Seasonal influenza vaccination in the Americas: Progress and challenges during the COVID-19 pandemic.

BACKGROUND: Vaccination is one of the most effective measures to prevent influenza illness and its complications; influenza vaccination remained important during the COVID-19 pandemic to prevent additional burden on health systems strained by COVID-19 demand. OBJECTIVES: We describe policies, coverage, and progress of seasonal influenza vaccination programs in the Americas during 2019-2021 and discuss challenges in monitoring and maintaining influenza vaccination coverage among target groups during the COVID-19 pandemic. METHODS: We used data on influenza vaccination policies and vaccination coverage reported by countries/territories via the electronic Joint Reporting Form on Immunization (eJRF) for 2019-2021. We also summarized country vaccination strategies shared with PAHO. RESULTS: As of 2021, 39 (89 %) out of 44 reporting countries/territories in the Americas had policies for seasonal influenza vaccination. Countries/territories adapted health services and immunization delivery strategies using innovative approaches, such as new vaccination sites and expanded schedules, to ensure continuation of influenza vaccination during the COVID-19 pandemic. However, among countries/territories that reported data to eJRF in both 2019 and 2021, median coverage decreased; the percentage point decrease was 21 % (IQR = 0-38 %; n = 13) for healthcare workers, 10 % (IQR = -1.5-38 %; n = 12) for older adults, 21 % (IQR = 5-31 %; n = 13) for pregnant women, 13 % (IQR = 4.8-20.8 %; n = 8) for persons with chronic diseases, and 9 % (IQR = 3-27 %; n = 15) for children. CONCLUSIONS: Countries/territories in the Americas successfully adapted influenza vaccination delivery to continue vaccination services during the COVID-19 pandemic; however, reported influenza vaccination coverage decreased from 2019 to 2021. Reversing declines in vaccination will necessitate strategic approaches that prioritize sustainable vaccination programs across the life course. Efforts should be made to improve the completeness and quality of administrative coverage data. Lessons learned from COVID-19 vaccination, such as the rapid development of electronic vaccination registries and digital certificates, might facilitate advances in coverage estimation.

Formation of Interpersonal Competencies Through Interprofessional Simulation: Nursing and Medicine.

AIM: The aim of this study was to analyze the process of interpersonal competencies formation in nursing and medical students who participated in a standardized interprofessional clinical simulation. BACKGROUND: Interprofessional education in health sciences has had an important impact on the development of relational qualities centered on the patient. METHOD: The study followed a qualitative interpretive approach with students. Students who participated in clinical simulation activities were asked about their experiences and their learning process with respect to interpersonal competencies. A thematic analysis of the data was performed. RESULTS: Three themes emerged: 1) approaching the practice with uncertainty and fear of new relationships, 2) reflecting on decisions while recognizing distinctive roles, and 3) recognizing the human sense of practice while developing skills for caring and curing. CONCLUSION: Students underwent this process and learned about empathy, communication, critical reflexive thinking, and teamwork.

Simulación interprofesional en estudiantes de enfermería y medicina, experiencias de sus protagonistas / Interprofessional Simulation with Nursing and Medical Students: The Protagonists' Experiences

Introducción: El impacto que ha tenido la implementación y avance de la educación interprofesional en las ciencias de la salud, ha demostrado que, articulado a diferentes estrategias didácticas, como la simulación clínica estandarizada, optimiza el aprendizaje colaborativo y el trabajo en equipo. Objetivo: Comprender los significados que estudiantes de enfermería y medicina le otorgaron a la educación interprofesional, desarrollada a través de simulación clínica estandarizada. Métodos: Estudio cualitativo interpretativo, donde a través de una determinación a priori basadas en criterios, se seleccionaron 40 estudiantes de enfermería y medicina que participaron de cuatro casos dentro de simulación clínica estandarizada, durante el segundo semestre del año 2019. Estas interacciones fueron videograbadas y luego se realizaron grupos focales para indagar la experiencia que los estudiantes habían tenido en la actividad simulada. Se realizó análisis de contenido de los videos y los grupos focales hasta que no se encontraron nuevos códigos. Resultado: Emergieron tres categorías principales: 1) Identificar las habilidades relacionales necesarias para la atención, 2) Aprender a colaborar a través de la educación interprofesional y 3) Sensaciones implícitas dentro de la simulación interprofesional. Conclusiones: La experiencia y significado que los estudiantes de enfermería y medicina le otorgaron a esta didáctica interprofesional les ayudó a reconocer la reflexión como punto de partida para el aprendizaje significativo y a descubrir en el compañero saberes que podían nutrir su proceso de formación, así como impactarlos en el desarrollo de habilidades interpersonales importantes en la práctica y que aplicarán en su futuro profesional(AU)

