4 Domain Sports PROM in Spanish: Cross-cultural adaptation in the Chilean population and reliability analysis.

Background Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4 DSP) into Spanish. Methods A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4 DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated. Results The S-4DSP was fully completed by 108 participants (mean age 34 ± 10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively. Conclusions The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction.

Behind the Headset: Predictive Accuracy of Patient-Reported Outcome Measures for Voice Symptoms in Call Centers

Objective: This study examines factors predicting self-reported voice symptoms in call center workers. Methods: Multivariate analysis and predictive modeling assess personal, work-related, acoustic, and behavioral factors. Generalized Linear Models (GLMs) and Receiver Operating Characteristic (ROC) curves are employed. Results: Age and sleep patterns impacted voice quality and effort, while workplace factors influenced symptom perception. Unhealthy vocal behaviors related to tense voice and increased effort, while hydration was protective. Voice acoustics showed diagnostic potential, supported by ROC data. These findings emphasize voice symptom complexity in call center professionals, necessitating comprehensive assessment. Limitations: This study recognizes its limitations, including a moderate-sized convenience sample and reliance on PROM metrics. Future research should incorporate more objective measures in addition to self-reports and acoustic analysis. Value: This research provides novel insights into the interplay of personal, occupational, and voice-related factors in developing voice symptoms among call center workers. Predictive modeling enhances risk assessment and understanding of individual susceptibility to voice disorders. Conclusion: Results show associations between various factors and self-reported voice symptoms. Protective factors include sleeping more than six hours and consistent hydration, whereas risk factors include working conditions, such as location and behaviors like smoking. Diagnostic models indicate good accuracy for some voice symptom PROMs, emphasizing the need for comprehensive models considering work factors, vocal behaviors, and acoustic parameters to understand voice issues complexity.

Objetivo: Este estudio examina los factores que predicen los síntomas de voz en los trabajadores de call centers. Métodos: Se utilizan análisis multivariados y modelos predictivos para evaluar factores personales, laborales, acústicos y de comportamiento. Se emplean Modelos Lineales Generalizados (GLM) y curvas ROC. Resultados: La edad y los patrones de sueño afectaron la calidad vocal y el esfuerzo, mientras que los factores laborales influyeron en la percepción de síntomas. Los comportamientos vocales no saludables se relacionaron con voz tensa y mayor esfuerzo, mientras que la hidratación fue protectora. Los parámetros acústicos de voz mostraron potencial diagnóstico respaldado por datos de ROC. Los hallazgos subrayan complejidad de síntomas vocales en profesionales de centros de llamadas, requiriendo una evaluación integral. Limitaciones: Este estudio reconoce sus limitaciones, que incluyen una muestra de conveniencia de tamaño moderado y la dependencia de medidas PROMs. Futuras investigaciones deberían incorporar medidas objetivas, además de los autorreportes y análisis acústico. Importancia: Esta investigación aporta nuevos conocimientos sobre factores personales, laborales y síntomas de voz en trabajadores de call centers. El modelado predictivo mejora la evaluación de riesgos y la comprensión de la susceptibilidad individual a trastornos de la voz. Conclusión: Los resultados muestran asociaciones entre diversos factores y los síntomas vocales reportados. Los factores de protección incluyen dormir más de seis horas y una hidratación constante; los factores de riesgo incluyen las condiciones de trabajo, como la ubicación y comportamientos como fumar. Los modelos de diagnóstico indican una buena precisión para algunas PROMs de síntomas de la voz, lo que subraya la necesidad de modelos integrales que tengan en cuenta los factores laborales, los comportamientos vocales y los parámetros acústicos para comprender la complejidad de los problemas de la voz.

Perception of patients with retinal pathology on aspects of visual function and their management.

BACKGROUND AND OBJECTIVE: Age-related macular degeneration (AMD) and diabetic retinopathy (DR) are highly prevalent. OBJECTIVE: To explore perceptions of patients with AMD or DR about the impact of the disease and treatment on their daily living activities. MATERIALS AND METHODS: Semi-structured interviews with a questionnaire developed from validated patient reported outcomes questionnaires. The questionnaire consisted of 19 questions about the disease and 9 about the treatment. The questions (items) were answered on a scale from 1 to 9. In addition, the patient interviewed was invited to make free comments on each question. Nine patients with AMD and 9 with DR were interviewed by videoconference or telephone call. A quantitative analysis of the responses and a qualitative analysis of the comments were carried out. RESULTS: The most relevant item for patients with AMD or DR is "Recognize people when they are nearby", and "Read text in normal size font in a newspaper or book", followed, in patients with AMD, by "Do things what you would like" and, in patients with DR, "Feeling frustrated by the vision problems." Regarding the treatment, the most relevant aspects for both groups is that the treatment works and receiving appropriate information before and after the treatment. The qualitative comments were focused to the disease, the treatment, and to the role of doctors and the health system. CONCLUSION: Quantitative responses and free comments can be useful to improve the care of patients with AMD or DR by physicians and the health system.

Factores asociados con la fragilidad en un servicio ambulatorio de geriatría de un hospital universitario en Bogotá (Colombia) / Factors Associated with Frailty in the Geriatric Outpatient Service of a University Hospital in Bogotá (Colombia) / Fatores associados à fragilidade no ambulatório de geriatria de um hospital universitário de Bogotá (Colômbia)

