Addressing Driving in Acute Care: Perceived Relevance and Competence.

Background. Recent legislation has expanded the responsibilities of occupational therapists regarding fitness to drive in the Canadian province of Ontario. To date, little is known about the practice of acute care occupational therapy with addressing driving, or how such responsibilities have affected clinical practice. Purpose. The objective of this study was to understand the relevance of driving-related knowledge areas to acute care occupational therapists and examine their self-reported competency for these areas. Method. Anonymous online surveys were administered to 41 occupational therapists working in acute care hospitals in Ontario. Findings. Therapists reported many driving-related knowledge areas are relevant to acute care practice yet consistently reported lower levels of competence for addressing such areas. Implications. Findings support the need for further competency development regarding driving-related practice in acute care. Occupational therapy curriculum and continuing education initiatives are avenues for capacity-building. Future research to identify effective competency development strategies is warranted.

La necesidad de la Enfermería Escolar: una revisión integradora de la literatura / The need for School Nursing: an integrative literature review

Introducción: La salud escolar debe velar por el bienestar integral de la comunidad escolar, fortaleciendo conductas de autocuidado y hábitos saludables a través de la promoción y prevención e investigación en salud. El abordaje holístico que define a la Enfermería hace que la inclusión de la enfermera escolar sea fundamental en los diferentes centros educativos. Objetivo: Analizar los beneficios del rol de la enfermería escolar en base a sus competencias para identificar la necesidad que supone la figura de la enfermería en los colegios.Metodología: Revisión integrativa de la literatura, cualitativa siguiendo las indicaciones de la declaración PRISMA. La búsqueda de las publicaciones se llevó a cabo en las bases de datos Web of Science y MedLine, seleccionándose aquellos artículos publicados en los últimos 5 años en inglés y español. Resultados: se incluyeron un total de 10 artículos. Su análisis muestra las competencias de la enfermera escolar, la perspectiva que tienen los docentes y los padres de la figura de la enfermera escolar, así como la necesidad que aporta a comunidad escolar. Conclusiones: La presencia de la enfermera escolar en los centros educativos garantiza tranquilidad y beneficios para la comunidad, no solo mediante actividades de prevención o asistenciales, sino también mediante estrategias de educación para la salud. Nuestra investigación ha recogido cómo pese a que existe un argumento firme y conciso sobre la importancia de esta figura continúa la lucha por su implantación. (AU)

Introduction: School health must ensure the comprehensive well-being of the school community, strengthening self-care behaviours and healthy habits through promotion and prevention and through health-related research. The holistic approach that defines Nursing makes the inclusion of the school nurse fundamental in the different educational centres.Objective: To analyse the benefits of the role of school nursing based on their remit to identify the need for nurses in schools. Methodology: Integrative review of the literature and qualitative review based on the indications of the PRISMA statement. The search for publications was carried out in the Web of Science and MedLine databases, selecting those articles published in the last 5 years in English and Spanish. Results: A total of 10 articles were included. Their analysis shows the remit of the school nurse, the perspective that teachers and parents have of the school nurse role, as well as the need it represents to the school community.Conclusions: The presence of the school nurse in educational centres ensures tranquillity and benefits for the community, not only through prevention or assistance activities, but also through health education strategies. Our research has revealed how, despite the fact that there is a firm and concise argument regarding the importance of this role, the fight for its establishment continues. (AU)

The Clinical Usefulness of the Practice Resource for Driving after Stroke (PReDAS).

Occupational Therapists (OTs) have identified a critical need for organized, evidence-based resources to approach driving post-stroke. The Practice Resource for Driving After Stroke (PReDAS) is a resource to support the clinical reasoning and practice of health professionals for addressing driving in acute stroke care. The purpose of this pilot study is to evaluate the usefulness of the PReDAS to support clinician and patient decision-making about return to driving after stroke/Transient Ischemic Attack (TIA) in the acute care hospital setting. OTs, physicians, and patients diagnosed with stroke/TIA were surveyed regarding their experience with the PReDAS in acute care. Patient participants were also contacted for a follow-up questionnaire. OT, physician and patient stakeholders reported the PReDAS was useful to support decision-making for driving. The majority of patients recalled information provided in acute care and abstained from driving as advised. This study provides preliminary support for the clinical usefulness of the PReDAS.

