Evaluación de BIZI, nuevo programa en línea en español para prevenir el suicidio desde la comunidad / Evaluation of BIZI, a new Spanish-language online program for community-based suicide prevention / Avaliação do BIZI, um novo programa on-line em espanhol para prevenção de suicídio com base na comunidade

RESUMEN Objetivo. Evaluar el Programa BIZI, un programa de formación de guardianes o gatekeepers (GTK, por su sigla en inglés) en español y con un formato novedoso en línea, autocompletado, breve y de acceso libre desarrollado como parte de la estrategia de prevención de suicidio en Euskadi (España) para mejorar la prevención del suicidio desde entornos comunitarios. Métodos. Un grupo multicomponente de expertos creó el programa y probó su usabilidad en una fase preliminar. Para la evaluación se utilizó un diseño de grupo único y medidas repetidas (antes, posinmediato y a los tres meses). Se evaluó su impacto en las competencias GTK básicas con cuestionarios en línea, así como la adherencia a los contenidos y satisfacción. Se incluyeron en el estudio agentes comunitarios (educadores y trabajadores sociales, ente otros) que respondieron a una invitación enviada por los coordinadores comarcales de salud pública. Resultados. En total, 728 personas accedieron a la formación, y 86% la finalizó. Completaron la evaluación 569 personas (81,2% eran mujeres, la edad media fue de 41,4 años). Las competencias GTK básicas de actitud, autoeficacia y conocimiento mejoraron de manera significativa, y la mejora se mantuvo ≥ 3 meses en una submuestra (P = 0,0001). Conclusiones. Los resultados son prometedores y sugieren la utilidad de BIZI para mejorar la capacidad y la disposición de agentes comunitarios para identificar a personas en riesgo y derivarlos a recursos especializados. Su formato novedoso le confiere ventajas importantes respecto de otros formatos GTK más habituales, y facilita su difusión en entornos de escasos recursos. Es el primer programa de este tipo cuya eficacia ha sido demostrada y también el primero disponible en español.

ABSTRACT Objective. To evaluate the BIZI program, a Spanish-language gatekeeper training program with a novel online self-learning format that is brief and open-access. It was developed as part of the suicide prevention strategy in Euskadi (Spain) to improve community-based suicide prevention. Methods. A group of experts from different fields created the program and tested its usability in a preliminary phase. A single-group design was used for the evaluation, with repeated measurements (before, immediately after, and after three months). Online questionnaires were used to evaluate the program's impact on core competencies for gatekeepers, as well as adherence to content and user satisfaction. Community agents (educators and social workers, among others) who responded to an invitation sent by regional public health coordinators were included in the study. Results. In total, 728 people accessed the training, and 86% completed it; 569 people completed the assessment (81.2% women, mean age 41.4 years). The core gatekeeper competencies of attitude, self-efficacy, and knowledge improved significantly, and improvement was sustained ≥3 months in a subsample (P = 0.0001). Conclusions. The results are promising and suggest that BIZI is useful in improving the capacity and willingness of community agents to identify people at risk and refer them to specialized resources. Its novel format gives it important advantages over other more common gatekeeper training programs, facilitating its dissemination in low-resource environments. It is the first program of its kind whose effectiveness has been demonstrated and also the first available in Spanish.

RESUMO Objetivo. Avaliar o Programa BIZI, um programa de capacitação de gatekeepers em espanhol com um formato inovador on-line autoinstrucional, breve e de livre acesso, desenvolvido como parte da estratégia de prevenção de suicídio em Euskadi (Espanha) para melhorar a prevenção de suicídio em ambientes comunitários. Métodos. O programa foi desenvolvido por um grupo multidisciplinar de especialistas, e sua usabilidade testada em uma fase preliminar. Para a avaliação, foi utilizado um delineamento de grupo único e medidas repetidas (antes, imediatamente após e aos três meses). Foram utilizados questionários on-line para avaliar o impacto sobre as competências básicas do gatekeeper, a adesão ao conteúdo e a satisfação. Fizeram parte do estudo os agentes comunitários (educadores e assistentes sociais, entre outros) que responderam a um convite enviado pelos coordenadores de saúde pública da comarca. Resultados. O programa de capacitação foi acessado por 728 pessoas e concluído por 86% delas. Um total de 569 pessoas concluiu a avaliação (81,2% do sexo feminino, idade média de 41,4 anos). As competências básicas do gatekeeper relativas a atitude, autoeficácia e conhecimento melhoraram significativamente, e essa melhoria se manteve em uma subamostra por um período de 3 meses ou mais (P = 0,0001). Conclusões. Os resultados são promissores e indicam a utilidade do BIZI para melhorar a capacidade e a disposição dos agentes comunitários para identificar pessoas em situação de risco e encaminhá-las para recursos especializados. Seu formato inovador confere vantagens importantes em relação a outros programas de gatekeeper mais comuns e facilita sua disseminação em ambientes com poucos recursos. Esse é o primeiro programa desse tipo com eficácia comprovada, além de ser o primeiro disponível em espanhol.

Usefulness, Reliability, Quality, and Content of Portuguese Language YouTube Videos on COVID-19

Abstract Objective: To investigate the usefulness, reliability, quality, and content of Portuguese-language YouTube videos on COVID-19. Material and Methods: Three keywords selected on Google Trends were searched on YouTube, and the 60 first videos listed with each term were analyzed. Two calibrated researchers evaluated the reliability (DISCERN Modified Scale), the quality (Global Quality Score - GQS), and the usefulness of videos for the users (COVID-19 Specific Score - CSS). The number of views, likes, and engagement were also analyzed. The data were evaluated by the Mann-Whitney test and Spearman correlation (α=5%). Results: 59 videos were included. The average scores of quality, reliability, and usefulness were 3.0 (±1.1), 3.2 (± 0.8), and 1.5 (± 0.9), respectively. Two-thirds of the videos (64.4%) had low/moderate quality, and the majority (76.2%) were about signs and symptoms. The numbers of views (p=0.005), likes (p=0.006), and engagement (p=0.014) were significantly higher in moderate/good quality videos. The number of comments (p=0.007), duration of videos (p=0.004), and the DISCERN score (p<0.001) were significantly higher in videos made by health professionals. The general quality of the videos was positively correlated to the CSS scores, number of views, likes, and engagement (p<0.05). Conclusion: Most videos had moderate quality and reliability and low usefulness for the users.

