RESUMEN El objetivo del estudio fue evaluar las características de fermentación del cacao Criollo y CCN-51, con la acción de bacterias (Lactobacillus fermentum) y levaduras (Saccharomycescerevisiae), en el distrito de Ayna San Francisco, provincia de La Mar - Ayacucho (VRAEM). Investigación experimental, aplicada y cuantitativa. Fueron establecidos seis tratamientos incluyendo los testigos, dos tratamientos se adicionaron con levadura (Saccharomycescerevisiae) al 5gr/kg de cacao, dos tratamientos se adiciono bacteria (Lactobacillus fermentum) al 3gr./kg de cacao y dos tratamientos fueron testigo. El mayor porcentaje de granos fermentados lo obtuvo el tratamiento con adición de levadura (Saccharomycessereviseae) que aceleró la fermentación aumentando la temperatura a 40°C a, mientras que el tratamiento con las bacterias (Lactobacillus fermentum), no logró fermentar adecuadamente, debido a que se reportaron temperaturas bajas 20.9ºC y presencia de granos violetas 77%. Concluye que la acción de la levadura en el proceso de fermentación mejoró las características organolépticas, mientras que la bacteria (Lactobacillus fermentum) desarrollo características más amargos y astringentes con menos características organolépticas. Al evaluar el análisis físico de los granos del cacao, mostraron un pH promedio entre 4.5. a 5.8, donde el cacao con pH menor a 5, son más amargos.

ABSTRACT The aim of the study was to evaluate the fermentation characteristics of Criollo and CCN-51 cocoa, with the action of bacteria (Lactobacillus fermentum) and yeasts (Saccharomyces cerevisiae), in the district of Ayna San Francisco, province of La Mar - Ayacucho (VRAEM). Experimental, applied and quantitative research. Six treatments were established, including the controls, two treatments were added with yeast (Saccharomyces cerevisiae) at 5 g/kg of cocoa, two treatments were added with bacteria (Lactobacillus fermentum) at 3 g/kg of cocoa and two treatments were the controls. The highest percentage of fermented beans was obtained by the treatment with the addition of yeast (Saccharomyces sereviseae), which accelerated fermentation by increasing the temperature to 40°C, while the treatment with bacteria (Lactobacillus fermentum) did not ferment adequately, due to low temperatures of 20.9°C and the presence of purple beans (77%). It concludes that the action of the yeast in the fermentation process improved the organoleptic characteristics, while the bacteria (Lactobacillus fermentum) developed more bitter and astringent characteristics with less organoleptic characteristics. When evaluating the physical analysis of the cocoa beans, they showed an average pH between 4.5 and 5.8, where cocoa with a pH lower than 5 is more bitter.

Abstract The research aimed to highlight educational progress by analyzing authors' perspectives and approaches to quality assurance policies in Higher Education between 2019 and 2023. The PRISMA systematic review method was employed to identify 30 studies from three major databases: ERIC, Scopus, and SciELO. Inclusion criteria focused on studies published in English, excluding those not centered on Higher Education and quality assurance as main competencies. he results revealed a complexity of approaches regarding quality assurance policies in Higher Education. These policies seek to enhance both relevance and educational experience. The importance of ensuring quality standards to ensure that higher education meets its academic and social objectives is emphasized. Additionally, the need to adapt these policies to changing educational demands and contexts is evident, as well as to promote the participation of diverse stakeholders in their design and implementation. The study underscores the importance of comprehensively addressing quality assurance policies to strengthen and enhance their contribution to social and economic development.

Resumen La investigación tuvo como objetivo destacar los progresos educativos mediante el análisis de las perspectivas y enfoques de los autores sobre las políticas de aseguramiento de la calidad en la Educación Superior entre 2019 y 2023. Se empleó el método de revisión sistemática PRISMA para identificar 30 estudios de tres importantes bases de datos: ERIC, Scopus y SciELO. Los criterios de inclusión se enfocaron en estudios publicados en inglés, excluyendo aquellos que no se centraban en la Educación Superior y el aseguramiento de la calidad como competencias principales. Los resultados revelaron una complejidad de enfoques en relación con las políticas de aseguramiento de la calidad en la Educación Superior. Estas políticas buscan mejorar tanto la pertinencia como la experiencia educativa. Se destaca la importancia de garantizar estándares de calidad para asegurar que la educación superior cumpla con sus objetivos académicos y sociales. Además, se evidencia la necesidad de adaptar estas políticas a las cambiantes demandas y contextos educativos, así como de promover la participación de diversos actores en su diseño e implementación. El estudio subraya la relevancia de abordar de manera integral las políticas de aseguramiento de la calidad para fortalecer y mejorar su contribución al desarrollo social y económico.