Introducción: la fragilidad, entendida como un estado previo a la discapacidad, confiere mayor vulnerabi-lidad a estresores externos y contribuye a desenlaces negativos como caídas, hospitalización, discapacidad y mortalidad. El objetivo de este estudio fue identificar su prevalencia y evaluar los factores asociados en los pacientes del Servicio Ambulatorio de Geriatría del Hospital Universitario San Ignacio (husi) en Bogotá (Colombia). Materiales y métodos: estudio de corte transversal con 689 pacientes atendidos en la consulta externa de geriatría del husi entre agosto de 2016 y marzo de 2020. Mediante regresiones logísticas se iden-tificaron los factores relacionados con la fragilidad. Resultados: la prevalencia fue del 35.4 %. En el análisis bivariado, las variables asociadas con la fragilidad fueron edad mayor de 80 años (or: 2.07; ic95 %: 1.40-3.20; p = 0.001), sexo femenino (or: 1.40; ic95 %: 0.99-2.02; p = 0.03), multimorbilidad (or: 2.13; ic95 %: 1.40-2.90; p < 0.001) y malnutrición (or: 2.23; ic95 %: 1.22-4.07; p = 0.009). En el análisis multivariado, la multimor-bilidad (or: 2.46; ic95 %: 1.62-3.75; p = 0.001), la velocidad de la marcha lenta (or: 5.15; ic95 %: 3.0-8.60; p = 0.001) y el perímetro de pantorrilla bajo (or: 1.60; ic95 %: 1.03-2.50; p = 0.06) se vincularon con la fragilidad. Conclusión: la prevalencia de fragilidad en el servicio de geriatría del husies mayor a la de los referentes nacionales; adicionalmente, las variables analizadas coinciden con las encontradas en la literatura; todo esto respecto a la gran complejidad clínica de los pacientes. Es clave la detección de los factores que se asocian con fragilidad, a fin de intervenirlos y prevenir desenlaces adversos

Introduction: Frailty, understood as a pre-disability state, increases vulnerability to external stressors and contributes to negative outcomes such as falls, hospitalization, disability, and mortality. This study aims to identify the prevalence of frailty and assess the associated factors in patients attending the geriatric outpatient service of the Hospital Universitario San Ignacio (husi). Materials and methods: A cross-sectional study involving 689 patients treated at the husigeriatric outpatient clinic between August 2016 and March 2020. Logistic regressions were conducted to identify factors associated with frailty. Results: The prevalence of frailty was 35.4 %. In bivariate analysis, variables associated with frailty included age over 80 years (or: 2.07; ci95 %: 1.40-3.20; p = 0.001), female sex (or: 1.40; ci95 %:0.99-2.02; p= 0.03), multimorbidity (or: 2.13; ci95 %:1.40-2.90; p < 0.001) and malnutrition (or: 2.23; ci95 %: 1.22-4.07; p = 0.009). In multivariate analysis, multimorbidity (or: 2.46; ci95 %: 1.62-3.75; p = 0.001), slow walking speed (or: 5.15; ci95 %: 3.0-8.60; p = 0.001) and low calf perimeter (or: 1.60; ci95 %: 1.03-2.50; p = 0.06) were associated with frailty. Conclusion: The prevalence of frailty in our center exceeds national references; and the identified variables align with those reported in the literature; reflecting the considerable clin-ical complexity of our patients. Detecting factors associated with frailty is crucial for intervention and prevention of adverse outcomes

ntrodução: a fragilidade, entendida como um estado anterior à incapacidade, confere maior vulnerabi-lidade a estressores externos e contribui para desfechos negativos como quedas, hospitalização, incapa-cidade e mortalidade. O objetivo deste estudo foi identificar a prevalência e avaliar os fatores associados à fragilidade em pacientes do ambulatório de geriatria do Hospital Universitário San Ignacio (husi) de Bogotá, Colômbia. Materiais e métodos: estudo transversal com 689 pacientes atendidos no ambulatório de geriatria do husi entre agosto de 2016 e março de 2020. Foram realizadas regressões logísticas para identificar fatores associados à fragilidade. Resultados: a prevalência de fragilidade foi de 35.4 %. Na análise bivariada, as variáveis associadas à fragilidade foram: idade acima de 80 anos (or:2.07; ic95 %:1.40-3,20; p = 0.001), gênero feminino (or:1.40; ic95 %:0.99-2.02; p = 0.03), multimorbidade (or: 2.13; ic95 %: 1.40-2.90; p < 0.001) e desnutrição (or:2.23; ic95 %:1.22-4.07; p = 0.009). Na análise multivariada, multimorbidade (or:2.46; ic95 %: 1.62-3.75; p = 0.001), velocidade lenta de caminhada (or:5.15; ic95 %:3.0-8.60; p = 0.001) e baixa circunferência da panturrilha (or: 1.60; ic95 %: 1.03-2.50; p = 0.06) foram associados à fragilidade. Conclusão: a prevalência de fragilidade no husi é superior à das referências nacionais; adicionalmente, as variáveis associadas coincidem com as encontradas na literatura; tudo isso em relação à grande complexidade clínica dos nossos pacientes. É fundamental detectar os fatores associados à fragilidade para intervir e prevenir resultados adversos

Sepsis 3-hour bundle compliance and prognosis in emergency department patients aged 65 years or older. / Cumplimiento del paquete de medidas en las primeras tres horas en urgencias y su relación con el pronóstico de los pacientes mayores de 65 años con sepsis.

OBJECTIVES: To analyze 3-hour bundle compliance in for patients aged 65 years or older with sepsis treated in our emergency department (ED) and to explore the association between compliance and mortality. MATERIAL AND METHODS: Retrospective observational study in patients aged 65 years or older treated in our ED between January 1, 2020 and December 31, 2022. Factors associated with mortality at the end of the episode were also analyzed. RESULTS: Data for 190 patients were analyzed; 98 (51%) were men. Eighty-five (45%) were aged between 65 and 79 years, and 105 (55%) were aged 80 years or older. Mortality was higher in the patients over 80 years of age (62%) vs 33% of the patients under 80 years of age (P = .001). Overall mean survival time was 38 days (95% CI, 28-48 days). Cox regression analysis showed that 3-hour bundle compliance was associated with longer survival (HR, 0.56; 95% CI, 0.34-0.95; P = .03). Mean survival in patients older than 80 years was 21 days (95% CI, 13-30 days), and 3-hour bundle compliance was associated with longer survival (hazard ratio, 0.51; 95% CI, 0.3-0.9; P = .02). CONCLUSION: Three-hour sepsis bundle compliance in the ED was associated with longer survival in patients aged 65 years or older.