Aplicaciones móviles para el autoaprendizaje en el cuidador del adulto mayor con accidente cerebrovascular: Revisión integradora / Mobile applications for self-learning in the caregiver of the elderly with stroke: integrative review

Resumen Objetivo: Analizar la evidencia disponible en la literatura sobre intervenciones con aplicaciones móviles para favorecer el autoaprendizaje de atención y asistencia en el cuidador primario del adulto mayor, con secuelas físicas de accidente cerebrovascular. Material y Métodos: Revisión integradora de la literatura publicada entre Enero de 2018 y Junio 2022 en las bases de datos CINAHL, EMBASE, LILACS, PubMed, Scopus y EBSCOhost. Los datos obtenidos se analizaron en cuatro etapas: identificación del tema, muestreo, selección y categorización de estudios y análisis, evaluación e interpretación de resultados bajo el método CASPe. Resultados: 2 fueron cualitativos y 1 cuantitativo; las intervenciones digitales fueron: mHealth, Movies4Stroke y MoCaB utilizadas para el autoaprendizaje y asistencia en el cuidador primario en las dimensiones control de la presión arterial, glucosa, colesterol y adherencia farmacológica. Las intervenciones educativas digitales aumentan el autoaprendizaje y facilita la atención en el cuidador del adulto mayor con secuelas físicas por accidente cerebrovascular. Conclusiones: Las intervenciones educativas digitales para el autoaprendizaje y asistencia en el cuidador primario desde la evidencia científica son mínimas. Es necesario diseñar intervenciones digitales accesibles, dinámicas y de fácil interacción para el autoaprendizaje en la generación de habilidades de cuidados en el encargado primario del adulto mayor con secuelas físicas post accidente cerebrovascular.

Abstract Objective: To analyze the evidence available in the literature on interventions with mobile applications to promote self-learning of care and assistance in the primary caregiver of the elderly with physical sequelae of stroke. Material and Methods: Integrative review of the literature published between January 2018 and June 2022 in the CINAHL, EMBASE, LILACS, PubMed, Scopus and EBSCOhost databases. The data obtained was analyzed in four stages: theme identification, sampling, selection and categorization of studies and analysis, evaluation and interpretation of results under the CASPe method. Results: 2 were qualitative and 1 quantitative; the digital interventions were: mHealth, Movies4Stroke and MoCaB used for self-learning and assistance in the primary caregiver in the dimensions of blood pressure control, glucose, cholesterol and pharmacological adherence. Digital educational interventions increase self-learning and facilitate care in the caregiver of the elderly with physical sequelae due to stroke. Conclusions: Digital educational interventions for self-learning and assistance in the primary caregiver from the scientific evidence are minimal. It is necessary to design accessible, dynamic and easy-to-interact digital interventions for self-learning in the generation of care skills in the primary caregiver of the elderly with post-stroke physical sequelae.

Perfil Biossociodemográfico e Digital de Participantes de uma Intervenção Educativa Online sobre Colostomia / Biosociodemographic and Digital Profile of Participants in an Online Educational Intervention on Colostomy / Perfil Biosociodemográfico y Digital de los Participantes en una Intervención Educativa Online Sobre Colostomía

Objetivo:Identificar o perfil biossociodemográfico e digital das pessoas com colostomia e dos cuidadores que participaram da intervenção educativa online sobre colostomia. Método: Estudo transversal realizado com 20 pessoas com colostomia e 32 cuidadores, no período de setembro/novembro de 2020, em um centro integrado de saúde de Teresina, Piauí. Utilizaram-se instrumentos de caracterização sociodemográfica e clínica, acesso ao computador e à internet e proficiência digital básica, todos submetidos à análise estatística. Resultados: Das pessoas com colostomia e cuidadores, 60% eram do sexo masculino e 75% do feminino. Predominou a colostomia temporária (55%) de cor vermelho vivo e formato regular (80%). A maioria dos cuidadores tinha ocupação laboral (46,9%), e 8 horas/semanais eram dedicadas ao cuidado. O grau de proficiência digital foi baixo (76,9%). Conclusão: A identificação do perfil biossociodemográfico e digital dos participantes pode contribuir na adoção de estratégias educativas conforme a maturidade digital ou a necessidade de suporte para o uso de tecnologias, para otimização do cuidado em saúde e qualificação da assistência prestada.

Objective:To identify the biosociodemographic and digital profile of people with colostomy and caregivers who participated in the online educational intervention on colostomy. Method: Cross-sectional study carried out with 20 people with colostomy and 32 caregivers, in the period of September/November 2020, in an integrated health center in Teresina, Piauí, Brazil. Sociodemographic and clinical characterization instruments, computer and internet access, and basic digital proficiency submitted to statistical analysis were used. Results: Among people with colostomy and caregivers, 60% were male and 75% female. Temporary colostomy (55%) with bright red color and regular shape (80%) predominated. Most caregivers had a job (46.9%), and 8 hours/week were dedicated to care. The degree of digital proficiency was low (76.9%). Conclusion: The identification of the biosociodemographic and digital profile of the participants can contribute to the adoption of educational strategies according to digital maturity or the need for support for the use of technologies, to optimize health care and qualify the assistance provided.

Objetivo:Identificar el perfil biosociodemográfico y digital de personas con colostomía y cuidadores que participarían de la intervención educativa en línea sobre colostomía. Método: Estudio transversal, realizado con 20 personas con colostomía y 32 cuidadores, en el período de septiembre/noviembre de 2020, en un Centro Integrado de Salud de Teresina, Piauí. Se utilizaron instrumentos de caracterización sociodemográfica y clínica, acceso a computador e internet y competencia digital básica sometidos a análisis estadístico. Resultados: La mayoría de las personas con colostomía y cuidadores eran hombres (60%) y mujeres (75%), respectivamente. Predominó la colostomía temporal (55%) de color rojo vivo y forma regular (80%). La mayoría de los cuidadores tenían trabajo (46,9%), y se dedicaban al cuidado 8 horas/semana. El grado de competencia digital fue bajo (76,9%). Conclusión: La identificación del perfil biosociodemográfico y digital de los participantes puede contribuir para la adopción de estrategias educativas de acuerdo con la madurez digital o la necesidad de apoyo para el uso de tecnologías, para optimizar la atención en salud y calificar la asistencia brindada