Abstract Introduction Acquired tracheomalacia (ATM) is characterized by a loss of structural strength of the tracheal framework, resulting in airway collapse during breathing. Near half of the patients undergoing prolonged invasive mechanical ventilation will suffer tracheal lesions. Treatment for ATM includes external splinting with rib grafts, prosthetic materials, and tracheal resection. Failure in the use of prosthetic materials has made reconsidering natural origin scaffolds and tissue engineering as a suitable alternative. Objective To restore adequate airway patency in an ovine model with surgicallyinduced ATM employing a tissue-engineered extraluminal tracheal splint (TE-ETS). Methods In the present prospective pilot study, tracheal rings were partially resected to induce airway collapse in 16 Suffolk sheep (Ovis aries). The TE-ETS was developed with autologous mesenchymal-derived chondrocytes and allogenic decellularized tracheal segments and was implanted above debilitated tracheal rings. The animals were followed-up at 8, 12, and 16 weeks and at 1-year postinsertion. Flexible tracheoscopies were performed at each stage. After sacrifice, a histopathological study of the trachea and the splint were performed. Results The TE-ETS prevented airway collapse for 16 weeks and up to 1-year postinsertion. Tracheoscopies revealed a noncollapsing airway during inspiration. Histopathological analyses showed the organization of mesenchymal-derived chondrocytes in lacunae, the proliferation of blood vessels, and recovery of epithelial tissue subjacent to the splint. Splints without autologous cells did not prevent airway collapse. Conclusion It is possible to treat acquired tracheomalacia with TE-ETS without further surgical removal since it undergoes physiological degradation. The present study supports the development of tissue-engineered tracheal substitutes for airway disease. (ATM framework breathing lesions grafts resection alternative tissueengineered engineered TEETS. TEETS TE ETS . (TE-ETS) 1 Ovis aries. aries aries) mesenchymalderived mesenchymal derived followedup followed 8 12 1year year postinsertion stage sacrifice inspiration lacunae vessels degradation disease (TE-ETS

ABSTRACT Introduction: Dengue is an endemic virus in Paraguay, in recent years its probable role in the pathophysiology of autoimmune diseases has been reported, being able to trigger or exacerbate them. Objectives: To evaluate the evolution of patients with Systemic Lupus Erythematosus (SLE) diagnosed with dengue in the period of time between January 2020 and March 2020. Materials and Methods: Observational, analytical longitudinal study, the sample size was 19 patients with SLE, diagnosed with dengue fever in the period from January to March 2020. Data was collected through an electronic record with specific data of the clinical characteristics before dengue and the evolutionary characteristics of dengue in patients with SLE. The determination of the NS1 antigen was carried out through rapid immunochro- matographic tests and, prior to the rRT-PCR reaction, the extraction of the viral RNA was carried out. The index of IgG and IgM anti-DENV studies will be completed. Results: The mean age was 32.10 ± 13.83 years, 84% were female and 98% came from the central department. 42% (8/19) of the referred patients had previously suffered from den- gue. Of the total number of patients, 15 patients presented laboratory confirmation either by detection of the NS1 antigen, PCR, or serology, as shown in Graph 1; the rest were included in this cohort due to an epidemiological link. DENV-4 was the most frequent serotype in 64% (9). The mean value of dengue evolution time was 3.84 ± 1.259 and the predominant symptoms were fever in 74% (14/19) and myalgia in 63% (12/19). In relation to the evolution of the patients, 42% (8/19) were hospitalized, 5.2% (1/19) were admitted to the ICU and no patients appeared deceased. The mean of SLEDAI at the beginning of the Dengue infection was 2.5 points and at three months it was 3 points. No statistically significant difference was found between the score values before and after dengue. (p=0.451). Conclusion: The evolution of dengue in patients with SLE was favorable in the patients included in this study. PCR was the diagnostic method that most frequently was able to detect a positive result in the febrile stage of dengue in patients with SLE. Although hospital admissions were even obtained in the ICU, they did not develop due to dengue in patients with SLE.

