Abstract Introduction. There is a great human concern about antibiotics resistance due to their inappropriate use as growth promoters in animal husbandry. Objective. To evaluate the effect of a high level of zinc as a substitute to antibiotics in nursery pigs. Material and methods. The study was carried out from June to August 2022 in the province of Chiriqui, Panama. The experimental period was composed of three phases with 14 days per phase. The nursery pigs (n= 54) were distributed to one of three treatments with six replicates per treatment and three pigs per replicate. The treatments were: 1) control diet, which was formulated to meet the nutritional requirements for nursery pigs; 2) similar to treatment 1, plus 200 mg of amoxicillin/kg of feed and 40 mg of florfenicol/kg of feed during phase 1 (P1) and phase 2 (P2), respectively; and 3) similar to treatment 1, plus 2000 ppm and 1600 ppm of zinc during P1 and P2, respectively. In phase 3 (P3), all pigs were fed a common diet. Results. The supplementation of zinc improved the average daily gain in all phases. Pigs fed zinc diet had better F:G ratio in P2 compared to pigs fed antibiotic diet (p < 0.05). A higher concentration of hemoglobin and percentage of monocytes was found in pigs fed with higher level of zinc than the other treatments (p < 0.05). Furthermore, Pigs fed the antibiotic, or the control diet had a lower percentage of fecal dry matter compared to those supplemented with zinc. (p < 0.05). Conclusion. The supplementation of high levels of zinc exerted improvements, in comparison to the antibiotic, in terms of hemoglobin concentration, incidence of diarrhea and weight gain in pigs during 42 days after weaning.

Resumen Introducción. Existe una gran preocupación humana por la resistencia a los antibióticos debido a su uso inadecuado como promotores del crecimiento en la cría de animales. Objetivo. Evaluar el efecto de altos niveles de zinc como sustituto del antibiótico en lechones destetados. Material y métodos. El estudio se realizó de junio a agosto de 2022 en la provincia de Chiriquí, Panamá. El periodo experimental estuvo compuesto por tres fases con 14 días por fase. Los cerdos destetados (n= 54) fueron asignados a uno de tres tratamientos con seis repeticiones por tratamiento y tres cerdos por repetición. Los tratamientos fueron: 1) dieta control, formulada para suplir los requerimientos nutricionales para cerdos destetados; 2) similar al tratamiento 1, más 200 mg de amoxicilina/kg de alimento y 40 mg de florfenicol/kg de alimento durante la fase 1 (P1) y fase 2 (P2), respectivamente; y 3) similar al tratamiento 1, más 2000 ppm y 1600 ppm de zinc durante P1 y P2, respectivamente. En la fase 3 (P3), todos los cerdos fueron alimentados con una dieta común. Resultados. La suplementación con zinc mejoró la ganancia de peso en todas las fases. Los cerdos alimentados con zinc tuvieron mejor relación F:G en P2 en comparación a los cerdos suplementados con antibiótico (p < 0.05). Se encontró una mayor concentración de hemoglobina y porcentaje de monocitos en cerdos alimentados con zinc que en los otros tratamientos (p < 0.05). Los cerdos alimentados con antibiótico o la dieta control tuvieron un menor porcentaje de materia seca fecal en comparación a los suplementados con zinc (p < 0.05). Conclusión. La suplementación de altos niveles de zinc ejerció mejoras, en comparación al antibiótico, en cuanto a la concentración de hemoglobina, incidencia de diarrea y ganancia de peso en cerdos durante los 42 días posteriores al destete.

Abstract: This study aims to identify and analyze the main research streams on digital safety and online privacy related to higher education students. Students are at risk of cybercrime, including online harassment, identity theft, and exposure to inappropriate content. A systematic literature review is conducted on digital security, cybersecurity, Internet security, online safety, and use of digital technologies. The results show that publications on digital security for higher education students have increased consistently during the last two decades. The main research streams are: digital risk and student perspectives, digital children, digital teenagers, online harassment, and digital behavior. In conclusion, this study provides a wide assessment on digital security for university students and highlights the importance of future research on improving awareness and safety on digital environments for teenagers.

Resumen: Este estudio tiene como objetivo identificar y analizar las principales corrientes de investigación en seguridad digital y privacidad en línea para estudiantes de educación superior. Los estudiantes están en riesgo de ser víctimas de ciberdelitos, como el acoso en línea, el robo de identidad y la exposición a contenido inapropiado. Se realiza una revisión sistemática de la literatura sobre seguridad digital, ciberseguridad, seguridad en Internet y uso de tecnologías digitales. Los resultados muestran que la producción científica sobre seguridad digital en estudiantes de educación superior ha experimentado un crecimiento sostenido durante las últimas dos décadas. Las corrientes de investigación más destacadas son: riesgo digital y perspectivas estudiantiles, digital children, jóvenes digitales, ciberacoso y comportamiento digital. En conclusión, se proporciona una visión amplia sobre la seguridad digital en estudiantes universitarios y se destaca la importancia de futuras investigaciones para mejorar la conciencia y protección de los jóvenes en el entorno digital.