Inventando cuidados em tempo de pandemia: relato de experiência / Inventing care in a time of a pandemic: experience report / Inventar el cuidado en tiempos de pandemia: informe de experiencia

Durante a pandemia de Covid-19, ações grupais de cuidado realizadas nos cursos de formação superior brasileiros tiveram de ser adaptadas para o ambiente virtual. Apresenta-se a experiência formativa realizada em 2020 por alunos da Universidade Federal de São Paulo juntamente com um grupo de mulheres em situação de vulnerabilidade, participantes do "Projeto Delicadas Coreografias", um projeto de extensão de cuidado em saúde por meio de práticas corporais. Considerando o sofrimento causado pelo momento pandêmico e as barreiras comunicacionais de acesso vivido pelos estudantes e pelas mulheres, foram realizados encontros remotos na busca de promover cuidado a partir da produção de um espaço de confiança, que fosse também lúdico, vincular e inventivo. Os encontros no ambiente virtual permitiram dar visibilidade e dizibilidade a processos singulares, configurando, então, em outros modos de produzir cuidado e tecer uma formação em saúde em tempos de pandemia.(AU)

Durante la pandemia de Covid-19, las acciones de atención grupal realizadas en los cursos de educación superior brasileña tuvieron que adaptarse al entorno virtual. Presentamos la experiencia formativa realizada en 2020 por estudiantes de la Universidad Federal de São Paulo, campusBaixada Santista junto a un grupo de mujeres en situación de vulnerabilidad, participantes del "Proyecto Delicadas Coreografias", un proyecto de extensión del cuidado de la salud a través de prácticas corporales. Considerando el sufrimiento causado por elmomento de la pandemiay las barreras comunicacionales de acceso que viven estudiantes y mujeres, se realizaron encuentros a distancia en la búsqueda de promover el cuidado a partir de la producción de un espacio de confianza, también lúdico, vinculante e inventivo. Los encuentros en el ambiente virtual permitieron dar visibilidad y deciridad procesos singulares, configurándose, entonces, en otras formas de producir cuidado y tejer una educación en salud en tiempos de pandemia. (AU)

During the Covid-19 pandemic, group care actions carried out in Brazilian higher education courses had to be adapted to the virtual environment. We present the training experience carried out in 2020 by students from Federal University of São Paulo, campusBaixada Santista together with a group of women in situations of vulnerability, participants of the "Project Delicates Choreographies", a project to extend health care through corporeal practices. Considering the suffering caused by the pandemic moment and the communicational barriers of access experienced by students and women, remote meetings were held in the search to promote care from the production of a space of trust, which was also playful, bonding and inventive. The meetings in the virtual environment allowed to give visibility and sayability to singular processes, configuring, then, in other ways of producing care and weaving a health education in times of pandemic. (AU)

Stress levels and coping strategy of nursing students in online learning during COVID-19 Pandemic. A mixed-methods study / Nivel de estrés y estrategias de afrontamiento de los estudiantes de enfermería por el aprendizaje en línea durante la pandemia COVID-19. Un estudio de métodos mixtos / Nível de estresse e estratégias de enfrentamento de estudantes de enfermagem devido ao aprendizado online durante a pandemia de COVID-19. Um estudo de métodos mistos

Objective. To explain the stress level and coping strategies of nursing students in online learning during Covid-19 pandemic. Methods. Explanatory sequential mixed method QUAN-QUAL study conducted at a private university in Bandung, Indonesia. Of the 260 nursing students, 157 consented to participate and answered a Depression Anxiety Scale-42 (DDAS-42) and The Ways of Coping in the Indonesian version. The participants of the quantitative phase with the indicative of stress were interviewed individually (n=17) to provide an in-depth understanding of the students' experiences of stress and coping strategy in online learning. Results. Almost one out of two students (47.1%) had some level of stress (16% between severe and extremely severe). Most nursing students (45.9%) used emotion focused coping strategies. Stress level was significantly higher among female students and internship academic level (p<0.05). Nursing students' sources of stress were new experiences and hindrances to online learning. Coping strategies included seeking support and positive acceptance. Conclusion. A high proportion of nursing students experienced stress during their education process in COVID-19 times; they used specially emotion-focused coping strategies to reduce barriers to online learning.

Objetivo. Describir el nivel de estrés y las estrategias de afrontamiento de los estudiantes de enfermería en el aprendizaje en línea durante la pandemia de Covid-19. Métodos. Estudio secuencial de método mixto QUAN-QUAL realizado en una universidad privada de Bandung, Indonesia. De los 260 estudiantes de enfermería, 157 consintieron en participar y respondieron las escalas de Depresión y Ansiedad-42 (DDAS-42) y la de Formas de Afrontamiento. Se entrevistó individualmente a los participantes que en la fase cuantitativa mostraron indicios de estrés (n=17) para conocer en profundidad sus experiencias y las estrategias de afrontamiento empleadas. Resultados. Casi uno de cada dos estudiantes (47.1%) presentó algún nivel de estrés (16% entre severo y extremadamente severo). El 45.9% de los estudiantes utilizo estrategias de afrontamiento centradas en las emociones. El nivel de estrés fue significativamente mayor en el sexo femenino y en el nivel académico de internado (p<0.05). Las fuentes fueron las nuevas experiencias y los obstáculos para el aprendizaje en línea. Las estrategias de afrontamiento incluyeron la búsqueda de apoyo y la aceptación positiva. Conclusión. Una alta proporción de estudiantes de enfermería experimentó estrés durante su proceso de formación en tiempos de COVID-19, ante lo cual utilizó estrategias de afrontamiento centradas en las emociones para reducir las barreras al aprendizaje en línea

Objetivo. Descrever o nível de estresse e as estratégias de enfrentamento de estudantes de enfermagem no ensino online durante a pandemia do Covid-19. Métodos. Estudo sequencial de método misto QUAN-QUAL realizado em uma universidade particular em Bandung, Indonésia. Dos 260 estudantes de enfermagem, 157 consentiram em participar e responderam às escalas de Depressão e Ansiedade-42 (DDAS-42) e Formas de Enfrentamento. Os participantes que na fase quantitativa apresentaram sinais de estresse foram entrevistados individualmente (n=17) para conhecer a fundo as experiências de estresse e as estratégias de enfrentamento utilizadas. Resultados. Quase um em cada dois alunos (47.1%) apresentou algum nível de estresse (16% entre grave e extremamente grave). 45.9% dos alunos usaram estratégias de enfrentamento focadas na emoção. O nível de estresse foi significativamente maior no sexo feminino e no nível acadêmico do internato (p<0.05). As fontes de estresse dos estudantes de enfermagem foram novas experiências e obstáculos para o aprendizado online. As estratégias de enfrentamento incluíram a busca de apoio e aceitação positiva. Conclusão. Uma alta proporção de estudantes de enfermagem experimentou estresse durante seu processo de formação em tempos de COVID-19, para os quais eles usaram especialmente estratégias de enfrentamento focadas na emoção para reduzir as barreiras ao aprendizado online.