RESUMEN Introducción: El dengue es una virosis endémica en Paraguay. En los últimos años, se ha reportado su probable papel en la fisiopatología de las enfermedades autoinmunes, ya que puede desencadenarlas o exacerbarlas. Objetivos: Evaluar la evolución de los pacientes con Lupus Eritematoso Sistémico (LES) con diagnóstico de dengue en el periodo de tiempo entre enero de 2020 a marzo de 2020. Materiales y Métodos: Se realizó un estudio observacional, analítico de corte longitudinal, con una muestra de 19 pacientes con lupus eritematoso sistémico (LES), diagnosticados de dengue en etapa febril entre enero y marzo del año 2020. Se recogieron datos mediante un registro electrónico con datos específicos de las características clínicas previas al den- gue y las características evolutivas del dengue en los pacientes con LES. Se determinó el antígeno NS1 mediante pruebas rápidas inmunocromatográficas y se extrajo el ARN viral previo a la reacción de rRT-PCR. Se midió el índice de anticuerpos IgG e IgM anti-DENV. Resultados: La edad media fue de 32,10±13,83 años; el 84% eran mujeres y el 98% pro- cedían del Departamento Central. El 42% (8/19) de los pacientes afirmaron haber padecido dengue anteriormente. De los 19 pacientes, 15 presentaron una confirmación laboratorial mediante la detección del antígeno NS1, la PCR o la serología, como se muestra en el gráfico 1; los demás se incluyeron en esta cohorte por nexo epidemiológico. El DENV-4 fue el serotipo más frecuente, con un 64%. La media del tiempo de evolución del dengue fue de 3,84±1,259 días y los síntomas más comunes fueron la fiebre en un 74%(14/19) y las mialgias en un 63%(12/19). En cuanto a la evolución de los pacientes, el 42% (8/19) requirieron hospitalización, el 5,2%(1/19) ingresaron en UCI y no hubo fallecimientos. La media de SLEDAI al inicio de la infección por dengue fue de 2,5 puntos y a los tres meses fue de 3 puntos; no se halló una diferencia estadísticamente significativa entre los valores del score antes y después del dengue (p=0,451). Conclusión: La evolución del dengue en pacientes con LES fue favorable en los pacientes incluidos en este estudio. La PCR fue el método diagnóstico que con mayor frecuencia pudo detectar un resultado positivo en la etapa febril del dengue en pacientes con LES. Aunque se registraron ingresos hospitalarios, incluso en UCIA, no se produjo ningún falle- cimiento por dengue en pacientes con LES.

Abstract This report describes a fatal case of mucosal disease in a two-year-old bull. For causal agent detection, scab, whole blood, and feces samples were tested by RT-PCR, PCR, ELISA, and viral isolation. RT-PCR positive amplification was obtained in blood samples for bovine viral diarrhea virus (BVDV). Viral isolation from the scab samples confirmed BVDV as the causative agent of the clinical manifestations. Subsequently, genetic characterization based on phylogenetic analysis of three partial sequences revealed the presence of BVDV subgenotype 1b in analyzed samples. Due to the development of clinical manifestation named mucosal disease, these findings suggest the detection of BVDV persistently infected (PI) bull; therefore, these results demonstrate the importance of establishing BVDV control programs that rely on testing the presence of PI in cattle from Mexico.

Resumen El virus de la diarrea viral bovina (VDVB) genera pérdidas significativas en la producción de bovinos. Se reporta sobre un caso fatal de la enfermedad de las mucosas en un toro de dos años. Para la detección del agente causal, se analizaron muestras de lesiones, de sangre completa y de heces mediante el RT-PCR, PCR, ELISA y aislamiento viral. Se obtuvo amplificación positiva por RT-PCR en muestras de sangre para el virus de la diarrea viral bovina (VDVB). El aislamiento viral de las muestras de las lesiones confirmó que el VDVB fue el agente causal de las manifestaciones clínicas. Una caracterización genética basada en el análisis filogenético de tres secuencias parciales identificó la presencia del subgenotipo 1b del VDVB en las muestras analizadas. El animal muestreado manifestaba signos clínicos indicando que tenía la enfermedad de las mucosas, lo cual sugiere que sufría de una infección persistente (IP) por VDVB. Este hallazgo resalta la importancia de establecer programas de control de VDVB basados en probar la presencia de IP en el ganado de México.

ABSTRACT Introduction: COVID-19 has a significant impact on the hematopoietic system and hemostasis. Leukocytosis, lymphopenia, and thrombocytopenia are associated with increased severity and even death in COVID-19 cases. Objective: The aim is to examine the laboratory results of COVID-19 patients from a hospital in the Peruvian Amazon and their clinical prognosis. Material and Methods: An analytical cross-sectional study was carried out whose purpose was to identify the laboratory tests of patients with COVID-19 and mortality in a hospital in Ucayali, Peru during the period from March 13 to May 9, 2020, selecting a total of 127 with Covid-19. Mean and the standard deviation was described for age, leukocytes, neutrophils, platelets, RDW-SD; median and interquartile range for the variables lymphocyte, RN / L, fibrinogen, CRP, D-dimer, DHL, hematocrit, monocytes, eosinophils. Results: No differences were observed in this population regarding death and sex (OR: 1.31; 95% CI 0.92 to 1.87), however, it was observed that, for each one-year increase, the probability of death increased by 4% (PR: 1.04, 95% CI 1.03 to 1.05). The IRR (Incidence Risk Ratio) analysis for the numerical variables showed results strongly associated with hematological values such as Leukocytes (scaled by 2500 units) (IRR: 1.08, 95% CI 1.03 to 1.13), neutrophils (scaled by 2500 units) (IRR: 1.08; 95% CI 1.03 to 1.13), on the contrary, it is observed that the increase of 1000 units in lymphocytes, the probability of dying decreased by 48% (IRR: 0.52; 95% CI 0.38 to 071). Conclusions: Parameters such as leukocytes,neutrophils and D-dimer were statistically much higher in patients who died.