Compositing or regularization of drillhole data is common practice in mineral resource estimation and is deemed a necessary step in producing unbiased estimates of mineral resources and reserves. Commonly, data are collected over irregular distances due to the varying relative thicknesses of lithologies drilled or sampling/assaying strategies. This necessitates data transformation to regular lengths of equal size to ensure that all data have the same sample support. However, there have been few detailed publications on the effect of this process on the composited data that are subsequently taken forward for the estimation process. In this paper, three currently available compositing methods are reviewed and the effects of inappropriate compositing methodologies presented. It is shown through a case study that compositing samples to different lengths leads to changes in the average and variance of the grades in the drillcores in the dataset, which will impact the final estimated value. These differences are exacerbated by breaks or gaps in data where, for a variety of reasons, there has been no data collection or data have been lost. The importance of appropriately treating blank and zero data is also presented. Globally, these differences might be minimal, but locally may be substantial, affecting the efficiency of the estimation and subsequent use of the results in, for example, mine planning and reconciliation. Further detailed investigation of compositing practices is required if the full implications of compositing are to be understood and any induced bias effectively defined.

ABSTRACT Introduction. Inappropriate use of antimicrobials in the Intensive Care Unit (ICU) contributes to bacterial resistance. Objective. The purpose of the present study was to measure the use and type of antimicrobials in patients hospitalized in the Intensive Care Unit of the Loreto Regional Hospital (HRL). Methods. Descriptive study. We reviewed 120 medical records in ICU-HRL patients from January to June 2023. Results. Most patients used antimicrobials (74.2%), indicated for septic shock (42.7%), 1 to 3 antimicrobials (93.2%), with therapy of 1 to 3 days (45%). Of the total number of antimicrobials used, the greatest proportion were bactericides 89 (90.4%), from the cephalosporin family (33.1%) and carbapenemics (23.5%); the most commonly used drugs were ceftriaxone (26.5%) and meropenem (21.1%) by the intravenous route (90.4%). Conclusion. The highest proportion of hospitalized patients use antimicrobials of the cephalosporin and carbapenemics family.

RESUMEN Introducción. El uso inapropiado de antimicrobianos en las unidades de cuidados intensivos (UCI) contribuye a la resistencia bacteriana. Objetivo. El propósito del presente estudio fue medir el uso y tipo de antimicrobianos en los pacientes hospitalizados en la Unidad de Cuidados Intensivos del Hospital Regional de Loreto (HRL). Métodos. Estudio de tipo descriptivo. Revisamos 120 historias clínicas en pacientes de UCI-HRL desde enero a junio 2023. Resultados. La mayoría de los pacientes usaron antimicrobianos (74,2%), indicados por shock séptico (42,7%), de 1 a 3 antimicrobianos (93,2%), con terapia de 1 a 3 días (45%). Del total de antimicrobianos usados, la mayor proporción fueron bactericidas 89 (90,4%), de la familia de cefalosporinas (33,1%) y carbapenémicos (23,5%); los fármacos más empleados fueron ceftriaxona (26,5%) y meropenem (21,1%) por vía intravenosa (90,4%). Conclusión. La mayor proporción de pacientes hospitalizados usan antimicrobianos de la familia de cefalosporinas y carbapenémicos.

SUMMARY OBJECTIVE: The aim of this study was to assess the results and efficiency of two real-time polymerase chain reaction procedures for detecting human papillomavirus utilizing urine samples. METHODS: This study comprised 151 patients who had previously tested positive for human papillomavirus in their cervical samples. Two different commercial real-time polymerase chain reaction techniques were used for identification and genotyping human papillomavirus in urine specimens. The urine samples of 151 patients were evaluated via the Roche Cobas test, and the urine samples of 91 patients were also evaluated via the Qiagen test. RESULTS: The overall consistency of urine and cervical swab specimens for the identification of human papillomavirus in Roche Cobas and Qiagen tests were 44.8 and 44%, respectively. The rates of positive human papillomavirus results from urine samples were 57 and 70.3%, respectively. The overall concordance among Roche Cobas and Qiagen tests utilizing urine samples for human papillomavirus type 16/18 was 84.3% with a kappa value of 0.675, and for other high-risk-human papillomavirus, it was 75.60% with a kappa value of 0.535. Roche Cobas showed high concordance with Qiagen test. CONCLUSION: human papillomavirus positivity was not detected in all urine samples. It is still inappropriate to recommend the use of urine liquid biopsy for the accurate and reliable detection of human papillomavirus. Due to the lack of a standardized tool, the utilization of urine samples as a screening human papillomavirus test remains a challenge.