Construction of intervention program for physical and mental adjustment for primary caregivers of cancer patients based on network cognitive behavior therapy / 中国实用护理杂志

Objective:Based on cognitive behavioral therapy, to construct a physical and mental adjustment intervention plan for the main caregiver of cancer patients through the network platform.Methods:Through evidence-based literature published from July 2012 to July 2022 screening and evaluation, combined with qualitative interviews for 10 primary caregivers of cancer patients, the intervention plan for physical and mental adjustment of the main caregivers of cancer patients was preliminarily formulated. After consultation with Delphi experts (15 cases) through two rounds, the intervention plan was finally determined.Results:In the two rounds of expert letter inquiries, 15 questionnaires were distributed and 15 valid questionnaires were recovered. The effective recovery rate was 100.00% and the expert authority coefficient were 0.89 and 0.90 in the two rounds of expert letter inquiries respectively, the Kendall harmony coefficients were 0.279 and 0.323 respectively, and the differences were all statistically significant ( P<0.01). The intervention plan for physical and mental adjustment ofthe main caregivers of cancer patients included 5 first-level indicators (basic knowledge, symptom education, home care knowledge, relaxation training, social support), 27 second-level indicatorsand 54 third-level indicators. Conclusions:The method of the psychosomatic regulation intervention program is scientific and practical, which can be initially applied to the psychological adjustment of the main caregivers of cancer patients, so as to provide a reference for improving their negative emotions.

Desenvolvimento de sistema baseado na internet para orientação e telemonitoramento de usuários de prótese auditiva / Development of an Internet-based system to guide and telemonitor hearing aid users

RESUMO Objetivo Desenvolver e verificar a usabilidade de um sistema baseado na internet para telemonitoramento e orientação do usuário de prótese auditiva bem como monitorar o desempenho de longo prazo em um grupo piloto. Método O sistema Escuto, mas não entendo foi desenvolvido baseado em recomendações de literatura para layout, design e conteúdo de orientação e aconselhamento. Seguimos três etapas: planejamento, elaboração do design e conteúdo e teste piloto. A amostra foi formada por 43 adultos e idosos, com perda auditiva, de qualquer tipo e grau, uso regular de prótese auditiva de no mínimo 30 dias e no máximo 24 meses; com habilidade de leitura e sem evidências de comprometimentos cognitivos. Os indivíduos foram acompanhados por um período de oito a 12 meses. O desempenho dos usuários foi monitorado por meio do questionário Speech Spatial and Qualities of Hearing Scale. A usabilidade deste material foi avaliada com o questionário System Usability Scale. Resultados Foi observada melhora de desempenho e aumento de uso diário autorrelatado das próteses auditivas após o período de orientação e telemonitoramento via sistema para todos os participantes da pesquisa. Em todas as análises da escala SUS foi possível observar o desempenho superior a 70 pontos, demonstrando a boa usabilidade do sistema. Na análise do desempenho do SSQ, nos três momentos da pesquisa, observou-se resposta positiva em todos os domínios, mostrando assim uma evolução com o uso das próteses auditivas, com dados significantes para o domínio Audição para a fala. Conclusão A usabilidade do sistema foi considerada adequada pelos indivíduos participantes do estudo.

ABSTRACT Purpose To develop and verify the usability of an internet-based system for telemonitoring and guidance of the hearing aid user as well as monitoring the long-term performance in a pilot group. Methods The system "I can hear, but I can't understand" was developed based on recommendations in the literature regarding layout, design, and content for guidance and advice. Three stages were followed: planning, design and content development, and pilot testing. The sample consisted of 43 adults and older adults with any type and degree of hearing loss, who had been regularly using a hearing aid for at least 30 days and at most 24 months, with reading skills and no evidence of cognitive impairments. The individuals were followed up for 8 to 12 months. The users' performance was monitored with the Speech, Spatial and Qualities of Hearing Scale. The usability of this material was assessed with the System Usability Scale. Results Improved performance and increased self-reported daily use of the hearing aid were observed after the period of guidance and telemonitoring via the system for all research participants. In all analyzes of the SUS scale, it was possible to observe a performance superior to 70 points, demonstrating good usability of the system. In the analysis of the performance of the SSQ, in the three moments of the research, a positive response was observed in all domains, thus showing progress in the use of hearing aids, with significant data for the domain of Hearing Speech. Conclusion The system "I can hear, but I can't understand" proved to be an easy-to-use and effective tool to telemonitor hearing aid users.

Efeito de uma ação de aconselhamento nutricional, com uso de rede social, no enfrentamento à obesidade / Effect of a nutritional counseling activities, by using a social network, in coping with obesity

Estratégias inovadoras precisam ser adotadas para o combate à crescente prevalência de obesidade. Assim, o objetivo desse trabalho é avaliar o efeito de uma ação de aconselhamento nutricional com uso de rede social no enfrentamento à obesidade. Este é um estudo experimental do tipo antes e depois, incluindo 60 indivíduos com excesso de peso e adscritos a uma Unidade Básica de Saúde. Foi realizado de junho-outubro de 2020. As ações educativas (compartilhamento de informações sobre alimentação saudável e saúde e pactuação de desafios) foram realizadas pelo aplicativo WhatsApp®, semanalmente, por 16 semanas. Foram coletadas informações sociodemográficas, econômicas, clínicas, antropométricas, sobre consumo alimentar e exames bioquímicos. Os dados foram comparados por teste de Wilcoxon ou Kappa. A maioria dos participantes era do sexo feminino e 36,4% com diagnóstico de hipertensão. Após a intervenção, verificou-se redução de circunferência da cintura (antes:107,3±11,4; depois:105,6±11,5 cm, p=0,004), colesterol total (antes:205,9±48,3; depois:191,5±34,3 mg/dL, p<0,001) e LDL-c (antes:132,4±37,8; depois:120,2±29,3 mg/dL, p<0,001). A ação foi capaz de promover reduções de marcadores corporais de obesidade e de descompensações metabólicas associadas a obesidade, demonstrando a importância de intervenções inovadoras que possam somar a outras intervenções e facilitar a adesão do público.