RESUMEN Introducción: COVID-19 tiene un impacto significativo en el sistema hematopoyético y la hemostasia. La leucocitosis, la linfopenia y la trombocitopenia se asocian con una mayor gravedad e incluso la muerte en los casos de COVID-19. Objetivo: examinar los resultados de laboratorio de pacientes con COVID-19 de un hospital de la Amazonía peruana y su pronóstico clínico. Material y métodos: Se realizó un estudio transversal analítico cuyo propósito fue identificar las pruebas de laboratorio de pacientes con COVID-19 y mortalidad en un hospital de Ucayali, Perú durante el periodo del 13 de marzo al 9 de mayo del 2020, seleccionando un total de 127 con COVID-19. Se describió la media y la desviación estándar para edad, leucocitos, neutrófilos, plaquetas, RDW-SD; mediana y rango intercuartílico para las variables linfocito, RN/L, fibrinógeno, PCR, dímero D, DHL, hematocrito, monocitos, eosinófilos. Resultados: No se observaron diferencias en esta población en cuanto a muerte y sexo (OR: 1,31; IC 95% 0,92 a 1,87), sin embargo, se observó que, por cada aumento de un año, la probabilidad de muerte aumentaba un 4% (RP: 1,04). , IC del 95%: 1,03 a 1,05). El análisis de RIR (Razón de incidencia de riesgos) para las variables numéricas mostró resultados fuertemente asociados con valores hematológicos como Leucocitos (escala de 2500 unidades) (RRI: 1.08, 95% CI 1.03 a 1.13), neutrófilos (escala de 2500 unidades) (RRI: 1.08; IC 95% 1.03 a 1.13), por el contrario, se observa que al aumento de 1000 unidades en linfocitos, la probabilidad de morir disminuyó en un 48% (TIR: 0.52; IC 95% 0.38 a 071). Conclusiones: Parámetros tales como los leucocitos, los neutrófilos y el dímero D fueron estadísticamente mucho más altos en los pacientes que fallecieron.

Resumen: El objetivo de este estudio es determinar la frecuencia de eventos adversos de la vacunación contra el COVID-19 en pacientes con LES que son atendidos en centros médicos de referencia en Paraguay. Este es un estudio observacional, transversal, descriptivo. Se incluyeron 52 pacientes con LES que recibieron al menos una dosis de la vacuna anticovid. De los cuales el 100% recibieron la primera dosis, el 92,3% la segunda dosis y el 15,38% la tercera dosis; el 44,6% recibió Sputnik-V; 16% Moderna; 12,5% Pfizer, 7,1% AstraZeneca, 3,6% Covaxin y 2,1% Hayat Vax, 8 pacientes recibieron su tercera dosis correspondiente a 3 de Pfizer, 3 de Moderna, 2 de AstraZeneca. En las 108 dosis aplicadas se registraron un total de 43 evento advserso, el 95,3% dentro de los primeros 5 días y el resto a los 5 días. El 51,2% presentó el evento advserso tras la primera dosis, el 39,5% tras la segunda dosis y el 9,3% tras la tercera dosis. La duración media de los síntomas fue de 2,3 días ±1,4. El efecto adverso más importante fue el dolor en el sitio de inyección, seguido de fiebre y fatiga. La exacerbación del LES también se registró como evento advserso en el 8,3%. Se registraron efectos adversos leves, se concluye que vacunación contra COVID-19 es segura para pacientes con LES.

Abstract: The aim of this study is to determine the frequency of adverse events of COVID-19 vaccination in patients with SLE who are attended at referral medical centers in Paraguay. This is an observational, cross-sectional, descriptive study. Fifty-two patients with SLE who received at least one dose of anticovid vaccine were included. Of which 100% received the first dose, 92.3% the second dose and 15.38% the third dose; 44.6% received SputnikV; 16% Moderna; 12.5% Pfizer, 7.1% AstraZeneca, 3.6% Covaxin and 2.1% Hayat Vax, 8 patients received their third dose corresponding to 3 from Pfizer, 3 from Moderna, 2 from AstraZeneca. In the 108 doses applied, a total of 43 adverse events were recorded, 95.3% within the first 5 days and the rest at 5 days. A total of 51.2% presented the adverse event after the first dose, 39.5% after the second dose and 9.3% after the third dose. The mean duration of symptoms was 2.3 days ±1.4. The most important adverse effect was pain at the injection site, followed by fever and fatigue. Exacerbation of SLE was also recorded as an adverse event in 8.3%. Mild adverse effects were recorded, it is concluded that vaccination against covid 19 is safe for patients with SLE.

Mobile applications (Apps) may become effective aids in health care. Health Apps could reduce barriers such as access and costs and could be used to monitor symptoms, behaviors and even treatments. There is more evidence of their usefulness in nutrition, cardiovascular and mental health. Despite this, its current use is predominantly for information purposes. Healthcare App quality evaluation should consider both clinical and technological aspects since the evidence on its clinical effectiveness is still incipient and they have associated risks. In Chile, the use of mobile technology and Apps is increasing, but there are no regulations for their use. There are few national institutions oriented to the creation and development of Apps for healthcare, highlighting the Digital Transformation Committee, part of the Corporation for the Promotion of Production (CORFO) and the National Center for Health Information Systems (CENS). General recommendations for healthcare App development and use have been established. In this process, it would be beneficial to include actors involved in care. Given the progress of healthcare Apps worldwide and nationally, it is important that health professionals develop digital skills to maximize the potential benefit of these technologies.

