéutica, 14 (24%) trabajadores del hotel y 2 (4%) acompañantes. Posterior al encuentro 6 personas refirieron sintomatología, únicamente 1 (2%) reportó prueba positiva para SARS-CoV-2, refiriendo el uso continuo de cubrebocas de tipo KN-95 durante el evento. No se documentaron otros casos. Conclusiones: La implementación de medidas de seguridad en la reunión redujo el riesgo de contagio entre participantes; este evento podría ser usado como referencia en reuniones presenciales de tipo académicas aún en la era post-pandemia.

Abstract Background: Contention strategies have been implemented since the beginning of the COVID-19 pandemic. Objective: To evaluate the impact of safety measures and infection rate during an academic meeting. Methods: A cross-sectional study was performed. A survey was used and data analysis performed afterwards. Results: Fifty-eight (mean age 34, 67% males) attendees were included; 34 were medical professionals (57%), 8 (14%) worked for the pharmaceutical industry, 14 (24%) were hotel staff and 2 (4%) were accompanying relatives. Following the meeting, out of a total of 6 attendees who referred symptoms, only 1 (2%) tested positive, this participant stated to have maintained the use of a KN-95 mask throughout the event, with no further spreading reported until today. Conclusions: The implementation of safety measures in the meeting reduced the risk of contagion among participants. This event might be used as an important reference for future “in-person” academic activities in the post-pandemic era.

Abstract Vaccine hesitancy is a phenomenon with the potential to reduce vaccination coverage rates, as observed with the yellow fever vaccine (YFV), leading to epidemics and the reintroduction of controlled immunopreventable diseases. This study, together with the scientific literature, aims to map the relationship among the lack of information, vaccine safety and adverse events, and vaccine hesitancy concerning YFV. A scoping review was conducted in the Virtual Health Library (VHL), National Library of Medicine (PubMed), SCOPUS, Embase, and Web of Science databases, using controlled (DeCS/MeSH) and uncontrolled descriptors. In this work, we selected eleven articles, published in English, Spanish, and Portuguese, with no time limits, which met the inclusion criteria. False information, inadequate knowledge about the immunizer, lack of time to take a vaccination, acceptance of the vaccine, vaccine safety, and fear of adverse events were related to vaccine hesitancy. This study reinforces the importance of access to adequate information, provides guidance on YFV safety and adverse events, and can aid in the development of public health strategies to mitigate hesitancy.

Resumo A hesitação vacinal é um fenômeno com potencial para reduzir as taxas de cobertura vacinal, como observado na vacina contra febre amarela (VFA), propiciar epidemias e a reintrodução de doenças imunopreveníveis controladas. O objetivo deste estudo é mapear junto à literatura científica a relação entre a falta de informação, a segurança da vacina e os eventos adversos e a hesitação vacinal da VFA. Foi realizada uma revisão de escopo nas bases Biblioteca Virtual em Saúde (BVS), National Library of Medicine (PubMed), SCOPUS, Embase e Web of Science utilizando descritores controlados (DeCS/MeSH) e não controlados. Foram selecionados 11 artigos publicados nos idiomas inglês, espanhol e português, sem delimitação de tempo e que atenderam aos critérios de inclusão. Estiveram relacionados à hesitação vacinal da VFA informações falsas, conhecimento inadequado sobre o imunizante, falta de tempo para se vacinar, aceitação da vacina, insegurança na vacina e medo dos eventos adversos. Este estudo reforça a importância do acesso a informações adequadas, orientações sobre a segurança e os eventos adversos da VFA e pode auxiliar na elaboração de estratégias de saúde pública para mitigar a hesitação vacinal.