Innovative strategies need to be adopted to combat the growing prevalence of obesity. Thus, the aim of this study is to evaluate the effect of a nutritional counseling activity using a social network in coping with obesity. This is a before-and-after experimental study, including 60 overweight individuals enrolled in a Primary Care Center. It was carried out from June to October 2020. Educational actions (sharing information about healthy eating and health and agreeing on challenges) were carried out through the WhatsApp® application, weekly, for 16 weeks. Sociodemographic, economic, clinical, anthropometric, food consumption, and biochemical data were collected. Data were compared by the Wilcoxon or Kappa test. Most participants were female and 36.4% had a diagnosis of hypertension. After the intervention, there was a reduction in waist circumference (before:107.3±11.4; after:105.6±11.5 cm, p=0.004), total cholesterol (before:205.9±48, 3; after:191.5±34.3 mg/dL, p<0.001), and LDL-c (before:132.4±37.8; after:120.2±29.3 mg/dL, p<0.001). The activity was able to promote reductions in body markers of obesity and metabolic imbalances associated with obesity, demonstrating the importance of innovative interventions that can add to other interventions and facilitate public adherence.

Association between the Mediterranean Diet Index and self-reported Gingival Health Status Indicators in a population of Chilean adults: a cross-sectional study

Abstract Despite the recognized impact of diet on non-communicable diseases, the association between the Mediterranean diet and periodontal diseases is still uncertain. This study aimed to determine the association between adherence to the Mediterranean Diet Index (MDI) and self-reported gingival health status in Chilean adults, exploring the feasibility of using validated web-based survey questionnaires. Methodology Cross-sectional data were collected from a representative sample of a population of Chilean adults (18-60 years old) using a low-cost and time-saving methodology. By the PsyToolkit platform, anonymous survey data were downloaded and analyzed in bivariate (crude) and backward stepwise selection multivariate logistic regression models adjusted for sociodemographic determinants, smoking, and dental attendance using STATA 17. Odds ratios (OR) [95% confidence intervals] were estimated. Results In total, 351 complete statistical data were mostly obtained from female university students who had never smoked and reported having visited a dentist in the previous year. Multivariate regression models showed an association between MDI and very good/good gingival health status (OR 1.18 [95% CI 1.04-1.34], p=0.013), absence of bleeding on toothbrushing (OR 1.12 [95% CI 1.01-1.25], p=0.035), and absence of clinical signs of gingival inflammation (OR 1.24 [95% CI 1.10-1.40], p<0.001), after controlling for age, sex, educational level, smoking, and dental attendance. Conclusions We associated adherence to the Mediterranean diet with better self-reported gingival health status in a population of Chilean adults in an entirely web-based research environment. Longitudinal studies with random sampling are required to establish the effect of diet on gingival and periodontal health. Nevertheless, this evidence could contribute to the design of low-cost surveillance programs to reduce the burden of periodontal disease and related "common risk factors".

Evidências tecnológicas para assistência ambulatorial e domiciliar em urologia pediátrica: revisão de escopo / Technological evidence for outpatient and home care in pediatric urology: a scoping review

RESUMO Objetivo mapear as evidências sobre as tecnologias baseadas na internet e sua aplicabilidade no cuidado ambulatorial e domiciliar em urologia pediátrica. Métodos trata-se de revisão de escopo, com buscas conduzidas em seis bases de dados, sem limite de tempo, nos idiomas português, inglês e espanhol. Resultados 2.200 artigos foram obtidos, sendo 19 publicações elegíveis para a amostra final. As tecnologias baseadas na internet mais utilizadas foram telessaúde e telemedicina (47,3%), programas de intervenção online (21,0%) e aplicativos móveis (15,8%), com uma taxa menor de uso de serious game s, mídias sociais e vídeos de micção (5,3%), majoritariamente no contexto domiciliar. Conclusão o mapeamento das evidências tecnológicas na assistência ambulatorial e domiciliar em urologia pediátrica permitiu identificar os tipos de tecnologia e suas aplicações voltadas para o autogerenciamento dos sintomas e autoeficácia, para o monitoramento e acompanhamento do cuidado urológico. Contribuições para a prática: as evidências sintetizadas contribuem para uma prática profissional expandida, qualificada e inovadora junto à população pediátrica com sintomas urinários e intestinais, características relacionadas a uma prática avançada de enfermagem, além de favorecer diagnóstico precoce e maior adesão terapêutica, particularmente por apoiar intervenções personalizadas às necessidades do paciente pediátrico e sua família.

ABSTRACT Objective to map the evidence on web-based technologies and their applicability in outpatient and home care in pediatric urology. Methods this is a scoping review, with searches conducted in six databases, with no time limit, in Portuguese, English, and Spanish. Results 2,200 articles were obtained, with 19 publications eligible for the final sample. The most used web-based technologies were telehealth and telemedicine (47.3%), online intervention programs (21.0%), and mobile apps (15.8%), with a lower rate of use of serious games, social media, and urination videos (5.3%), mostly in the home setting. Conclusion the mapping of technological evidence in outpatient and home care in pediatric urology allowed us to identify the types of technology and their applications focused on self-management of symptoms and self-efficacy, for monitoring and follow-up of urologic care. Contributions to practice: the synthesized evidence contributes to an expanded, qualified, and innovative professional practice with the pediatric population with urinary and bowel symptoms, characteristics related to advanced nursing practice, in addition to favoring early diagnosis and greater therapeutic adherence, particularly by supporting interventions tailored to the needs of the pediatric patient and his family.