Introduction: The impact of the implementation and advancement of interprofessional education in health sciences has shown that, in articulation with different didactic strategies (such as standardized clinical simulation), collaborative learning and teamwork are optimized. Objective: To understand the meanings that nursing and medical students gave to interprofessional education, developed through standardized clinical simulation. Methods: An interpretive qualitative study was conducted, by means of an a priori determination based on criteria; 40 nursing and medical students were selected to participate in four cases within standardized clinical simulation, during the second semester of 2019. These interactions were recorded and focus groups were then held to delve into the students' experience of the simulated activity. Content analysis was applied to the videos and focus groups until new codes were found. Results: Three main categories emerged: 1) identifying relational skills needed for care, 2) Learning how to collaborate through interprofessional education, and 3) implicit feelings within interprofessional simulation. Conclusions: The experience and meaning that nursing and medical students gave to this interprofessional didactic resource helped them recognize thinking as a starting point for meaningful learning, as well as discover, in their partners, knowledge that could nurture their training process and impact them in the development of important interpersonal skills in practice and that they will apply in their professional future(AU)

Promoting immunization equity in Latin America and the Caribbean: Case studies, lessons learned, and their implication for COVID-19 vaccine equity.

In 2020, the World Health Organization launched the Immunization Agenda 2030: A Global Strategy to Leave No One Behind, which prioritizes high equitable immunization coverage at the national level and in all districts. Achieving high and homogenous immunization coverage, which is all the more important within the current context of the COVID-19 pandemic and vaccine rollout, requires the strengthening of existing immunization activities and innovative approach to immunization promotion. This research applied a descriptive case study methodology to document the implementation of strategic multi-level alliances to promote equitable immunization access and demand in Colombia, Guyana, and Sucre, Bolivia. Data collection, carried out between September 2019 and March 2020, included documentary reviews, semi-structured interviews, focus groups, and site visits accompanied by discussions with relevant stakeholders. Case studies provide valuable examples of people-centered, partnership-based, country-owned, and data-guided approaches to promoting equitable immunization coverage, including multi-level partnerships to build technical capacity for the identification and measurement of social inequalities impacting immunization in Colombia; intersectoral and community collaboration for pro-equity emergency response to regional vaccine preventable disease outbreaks in Guyana; and strategic alliances with the education sector and civil society organizations for the introduction of the human papilloma virus (HPV) vaccine in Sucre, Bolivia. Lessons learned highlight avenues for improving the impact of multi-level, equity-focused capacity building, particularly at the local level; optimizing the use of data and resources, partnerships, and community and stakeholder education and empowerment. While impact studies are needed to better understand the quantitative contributions of such strategic alliances, these case studies illustrate their practical significance and reinforce the value of multi-level, intersectoral collaboration for enhancing equitable immunization access and demand. The experiences of Colombia, Guyana, and Sucre, Bolivia provide evidence-based insight to support pro-equity immunization program planning to ensure that no one is left behind and that everyone, everywhere receives the benefits of vaccines, both routine and for COVID-19.

Higher education managers' perspectives on quality management and technology acceptance: A tale of elders, mediators, and working bees in times of Covid-19.

The Covid-19 pandemic has emphasized the role of educational management information systems (EMIS) for quality management (QM) in higher education, and set new directions for post-pandemic studies. Successful implementation of QM processes depends largely on managers' perceptions about quality and educational technology. However, higher education managers' profiles regarding these quality perceptions and their EMIS acceptance have been insufficiently investigated so far. In response to this research gap, we identified such profiles based on a quantitative survey of N = 70 managers from Chilean higher education institutions during the Covid-19 pandemic. A cluster analysis revealed three distinct manager types: "Elders" (oldest participants, almost equally distributed across positions, with least frequent EMIS access, moderate EMIS acceptance, and highest QM perceptions), "Mediators" (in operational and middle-management positions, with moderately frequent access to EMIS, and lowest EMIS acceptance and QM perceptions), and "Working Bees" (younger females in operational positions, with most frequent EMIS access, highest EMIS acceptance, and moderate QM perceptions). Knowledge of these profiles may enable customized training in the recovery after the Covid-19 pandemic.