Factores psicológicos relacionados al aislamiento social en estudiantes universitarios

Introducción: durante la pandemia de COVID-19, se han implementado medidas de distanciamiento social en muchos países para interrumpir la transmisión viral y retrasar la propagación de la infección. Las personas que están en aislamiento social, con movilidad restringida y pobre contacto con los demás son vulnerables a presentar complicaciones psiquiátricas que van desde síntomas aislados hasta el desarrollo de un trastorno mental. Objetivo: fundamentar la influencia de los factores psicológicos relacionados al aislamiento social en estudiantes universitarios. Método: se realizó una revisión bibliográfica en las bases de datos Scopus, BASE, Clinical-Key, SciELO y LILACS. De los 46 artículos recuperados se seleccionaron 23 para el desarrollo de la investigación. Desarrollo: en los seres humanos la respuesta fisiológica al estrés está modulada por el nivel psicológico, al estar inmersos en una sociedad cambiante desde lo económico y hasta lo familiar, se es vulnerable a padecerlo, la importancia es la frecuencia con la que se experimenta y el daño que ello va ocasionando al propio organismo. Conclusiones: los estudiantes universitarios se ven expuestos a la influencia de factores psicológicos que van desde síntomas aislados hasta el desarrollo de afectaciones mentales como insomnio, ansiedad, depresión y trastorno por estrés postraumático, los cuales actúan de forma directa e indirecta en el proceso salud-enfermedad. (provisto por Infomedic International)

Introduction: During the COVID-19 pandemic, social distancing measures have been implemented in many countries to interrupt viral transmission and delay the spread of infection. People in social isolation, with restricted mobility and poor contact with others are vulnerable to psychiatric complications ranging from isolated symptoms to the development of a mental disorder. Objective: to substantiate the influence of psychological factors related to social isolation in university students. Method: a bibliographic review was carried out in the Scopus, BASE, Clinical-Key, SciELO and LILACS databases. Of the 46 articles retrieved, 23 were selected for the development of the research. Development: in human beings the physiological response to stress is modulated by the psychological level, being immersed in a changing society from the economic and family level, one is vulnerable to suffer it, the importance is the frequency with which it is experienced and the damage it causes to the organism itself. Conclusions: university students are exposed to the influence of psychological factors ranging from isolated symptoms to the development of mental disorders such as insomnia, anxiety, depression and post-traumatic stress disorder, which act directly and indirectly in the health-disease process. (provided by Infomedic International)

Mobile-based brief interventions targeting cannabis-impaired driving among youth: A Delphi study.

INTRODUCTION: Brief interventions delivered using mobile technologies have become popular to reduce youth alcohol use, however, few have been applied to cannabis use and driving under the influence of cannabis (DUIC). This Delphi study sought to create and compare consensus among a panel of experts (potential intervention developers) and a panel of youth (intervention audience) on the characteristics to prioritize in a youth DUIC mobile-based brief intervention. METHODS: A two-round two-panel Delphi study was conducted among 26 professionals with expertise in youth substance use and impaired driving and 20 youth who use cannabis. Participants ranked the importance of 45 evidence-informed intervention characteristics using a 7-point Likert scale. Characteristics that received an interquartile deviation score ≤ 1 (indicating consensus) and a median score of ≥6 (indicating importance) in both panels were considered shared priorities. Differences in panel rankings were quantified using Mann-Whitney U tests. RESULTS: Consensus was achieved for 41 characteristics in the professional panel and 34 in the youth panel, with ratings generally higher among professionals. Overall, 16 shared priorities emerged. These include critical theoretical characteristics (e.g., self-efficacy, motivation, overcoming barriers), practical characteristics (e.g., mobile availability, estimates of intervention length, ability to input behaviours) and core contents (e.g., real-life stories, education on the risks/dangers, appropriate messaging). Youth's perceptions on the dangers of DUIC received the most support for an intervention outcome. CONCLUSIONS: Findings can inform the development of mobile-based brief interventions for youth, an essential step in reducing DUIC among youth and addressing this public health concern.