Infodemiologia sobre protocolos de automonitoramento da glicemia capilar na internet brasileira / Infodemiology on capillary blood glucose self-monitoring protocols on the Brazilian internet

A Automonitoramento da Glicemia Capilar (AMGC) é importante ferramenta no controle da glicemia e no manejo do Diabetes mellitus (DM) e os protocolos de dispensação de insumos são orientados por diretrizes de tratamento e regulamentações específicas. O objetivo desse estudo infodemiológico foi analisar as publicações na internet brasileira sobre protocolos AMGC por Secretarias Municipais e/ou Estaduais de saúde disponíveis em websites brasileiros. Para a busca foi utilizada a ferramenta Google e identificadas 286 URL. A pesquisa identificou 23 protocolos disponíveis em sites governamentais, revelando sendo que 10 (43,47%) são da região Sudeste, todos os protocolos definiram o diagnóstico de Diabetes mellitus (DM) tipo 1, DM tipo 2 em uso de insulina e DM gestacional (DMG), em 11 protocolos (47.8%) o fornecimento mensal de tiras de glicemia capilar é realizado pela farmácia e a quantidade variou de 30 até 120 tiras conforme o tipo de diabetes e uso de insulina. Os protocolos analisados enfatizam a importância da educação em DM, com 60,8% deles incorporando programas educacionais. Apesar da dinamicidade da informação na internet ressaltase a necessidade de transparência nos critérios de inclusão e manutenção do fornecimento das TGC, qualificando o cuidado ao paciente com DM. A elaboração e divulgação de protocolos fortalecem a transparência do SUS, auxiliam na organização dos fluxos de documentos entre os profissionais envolvidos e o acesso equitativo aos insumos.

Self-Monitoring of Blood Glucose (SMBG) is an important tool in controlling blood glucose and managing Diabetes mellitus (DM) and input dispensing protocols are guided by treatment guidelines and specific regulations. The objective of this infodemiological study was to analyze publications on the Brazilian internet about SMBG protocols by Municipal and/or State Health Departments available on Brazilian websites. For the search, the Google tool was used and 286 URLs were identified. The research identified 23 protocols available on government websites, revealing that 10 (43.47%) are from the Southeast region, all protocols defined the diagnosis of Diabetes mellitus (DM) type 1, type 2 DM using insulin and gestational DM (GDM), in 11 protocols (47.8%) the monthly supply of capillary blood glucose test strips is provided by the pharmacy and the quantity varies from 30 to 120 strips depending on the type of diabetes and insulin use. The protocols analyzed emphasize the importance of DM education, with 60.8% of them incorporating educational programs. Despite the dynamics of information on the internet, the need for transparency in the inclusion criteria and maintenance of the supply of BGTS is highlighted, qualifying care for patients with DM. The development and dissemination of protocols strengthens the transparency of the SUS, assists in the organization of document flows between the professionals involved and equitable access to inputs.

Efficacy of iSupport-Brasil for unpaid caregivers of people living with dementia: protocol for a randomized and controlled clinical trial / Eficácia do iSupport-Brasil para cuidadores informais de pessoas que vivem com demência: protocolo de um ensaio clínico randomizado e controlado

ABSTRACT. Unpaid caregivers of people living with dementia tend to suffer mental health problems as a result of the negative effects associated with the care tasks. Thus, psychosocial interventions for this population group are necessary. iSupport is an online support program for caregivers that was created by the World Health Organization. Objective: To describe the design of a randomized clinical trial to measure the efficacy of the iSupport-Brasil version on caregivers' mental health and well-being. Methods: The participants will be randomized into Intervention Group (IG) (n=195) and Control Group (CG) (n=195). For three months, the IG will access the iSupport-Brasil platform, the CG will enter the electronic page of the Brazilian Alzheimer's Association, and both groups will be emailed the preliminary version of the "Guia de cuidados para a pessoa idosa" e-book (a guide to providing care to the elderly) from the Ministry of Health. The data will be collected at three moments: baseline, and three and six months after the beginning of the intervention. Results: It is expected that it will be possible to provide diverse validity evidence about iSupport-Brasil as an online and free intervention alternative, as a preventive means and as a way to promote mental health among caregivers of people living with dementia. Conclusion: Through the evaluation protocol of this randomized clinical trial on the effects of the iSupport-Brasil program, it may become a reference for countries that plan to adapt and improve the iSupport program using digital health solutions.

RESUMO. Cuidadores informais de pessoas que vivem com demência tendem a sofrer problemas de saúde mental como resultado dos efeitos negativos associados às tarefas de cuidado. Assim, intervenções psicossociais para essa população são necessárias. O iSupport é um programa de apoio online para cuidadores criado pela Organização Mundial da Saúde. Objetivo: Descrever o desenho de um ensaio clínico randomizado para medir a eficácia da versão iSupport-Brasil na saúde mental e no bem-estar de cuidadores. Métodos: Os participantes serão randomizados em Grupo Intervenção (GI) (n=195) e Grupo Controle (GC) (n=195). Durante três meses, o GI acessará a plataforma iSupport-Brasil, o CG entrará na página eletrônica da Associação Brasileira de Alzheimer e ambos os grupos receberão por e-mail a versão preliminar do e-book Guia de cuidados para a pessoa idosa, do Ministério da Saúde. Os dados serão coletados em três momentos: linha de base, três e seis meses após o início da intervenção. Resultados: Espera-se que seja possível fornecer diversas evidências sobre os efeitos do iSupport-Brasil como alternativa de intervenção online e gratuita, de forma a promover a saúde mental entre os cuidadores de pessoas que vivem com demência. Conclusão: O protocolo de avaliação deste ensaio clínico randomizado sobre os efeitos do programa iSupport-Brasil pode se tornar uma referência para os países que planejam adaptar e melhorar esta intervenção, usando soluções digitais de saúde.

Internet-based group cognitive behavioral therapy for depression and anxiety symptoms / 四川精神卫生

This paper presents a systematic review of extant research investigating the effectiveness of Internet-based group cognitive behavioral therapy （IGCBT） for depression and anxiety symptoms with an emphasis on the treatment modalities， treatment protocols， efficacy and mechanism， together with a summary of research limitations and suggestions for future research. Cognitive behavioral therapy （CBT） is a structured， short-term and present-oriented psychotherapeutic treatment， its Internet- and group-delivered modalities have led to its wider application， and has proven to be clinically effective in alleviating depression and anxiety symptoms caused by different diseases， whereas some drawbacks have been reported. Thus this paper elaborates the clinical application， therapeutic effect and underlying mechanisms of IGCBT intervention for depression and anxiety symptoms， so as to provide references for its future application. ［Funded by the Natural Science Foundation of the Inner Mongolia Autonomous Region （number， 2019MS03038）

Evaluation on quality of internet-based reporting of COVID-19 in Ningxia, 2020-2021 / 中国热带医学