OBJETIVO: Analizar el cumplimiento del paquete de medidas de tratamiento de la sepsis en las primeras 3 horas de asistencia en urgencias y su relación con la mortalidad en una cohorte de pacientes $ 65 años. METODO: Estudio observacional retrospectivo. Se seleccionaron los pacientes con una edad $ 65 años visitados en urgencias del 1 de enero de 2020 al 31 de diciembre de 2022 diagnosticados de sepsis o shock séptico. Se determinaron los factores asociados a mortalidad al final del episodio. RESULTADOS: Se incluyeron 190 pacientes, 98 (51%) varones y 85 (45%) tenían una edad 65­79 años (añosos) y 105 (55%) $ 80 años (muy añosos). La mortalidad al final del episodio fue mayor en el grupo de pacientes muy añosos (62% vs 33%, p = 0,001). La media de supervivencia fue de 38 días (IC 95%: 28-48). Mediante regresión de Cox se determinó que el cumplimiento del paquete de medidas en las primeras tres horas se asoció a mayor supervivencia (HR: 0,56, IC 95%: 0,34-0,95 p = 0,03). En el grupo de pacientes muy añosos, la media de supervivencia fue de 21 días (IC 95%: 1-30); el cumplimiento de las medidas dentro de las primeras 3 horas se asoció a mayor supervivencia (HR: 0,51, IC 95%: 0,3-0,9 p = 0,02). CONCLUSIONES: El cumplimiento del paquete de medidas en las primeras 3 horas se asoció con una mayor supervivencia en los pacientes mayores de 65 años con sepsis en urgencias.

Assessing the impact of preventative measures to limit the spread of Toxoplasma gondii in wild carnivores of Madagascar.

Novel multihost pathogens can threaten endangered wildlife species, as well as humans and domestic animals. The zoonotic protozoan parasite Toxoplasma gondii is transmitted by members of Felidae and can infect a large number of animal species, including humans. This parasite can have significant health consequences for infected intermediate hosts and could further endanger wild carnivore populations of Madagascar. Building on an empirical characterization of the prevalence of the pathogen in local mammals, we used mathematical models of pathogen transmission in a multihost community to compare preventative measures that aim to limit the spread of this parasite in wild carnivores. Specifically, we examined the effect of hypothetical cat vaccination and population control campaigns on reducing the risk of infection by T. gondii in wild Eupleridae. Our model predicted that the prevalence of exposure to T. gondii in cats would be around 72% and that seroprevalence would reach 2% and 43% in rodents and wild carnivores, respectively. Reducing the rodent population in the landscape by half may only decrease the prevalence of T. gondii in carnivores by 10%. Similarly, cat vaccination and reducing the population of definitive hosts had limited impact on the prevalence of T. gondii in wild carnivorans of Madagascar. A significant reduction in prevalence would require extremely high vaccination, low turnover, or both in the cat population. Other potential control methods of T. gondii in endangered Eupleridae include targeted vaccination of wild animals but would require further investigation. Eliminating the threat entirely will be difficult because of the ubiquity of cats and the persistence of the parasite in the environment.

Evaluación del impacto de las medidas preventivas para limitar el contagio de Toxoplasma gondii en los carnívoros silvestres de Madagascar Resumen Los patógenos novedosos con múltiples hospederos pueden amenazar tanto a las especies silvestres como a los humanos y a los animales domésticos. Los miembros de la familia Felidae transmiten el protozoario parásito Toxoplasma gondii, el cual puede infectar a un gran número de especies animales, incluyendo al humano. Este parásito puede generar consecuencias importantes para la salud en los hospederos intermediarios infectados y podría poner más en peligro a las poblaciones de carnívoros silvestres de Madagascar. Usamos modelos matemáticos de la transmisión de patógenos en una comunidad con múltiples hospederos a partir de una caracterización empírica de la prevalencia del patógeno en los mamíferos locales para comparar las medidas preventivas que buscan limitar la transmisión de este parásito en los carnívoros silvestres. En específico, examinamos el efecto de la vacunación hipotética de felinos y las campañas de control poblacional sobre la reducción del riesgo de infección de T. gondii en los Eupleridae silvestres. Nuestro modelo predijo que la prevalencia de la exposición a T. gondii en los felinos sería de un 72% y que la seroprevalencia llegaría al 2% y al 43% en los roedores y carnívoros silvestres, respectivamente. La reducción a la mitad de la población de roedores en el paisaje podría disminuir sólo en un 10% la prevalencia del protozoario en los carnívoros. De forma similar, la vacunación y la reducción de la población de hospederos definitivos tuvieron un impacto limitado sobre la prevalencia de T. gondii en los carnívoros silvestres de Madagascar. Una reducción significativa en la prevalencia requeriría que la población de felinos tuviera una vacunación extremadamente elevada, baja rotación, o ambas. Otros métodos potenciales de control de T. gondii en los Eupleridae incluyen la vacunación de animales silvestres, pero requieren de mayor investigación. La eliminación completa de la amenaza será difícil por la ubicuidad de los felinos y la persistencia del parásito en el ambiente.

Patient-reported outcome measures for assessing atopic dermatitis in clinical practice. / Medidas de resultados comunicados por el paciente para evaluar la dermatitis atópica.

Atopic dermatitis is a chronic skin condition that affects up to 20% of children and 10% of adults worldwide. Due to the high burden of dermatological signs and symptoms, atopic dermatitis has a significant impact on the quality of life of patients and their families. In the absence of objective measures to accurately assess severity and symptom burden, patient-reported outcome measures are essential to monitor the impact and progression of the disease, as well as the efficacy of treatments. Although there are currently no standardised guidelines for their use in clinical practice, there are some initiatives, such as the Harmonise Outcome Measures for Eczema and Vivir con Dermatitis Atópica, that can provide guidance. As healthcare systems move towards value-based healthcare models, patient-reported measures are becoming increasingly important for incorporating the patient perspective and improving the quality of healthcare services. The use of these measures can help monitor disease activity and guide treatment decisions. This article discusses the impact of atopic dermatitis and describes the patient-reported outcome measures commonly used in atopic dermatitis and the recommendations of the initiatives that have selected a core set of measures to best assess atopic dermatitis in clinical practice. Considering the recommendations of these initiatives and based on our experience in clinical practice, we propose the use of the Dermatology Life Quality Index to assess the impact of the disease on quality of life, the Patient-Oriented Eczema Measure to assess symptom severity, and the Numerical Rating Scale or the Visual Analogue Scale to measure itch intensity. To systematize the administration of these measures and to integrate them into hospital information systems and medical records, we emphasise the importance of telemedicine platforms that allow the electronic administration of these instruments.