ABSTRACT BACKGROUND: The epidemiology of potentially inappropriate medications (PIMs) in critical care units remains limited, especially in terms of the factors associated with their use. OBJECTIVE: To estimate the incidence and factors associated with PIMs use in intensive care units. DESIGN AND SETTING: Historical cohort study was conducted in a high-complexity hospital in Brazil. METHODS: A retrospective chart review was conducted on 314 patients aged ≥ 60 years who were admitted to intensive care units (ICUs) at a high-complexity hospital in Brazil. The dates were extracted from a “Patient Safety Project” database. A Chi-square test, Student’s t-test, and multivariable logistic regression analyses were performed to assess which factors were associated with PIMs. The statistical significance was set at 5%. RESULTS: According to Beers’ criteria, 12.8% of the identified drugs were considered inappropriate for the elderly population. The incidence rate of PIMs use was 45.8%. The most frequently used PIMs were metoclopramide, insulin, antipsychotics, non-steroidal anti-inflammatory drugs, and benzodiazepines. Factors associated with PIMs use were the number of medications (odds ratio [OR] = 1.17), length of hospital stay (OR = 1.07), and excessive potential drug interactions (OR = 2.43). CONCLUSIONS: Approximately half of the older adults in ICUs received PIM. Patients taking PIMs had a longer length of stay in the ICU, higher numbers of medications, and higher numbers of potential drug interactions. In ICUs, the use of explicit methods combined with clinical judgment can contribute to the safety and quality of medication prescriptions. BACKGROUND (PIMs limited OBJECTIVE SETTING highcomplexity high complexity Brazil METHODS 31 6 (ICUs Patient Project database Chisquare Chi square test Students Student s ttest, ttest t t-test 5 5% RESULTS Beers criteria 128 12 8 12.8 population 458 45 45.8% metoclopramide insulin antipsychotics nonsteroidal non steroidal antiinflammatory anti inflammatory benzodiazepines odds OR [OR 1.17, 117 1.17 , 1 17 1.17) 1.07, 107 1.07 07 1.07) 2.43. 243 2.43 . 2 43 2.43) CONCLUSIONS PIM ICU prescriptions 3 12. 4 45.8 11 1.1 10 1.0 0 24 2.4 45. 1. 2.

ABSTRACT Objective: To evaluate severe acute respiratory syndrome surveillance in a pediatric unit. Methods: Descriptive study of reported severe acute respiratory syndrome cases with the detection of respiratory viruses in the nasopharyngeal sample of patients hospitalized between 2013 and 2019, in a reference hospital in the Federal District, Brazil. Results: A total of 269 children had one or more viruses detected, resulting in 280 viruses, of which 152 (54%) were respiratory syncytial virus. The detection of respiratory syncytial virus was higher during the autumn-winter period. Children´s median age was 6.9 months, 156 (58%) were male, 104 (39%) had comorbidity, 197 (73%) required mechanical ventilation, 241 (90%) received antibiotics, and 146 (54%) oseltamivir. There were 19 (7%) deaths. The median time from symptom onset to sample collection was 5 days and the median time from sample collection to final results was 6 days. Conclusions: The system needs to reduce the time to deliver results so that inappropriate use of antibiotics and antivirals can be avoided. Moreover, the burden of viral pneumonia was relevant and the system must be flexible enough to include emerging viruses in order to be useful in responding to public health emergencies caused by respiratory viruses. Objective unit Methods 201 2019 District Brazil Results 26 detected 28 15 54% 54 (54% autumnwinter autumn winter period Childrens Children s 69 9 6. months 58% 58 (58% male 10 39% 39 (39% comorbidity 73% 73 (73% ventilation 24 90% 90 (90% 14 oseltamivir 1 7% 7 (7% deaths Conclusions avoided Moreover 20 2 (54 (58 3 (39 (73 (90 (7 (5 (3 (9 (

RESUMO Objetivo: Avaliar a vigilância da síndrome respiratória aguda grave em uma unidade pediátrica. Métodos: Estudo descritivo dos casos de síndrome respiratória aguda grave, notificados e com a detecção de vírus respiratório em amostra de nasofaringe de pacientes internados entre 2013 e 2019, em um hospital de referência do Distrito Federal. Resultados: Um total de 269 crianças tiveram algum vírus detectado, resultando em 280 vírus, sendo 152 (54%) vírus sincicial respiratório. A detecção do vírus sincicial respiratório foi maior durante o período de outono-inverno. A mediana da idade das crianças foi de 6,9 meses, 156 (58%) eram do sexo masculino, 104 (39%) tinham comorbidade, 197 (73%) necessitaram de ventilação mecânica, 241 (90%) receberam antibióticos e 146 (54%) oseltamivir. Ocorreram 19 (7%) óbitos. A mediana do tempo desde o início dos sintomas até a coleta da amostra foi de 5 dias, e do tempo da coleta até o resultado foi de 6 dias. Conclusões: O sistema necessita reduzir o tempo do resultado final para que seja possível evitar o uso inadequado de antibióticos e antivirais. Ademais, o impacto das pneumonias virais foi relevante e o sistema deve ser flexível suficiente para incluir vírus emergentes, para ser útil na resposta às emergências de saúde pública causada por vírus respiratórios. Objetivo pediátrica Métodos 201 2019 Federal Resultados 26 detectado 28 15 54% 54 (54% outonoinverno. outonoinverno outono inverno. inverno outono-inverno 69 9 6, meses 58% 58 (58% masculino 10 39% 39 (39% comorbidade 73% 73 (73% mecânica 24 90% 90 (90% 14 oseltamivir 1 7% 7 (7% óbitos dias Conclusões antivirais Ademais emergentes respiratórios 20 2 (54 (58 3 (39 (73 (90 (7 (5 (3 (9 (