Abstract: Low back pain is a medical term used to describe pain, muscle tension and/or stiffness in the lower back region. In Mexico, it has been observed that 13% of the population (age 20 to 59) that attends the Family Medicine Units of the IMSS manifests this type of pain. Occupational low back pain is characterized by pain of variable intensity and duration that can cause disability and occupational invalidity. The annual prevalence of low back pain among health personnel is approximately 77%. We conducted a prospective, observational, cross-sectional study in which we evaluated low back pain among residents of the surgical branch (orthopedics and traumatology, general surgery) and the non-surgical branch (internal medicine). The Oswestry and Roland Morris Test was applied to all participants at the beginning of the academic cycle with the intention of recognizing the degree of low back pain they presented, and the same test was applied after a year later. The residents in the surgical branch present an increase in low back pain compared to non-surgical residents with a p = 0.007. It is recommended that this line of research be continued in the future, emphasizing the risk factors among surgical residents.

Resumen: La lumbalgia es un término médico utilizado para describir dolor, tensión muscular y/o rigidez en la región lumbar. En México se ha observado que el 13% de la población (edad de 20 a 59 años) que acude a las Unidades de Medicina Familiar del IMSS manifiesta este tipo de dolor. La lumbalgia ocupacional se caracteriza por dolor de intensidad y duración variable que puede causar incapacidad e invalidez laboral. La prevalencia anual de lumbalgia en personal de salud es aproximadamente de 77%. Se realizó un estudio prospectivo, observacional, transversal. En el cual evaluamos la lumbalgia existente entre los residentes de la rama quirúrgica (Ortopedia y Traumatología, Cirugía General) y la rama no quirúrgica (Medicina Interna). A todos los participantes se les aplicó el test de Oswestry y Roland Morris al inicio del ciclo académico con la intención de reconocer el grado de lumbalgia que presentaban y se volvió a aplicar el mismo test un año después. Los residentes de la rama quirúrgica presentan aumento en lumbalgia a comparación de los residentes no quirúrgicos con una p = 0.007. Se recomienda que en un futuro se continúe con esta línea de investigación haciendo énfasis en los factores de riesgo que hay entre los residentes quirúrgicos.

Background: Vitamin K antagonist medications (VKA) are essential for the prevention of thromboembolic events, but their effectiveness is influenced by multiple factors, such as the type of medication chosen. Aim: To evaluate the efficacy in anticoagulant control of the bioequivalent and non-bioequivalent drugs of acenocoumarol compared to the reference drug. To evaluate the efficacy of warfarin bioequivalents available in Chile. To contrast the overall anticoagulant control efficacy between acenocoumarol and warfarin. Material and Methods: The results of 69333 outpatient oral anticoagulation controls were analyzed. Patient were separated in groups according to the drug that they used. Subsequently, the proportions of controls outside the range for each of acenocoumarol and warfarin bioequivalent drugs were compared. Acenocoumarol non-bioequivalent drugs were also compared with the reference drug. Acenocoumarol was compared with warfarin. Results: Acenocoumarol bioequivalent drugs and the reference drug had a similar proportion of controls outside the range (Odds ratios (OR) 0.812; 0.969; 0.974 and 0.963). Non-bioequivalent drugs had a higher proportion than the reference drug (OR 1.561 and 2.037). Both warfarin brands have a similar proportion of controls outside of the range (OR 1.050). Acenocoumarol compared to warfarin had a significant higher proportion of controls outside the range (OR 1.191). Conclusions: The pharmacological presentation of vitamin K antagonists could influence anticoagulant control. Therefore, it is not prudent to switch these presentations frequently.

Resumen Objetivo. Conocer el estado del arte, relacionado con la temática de Educación Interprofesional (EIP) en la formación de estudiantes de enfermería y medicina, y el nivel de evidencia desarrollado hasta el momento. Métodos. Revisión Sistemática exploratoria, declarada como Scoping review por la Joanna Briggs Institute -JBI-, en la que se realizó una búsqueda en bases de datos de Embase, Science direct, Pubmed-Medline, Academic search complete, BVS, Scopus y ERIC, entre 2009-2019 utilizando los términos DeCS y MeSH de Interprofessional education, education research, healthcare professionals, nursing y medicine. Se seleccionaron 39 artículos originales luego del proceso de crítica con los criterios de JBI. Resultados. Emergieron cuatro núcleos temáticos: Experiencias y percepciones del aprendizaje interprofesional, Didácticas vinculadas a la EIP, Indicadores empíricos relacionados con la EIP y Desarrollo de competencias profesionales. El mayor nivel de evidencia lo presentan los artículos sobre empleo de didácticas; por el contrario, no se encontraron artículos que trataran temáticas relacionadas con la inclusión temprana de EIP en los currículos de enfermería y medicina, pues son actualmente necesarios para complementar el enfoque de atención centrada en el paciente. Conclusión. Los núcleos temáticos muestran que el nivel de evidencia de la literatura es variado, aunque en su mayoría de alcance descriptivo, lo que resalta el desarrollo de competencias profesionales como resultado de la educación interprofesional.