@#Abstract: Objective　To find out the existing problems and provide reference for further improving the quality of report information by analyzing the report cards of COVID-19 and the positive report cards of primary screening reported in Ningxia. Methods　All COVID-19 case cards from 2020 to 2021 and initial screening positive cards were derived from the Chinese Information System for Disease Control and Prevention according to final review date. The timeliness of case reporting, timeliness of case review, completeness and accuracy of the case cards were analyzed. Results　In Ningxia, the first case of COVID-19 was reported on January 20, 2020, and as of December 31, 2021, 122 confirmed cases and 4 symptomatic infected cases were reported. In 2021, the timely reporting rate of COVID-19 was 98.00%, which increased by 8.24% compared with 2020 (90.54%). Compared with 2020, the average time limit for diagnosis to reporting of COVID-19 in 2021 was shortened by 83.12%; in 2021, the timely review rate of COVID-19 was 100.00%, which increased by 13.84% compared with 2020 (87.84%). Compared with 2020, the time from reporting to final review was shortened by 98.91%. In 2021, the timely rate of positive reports in COVID-19 in Ningxia was 90.00%, among which the timely rate of reports by county (district) nucleic acid detection institutions was the highest (92.31%), followed by municipal (91.67%) and autonomous region (81.82%). Conclusions　At the beginning of the epidemic in 2020, the timeliness of COVID-19 in Ningxia was poor, and through the implementation of measures such as technical training, supervision and inspection to continuously optimize the staffing of medical institutions and disease control institutions, the timeliness of reporting COVID-19 in Ningxia in 2021 was substantially improved, but there were still some weak links. In the future work, technical guidance and training should be carried out for weak links, and efforts should be made to improve the quality of reports.

Internet-Based Self-Care Monitoring Among Diabetes Mellitus Patients During The Covid-19 Pandemic: A Systematic Scoping Review

@#The COVID-19 pandemic affects blood glucose control in patients with type 2 diabetes mellitus (type 2 DM). Internet-based interventions show great potential in type 2 DM patients care. The aim of the study is to identify internet-based self-care monitoring interventions in type 2 DM patients during the COVID-19 pandemic. Using a systematic scoping review of PubMed, CINAHL, SAGE Journals, and ScienceDirect spanning 2019-2022, full-text articles, and randomized controlled trials. Study quality was assessed using the Joanna Briggs Institute (JBI) appraisal tool. Overall, 12 studies revealed that the internet was effectively used for self-care monitoring in type 2 DM patients during the COVID-19 pandemic such as to monitor blood sugar, diet, physical activity, drug use, problem solving, and dealing with stress, including mobile health (applications), web, telephone, and SMS (Short Message Service). Our finding highlights internet-based self-care monitoring can be a model of nursing intervention to prevent and increase the quality of life in DM patients.

Estudio piloto de un programa basado en Internet para la prevención e intervención temprana de la depresión en adolescentes / Feasibility and effectiveness of an Internet-based program for the prevention and early intervention of depression inInternet adolescents

Resumen Antecedentes: la alta prevalencia de depresión en la adolescencia y sus graves consecuencias, asociadas a su falta de detección y tratamiento, estimulan el interés en la investigación respecto a su prevención e intervención tempranas. Las intervenciones basadas en las tecnologías de la información y la comunicación (TIC), dada su flexibilidad y capacidad de difusión, representan oportunidades innovadoras; no obstante, en Latinoamérica hay poca evidencia sobre su impacto y eficacia. Objetivo y metodología: se realiza un estudio piloto cuantitativo cuasiexperimental que busca evaluar la factibilidad del programa basado en Internet "Cuida tu Ánimo", mediante las variables de uso y aceptabilidad, y la estimación del efecto, en 215 adolescentes (103 grupo activo, 112 grupo control) de dos instituciones educativas de la ciudad de Medellín. Se evaluaron las interacciones de los adolescentes con el Programa, su uso-aceptabilidad, el nivel de sintomatología depresiva y otros aspectos relacionados. Resultados: los adolescentes reportan alta aceptación y uso muy moderado del Programa. Señalan el aprendizaje sobre depresión y detección temprana del riesgo que les proporcionó el Programa; y recomiendan aumentar la interactividad de la plataforma web, generar contenidos más diversos y entretenidos, y aumentar los niveles de presencialidad de la intervención. Conclusiones: los programas basados en las TIC pueden ser un complemento favorable para la prevención e intervención tempranas de la depresión en adolescentes. Dada la dificultad de asociar la estimación del efecto del Programa con su uso, se recomienda en estudios futuros utilizar un diseño que permita relacionar los indicadores de uso con los de resultado (dosis-efecto).

Abstract Background: the high prevalence of depression in adolescence and its serious consequences, associated with its lack of detection and treatment, stimulate interest in research regarding its early prevention and intervention. Interventions based on information and communication technologies (ICT), given their flexibility and capacity for dissemination, represent innovative opportunities; however, in Latin America there is little evidence on their impact and efficacy. Objective and Methods: a quasi-experimental quantitative pilot study was carried out to evaluate the feasibility, through the variables of use and acceptability, and the estimated effect of the Internet-based program "Cuida tu Ánimo", in 215 adolescents (103 active group, 112 control group) from two educational institutions. The adolescents' interactions with the program, its use-acceptability, and the level of depressive symptomatology and other related aspects were evaluated. Results: the adolescents report high acceptance and very moderate use of the Program. They point out that the program allowed them to learn about depression and early detection of risk; also, they recommend increasing the interactivity of the web platform, designing more diverse and entertaining content, and increasing the presence of the intervention. Conclusions: Internet-based programs such as Cuida tu Ánimo can be a favorable complement for the prevention and early intervention of depression in adolescents. Considering the difficulty in relating the estimation of the Program's effect with its use, it is recommended that future studies include a design that permits associating the use indicators with the outcome indicators (dose-effect).