Aferição da circunferência da panturrilha no rastreio da sarcopenia em idosos / Assessment of the scope circumference in the screening of sarcopenia in elderly people / Medición de la circunferencia de la pantorrilla en el cribado de sarcopenia en ancianos

Objetivo: Analisar a prática do enfermeiro da atenção primária à saúde acerca da aferição da circunferência da panturrilha no rastreio da sarcopenia em idosos. Métodos: Estudo descritivo de abordagem qualitativa, realizado com enfermeiros que atuam na atenção primária à saúde. As entrevistas foram realizadas mediante utilização de roteiro semiestruturado, nos meses de maio a julho de 2019. Resultados: Participaram do estudo 24 enfermeiros com idade média de 31,4 anos, predominantemente do sexo feminino. O tempo de formação dos participantes variou de cinco meses a 15 anos e, a maioria dos entrevistados relatou possuir pós-graduação (n=18), principalmente nas áreas de saúde da família e urgência e emergência. A maioria não utilizava em sua prática diária a avaliação da circunferência da panturrilha e alguns a realizavam apenas em idosos hipertensos e diabéticos. Conclusão: Há uma escassa utilização da aferição da circunferência da panturrilha na prática clínica do enfermeiro, o que compromete o rastreio da sarcopenia, e consequentemente dificulta a realização de ações que minimizam as complicações desta doença. (AU)

Objective: To analyze the practice of nurses in primary health care about measuring the circumference of the calf in screening for sarcopenia in the elderly. Methods: Descriptive study with a qualitative approach, carried out with nurses who work in primary health care. The interviews were conducted using a semi-structured script, from May to July 2019. Results: 24 nurses with a mean age of 31.4 years, predominantly female, participated in the study. Participants' training time ranged from five months to 15 years, and most respondents reported having a postgraduate degree (n=18), mainly in the areas of family health and urgency and emergency. Most did not use calf circumference assessment in their daily practice and some performed it only in hypertensive and diabetic elderly. Conclusion: There is little use of calf circumference measurement in clinical nursing practice, which compromises sarcopenia screening and, consequently, makes it difficult to carry out actions that minimize the complications of this disease. (AU)

Objetivo: Analizar la práctica de enfermeras de atención primaria de salud sobre la medición de la circunferencia de la pantorrilla en el cribado de sarcopenia en el anciano. Métodos: Estudio descriptivo con abordaje cualitativo, realizado con enfermeras que laboran en la atención primaria de salud. Las entrevistas se realizaron mediante un guión semiestructurado, de mayo a julio de 2019. Resultados: Participaron del estudio 24 enfermeras con una edad promedio de 31,4 años, predominantemente mujeres. El tiempo de formación de los participantes osciló entre cinco meses y 15 años, y la mayoría de los encuestados informó tener un título de posgrado (n = 18), principalmente en las áreas de salud familiar y urgencia y emergencia. La mayoría no utilizó la evaluación de la circunferencia de la pantorrilla en su práctica diaria y algunos la realizaron solo en ancianos hipertensos y diabéticos. Conclusión: La medición del perímetro de la pantorrilla es escasa en la práctica clínica de enfermería, lo que compromete el cribado de sarcopenia y, en consecuencia, dificulta la realización de acciones que minimicen las complicaciones de esta enfermedad. (AU)

Impact of patient safety on outcomes. From prevention to the treatment of post-intensive care syndrome.

Survivors of critical illness may present physical, psychological, or cognitive symptoms after hospital discharge, encompassed within what is known as post-intensive care syndrome. These alterations result from both the critical illness itself and the medical interventions surrounding it. For its prevention, the implementation of the ABCDEF bundle (Assess/treat pain, Breathing/awakening trials, Choice of sedatives, Delirium reduction, Early mobility and exercise, Family) has been proposed, along with additional strategies grouped under the acronym GHIRN (Good communication, Handout materials, Redefined ICU architectural design, Respirator, Nutrition). In addition to these preventive measures during the ICU stay, high-risk patients should be identified for subsequent follow-up through multidisciplinary teams coordinated by Intensive Care Medicine Departments.

A standard lexicon of terms for area-based conservation version 1.0.

Target 3 in the Kunming-Montreal Global Biodiversity Framework (GBF) calls for protecting at least 30% of the world's lands and waters in area-based conservation approaches by 2030. This ambitious 30×30 target has spurred great interest among policy makers, practitioners, and researchers in defining and measuring the effectiveness of these types of approaches. But along with this broad interest, there has also been a proliferation of terms and their accompanying abbreviations used to describe different types of conservation areas and their governance, planning, management, and monitoring. The lack of standard terms is hindering the use and assessment of area-based approaches to conserve the world's biodiversity. It is difficult to track progress toward GBF Target 3 or to share learning with other practitioners if different groups of people are using different words to describe the same concept or similar words to talk about different concepts. To address this problem, the International Union for Conservation of Nature's World Commission on Protected Areas commissioned a task force to review existing terms and recommend a standard English-language lexicon for this field based on key criteria. The results were definitions of 37 terms across 6 categories, including types of protected and additional conservation areas (e.g., protected area, additional conservation area), sets of these areas (protected area network, protected area system), their governance and management (governance, rightsholders), assessment (effectiveness, equitability), spatial planning (key biodiversity area), and action planning (value, outcome, objective). Our standard lexicon can provide a common language for people who want to use it and a shared reference point that can be used to translate various terms used by different groups. The common understanding provided by the lexicon can serve as a foundation for collaborative efforts to improve the policies, implementation, assessments, research, and learning about this important set of conservation approaches.