Systemic lupus erythematosus/ANCA-associated vasculitis overlap: An explanation for atypical lupus manifestation.

The coexistence of systemic lupus erythematosus (SLE) and ANCA-associated vasculitis (AAV) as an overlapping syndrome is not common. Here, we report a case of a 33-year-old woman, with recent SLE diagnosis due to skin, kidney, articular, and immunologic compromise, in whom a chest CT scan showed bilateral nodules, consolidations, and tree-in-bud pattern; thoracoscopic lung biopsy revealed diffuse non-caseating granulomas, without other features of sarcoid, organizing pneumonia, or hypersensitivity pneumonitis with high positive p-ANCA titers. Overlap between SLE and AAV was a possible explanation for lupus granulomatous pneumonitis, and for this reason, a multidisciplinary meeting was held to evaluate complex patients with interstitial lung diseases patients.

Factores estresores, Inteligencia Emocional y Engagement en los estudiantes de enfermería durante sus prácticas clínicas / Stressor factors, Emotional Intelligence and Engagement during clinical practice in nursing students

Objetivo principal: Analizar la percepción de estrés, inteligencia emocional y engagement en los estudiantes de grado en Enfermería del Campus de Ponferrada durante el desarrollo de sus prácticas clínicas. Metodología: estudio cuantitativo, descriptivo, correlacional de corte transversal. La muestra fue de 73 estudiantes. Se utilizaron los cuestionarios: KEZKAK, TMMS-24 y UWES-S y datos sociodemográficos. Resultados principales: El 78,1% de los alumnos presentaron estrés siendo las mujeres las que alcanzaron puntuaciones más elevadas. Los estudiantes procedentes de fuera de Ponferrada percibieron mayores tasas de estrés. La puntuación media de la Inteligencia Emocional fue de 78.92±15.11. Las dimensiones de la Inteligencia Emocional correlacionan positivamente con las dimensiones del engagement. Conclusión principal: Los estudiantes de Grado en Enfermería perciben estrés durante el desarrollo de las prácticas clínicas, sin embargo, presentan una adecuada Inteligencia Emocional y niveles altos de engagement.(AU)

Objective: To analyze the perception of stress, emotional intelligence and engagement in Nursing Degree students from the Ponferrada Campus during the development of their clinical practices. Methods: quantitative, descriptive, correlational cross-sectional study. The sample was 73 students. The questionnaires were used: KEZKAK, TMMS-24 and UWES-S and sociodemographic data. Results: 78.1% of the students presented stress, with women reaching the highest scores. Students from outside Ponferrada perceived higher rates of stress. The mean Emotional Intelligence score was 78.92±15.11. The dimensions of Emotional Intelligence positively correlate with the dimensions of engagement. Conclusions: Nursing degree students perceive stress during the development of clinical practices, however they present adequate Emotional Intelligence and high levels of engagement.(AU)

Young drivers' determinants of driving under the influence of cannabis: Findings from the Youth Cannabis and Driving Survey (YouCanDS).