Abstract Objective. This work sought to know the state of the art related to the theme of Interprofessional Education (IPE) in the training of Nursing and Medical students and the level of evidence developed thus far. Methods. This was an exploratory systematic review, declared as scoping review by the Joanna Briggs Institute, JBI, in which a search was performed in Embase, Science direct, Pubmed-Medline, Academic search complete, BVS, Scopus and ERIC databases, limiting between 2009 - 2019 by using the DeCS and MeSH terms of Interprofessional education, education research, healthcare professionals, nursing and medicine, selecting 39 original articles after carrying out the review process with the criteria by the JBI. Results. Four thematic nuclei emerged: Experiences and perceptions of interprofessional learning, Didactics related with IPE, Empirical indicators related with IPE, and Development of professional skills. The highest level of evidence is presented by the articles dealing with didactics; on the contrary, no articles were found that dealt with topics related with early inclusion of IPE in the medical and nursing curricula, which are currently necessary to complement the focus of patient-centered care. Conclusion. The thematic nuclei show that the level of evidence in the literature is varied, although mostly descriptive in scope, highlighting the development of professional skills as a result of interprofessional education.

Resumo Objetivo. Conhecer o estado da arte, relacionado com a temática de Educação Interprofissional (EIP) na formação de estudantes de enfermagem e medicina, e o nível de evidência desenvolvido até o momento. Métodos. Revisão Sistemática exploratória, declarada como Scoping review pela Joanna Briggs Institute -JBI-, na qual se realizou uma busca em bases de dados de Embase, Science direct, Pubmed-Medline, Academic search complete, BVS, Scopus e ERIC, limitando entre 2009-2019 utilizando os termos DeCS e MeSH de Interprofessional education, education research, healthcare professionals, nursing and medicine. Se selecionaram 39 artigos originais após de realizado o processo de crítica com os critérios de JBI. Resultados. Emergiram quatro núcleos temáticos: Experiências e percepções da aprendizagem interprofissional, Didáticas vinculadas à EIP, Indicadores empíricos relacionados com a EIP e Desenvolvimento de competências profissionais. O maior nível de evidência o apresentam os artigos sobre emprego de didáticas; pelo contrário, não se encontraram artigos que trataram temáticas relacionadas com a inclusão precoce de EIP nos currículos de enfermagem e medicina, sendo atualmente necessários para complementar o enfoque de atenção centrada no paciente. Conclusão. Os núcleos temáticos mostram que o nível de evidência da literatura é variado, embora na sua maioria de alcance descritivo, ressaltando o desenvolvimento de competências profissionais como resultado da educação interprofissional.

The purpose of this research was to evaluate the scientific production on teacher stress. It is a cross-sectional descriptive study of articles published in journals indexed in the SciELO collection between 2010 and 2018. An estimate of publications per year, journals, institutional affiliations and publication topics was analyzed. It was found that between the aforementioned years, 60 articles on the subject have been published, out of which the years of greatest production fluctuate between 2014 and 2018. The main journals that published articles on this topic are: Research News in Education, Uninorte Health Magazine and the Magazine of Medical Sciences of Pinar del Río in Cuba. In addition, Brazil, Colombia and Cuba have the institutional affiliations with the highest number of published articles. We can conclude that teacher stress as a research variable has been studied gradually in Latin American countries; however, it is necessary to continue strengthening these studies in other databases.

La presente investigación tuvo como objetivo evaluar la producción científica sobre estres docente. Es un estudio descriptivo transversal de los artículos publicados en revistas indizadas en la colección SciELO entre los años 2010 y 2018. Se analizó estimación de publicaciones por año, revistas, afiliaciones institucionales y temáticas de publicación. Se encontró que entre los años mencionados se han publicado 60 artículos sobre la temática, de los cuales los años de mayor producción fluctuan entre 2014 a 2018, las principales revistas de publicación sobre este tópico son: Actualidades Investigativas en Educación, Revista Salud Uninorte y Revista de Ciencias Médicas de Pinar del Río; además Brasil, Colombia y Cuba son los afiliaciones a instituciones de estos países con mayor cantidad de artículos publicaods. Podemos concluir que el estres docente como variable de investigación viene siendo estudiado de a poco en países latinoamericanos; sin embargo, es necesario seguir fortaleciendo estos estudios en demás bases de datos.