Un léxico estandarizado de términos para la conservación basada en áreas versión 10 Resumen El objetivo 3 del Marco Global para la Biodiversidad de Kunming­Montreal (GBF) establece la protección de al menos el 30% de los suelos y aguas del planeta con estrategias de conservación basada en áreas para el 2030. Este objetivo ambicioso de 30x30 ha provocado un gran interés por definir y medir la eficiencia de este tipo de estrategias entre quienes hacen las políticas, los practicantes y los investigadores. Junto con este interés generalizado también ha habido una proliferación de términos y abreviaciones usados para describir los diferentes tipos de áreas de conservación y su gestión, planeación, manejo y monitoreo. La falta de términos estandarizados dificulta el uso y la evaluación de las estrategias basadas en áreas para conservar la biodiversidad mundial. Es difícil registrar los avances hacia el Objetivo 3 del GBF o compartir el aprendizaje con otros practicantes si diferentes grupos de personas usan diferentes palabras para describir el mismo concepto o palabras similares para hablar de conceptos distintos. Para abordar este problema, la Comisión Mundial de Áreas Protegidas de la Unión Internacional para la Conservación de la Naturaleza comisionó un grupo de trabajo para que revise los términos existentes y recomiende un léxico estandarizado en inglés para este campo con base en criterios clave. Como resultado obtuvieron la definición para 37 términos de seis categorías, incluyendo los tipos de área protegida y las áreas adicionales de conservación (p. ej.: área protegida, área adicional de conservación), los conjuntos de estas áreas (p. ej.: red de áreas protegidas, sistema de áreas protegidas), su gestión y manejo (gobernanza, derechohabientes), evaluación (efectividad, equidad), planeación espacial (área clave de biodiversidad) y plan de acción (valor, resultado, objetivo). Nuestro léxico estandarizado puede proporcionar un lenguaje común para la gente que quiera usarlo y una referencia compartida que puede usarse para traducir varios términos que usan los diferentes grupos. El conocimiento común proporcionado por el léxico puede fungir como una base para que los esfuerzos colaborativos mejoren las políticas, implementación, evaluación, investigación y aprendizaje sobre este conjunto importante de estrategias de conservación.

Política Antimanicomial do ERJ / Anti-Asylum Policy from ERJ

Tem como objetivo pactuar em CIB, apresentar o marcos normativos, atribuiçoes da programa AMAQ e equipes EAP.

The Moderating Role of Perceived Efficacy of COVID-19 Prevention Measures on the Relation Between Perceived Risk and Perceived Mental Health / El rol moderador de la eficacia percibida de las medidas de prevención frente al COVID-19 en la relación entre la percepción de riesgo y la salud mental percibida

La pandemia del COVID-19 ha llevado a los países a adoptar severas y prolongadas medidas que —junto con el alto número de contagios y muertes y la continua información negativa— ha afectado la salud mental de las personas. Este estudio analiza el impacto de la crisis sanitaria del COVID-19 en España explorando el rol moderador de la eficacia percibida de las medidas de contención en la relación que establece la percepción del riesgo del COVID-19 con el estrés y la depresión. Un total de 478 adultos residentes en España (un 66.9% mujeres; Medad = 36.30, DT = 15.32) completaron un cuestionario con escalas concebidas para medir el riesgo percibido del COVID-19, la eficacia percibida de las medidas de protección, el estrés y la depresión entre el 16 de mayo y el 6 de junio de 2021. Los resultados confirmaron el rol moderador de la eficacia percibida, la cual actuó como un factor protector del estrés y la depresión al disminuir el impacto negativo que la percepción de riesgo del COVID-19 tiene en ambas variables relacionadas con el distrés mental. La percepción que tienen los individuos sobre la efectividad de las medidas de protección parece ser un factor protector relevante en relación con la salud mental durante una pandemia. Se subraya la relevancia de intervenciones psicológicas y de políticas gubernamentales que mejoren la comunicación positiva del riesgo y la información adecuada sobre la eficacia de las medidas de protección.(AU)

The pandemic situation caused by COVID-19 led countries to adopt harsh and prolonged (over time) measures that—along with the high number of infections and deaths and continuous negative information—have affected the mental health of individuals. In this study, the impact on mental health of the COVID-19 health crisis in Spain was explored through the perceived efficacy of pandemic containment measures as a moderator of the relationship that COVID-19 perceived risk establishes with stress and depression. A questionnaire composed of scales conceived to measure COVID-19 perceived risk, perceived efficacy of COVID-19 prevention measures, stress, and depression was completed by 478 adults living in Spain (66.9% females, Mage= 36.30, SD= 15.32) between May 16, 2021, and June 6, 2021. The results confirmed the moderating role of per-ceived efficacy. Perceived efficacy acted as a protective factor for stress and depression by decreasing the negative impact that perceived risk had on both variables related to mentaldistress. Also, the perception that par-ticipants had about the effectiveness of prevention measures appeared to be a relevant protective factor regarding mental health during the pandem-ic. This study highlights the relevance of psychological interventions and government policies that improve positive risk communication and pro-vide adequate information regarding the effectiveness of health-prevention measures.(AU)

4 Domain Sports PROM in Spanish: Cross-cultural adaptation in the Chilean population and reliability analysis. / 4 Domain Sports PROM en español: adaptación transcultural en la población chilena y análisis de confiabilidad.

BACKGROUND: Patient-Reported Outcome Measures (PROMs) are tools of increasing interest in the sports population. The purpose of this study was to perform the cross-cultural adaptation and reliability analysis of the 4 Domain Sports Patient-Reported Outcome Measure (4DSP) into Spanish. METHODS: A six-stage cross-cultural adaptation protocol was executed to obtain the Spanish version of the 4DSP (S-4DSP). Subsequently, the questionnaire was administered to a population of 108 postoperative athletes with ACL (Anterior Cruciate Ligament) injuries. The questionnaire was administered again after 30 days. Acceptability, floor and ceiling effects, internal consistency (Cronbach's alpha), and reproducibility (Intraclass Correlation) were evaluated. RESULTS: The S-4DSP was fully completed by 108 participants (mean age 34±10.75, 26% women), achieving 100% acceptability. No floor effect was detected. The statistical analysis yielded a global Cronbach's alpha for the questionnaire of 0.65, and domain-specific alphas of 0.88, 0.72, 0.27, and 0.68 for the first, second, third, and fourth domains, respectively. The Intraclass Correlation test reached a maximum of 0.94 and a minimum of 0.48 for the first and fifth questions, respectively. CONCLUSIONS: The S-4DSP is a reliable and useful tool for evaluating Spanish-speaking athletes after ACL reconstruction.