INTRODUCTION: Driving under the influence of cannabis (DUIC) is proven to increase the risk of collisions and is most common among young drivers (ages 16 to 24). However, little is known about the specific determinants of DUIC behavior among youth, which limits the capacity to develop evidence-based prevention and intervention efforts. This study developed and evaluated a youth DUIC questionnaire, which was used to establish the DUIC determinants of young drivers. METHOD: The questionnaire was based on the theoretical framework of general deterrence and general prevention. Data obtained included: demographics, past cannabis use and DUIC experiences, DUIC intention, experiences riding as a passenger with someone DUIC, knowledge and credibility of the law, attitudes towards DUIC, and social controls. The resulting questionnaire was validated for a sample of 426 young drivers in the province of Ontario, Canada. An ordinal regression was conducted to examine the relationships between questionnaire items and DUIC intention. RESULTS: The questionnaire displayed good construct validity and internal consistency across four out of five domains (KMO and Cronbach α values ≥ 0.70). Of the 426 respondents (52.6% female), 356 (83.6%) reported previous cannabis use, with 296 (69.5%) doing so in the past year, and 142 (33.3%) reporting DUIC. Furthermore, 179 (42%) study participants indicated at least a slight chance of DUIC in the next year. The regression analysis identified six variables predictive of DUIC intention: past DUIC incidence, perceived percent of those convicted that receive the penalty, moral awareness, perceived dangerousness, minor accident risk, and vicarious punishment avoidance. CONCLUSIONS: Preventive efforts should emphasize these determinants when designing targeted strategies and interventions. Practical Applications: These efforts should focus on educating the dangers and risk of a vehicle collision, that law enforcement has the capacity to apprehend and appropriately punish individuals DUIC, and that DUIC is wrong and socially unacceptable.

Clinical predictors of driving simulator performance in drivers with multiple sclerosis.

BACKGROUND: Drivers with multiple sclerosis (MS) may experience visual-cognitive impairment that affects their fitness to drive. Due to limitations associated with the on-road assessment, an alternative assessment that measures driving performance is warranted. Whether clinical indicators of on-road outcomes can also predict driving performance outcomes on a driving simulator are not fully understood. OBJECTIVE: This study examined if deficits in immediate verbal/auditory recall (California Verbal Learning Test-Second Edition; CVLT2-IR) and/or slower divided attention (Useful Field of View™; UFOV2) predicted deficits in operational, tactical, or strategic maneuvers assessed on a driving simulator, in drivers with and without MS. METHODS: Participants completed the CVLT2-IR, UFOV2, and a driving simulator assessment of operational, tactical, and strategic maneuvers. RESULTS: Deficits in immediate verbal/auditory recall and slower divided attention predicted adjustment to stimuli errors, pertaining to tactical maneuvers only, in 36 drivers with MS (vs 20 drivers without MS; F(3, 51) = 6.1, p = 0.001, R2 = 0.3, Radj2=0.2). CONCLUSION: The CVLT2-IR and UFOV2 capture the visual and verbal/auditory recall, processing speed, and divided attention required to appropriately adjust to stimuli in a simulated driving environment. Clinicians may use the CVLT2-IR and UFOV2 as precursors to driving performance deficits in drivers with MS.

Young and under the influence: A systematic literature review of the impact of cannabis on the driving performance of youth.

BACKGROUND: Young drivers ages 15-24 continue to constitute a high-risk population for fatal motor vehicle collisions (MVCs) compared to all other age groups. Driving under the influence of cannabis is an important contributor to the high rates of MVCs among youth. Understanding the specific impact of cannabis on the driving performance outcomes of young drivers can inform injury prevention, education, and intervention strategies. OBJECTIVES: This systematic literature review (SLR) aims to determine the Class (I- highest to IV-lowest) of evidence and level of confidence (A-high to U-insufficient) in the effects of cannabis on the driving performance of young drivers. METHODS: Registered in PROSPERO (#CRD42020180541), this SLR searched seven data bases and appraised the quality and confidence in the evidence using an established research methodology. RESULTS: Class II evidence suggests that THC is likely to reduce mean speed, headway distance, and reaction time; and increase lane and steering wheel position variability among young drivers (Level B, moderate confidence). CONCLUSIONS: This study shows that there is a moderate to low level of confidence on the impact of cannabis on the specific driving performance outcomes of young drivers. A need remains for Class I and II studies that focus on the specific effects on young drivers, distinguish between the biological and socially constructed variables of sex and gender, and includes larger and more representative samples.