Diversos países latino-americanos já alcançaram avanços notáveis na oferta de assistência em saúde mental para pessoas com psicoses. No entanto, as clínicas de saúde mental geralmente realizam atividades de extensão muito limitadas dentro das comunidades, tendem a ter vínculos fracos com a assistência primária, raramente envolvem os próprios pacientes nos cuidados e poucas vezes prestam serviços orientados para a recuperação. O artigo descreve um estudo piloto randomizado e controlado sobre a Critical Time Intervention-Task Shifting (CTI-TS), que teve como objetivo analisar essas limitações. O estudo piloto foi realizado em Santiago (Chile) e no Rio de Janeiro (Brasil). Teve como meta a inclusão de 110 pessoas com psicose, recrutadas no momento da entrada em clínicas comunitárias de saúde mental. Os participantes foram randomizados para o CTI-TS ou para os cuidados usuais. Aqueles alocados ao grupo da intervenção receberam os cuidados usuais e os serviços de CTI-TS ao longo de 9 meses. Os desfechos primários incluíram a qualidade de vida (WHO Quality of Life Scale - Brief Version) e as necessidades não atendidas (Camberwell Assessment of Needs) no acompanhamento aos 18 meses. Os desfechos primários aos 18 meses serão analisados com a técnica de Equações de Estimação Generalizadas (GEE), com as observações agrupadas dentro dos locais do estudo. Serão utilizados modelos em três níveis para examinar as tendências temporais nos desfechos primários. Procedimentos semelhantes serão utilizados para analisar os resultados secundários. Espera-se que o estudo forneça uma base para planejar um estudo randomizado e controlado em grande escala e em múltiplos locais para estabelecer a eficácia da intervenção orientada para a recuperação, a exemplo da CTI-TS, na América Latina.

Several Latin American countries have made remarkable strides towards offering community mental health care for people with psychoses. Nonetheless, mental health clinics generally have a very limited outreach in the community, tending to have weaker links to primary health care; rarely engaging patients in providing care; and usually not providing recovery-oriented services. This paper describes a pilot randomized controlled trial (RCT) of Critical Time Intervention-Task Shifting (CTI-TS) aimed at addressing such limitations. The pilot RCT was conducted in Santiago (Chile) and Rio de Janeiro (Brazil). We included 110 people with psychosis in the study, who were recruited at the time of entry into community mental health clinics. Trial participants were randomly divided into CTI-TS intervention and usual care. Those allocated to the intervention group received usual care and, in addition, CTI-TS services over a 9-month period. Primary outcomes include quality of life (WHO Quality of Life Scale - Brief Version) and unmet needs (Camberwell Assessment of Needs) at the 18-month follow-up. Primary outcomes at 18 months will be analyzed by Generalized Estimating Equations (GEE), with observations clustered within sites. We will use three-level multilevel models to examine time trends on the primary outcomes. Similar procedures will be used for analyzing secondary outcomes. Our hope is that this trial provides a foundation for planning a large-scale multi-site RCT to establish the efficacy of recovery-oriented interventions such as CTI-TS in Latin America.

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Diversos países latino-americanos já alcançaram avanços notáveis na oferta de assistência em saúde mental para pessoas com psicoses. No entanto, as clínicas de saúde mental geralmente realizam atividades de extensão muito limitadas dentro das comunidades, tendem a ter vínculos fracos com a assistência primária, raramente envolvem os próprios pacientes nos cuidados e poucas vezes prestam serviços orientados para a recuperação. O artigo descreve um estudo piloto randomizado e controlado sobre a Critical Time Intervention-Task Shifting (CTI-TS), que teve como objetivo analisar essas limitações. O estudo piloto foi realizado em Santiago (Chile) e no Rio de Janeiro (Brasil). Teve como meta a inclusão de 110 pessoas com psicose, recrutadas no momento da entrada em clínicas comunitárias de saúde mental. Os participantes foram randomizados para o CTI-TS ou para os cuidados usuais. Aqueles alocados ao grupo da intervenção receberam os cuidados usuais e os serviços de CTI-TS ao longo de 9 meses. Os desfechos primários incluíram a qualidade de vida (WHO Quality of Life Scale - Brief Version) e as necessidades não atendidas (Camberwell Assessment of Needs) no acompanhamento aos 18 meses. Os desfechos primários aos 18 meses serão analisados com a técnica de Equações de Estimação Generalizadas (GEE), com as observações agrupadas dentro dos locais do estudo. Serão utilizados modelos em três níveis para examinar as tendências temporais nos desfechos primários. Procedimentos semelhantes serão utilizados para analisar os resultados secundários. Espera-se que o estudo forneça uma base para planejar um estudo randomizado e controlado em grande escala e em múltiplos locais para estabelecer a eficácia da intervenção orientada para a recuperação, a exemplo da CTI-TS, na América Latina.