RESUMO Introdução: A comunicação do fonoaudiólogo com o paciente afásico e sua família garante o seu bem-estar biopsicossocial e promove uma adequada relação médico-paciente. Objetivo: Avaliar uma proposta de estratégia para promover o princípio da beneficência entre o fonoaudiólogo, o paciente afásico e sua familia na Policlínico Universitario Dr. René Vallejo Ortiz, cidade de Manzanillo, Granma, Cuba. Método: Foi aplicada a técnica de Iadov ou critérios de usuário que permitiram avaliar a proposta. Para isso, foram entrevistados 15 fonoaudiólogos da província de Granma, foram escolhidos 10 intencionalmente, cujas qualidades atendiam aos requisitos para serem considerados usuários. Diferentes métodos, técnicas e procedimentos foram utilizados para processar e analisar os dados coletados. A escala de classificação Likert facilitou a interpretação qualitativa dos dados coletados. Resultados: A partir de critérios individuais, 60% dos usuários consideraram a proposta bastante adequada; a classificação mais baixa foi adequada (20%). No cálculo da avaliação do grupo, o índice obtido (0,5%) conferiu confiabilidade à proposta a ser implementada. Conclusões: Os usuários consideram que a proposta de estratégia atende aos requisitos para aplicação. Porém, existem alguns elementos que podem dificultar sua execução: o incorreto preparo científico-metodológico dos facilitadores, o uso inadequado de métodos e técnicas educativas, bem como a recusa dos fonoaudiólogos que não conscientizam sobre o necessidade de alcançar métodos de ação de acordo com princípios e valores profissionais.

ABSTRACT Introduction: Communication by the speech-language pathologist with the aphasic patient and his family guarantees their biopsychosocial well-being and promotes an adequate doctor-patient relationship. Objective: To evaluate a proposed strategy to promote the principle of beneficence between the speech-language pathologist, the aphasic patient and their family at the Policlínico Universitario Dr. René Vallejo Ortiz, Manzanillo city, Granma province, Cuba. Method: The Iadov technique or user criteria was applied that allowed the proposal to be evaluated. For this, 15 speech-language pathologists from the province of Granma, were surveyed; 10 were intentionally chosen, whose qualities met the requirements to be considered users. Different methods, techniques and procedures were used to process and analyze the data collected. The Likert rating scale facilitated the qualitative interpretation of the data collected. Results: From individual criteria, 60% of users considered the proposal quite appropriate; the lowest rating was adequate (20%). The calculation of the group assessment, the index obtained (0.5%) conferred reliability to the proposal to be implemented. Conclusions: Users consider that the strategy proposal meets the requirements for the application. However, there are some elements that could make its execution difficult: the incorrect scientific-methodological preparation of the facilitators, the inappropriate use of educational methods and techniques, as well as the refusal of those speech-language pathologists who do not raise awareness of the need to achieve methods. of action in accordance with professional principles and values.

RESUMEN Introducción: La comunicación por parte del logofonoaudiólogo con el paciente afásico y su familia garantiza el bienestar biopsicosocial de estos y favorece una adecuada relación médico-paciente. Objetivo: Evaluar una propuesta de estrategia para el fomento del principio de beneficencia entre el logofonoaudiólogo, el paciente afásico y su familia en el Policlínico Universitario Dr. René Vallejo Ortiz, ciudad de Manzanillo, Granma, Cuba. Método: Fue aplicada la técnica de Iadov o criterio de usuario que permitió evaluar la propuesta. Para ello se encuestaron 15 logofonoaudiólogos de la provincia de Granma, Cuba, se escogieron de manera intencional 10, cuyas cualidades cumplían los requisitos exigidos para ser considerados usuarios. Se utilizaron diferentes métodos, técnicas y procedimientos para procesar y analizar los datos recogidos. La escala valorativa Likert facilitó la interpretación cualitativa de los datos recogidos. Resultados: Desde el criterio individual el 60 % de los usuarios consideró la propuesta bastante adecuada; la valoración más baja fue de adecuada (20 %). El cálculo de la valoración grupal, el índice obtenido (0,5 %) le confirió confiabilidad a la propuesta para ser implementada. Conclusiones: Los usuarios consideran que la propuesta de estrategia cumple con los requisitos para la aplicación. No obstante, existen algunos elementos que pudieran dificultar la ejecución de la misma: la incorrecta preparación científico-metodológica de los facilitadores, el uso inadecuado de los métodos y técnicas educativas, así como la negativa de aquellos logofonoaudiólogos que no concienticen la necesidad de alcanzar modos de actuación acorde a los principios y valores profesionales.