Nivel de conocimientos, de actitudes y utilización de medidas preventivas entre los contactos domiciliarios de casos de COVID-19 tras la fase aguda de la pandemia / Level of knowledge, attitudes and the use of preventive measures among household contacts of COVID-19 cases after the acute phase of the pandemic

Fundamento. Describir el nivel de conocimiento y actitudes sobre la COVID-19 y sus medidas preventivas en contactos domiciliarios de casos de COVID-19 tras la fase aguda de la pandemia. Métodos. Encuesta a contactos domiciliarios de casos de COVID-19 realizada en centros de salud de Navarra (1) y Cataluña (8) entre mayo/2022 y julio/2023. Se evaluó el uso de medidas preventivas y, mediante 12 ítems, los conocimientos y actitudes frente a COVID-19. Resultados. Participaron 215 contactos que usaron correctamente las medidas preventivas (>85%), exceptuando mascarilla (35,8%) y distancia interpersonal (47%); >85% mostraron conocimientos adecuados en 5/6 ítems y >80% mostraron actitud positiva en 3/6 ítems. El 54,7% consideró que la COVID-19 influyó negativamente en su vida y el 54,1% que es mejor desarrollar inmunidad enfermando que mediante la vacunación. Conclusiones. Los contactos domiciliarios mostraron un correcto nivel de conocimiento y una actitud positiva frente a la COVID-19 y sus medidas preventivas. (AU)

Background. Assessment of the level of knowledge and attitudes regarding COVID-19 and preventive measures in household contacts of COVID-19 cases after the acute phase of the pandemic. Methods. Survey among household contacts of COVID-19 cases conducted in healthcare centers in Navarre (1) and Catalonia (8) between May 2022 and July 2023. The frequency of use of preventive measures and the knowledge and attitudes towards COVID-19 were assessed through 12 items. Results. 215 contacts participated who correctly used the preventive measures (>85%), except for facemasks (35.8%) and interpersonal distance (47%); >85% showed adequate knowledge (5/6 items) and >80% had a positive attitude (3/6 items). Moreover, 54.7% considered that COVID-19 negatively affected their life and 54.1% that it is better to develop immunity by getting infected than by vaccination. Conclusions. Household contacts show a correct level of knowledge and positive attitude towards the disease and its preventive measures. (AU)

Bottom-up global biodiversity metrics needed for businesses to assess and manage their impact.

Ensuring that companies can assess and manage their impacts on biodiversity will be crucial to solving the current biodiversity crisis, and regulatory and public pressure to disclose these impacts is increasing. Top-down intactness metrics (e.g., Mean Species Abundance) can be valuable for generating high-level or first-tier assessments of impact risk but do not provide sufficient precision or guidance for companies, regulators, or third-party assessors. New metrics based on bottom-up assessments of biodiversity (e.g., the Species Threat Abatement and Restoration metric) can accommodate spatial variation of biodiversity and provide more specific guidance for actions to avoid, reduce, remediate, and compensate for impacts and to identify positive opportunities.

Cuantificación vertical de la biodiversidad mundial necesarias para que las empresas evalúen y gestionen su impacto Resumen Para resolver la actual crisis de biodiversidad, es importante asegurar que las empresas puedan evaluar y gestionar su impacto sobre la biodiversidad. Además, cada vez es mayor la presión pública y legislativa para divulgar este impacto. La cuantificación vertical de la integridad (p. ej.: Abundancia Media de Especies) puede ser valiosa para producir evaluaciones de alto nivel o primera categoría del riesgo de impacto, pero no proporcionan suficiente precisión o guía para las empresas, los reguladores o los asesores de terceros. Las nuevas medidas basadas en evaluaciones verticales (p. ej.: la medida de Abatimiento y Restauración de Amenazas de Especies) pueden acomodar la variación espacial de la biodiversidad y proporcionar una guía más específica para las acciones necesarias para evitar, reducir, remediar y compensar los impactos e identificar las oportunidades positivas.

Risk Perceptions Regarding COVID-19 and Compliance with Protective Measures of Midwifery and Nursing Senior Students / Percepções de Risco Relacionadas à COVID-19 e Cumprimento de Medidas de Proteção de Estudantes Séniores de Obstetrícia e Enfermagem / Percepciones de Riesgo con respecto a COVID-19 y Cumplimiento de Medidas de Protección en Estudiantes Seniors de Obstetricia y Enfermería

ABSTRACT Objective: This study aims to examine the risk perceptions of midwifery and nursing senior students regarding COVID-19 and compliance with vaccination and protective measures. Method: This cross-sectional study was conducted in two academic years on senior midwifery and nursing students (n = 358). In the present study, the descriptive characteristics of the students and the COVID-19 risk perception scale were used. Results: The students' COVID-19 Risk Perception Scale scores were at a moderate level and a similar level in both years of this study. More than 80% of the students were fully vaccinated, and the family history of COVID-19 was positive in approximately half of them. In the second year of the pandemic, they paid less attention to social distance and avoidance of being indoors. Conclusion: Although the COVID-19 risk perceptions of future health professional students remained at a similar level during the examined period, it was found that in the second year of the pandemic, they started to get used to the process and paid less attention to social protective measures.

RESUMO Objetivo: Este estudo tem como objetivo examinar as percepções de risco de estudantes sêniores de obstetrícia e enfermagem em relação à COVID-19 e o cumprimento das medidas de vacinação e proteção. Método: Este estudo transversal foi realizado ao longo de dois anos acadêmicos com estudantes sêniores de obstetrícia e enfermagem (n = 358). No presente estudo, foram utilizadas as características descritivas dos estudantes e a escala de percepção de risco da COVID-19. Resultados: As pontuações dos estudantes na Escala de Percepção de Risco da COVID-19 situaram-se num nível moderado e semelhante em ambos os anos do estudo. Mais de 80% dos estudantes estavam totalmente vacinados, e aproximadamente metade deles tinha histórico familiar de COVID-19. No segundo ano da pandemia, prestaram menos atenção ao distanciamento social e aos hábitos de evitar permanência em espaços fechados. Conclusão: Embora as percepções de risco da COVID-19 dos futuros profissionais de saúde tenham permanecido em níveis semelhantes durante o período examinado, verificou-se que, no segundo ano da pandemia, começaram a acostumar-se com o processo e prestaram menos atenção às medidas de proteção social.