Several Latin American countries have made remarkable strides towards offering community mental health care for people with psychoses. Nonetheless, mental health clinics generally have a very limited outreach in the community, tending to have weaker links to primary health care; rarely engaging patients in providing care; and usually not providing recovery-oriented services. This paper describes a pilot randomized controlled trial (RCT) of Critical Time Intervention-Task Shifting (CTI-TS) aimed at addressing such limitations. The pilot RCT was conducted in Santiago (Chile) and Rio de Janeiro (Brazil). We included 110 people with psychosis in the study, who were recruited at the time of entry into community mental health clinics. Trial participants were randomly divided into CTI-TS intervention and usual care. Those allocated to the intervention group received usual care and, in addition, CTI-TS services over a 9-month period. Primary outcomes include quality of life (WHO Quality of Life Scale - Brief Version) and unmet needs (Camberwell Assessment of Needs) at the 18-month follow-up. Primary outcomes at 18 months will be analyzed by Generalized Estimating Equations (GEE), with observations clustered within sites. We will use three-level multilevel models to examine time trends on the primary outcomes. Similar procedures will be used for analyzing secondary outcomes. Our hope is that this trial provides a foundation for planning a large-scale multi-site RCT to establish the efficacy of recovery-oriented interventions such as CTI-TS in Latin America.

resumen está disponible en el texto completo

The Andes Mountains generate three hydrographic basins: The Pacific and the Atlantic basins, and the high elevation endorheic system of Lake Titicaca. In Peru, palm trees are largely diversified and documented in the eastern side of the Andes (Atlantic basin), in comparison to the Pacific basin, where the scarcity in the distribution of palm trees is evident before the extensive desert of Peru-Chile. This study seeks to inventory and determine the palm tree distribution in the Pacific basin of Peru. A bibliographical review and examination of herbarium collections from the study area where done, this was complemented with new specimens collected in the province of Santa Cruz (Cajamarca). A total of 7 species of palm trees were registered, distributed in 4 genera; genus Ceroxylon with greatest presence, with 4 species, followed by Geonoma, Chamaedorea and Aiphanes with one species each one. The species found in Cajamarca are: Ceroxylon quindiuense, C. parvifrons, C. parvum, C. vogelianum and Geonoma undata, and in Tumbes: Chamaedorea linearis and Aiphanes eggersii. A good representation of the Andean genera Ceroxylon is due to the dispersion and continuity or previous subcontinuity of the cloud forests with the inter-Andean slopes at Huancabamba deflection. Geonoma undata was registered in one location (Monteseco), but it is absent in nearby forests and isolated from populations of the eastern slopes. Aiphanes eggersii is an endemic palm tree of Tumbesian seasonally dry tropical forests shared by Peru and Ecuador, while Chamaedorea linearis is a species of wide Andean-Pacific distribution, with presence in subhumid montane forest of Tumbes. Amotape-Huancabamba deflection allowed a flow between the western and eastern slopes which explains the presence of palms species of the genera Ceroxylon and Geonoma; for Ceroxylon this biogeographic region was a place of speciation due to the presence of endemic species Ceroxylon parvum, C. peruvianum and C. quindiuense (Peruvian)

Los Andes generan tres cuencas hidrográficas: las vertientes del Pacífico, Atlántico y el sistema endorreico de altura del lago Titicaca. En Perú, las palmeras son mayormente diversificadas y documentadas en la vertiente oriental (cuenca atlántica), en comparación a la cuenca pacífica, donde la escasez en la distribución de palmeras es evidente ante el extenso desierto de Perú-Chile. El presente trabajo busca inventariar y determinar la distribución de las palmeras de la vertiente occidental de Perú. Se realizó revisión bibliográfica y de muestras de herbarios de la zona de estudio, completada por nuevas colectas de especímenes en las provincias de Santa Cruz y San Miguel (Cajamarca). Se registraron 7 especies de palmeras distribuidas en 4 géneros, siendo de mayor representatividad el género Ceroxylon, con 4 especies, seguido de Geonoma, Chamaedorea y Aiphanes con una especie cada uno. En Cajamarca se registró a Ceroxylon quindiuense, C. parvifrons, C. parvum, C. vogelianum y Geonoma undata, asimismo en Tumbes se registró a Chamaedorea linearis y Aiphanes eggersii. La representatividad del género andino Ceroxylon se debe a la dispersión y la continuidad o subcontinuidad pasada de los bosques nublados con la vertiente interandina en la deflexión de Huancabamba. Geonoma undata ha sido registrada en una sola localidad (Monteseco), ausente en bosques cercanos y aislada de las poblaciones de la vertiente oriental. Aiphanes eggersii es una palmera endémica de los bosques tropicales estacionalmente secos (BTES) de Tumbes compartidos por Perú y Ecuador, mientras que Chamaedorea linearis es una especie de amplia distribución andino- pacífica, con presencia en el bosque montano subhúmedo de Tumbes. La deflexión Amotape- Huancabamba permitió un flujo entre la vertiente occidental y oriental que explica la presencia de especies de palmeras de los géneros Ceroxylon y Geonoma; para Ceroxylon, esta región biogeográfica fue un lugar de especiación por la presencia de especies endémicas Ceroxylon parvum, C. peruvianum y C. quindiuense (peruana)