Final Year Students' Knowledge on Basic Manual Wheelchair Provision: The State of Occupational Therapy Programs in Colombia.

Access to personal mobility is a human right and as such, it implies the provision of wheelchair services for those with mobility impairments that need one. Lack of appropriately trained personnel is a major contributor to the gap in access to wheelchairs. Assistive technology provision is one of the core competencies of occupational therapists. The goal of this study was to assess the current wheelchair provision knowledge of final year occupational therapy students in Colombia as measured by the International Society of Wheelchair Professionals Basic Wheelchair Service Knowledge Test. A total of 83 students from 7 universities took the test. None of the students met the 70% passing threshold. The highest scores were in the assessment domain while the lowest in the fitting and user training domains. These results suggest that the current wheelchair provision education received in these programs do not meet the World Health Organization guidelines on appropriate wheelchair provision. The implementation of strategies to improve current wheelchair provision education in Colombian occupational therapy programs is granted.

Insufficient sleep and fitness to drive in shift workers: A systematic literature review.

BACKGROUND: Insufficient sleep, <6.5 h per night, majorly affects shift workers, placing them at higher risk for motor vehicle crash related injury or fatality. While systematic reviews (SLRs) examine the effects of insufficient sleep and driving, to date, no SLR focuses on driver fitness or performance in shift workers. OBJECTIVES: Determine the class of evidence (Class I-highest to Class IV-lowest), and level of confidence (Level A-high, to Level U-insufficient) in the determinants of driver fitness and performance in shift workers. Next, consider evidence-based recommendations for clinical practice, research, and policy. METHODS: A protocol was registered on PROSPERO (#CRD42018052905) using an established SLR methodology: a comprehensive electronic database search, study selection, data extraction, critical appraisal, analysis, and interpretation using published guidelines. RESULTS: Searches identified 1226 unique records with 11(2 on-road, 9 simulator) meeting final inclusion criteria. Class III to IV evidence identified that exposure to overnight shift work possibly predicts (Level C confidence) drivers at risk for adverse on-road outcomes and likely predicts (Level B) drivers at risk for adverse driving simulator outcomes. Higher ratings of subjective sleepiness and extended time driving possibly predict (Level C) drivers at risk for adverse driving simulator outcomes. CONCLUSIONS: This study demonstrates a low to moderate level of confidence in the determinants of driving in shift workers. A critical need exists for gold-standard on-road assessments integrating complex driving environments representative of real-world demands, targeting tactical and strategic outcomes in a broad spectrum of shift workers.

Obstrucción duodenal congénita de etiología múltiple: reporte de un caso con malrotación intestinal, bandas de Ladd y membrana duodenal intrínseca como causantes de obstrucción intestinal en el neonato / Congenital duodenal obstruction of multiple etiology: case report with intestinal malrotation, Ladd bands and intrinsic duodenal membrane as causes of intestinal obstruction in the neonate

Resumen: La obstrucción duodenal congénita agrupa un amplio espectro de anomalías en el desarrollo del intestino delgado; se clasifica según su etiología tanto en extrínseca como intrínseca. Su presentación es relativamente común, teniendo una incidencia de 1: 2.500-10.000 nacidos vivos y normalmente presenta asociación con aneuploidías (como la trisomía 21) y malformaciones cardíacas. Las imágenes tienen un papel importante en la aproximación diagnóstica y la radiografía de abdomen simple, es el primer escalón en la aproximación de la obstrucción intestinal. El tratamiento involucra una exploración quirúrgica del abdomen con corrección de los defectos encontrados. Este es un reporte de caso de un neonato que presentó obstrucción duodenal congénita de etiología tanto extrínseca (malrotacion intestinal y bandas de Ladd) como obstrucción intrínseca (membranas duodenales).