RESUMEN Objetivo: Este estudio tiene como objetivo examinar las percepciones de riesgo de los estudiantes seniors de obstetricia y enfermería con respecto a COVID-19 y su cumplimiento con la vacunación y las medidas de protección. Método: Este estudio transversal se llevó a cabo en dos años académicos con estudiantes seniors de obstetricia y enfermería (n = 358). En el presente estudio, se utilizaron las características descriptivas de los estudiantes y la escala de percepción de riesgo de COVID-19. Resultados: Las puntuaciones en la Escala de Percepción de Riesgo de COVID-19 de los estudiantes estaban en un nivel moderado y similar en ambos años de este estudio. Más del 80% de los estudiantes estaban completamente vacunados y la historia familiar de COVID-19 fue positiva en aproximadamente la mitad de ellos. En el segundo año de la pandemia, prestaron menos atención a la distancia social y a evitar estar en interiores. Conclusión: Aunque las percepciones de riesgo de COVID-19 de los futuros profesionales de la salud se mantuvieron en un nivel similar durante el período examinado, se encontró que en el segundo año de la pandemia, empezaron a acostumbrarse al proceso y prestaron menos atención a las medidas de protección social.

Bone reconstruction in the treatment of tibial hemimelia: an alternative to amputation? / Reconstrução óssea no tratamento da hemimelia tibial: uma alternativa para amputação?

ABSTRACT Objective: To evaluate the advantages and disadvantages of bone reconstruction and lengthening compared to amputation in the treatment of tibial hemimelia for patients and their families. Methods: Systematic review of articles published in English and Portuguese between 1982 and 2022 in the MEDLINE, PubMed, Cochrane and SciELO databases. The variables of interest were: year of publication, sample characteristics, classification of tibial hemimelia according to Jones, treatment outcome and follow-up time. Results: A total of eleven articles were included in the scope of this review. The studies involved 131 patients, 53.4% male and 46.6% female. The age of the patients who underwent a surgical procedure ranged from 1 year and 10 months to 15 years. The most common type was Jones' I (40.9%). The most recurrent complications in the reconstruction treatment were: infection of the external fixator path, flexion contracture (mainly of the knee), reduction in the range of motion of the knee and ankle. Conclusion: We did not find enough relevant studies in the literature to prove the superiority of reconstruction. Amputation remains the gold standard treatment for tibial hemimelia to this day. Level of Evidence III, systematic review of level III studies

RESUMO Objetivo: Avaliar as vantagens e desvantagens da reconstrução óssea e alongamento comparada à amputação no tratamento da hemimelia tibial para pacientes e familiares. Métodos: Revisão sistemática, com análise de artigos publicados nas línguas inglesa e portuguesa entre 1982 e 2022, nas bases de dados MEDLINE, PubMed, Cochrane e SciELO. As variáveis de interesse foram: ano de publicação, característica da amostra, classificação da hemimelia tibial segundo Jones, desfecho do tratamento e tempo de seguimento. Resultados: Fizeram parte do escopo desta revisão onze artigos. Os estudos envolveram 131 pacientes, 53,4% do sexo masculino e 46,6% do feminino. A idade dos pacientes submetidos a algum procedimento cirúrgico variou de 1 ano e 10 meses a 15 anos. O tipo mais comum foi o I de Jones (40,9%). As complicações mais recorrentes no tratamento pela reconstrução foram: infecção do trajeto de pinos do fixador externo, contratura em flexão (principalmente do joelho), redução do arco de movimento de joelho e tornozelo. Conclusão: Não encontramos na literatura estudos suficientemente relevantes para comprovar a superioridade da reconstrução. A amputação se mantém até os dias de hoje o tratamento padrão-ouro para hemimelia tibial. Nível de evidência III; revisão sistemática de estudos de nível III.

Growth charts of Brazilian youngs: 20-years data of 95,000 children and adolescents from "Projeto Esporte Brasil" / Curvas de crescimento de jovens brasileiros: dados de 20 anos com 95.000 crianças e adolescentes do "Projeto Esporte Brasil"

Abstract This article aims to present growth curves for height, weight, and BMI of 95,000 Brazilian youths aged 6 to 17 years, including the five regions of the country, the Amazon region, and indigenous populations, and compare them with the World Health Organization (WHO) growth references. The final sample consisted of 52,729 boys and 42,731 girls from the "Projeto Esporte Brasil" database. Body mass and height information were used to derive the curves. The generalized additive model for location, scale, and shape was employed. In this study, we present smoothed weight-for-age, height-for-age, and BMI-for-age curves for boys and girls. Differences were observed between the results of the Brazilian curves and the WHO growth references. The developed curves will be valuable for professionals in medicine, public health, nutrition, physical education, and other related fields, regarding the assessment of physical growth in Brazilian children and adolescents and monitoring the nutritional status of this population. Additionally, these curves will facilitate the identification of individuals or subgroups at risk of diseases and delayed growth, with a greater focus on specific country-related factors.

Resumo O objetivo do artigo é apresentar curvas de crescimento de altura, peso e IMC de 95.000 jovens brasileiros com idades entre 6 e 17 anos, incluindo as cinco regiões do país, a região da Amazônia e os povos indígenas, e comparar com as referências de crescimento da Organização Mundial da Saúde (OMS). A amostra final foi composta por 52.729 meninos e 42.731 meninas provenientes do banco de dados do "Projeto Esporte Brasil". As informações de massa corporal e estatura foram utilizadas para derivar as curvas. O modelo aditivo generalizado para localização, escala e forma foi usado. neste estudo, apresentamos as curvas suavizadas de peso-idade, altura-idade e IMC-idade para meninos e meninas. Foram observadas diferenças entre os resultados das curvas brasileiras e as referências de crescimento da OMS. As curvas desenvolvidas serão úteis para profissionais da medicina, saúde pública, nutrição, educação física, entre outros, no que diz respeito a avaliação do crescimento físico de crianças e adolescentes brasileiros e para monitorar o estado nutricional desta população. Além disso, essas curvas permitirão a detecção de indivíduos ou subgrupos em risco de doenças e crescimento retardado, com um foco maior em fatores específicos do país.