Video-retroalimentación Focalizado en los Recursos para mejorar la sensibilidad en díadas madre-infante con síntomas depresivos: protocolo de un ensayo clínico aleatorizado piloto / Strength-based Video-feedback to improve maternal sensitivity in mother-infant dyads with maternal depressive symptoms: Study protocol for a randomized controlled feasibility trial

Introduction Maternal sensitivity and mentalization are fundamental for children's mental health development. These skills have been negatively associated with maternal postpartum depressive symptomatology. Moreover, its prevalence increases in low socioeconomic and psychosocial risk contexts, where the access to treatment is scarce. Even though Attachment Based Interventios, such as Video-Feedback has been internationally recognized as an effective intervention. Its cost, as well as the need for language translation and cultural adaptation makes it difficult to implement in Latinamerican countries. Aim The present study aims to assess the feasibility and acceptability of an online Video-Feedback intervention informed n mentalization aimed at mother-infant dyads with depressive symptomatology who attend Chilean public health centers. Method This is a pilot randomized clinical trial with two groups of 60 mother-infant dyads between 4 and 12 months of age. Participants will be randomly assigned to control and experimental groups in a 1:1 ratio. Even though both groups will receive usual treatment, the experimental group will also receive the present video-intervention. At the end of the study, feasibility will be assessed based on focus groups aimed at interveners and quantitative outcomes such as recruitment rate, questionnaire completion rate and intervention completeness. Acceptability will be assessed from in-depth interviews with participants. In addition, effect sizes of primary and secondary outcomes will be calculated. Expected results Results are expected to generate parameters to design a larger-scale clinical trial and to preliminary assess the effect of the reported mentalization-informed intervention on maternal sensitivity. Additionally, it seeks to contribute with a mental health intervention for low-income mother-infant dyads, which can be implemented remotely, at a low cost, and that would be suitable for implementation at a mental health care system policy. The protocol of this trial's design was registered at Clinical Trials (NCT04748731).

Introducción La sensibilidad y la mentalización materna constituyen competencias fundamentales para el desarrollo de la salud mental infantil. A su vez, dichas habilidades han sido negativamente asociadas con la presencia de sintomatología depresiva postparto, la cual aumenta su prevalencia en contextos de bajo nivel socioeconómico y riesgo psicosocial, en donde el acceso a tratamiento escasea. Paralelamente, si bien internacionalmente el video-retroalimentación constituye una herramienta efectiva en intervenciones basadas en el apego, el costo, idioma y necesidad de adaptación cultural dificultan su implementación en países latinoamericanos. Objetivo Evaluar la factibilidad y aceptabilidad de una video-intervención informada por la mentalización, dirigida a díadas madre-bebé con sintomatología depresiva, atendidas en centros públicos de atención en salud mental en Chile. Métodos Ensayo clínico aleatorio piloto con dos grupos de 60 díadas madre-bebé de entre 4 y 12 meses de edad, quienes serán asignados aleatoriamente a grupos control y experimental en una proporción de 1:1. Si bien ambos grupos recibirán el tratamiento habitual, el grupo experimental recibirá también la video-intervención. Al término del estudio se evaluará la factibilidad a partir de grupos focales dirigidos a interventores e indicadores de resultados cuantitativos tales como tasa de reclutamiento, de completación de cuestionarios y finalización de la intervención. La aceptabilidad se evaluará a partir de entrevistas en profundidad a las participantes. Adicionalmente se calculará tamaño del efecto de indicadores de resultados primarios y secundarios. Resultados esperados Se espera que los resultados del estudio generen parámetros para diseñar un ensayo clínico de mayor escala y evaluar preliminarmente el efecto de la intervención informada en la mentalización en la sensibilidad materna. Se busca además contribuir con una intervención en salud mental basada en la teoría del apego dirigida a díadas madre-bebé de bajos ingresos, que pueda ser implementada de manera remota, a bajo costo y apta para ser escalada a los sistemas de atención en salud mental.

Usos e apropriações do Facebook no campo da alimentação e nutrição: uma revisão integrativa / Uses and appropriations of the Facebook and interfaces with the field of food and nutrition: an integrative review / Usos y apropiaciones de Facebook en el campo de la alimentación y la nutrición: una revisión integradora

Esta revisão integrativa objetivou caracterizar produções científicas que abordam interfaces entre a rede social Facebook e o campo da alimentação e nutrição. Entre agosto e outubro de 2018 as bases de dados Scientific Electronic Library Online, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Web of Science, Scopus e MEDical Literature Analysis and Retrieval System Online foram consultadas, e 85 artigos foram selecionados. Os estudos são emergentes no cenário internacional e incipientes no Brasil. Observou-se expressiva utilização do Facebook para mediação de ações de educação alimentar e nutricional, e seus usos também foram situados como práticas de risco ao reforçar o marketing nutricional de alimentos considerados insalubres e ao difundir conteúdos imagéticos que suscetibilizam internautas com relação aos transtornos alimentares. Observa-se que o Facebook vem sendo apropriado de diversas formas, a partir de interesses e valores que refletem a sociedade de seu tempo e espaço e que imprimem suas características nesses processos de apropriação

This integrative review aimed to characterize scientific productions that address interfaces between the Facebook social network and the field of food and nutrition. Between August and October 2018, the databases Scientific Electronic Library Online, Latin American and Caribbean Literature in Health Sciences, Web of Science, Scopus and MEDical Literature Analysis and Retrieval System Online were consulted and 85 articles were selected. The studies are emerging in the international scenario and incipient in Brazil. Significant use of Facebook was observed to mediate actions of food and nutritional education, and its uses were also situated as risk practices by reinforcing the nutritional marketing of foods considered unhealthy and by the dissemination of imagery contents that cause internet users to eating disorders. The Facebook has been appropriated in various ways, through interests and values that reflect society in its time and space, printing its characteristics in these processes of appropriation

Esta revisión integradora tuvo como objetivo caracterizar las producciones científicas que abordan las interfaces entre la red social Facebook y el campo de la alimentación y la nutrición. Entre agosto y octubre de 2018 las bases de datos Scientific Electronic Library Online, Literatura Latinoamericana y del Caribe en Ciencias de la Salud, Web of Science, Scopus y MEDical Literature Analysis and Retrieval System Online fueron consultadas y se seleccionaron 85 artículos. Los estudios son emergentes en el escenario interna-cional e incipientes en Brasil. Se observó expresiva utilización de Facebook para mediación de acciones de educación alimentaria y nutricional, y sus usos también se situaran como prácticas de riesgo al reforzar el marketing nutricional de alimentos considerados insalubres y por la difusión de contenidos imáginarios que hacen que los internautas sean susceptibles a los trastornos alimentarios. El Facebook viene siendo apropiado de diversas formas, mediante intereses y valores que reflejan la sociedad en su tiempo y espacio, imprimiendo sus características en esos procesos de apropiación