Abstract: Congenital duodenal obstruction groups together a broad spectrum of abnormalities in the development of the small intestine; it is classified according to its etiology as both extrinsic and intrinsic. Its presentation is relatively common, having an incidence of 1: 2.500-10.000 live births and it is normally associated with aneuploidy (such as trisomy 21) and cardiac malformations. Images play an important role in the diagnostic approach, with simple abdominal radiography being the first step in the approximation of intestinal obstruction. The treatment corresponds to a surgical exploration of the abdomen with resolution of the defects found. This is a case report of a newborn who presented congenital duodenal obstruction of both extrinsic etiology (intestinal malrotation and Ladd bands) and intrinsic obstruction (duodenal membranes).

Clinical Utility of the DriveFocus™ Intervention on Young Drivers With and Without Experience.

Introduction: The DriveFocus™ intervention addresses the ability of young drivers to detect and respond to critical roadway information. DriveFocus is an interactive video-based tablet application that teaches users how to detect and prioritize critical roadway items. However, young drivers with and without experience may respond differently to the intervention. Objectives: We compared the simulated driving performance of two 17 year-old licensed drivers with (novice) and without (learner) driving experience, after three (post-test 1) and six (post-test 2) intervention sessions. Methods: We collected clinical, driving performance (number of visual scanning, adjustment to stimuli, and total driving errors) and acceptability data. Results: The learner driver made more visual scanning, adjustment to stimuli and total errors when compared to the novice. Both participants exhibited a decrease in both types and number of driving errors from baseline to post-test 2 and the learner also made less driving errors at post-test 1. Both participants rated the perceived ease of use of the intervention favorably. Conclusions: This study lays the foundation to examine the impact of the DriveFocus™ intervention among novice and more experienced young drivers.

Driving with Parkinson's Disease: Exploring Lived Experience.

A growing body of literature has explored the impact of Parkinson's disease (PD) on fitness to drive. As such, evidence now supports the use of specific clinical tests for screening purposes, the predictive validity of risk impressions, and the critical driving errors that predict on-road pass/fail outcomes in this population. However, little is known about the lived experiences of persons with PD as they navigate driving-related concerns such as driving impairments, cessation, potential threats to independence, and community mobility. This qualitative secondary data analysis aimed to explore the driving-related lived experiences of persons with PD. We utilized summative content analysis to identify themes related to driving from transcribed interviews with nineteen community-dwelling individuals with PD who participated in the primary study. Five themes emerged within the analysis: (1) the meaning and significance of driving; (2) driving cessation; (3) modified driving behaviors; (4) factors affecting driving; and (5) accessibility. Participants identified driving as an activity that holds significant importance-both directly (i.e., as a primary activity) and as a means for enabling other activities. This study lays the foundation for the development of client-centred and evidence-informed driving interventions for individuals with PD, as well as the development of driving retirement programs.

Insufficient sleep and fitness to drive in shift workers: a systematic literature review protocol.

BACKGROUND: The majority of shift workers experience insufficient sleep as a result of their employment. Insufficient sleep is associated with impaired neurocognitive functioning, affecting key skills required for driving, resulting in shift workers experiencing a disproportionate burden of RTC injuries and fatalities. Yet, to our knowledge, no systematic literature review (SLR) exists to critically appraise and synthesise evidence on the determinants of fitness to drive (assessed on-road) and driving performance (assessed in a driving simulator) in shift workers with insufficient sleep. OBJECTIVES: A SLR protocol is established to conduct analysis and synthesis of the level of evidence and confidence in the determinants of fitness to drive and driving performance, among shift workers with insufficient sleep. METHODS: This study follows Cooper and Hedges' established SLR methodology: formulate the problem, locate and select studies, collect data, appraise critically, analyse and present data, interpret results and disseminate information. Critical appraisal and analysis follows the 2017 American Academy of Neurology guidelines determining the level of evidence and the level of confidence for each determinant identified in the literature. Protocol and results reporting adhere to the Preferred Reporting Items for Systematic reviews and Meta-Analyses Protocols guidelines. CONCLUSIONS: This SLR contributes to research evidence examining the impact of insufficient sleep and driver sleepiness on fitness to drive and driving performance. Analysis of the level of evidence and level of confidence in the existing literature will advance evidence-informed prevention strategies and critical decision-making, to mitigate adverse effects of insufficient sleep for improving road safety.