Abstract Globalization and the growing complexity and breadth of the phenomena that humanity must face put pressure on many scenarios, and as expected, it occurs on the educational scenario too. The curricula incorporate XXI century skills, HsXXI, to meet growing needs and give individuals more significant opportunities. However, it is not obvious that the decisions made are implemented, nor that teachers have sufficient preparation for them. Furthermore, we must consider the possibility that these measures may be inappropriate for teachers and may exclude a sector of students and might be exercising symbolic violence over the majority of them. On the other hand, since 1990, Ricardo Cantoral, his collaborators, and his followers have been developing an educational perspective of mathematics that does not begin in school but in the society that produces and uses this knowledge. In this essay, paying tribute to Ricardo Cantoral, we examine one of his works as an explicit option to make use of Socioepistemology to deal with the complex problem indicated, and we conclude that this option is appropriate to address it and that placing the problem it vis-à-vis the HsXXI allows us to update those categories. scenarios expected too skills opportunities However implemented them Furthermore hand 1990 Cantoral collaborators knowledge essay indicated visàvis vis à categories 199 19 1

Resumen La globalización y la complejidad y amplitud crecientes de los fenómenos que la humanidad debe enfrentar presionan a muchos escenarios, y, ciertamente, al educacional. Los currículos incorporan habilidades del siglo XXI, HsXXI, tanto para atender necesidades que incrementan como para dar mayores oportunidades a los individuos. Sin embargo, no es obvio que las decisiones tomadas se implementen, ni que los profesores dispongan de preparación suficiente para ello. Peor aún, se debe considerar la posibilidad de que tales medidas sean indebidas para los profesores, y que excluyan a un sector de los estudiantes y ejerzan violencia simbólica sobre la mayoría. Por su parte, desde 1990, Ricardo Cantoral, sus colaboradores y seguidores, han venido desarrollando una perspectiva educacional de la matemática que no comienza en la escuela, sino en la sociedad que produce y utiliza conocimiento. En este ensayo de homenaje a Ricardo Cantoral, examinamos uno de sus trabajos como opción explícita para valernos de la Socioepistemología para tratar la compleja problemática señalada, y concluimos que esa opción es apropiada para abordarla, y que situarla vis a vis las HsXXI permite actualizar aquellas categorías. escenarios ciertamente XXI individuos embargo implementen ello aún mayoría parte 1990 Cantoral seguidores escuela conocimiento señalada abordarla categorías 199 19 1

Abstract Objective To analyze the frequency of polypharmacy and the prescription of Potentially Inappropriate Medications (PIM) according to the Beers Criteria and CBMPI in older adults with clinical-functional vulnerability. Method This is a cross-sectional study where the medical records of 496 participants aged 60 and older, seen in their first appointment at a Gerontological Polyclinic, were analyzed. Sociodemographic data, medications, the Clinical-Functional Vulnerability Index-20 (IVCF-20), and falls were extracted from the medical records. Polypharmacy was defined as the simultaneous use of five or more medications. Participants were classified into three groups: robust, at risk, and vulnerable. Results The analysis revealed that 69 (13.91%) participants were using polypharmacy. Among polypharmacy users, 40 (57.97%) were using at least one PIM. The most commonly found PIM were glibenclamide and omeprazole, respectively. Older adults with vulnerability were three times more likely to have polypharmacy (OR 3.59; 95% CI 2.109-6.092). Conclusion The use of polypharmacy and PIM in this study was associated with the vulnerability of older adults, emphasizing the need for a thorough evaluation of medication prescriptions for this population. (PIM clinicalfunctional clinical functional crosssectional cross sectional 49 6 Polyclinic analyzed data medications ClinicalFunctional Clinical Functional Index20 Index 20 Index-2 IVCF20, IVCF20 IVCF , (IVCF-20) groups robust risk vulnerable 13.91% 1391 13 91 (13.91% users 4 57.97% 5797 57 97 (57.97% omeprazole respectively OR 3.59 359 3 59 95 2.1096.092. 21096092 2.109 6.092 . 2 109 092 2.109-6.092) population Index2 Index- IVCF2 (IVCF-20 13.91 139 1 9 (13.91 57.97 579 5 (57.97 3.5 35 1096 2.1096.092 2109609 2109 2.10 6092 6.09 10 09 2.109-6.092 (IVCF-2 13.9 (13.9 57.9 (57.9 3. 2.1096.09 210960 210 2.1 609 6.0 0 2.109-6.09 (IVCF- 13. (13. 57. (57. 2.1096.0 21096 21 2. 6. 2.109-6.0 (IVCF (13 (57 2.1096. 2.109-6. (1 (5 2.1096 2.109-6 ( 2.109-