Long-term visual acuity results from cataract surgery and its association with self-reported visual function: Catquest applicability / Resultados acuidade visual a longo prazo da cirurgia de catarata e sua associação com função visual autorreferida: aplicabilidade do Catquest

ABSTRACT Purposes: This study aimed to determine the association of the long-term refractive outcomes of cataract surgery with self-reported visual function obtained using Catquest-9SF. Methods: Patients recruited from the cataract outpatient clinic of VER MAIS Oftalmologia underwent a complete ophthalmologic examination. Patients who were diagnosed with cataract with indications for phacoemulsification and intraocular lens implantation received the Catquest-9SF questionnaire before and after surgery at 30 days and 1 year. Results: A total of 133 patients were recruited, but 32 patients were lost to follow-up; finally, data from 101 patients (48 men, 53 women) were analyzed. The crude variance explained by the data was 69.9%, and the unexplained variance in the first contrast was 2.39 eigenvalues (>2); thus, these results are different from those expected from random data. The people separation index was 2.95 (>2), and the people trust value was 0.9 (>0.8). These indices were evaluated in the assessment of skill levels. Visual acuity was the main variable that correlated with the Catquest score. Conclusions: The Catquest-9SF translated into Portuguese proved to be a one-dimensional and psychometrically valid tool to assess visual dysfunction in patients with cataract, and it is successful in objectively quantifying improvements after surgery. The results of this tool could be predictive and concordant of visual acuity improvement.

RESUMO Objetivo: Associar os resultados refrativos a longo prazo da cirurgia de catarata e a função visual autorreferida pelo questionário Catquest-9SF. Métodos: Paciente recrutados no ambulatório de catarata da VER MAIS Oftalmologia, foram submetidos a exame oftalmológico completo. Após diagnóstico de catarata com indicação de tratamento cirúrgico com facoemulsificação e implante de lente intraocular, o questionário foi aplicado antes da intervenção, 30 dias após cirurgia e 1 ano após, novamente. Resultados: Foram recrutados 133 pacientes. No decorrer do seguimento, 32 pacientes foram perdidos e ao final foram analisados os dados de 101 pacientes, dos quais 48 foram homens e 53 foram mulheres. A variância bruta explicada por dados foi de 69,9% e a inexplicada em primeiro contraste por 2,39 eigenvalores, sendo maior que 2, o que nos mostra que são resultados differentes dos esperados de dados aleatórios. O índice de separação de pessoas foi de 2.95 (>2) e o valor de confiança de pessoas foi de 0,9 (>0,8). Estes índices são os valores mínimos aceitáveis na diferenciação de níveis de habilidade. Acuidade visual foi a principal variável correlacionada com o score do Catquest. Conclusões: O Catquest-9SF traduzido para o português se demonstrou unidimensional e uma ferramenta psicometricamente válida para avaliar disfunção visual em pacientes com catarata, além de ter tido sucesso para quantificar objetivamente melhoras após a intervenção cirúrgica. Essa ferramenta pode ser utilizada como preditiva e concordante da melhora da acuidade visual.

Equilíbrio, quedas e risco de quedas na DPOC: revisão sistemática dos instrumentos de avaliação, propriedades de medida e utilidade clínica / Balance, falls, and risk of falls in COPD: systematic review of assessment instruments, measurement properties, and clinical utility

Resumo Objetivos Identificar os instrumentos de avaliação de equilíbrio, quedas e risco de quedas utilizados na DPOC, avaliar suas propriedades de medida, qualidade da evidência e utilidade clínica. Método A revisão foi produzida seguindo as orientações PRISMA e COSMIN, registrada no PROSPERO: CRD42021235118. As pesquisas foram realizadas de novembro de 2021 a setembro de 2022 nas bases de dados PubMed, LILACS, CINAHL, Embase, Web of Science e PEDro. Estudos observacionais transversais e coorte foram incluídos, sem restrição de idioma ou ano de publicação, desde que descreveram instrumentos clínicos de avaliação do equilíbrio, quedas e risco de quedas reportando no mínimo, uma das propriedades de medida: validade, confiabilidade e responsividade. Dois revisores independentemente aplicaram os critérios de elegibilidade, risco de viés pela COSMIN, qualidade da evidência pela abordagem GRADE e a avaliação da utilidade clínica pela Escala de Tyson e Connell. Resultados 9.102 estudos foram selecionados e 21 incluídos na revisão, nove estudos demonstraram propriedades de medida adequadas e suficientes e 12 instrumentos foram identificados, dos quais seis, foram avaliados quanto a qualidade de evidência. Conclusão Revisões sistemáticas de propriedades de medida requerem revisores especializados e habilidade em análise qualitativa. Com grau de recomendação "A", a Berg Balance Scale (BBS) e o teste Timed Up and Go (TUG) foram os instrumentos mais indicados na DPOC. Ao acrescentar a avaliação da utilidade clínica ao resultado, o TUG demonstra superioridade ao BBS, demostrando ser uma ótima ferramenta para triar indivíduos que necessitem de uma avaliação minuciosa do equilíbrio, quedas e risco de quedas.

Abstract Objectives to identify balance assessment instruments, issues and risks of issues used in COPD, evaluate their measurement properties, quality of evidence and clinical utility. Method A review was produced following the PRISMA and COSMIN guidelines, registered in PROSPERO: CRD42021235118. Searches were carried out from November 2021 to September 2022 in the PubMed, LILACS, CINAHL, Embase, Web of Science and PEDro databases. Cross-sectional and cohort observational studies were included, without restrictions on language or year of publication, as long as they described clinical instruments for assessing balance, falls and risk of falls reporting at least one of the measurement properties: validity, reliability and responsiveness. Two reviewers will independently apply the eligibility criteria, travel risk by COSMIN, quality of evidence by the GRADE approach and assessment of clinical utility by the Tyson and Connell Scale. Results 9,102 studies were selected and 21 included in the review, nine studies demonstrated adequate and sufficient measurement properties and 12 instruments were identified, of which six were evaluated for the quality of evidence. Conclusion Systematic reviews of measurement properties require specialized reviewers and skills in qualitative analysis. With a recommendation GRADE of "A", the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test were the most recommended instruments for COPD. By requiring the evaluation of the clinical utility of the result, the TUG demonstrates superiority to the BBS, proving to be a great tool for judging individuals who need a thorough assessment of balance, falls and risk of falls.