La Lepra: una enfermedad vigente / Leprosy: an ongoing disease

El libro resalta que la lepra continúa siendo una enfermedad presente en Colombia y que aún constituye un problema de salud pública importante por los costos sociales, económicos y de sufrimiento humano que conlleva. Sabiendo que la literatura sobre el tema es escasa en nuestro medio, este libro surge como una herramienta de consulta creada para médicos y otros profesionales de salud, con la certeza de que es preciso mejorar la oportunidad del diagnóstico. Siendo fundamental que, durante su proceso formativo, todos los profesionales de la salud adquieran conocimientos sobre dicha enfermedad, que cada día se hace más visible por sus secuelas y diagnóstico tardío.

The book highlights the fact that leprosy continues to be a disease present in Colombia and that it is still a major public health problem due to the social, economic and human suffering costs it entails. Knowing that the literature on the subject is scarce in our country, this book is intended as a reference tool for doctors and other health professionals, in the knowledge that it is necessary to improve the timeliness of diagnosis. It is essential that, during their training process, all health professionals acquire knowledge about this disease, which is becoming more and more visible every day due to its sequelae and late diagnosis.

La puntuación de apendicitis pediátrica en la atención primaria de salud / Pediatric Appendicitis Score in Primary Healthcare

Introducción: La apendicitis aguda es la enfermedad que mayores cirugías de urgencia demanda en el mundo y su diagnóstico adolece de uniformidad de criterios. Objetivo: Evaluar la efectividad de la puntuación de apendicitis pediátrica en la atención primaria de salud. Método: Se realizó un estudio cuantitativo, transversal de evaluación de prueba diagnóstica, con enmascaramiento doble ciego. El universo estuvo constituido 31 pacientes, de hasta quince años de edad, con diagnóstico clínico de apendicitis aguda tratados en la Policlínica Universitaria René Vallejo Ortiz, Manzanillo, Granma. A todo paciente con sospecha diagnóstica de apendicitis aguda se le aplicó la puntuación de apendicitis pediátrica antes de su remisión y evaluación por el cirujano pediatra y se determinó la capacidad diagnóstica de la puntuación. Resultados: La edad media fue 12,41 años. Predominó el sexo masculino (61,29 por ciento). El 100 por ciento, 93,55 por ciento y el 87,1 por ciento de los pacientes tuvieron un diagnóstico clínico, operatorio e histopatológico de apendicitis aguda, respectivamente en el nivel secundario de salud. La puntuación de apendicitis pediátrica tuvo una sensibilidad de 96,96 por ciento, una especificidad de 50 por ciento, un valor predictivo positivo de 92,86 por ciento y un valor predictivo negativo de 66,67 por ciento. Conclusiones: La puntuación de apendicitis pediátrica presentó patrones de sensibilidad y especificidad que la hacen recomendable para su uso en la atención primaria de salud(AU)