Resumo Objetivo Analisar a frequência de polifarmácia e prescrição de medicamentos potencialmente inapropriados (MPI) segundo os Critérios de Beers e CBMPI em pessoas idosas com vulnerabilidade clínico-funcional. Método Trata-se de um estudo transversal onde analisou-se os prontuários de 496 participantes com 60 anos ou mais, atendidos em primeira consulta em uma Policlínica Gerontológica. Os dados sociodemográficos, medicamentos, e o Índice de Vulnerabilidade Clínico Funcional 20 (IVCF-20) e quedas foram extraídos dos prontuários. A polifarmácia foi definida como o uso simultâneo de cinco ou mais medicamentos. Os participantes foram classificados em três grupos: robusto, em risco e vulnerável. Resultados A análise demonstrou que 69 (13,91%) dos participantes faziam uso de polifarmácia. Entre os usuários de polifarmácia, 40 (57,97%) faziam uso de pelo menos um MPI. Os MPIs mais encontrados foram a glibenclamida e o omeprazol, respectivamente. Pessoas idosas com vulnerabilidade apresentaram um risco três vezes maior de apresentar polifarmácia (RP 3,59; IC95% 2,109-6,092). Conclusão O uso de polifarmácia e MPI neste estudo estavam associados à vulnerabilidade da pessoa idosa, reforçando a necessidade de avaliação criteriosa de prescrições medicamentosas para essa população. (MPI clínicofuncional. clínicofuncional clínico funcional. funcional clínico-funcional Tratase Trata se analisouse analisou 49 6 Gerontológica sociodemográficos 2 IVCF20 IVCF (IVCF-20 grupos robusto vulnerável 13,91% 1391 13 91 (13,91% 4 57,97% 5797 57 97 (57,97% omeprazol respectivamente RP 3,59 359 3 59 IC95 IC 2,1096,092. 21096092 2,109 6,092 . 109 092 2,109-6,092) idosa população IVCF2 (IVCF-2 13,91 139 1 9 (13,91 57,97 579 5 (57,97 3,5 35 IC9 1096 2,1096,092 2109609 2109 2,10 6092 6,09 10 09 2,109-6,092 (IVCF- 13,9 (13,9 57,9 (57,9 3, 2,1096,09 210960 210 2,1 609 6,0 0 2,109-6,09 (IVCF 13, (13, 57, (57, 2,1096,0 21096 21 2, 6, 2,109-6,0 (13 (57 2,1096, 2,109-6, (1 (5 2,1096 2,109-6 ( 2,109-

Abstract In dermatologists' clinical practice, the use of systemic glucocorticoids is recurrent for the management of different comorbidities that require chronic immunosuppression. The prescription of this medication requires caution and basic clinical knowledge due to the several adverse effects inherent to the treatment. However, different doubts may arise or inappropriate conduct may be adopted due to the lack of objective and specific guidelines for the screening, prophylaxis and management of complications from chronic corticosteroid therapy. Considering this problem, the authors carried out a narrative review of the literature to gather up-to-date data on adverse effects secondary to the chronic use of systemic glucocorticoids. The broad approach to this topic made it possible to review the pathophysiology and risk factors for these complications, as well as to develop updated orientation that can be used as a learning tool and quick reference for dermatologists during their clinical practice with glucocorticoids. immunosuppression treatment However screening therapy problem uptodate up date

ABSTRACT Purpose To identify scientific evidence about (Work-Related Voice Disorder) and risk factors, as well as to point out vocal symptoms, instruments and evaluation methods in spoken voice professionals. Research strategy Integrative literature review carried out in LILACS, SciELO, MEDLINE/PubMed and Scopus databases. Selection criteria Articles with spoken voice professionals, which addressed individual, organizational and/or environmental risk factors linked to symptoms and/or voice disorders, observational studies, fully available, without restriction to language and year of publication. Results 58 papers were included, the largest publication between the years 2014 and 2022, predominantly in Brazil, with emphasis on the teacher. The most used evaluation method was vocal assessment using self-assessment protocols, followed by auditory-perceptual assessment and laryngological examination. The mostly identified risk factors were individual ones, followed by organizational and environmental ones, in addition to sensory and auditory vocal symptoms having been reported. Conclusion The most often self-reported factors were noise, intense voice use, respiratory changes, being female and inappropriate vocal practices. For sensory vocal symptoms, dry throat, throat clearing and vocal fatigue stand out, and for auditory symptoms, hoarseness. WorkRelated Work Related Disorder professionals LILACS SciELO MEDLINEPubMed MEDLINE PubMed databases andor or disorders studies available 5 included 201 2022 Brazil teacher selfassessment self protocols auditoryperceptual perceptual examination ones reported selfreported noise use changes practices hoarseness 20 202 2

RESUMO Objetivo Identificar evidências científicas sobre o distúrbio de voz relacionado ao trabalho e fatores de risco, além de apontar os sintomas vocais, instrumentos e métodos de avaliação em profissionais da voz falada. Estratégia de pesquisa Revisão integrativa da literatura, realizada nas bases de dados LILACS, SciELO, MEDLINE/PubMed e Scopus. Critérios de seleção Artigos com profissionais da voz falada, que abordassem os fatores de riscos individuais, organizacionais e/ou ambientais vinculados aos sintomas e/ou distúrbios de voz, estudos observacionais, disponíveis na íntegra, sem restrição ao idioma e ano de publicação. Resultados Foram incluídos 58 estudos, maior publicação entre os anos de 2014 e 2022, predominantemente no Brasil, em destaque, o professor. O método de avaliação mais utilizado foi autoavaliação com o uso dos protocolos, seguido da avaliação perceptivo-auditiva e do exame laringológico. Os fatores de risco mais identificados foram os individuais, seguidos dos organizacionais e ambientais, além de terem sido relatados os sintomas vocais sensoriais e auditivos. Conclusão Os fatores mais autorreferidos são ruído, uso intenso da voz, alterações respiratórias, ser do gênero feminino e práticas vocais inadequadas. Quanto aos sintomas vocais sensoriais, destacam-se garganta seca, pigarro e fadiga vocal, e quanto aos auditivos, rouquidão. falada literatura LILACS SciELO MEDLINEPubMed MEDLINE PubMed Scopus individuais eou ou observacionais íntegra 5 201 2022 Brasil destaque professor protocolos perceptivoauditiva perceptivo auditiva laringológico auditivos ruído respiratórias inadequadas destacamse destacam se seca vocal rouquidão 20 202 2

ABSTRACT OBJECTIVE To describe the prevalence of contraindicated use of combined hormonal contraceptives, progesterone-only contraceptives, and intrauterine devices in mothers participating in the 2015 Pelotas Birth Cohort according to the WHO medical eligibility criteria. METHODS The biological mothers of children belonging to the 2015 Pelotas birth cohort who attended the 48-month follow-up were studied. The 48-month follow-up data were collected from January 1, 2019, to December 31, 2019. Contraindicated use of modern contraceptives was considered to occur when these women presented at least one of the contraindications for the use of modern contraceptives and were using these methods. The prevalence of contraindicated use was calculated according to each independent variable and their respective 95% confidence intervals (95%CI). RESULTS The analyzed sample consisted of 3,053 women who used any modern contraceptive method. The prevalence of contraindicated use of modern contraceptives totaled 25.9% (95%CI: 24.4–27.5). Combined hormonal contraceptives showed the highest prevalence of contraindicated use (52.1%; 95%CI: 49.3–54.8). The prevalence of contraindicated use of modern contraceptives methods was greater in women with family income between one and three minimum wages, a 25–30 kg/m2 body mass index, indication by a gynecologist for the used method, and purchasing the contraceptive method at a pharmacy. The higher the women’s education, the lower the prevalence of inappropriate use of modern contraceptives. CONCLUSION In total, one in four women used modern contraceptives despite showing at least one contraindication. Policies regarding women’s reproductive health should be strengthened. progesteroneonly progesterone only 201 criteria 48month month 48 followup follow up studied 1 2019 31 95 95%CI. 95CI CI 95%CI . (95%CI) 3053 3 053 3,05 259 25 9 25.9 (95%CI 24.4–27.5. 244275 24.4–27.5 24 4 27 5 24.4–27.5) 52.1% 521 52 (52.1% 49.3–54.8. 493548 49.3–54.8 49 54 8 49.3–54.8) wages 2530 30 25–3 kgm2 kgm kg m2 m kg/m index pharmacy womens s education total contraindication strengthened 20 305 05 3,0 2 25. 24427 24.4–27. 52.1 (52.1 49354 49.3–54. 253 25– 0 3, 2442 24.4–27 52. (52. 4935 49.3–54 244 24.4–2 (52 493 49.3–5 24.4– (5 49.3– 24.4 ( 49.3 24. 49.

ABSTRACT OBJECTIVE To describe the prevalence of contraindicated use of combined hormonal contraceptives, progesterone-only contraceptives, and intrauterine devices in mothers participating in the 2015 Pelotas Birth Cohort according to the WHO medical eligibility criteria. METHODS The biological mothers of children belonging to the 2015 Pelotas birth cohort who attended the 48-month follow-up were studied. The 48-month follow-up data were collected from January 1, 2019, to December 31, 2019. Contraindicated use of modern contraceptives was considered to occur when these women presented at least one of the contraindications for the use of modern contraceptives and were using these methods. The prevalence of contraindicated use was calculated according to each independent variable and their respective 95% confidence intervals (95%CI). RESULTS The analyzed sample consisted of 3,053 women who used any modern contraceptive method. The prevalence of contraindicated use of modern contraceptives totaled 25.9% (95%CI: 24.4–27.5). Combined hormonal contraceptives showed the highest prevalence of contraindicated use (52.1%; 95%CI: 49.3–54.8). The prevalence of contraindicated use of modern contraceptives methods was greater in women with family income between one and three minimum wages, a 25–30 kg/m2 body mass index, indication by a gynecologist for the used method, and purchasing the contraceptive method at a pharmacy. The higher the women’s education, the lower the prevalence of inappropriate use of modern contraceptives. CONCLUSION In total, one in four women used modern contraceptives despite showing at least one contraindication. Policies regarding women’s reproductive health should be strengthened.