Introduction: Acute appendicitis is the disease demanding the biggest emergency surgeries worldwide and its diagnosis lacks criteria uniformity. Objective: To evaluate the effectiveness of the Pediatric Appendicitis Score in primary healthcare. Method: A quantitative, cross-sectional and double-masked study of diagnostic test evaluation was performed. The study population consisted of 31 patients, up to the age of fifteen years, with clinical diagnosis of acute appendicitis treated in René Vallejo Ortiz University Polyclinic of Manzanillo, Granma. All patients with suspected acute appendicitis were applied the Pediatric Appendicitis Score before referral and evaluation by the pediatric surgeon, and the diagnostic capacity of the score was determined. Results: The average age was 12.41 years. The male sex predominated (61.29 percent). 100 percent, 93.55 percent and 87.1 percent of the patients had a clinical, operative and histopathological diagnosis of acute appendicitis, respectively, at the secondary level of healthcare. The pediatric appendicitis score had sensitivity of 96.96 percent, specificity of 50 percent, a positive predictive value of 92.86 percent, and a negative predictive value of 66.67 percent. Conclusions: The Pediatric Appendicitis Score presented patterns of sensitivity and specificity that make it recommendable for usage in primary health care(AU)

Nivel de información sobre reanimación cardiopulmonar en la Atención Primaria de Salud / Range of Information on Cardiopulmonary Resuscitation in Primary Health Care

Introducción: La reanimación cardiopulmonar debe practicarse sobre toda persona en parada cardiorrespiratoria. Objetivo: Identificar el nivel de información sobre reanimación cardiopulmonar de médicos y enfermeras en una Policlínica Universitaria. Métodos: Se realizó un estudio descriptivo y transversal en un universo de 64 médicos y enfermeras de la Policlínica Universitaria Rene Vallejo Ortiz, Manzanillo, en el periodo septiembre a noviembre del 2016. Se aplicó un cuestionario confeccionado por los autores, sobre reanimación cardiopulmonar, en base a las recomendaciones de la American Heart Association. Resultados: De un total de 64 trabajadores el 25 por ciento eran licenciadas en enfermería; 26,56 por ciento, médicos especialistas; 34,38 por ciento, médicos residentes y el 14,06 por ciento, médicos generales. La media de años de experiencia fue de 9,64. Tan solo el 20,31 por ciento de los encuestados resultaron en un nivel de información satisfactorio a predominio de los médicos generales, los cuales representaron el 38,46 por ciento del total de profesionales en ese nivel de información. La calificación profesional de los doctores en medicina demostró estar relacionada con niveles insatisfactorios de conocimientos no siendo así con la autopercepción de sentirse apto para llevar a cabo maniobras de RCP efectivas. Conclusiones: El nivel de información sobre RCP fue insatisfactorio en un porcentaje alto de médicos y enfermeras y este se relacionó con la calificación profesional no siendo así con la autopercepción de capacidades cognitivas para realizar maniobras de RCP(AU)

Introduction: Cardiopulmonary resuscitation should be performed on any person with cardiorespiratory arrest. Objective: To identify the range of information on cardiopulmonary resuscitation of doctors and nurses in a university polyclinic. Methods: A descriptive and cross-sectional study was carried out in a universe of 64 doctors and nurses from Rene Vallejo Ortiz University Polyclinic, in Manzanillo, from September to November 2016. A questionnaire on cardiopulmonary resuscitation, prepared by the authors, was applied. It was based on the recommendations of the American Heart Association. Results: Sixty four 64 workers formed the sample. 25 percent were bachelors in nursing, 26.56 percent medical specialists, 34.38 percent resident doctors and 14.06 percent general practitioners. The average number of years of experience was 9.64. Only 20.31 percent of the respondents resulted in a satisfactory range of information and general practitioners were the majority, which represented 38.46 percent of the total number of professionals in this level of information. The professional qualification of the doctors in medicine showed to be related to unsatisfactory range of knowledge. However, their self-perception of feeling apt to carry out effective CPR maneuvers is satisfactory. Conclusions: The range of information on CPR was unsatisfactory in a high percentage of doctors and nurses and this was related to the professional qualification, nevertheless the self-perception of cognitive abilities to perform CPR maneuvers is satisfactory(AU)