RESUMEN: El número de jóvenes que utilizan las tecnologías digitales a una edad más temprana ha aumentado significativamente. Y considerando que el uso inapropiado y abusivo de las tecnologías puede ser perjudicial en varias dimensiones de la vida humana, este artículo presentará y discutirá la sistematización de las etapas de desarrollo y de la validación de un instrumento que tiene como objetivo medir indicadores de vulnerabilidad digital entre estudiantes de la secundaria. La construcción del Cuestionario de Identificación de Vulnerabilidad Digital (Q-IVD) se basa en la literatura, eligiendo el tipo de validación de contenido para evaluar, a través del método Delphi, el juicio de especialistas sobre los contenidos presentes en el instrumento. En este proceso de validación participó un panel de expertos compuesto por 26 jueces con formación y experiencia en los campos de la educación y la salud, y posteriormente, muestras de estudiantes que contribuyeron con el análisis semántico de las preguntas y la aplicación piloto del cuestionario para realizar los análisis y estadísticas de pruebas, destacando que todos estos pasos ocurrieron durante el período de pandemia. El Q-IVD obtuvo excelentes resultados en los procesos de validación, con un Índice de Validez de Contenido (IVC) superior a 0,80 en todas las preguntas y categorías, y comprobó su confiabilidad y consistencia a través del coeficiente alfa de Cronbach 0,821. La versión final del Q-IVD contiene 24 preguntas divididas en cuatro categorías, y durante el proceso de validación se mostró evidencia de que este instrumento también ha sido validado para su aplicabilidad a diferentes audiencias, a través de mejoras y adaptaciones transculturales, para investigar diferentes correlaciones junto con otros instrumentos de investigación y análisis estadísticos. RESUMEN significativamente humana secundaria QIVD Q IVD (Q-IVD literatura evaluar Delphi 2 salud posteriormente pruebas pandemia IVC (IVC 080 0 80 0,8 categorías 0821 821 0,821 audiencias transculturales estadísticos 08 8 0, 082 82 0,82

ABSTRACT: The number of young people using digital technologies at an earlier age has increased significantly. Considering that the inappropriate and abusive use of technologies can harm several dimensions of human life, this article presents and discusses the systematization of the development stages and the validation of an instrument that aims to measure digital vulnerability indicators among high schoolers. Based on the literature, the construction of the Digital Vulnerability Identification Questionnaire (DVI-Q) chooses, through the Delphi method, the type of content validation to evaluate the specialists' judgment about the contents in the instrument. A panel of 26 experts with training and experience in the education and health fields participated in this validation process. Further, samples of students participated, contributing to the semantic analysis of the questions and pilot application of the questionnaire to analyze and test the statistics. All these steps occurred during the pandemic period. The DVI-Q reached excellent results in the validation processes, with a Content Validity Index above 0.80 in all questions and categories. Its reliability and consistency was proven through Cronbach's alpha coefficient of 0.821. The final version of the DVI-Q contains 24 questions divided into four categories. During the validation process, evidence showed that this instrument could also be applied to different audiences to investigate different correlations, other research instruments, and statistical analyzes, after some improvements and cross-cultural adaptations. ABSTRACT significantly life schoolers literature DVIQ DVI Q (DVI-Q chooses method specialists 2 process Further statistics period processes 080 0 80 0.8 categories Cronbachs Cronbach s 0821 821 0.821 correlations instruments analyzes crosscultural cross cultural adaptations 08 8 0. 082 82 0.82

RESUMO: O número de jovens que fazem uso das tecnologias digitais cada vez mais precocemente tem aumentado de forma significativa. Considerando que o uso inadequado e abusivo das tecnologias pode ser prejudicial em várias dimensões da vida humana, será apresentada e discutida neste artigo a sistematização das etapas do desenvolvimento e da validação de um instrumento que objetiva mensurar indicativos de vulnerabilidade digital entre estudantes do Ensino Médio. A construção do Questionário de Identificação de Vulnerabilidade Digital (Q-IVD) está fundamentada na literatura, sendo escolhido o tipo de validação de conteúdo para avaliar, por meio do método Delphi, o julgamento de especialistas acerca dos conteúdos presentes no instrumento. Participou desse processo de validação um painel de especialistas composto por 26 juízes com formação e atuação nos campos da educação e saúde, e, posteriormente, amostras de estudantes que contribuíram com a análise semântica das questões e a aplicação-piloto do questionário para realização de análises e testes estatísticos, cabendo destacar que todas essas etapas ocorreram durante o período pandêmico. O Q-IVD obteve ótimos resultados nos processos de validação, com Índice de Validade de Conteúdo (IVC) acima de 0,80 em todas as questões e categorias, e teve sua confiabilidade e consistência comprovadas mediante o coeficiente alpha de Cronbach 0,821. A versão final do Q-IVD contém 24 questões distribuídas em quatro categorias, e, durante o processo de validação, foram evidenciados indícios de esse instrumento ter aplicabilidade validada também para diferentes públicos, mediante aprimoramento e adaptações transculturais, para investigar correlações diversas juntamente com outros instrumentos de pesquisa e análises estatísticas. RESUMO significativa humana Médio QIVD Q IVD (Q-IVD literatura avaliar Delphi 2 saúde posteriormente aplicaçãopiloto aplicação piloto estatísticos pandêmico IVC (IVC 080 0 80 0,8 categorias 0821 821 0,821 públicos transculturais estatísticas 08 8 0, 082 82 0,82