Anxiety, Low Self-Esteem and a Low Happiness Index Are Associated with Poor School Performance in Chilean Adolescents: A Cross-Sectional Analysis.

OBJECTIVE: To analyze the relationship between anxiety, self-esteem, happiness index and primary school students' academic performance in Chilean adolescents from the Biobío province. METHODOLOGY: 733 (46.1% girls; 12 (1.3 years)) public primary school students that completed the 2018 Health and School Performance Survey carried out in the Biobío province were included in this cross-sectional analysis. The BECK Anxiety Inventory (BAI) was used to measure anxiety while happiness index and self-esteem were measured using the subjective happiness scale and the Rosenberg self-esteem scale, respectively. School performance was measured by grade point average (GPA) of language, math, physical education and cumulative GPA, and behavior associated with cognition in the school context was also considered. The relationship between mental health indicators and school performance was investigated using a one-way ANOVA and Pearson correlation. RESULTS: In comparison to students with low anxiety levels and high self-esteem and happiness levels, students with higher anxiety levels, lower self-esteem and happiness levels perceived themselves as having memory problems. They were also slower to solve math problems, had a shorter attention span in class and presented more difficulties in solving complex tasks, as well as being more nervous during testing. These students also got the lowest grade point average in math, language and physical education. CONCLUSIONS: High anxiety levels, low self-esteem and low happiness levels were associated with lower school performance and weaker behavior associated with cognition in Chilean adolescents. Implementing plans of emotional education and mental health could improve academic achievement.

[Toxoplasma gondii IgG seroprevalence in children with cancer from National Children's Antineoplastic Drug Program network in the Metropolitan Region, Chile: a multicenter study]. / Estudio multicéntrico, de seroprevalencia de IgG Toxoplasma gondii en niños con cáncer de la red del Programa Infantil Nacional de Drogas Antineoplásicas en la Región Metropolitana, Chile.

BACKGROUND: Toxoplasma gondii is a protozoan that affects a third of the world population and whose updated seroprevalence in children with cancer in our environment is unknown. AIM: To describe the seroprevalence of IgG anti-T. gondii in pediatric population with cancer treated in hospitals of the Metropolitan Region, Chile. METHOD: Cross-sectional study of the population of pediatric cancer patients treated in Santiago city, A serum sample was taken from 100 patients between June 2016 and May 2019. ELISA IgG T. gondii was performed. RESULTS: Of 100 children, 51% male. 12 were positive (12%), 84 negative (84%) and 4 indeterminate (4%). The stratification by age showed 43% patients between 0-5 years, 29% between 6-10 years, 20% in the group of 11-15 years and 8% in patients > 15 years. Sixty one percent of the samples came from patients with acute leukemia. The percentage of women who tested positive for IgG was 21% compared to 4% in men (P < 0.0011). CONCLUSION: 84% of children undergoing cancer treatment are seronegative for T. gondii, so it is important to educate on the prevention of the acquisition of this parasite in this population, due to the risk of developing serious and fatal disease.

Estudio multicéntrico, de seroprevalencia de IgG Toxoplasma gondii en niños con cáncer de la red del Programa Infantil Nacional de Drogas Antineoplásicas en la Región Metropolitana, Chile / Toxoplasma gondii IgG seroprevalence in children with cancer from National Children's Antineoplastic Drug Program network in the Metropolitan Region, Chile: a multicenter study

INTRODUCCIÓN: Toxoplasma gondii es un protozoo que afecta a un tercio de la población mundial y cuya seroprevalencia actualizada en niños con cáncer en nuestro medio, se desconoce. OBJETIVO: Describir la seroprevalencia de IgG anti-T. gondii en población pediátrica con cáncer atendida en hospitales públicos de la Región Metropolitana, Chile. MÉTODO: Estudio transversal de pacientes pediátricos oncológicos atendidos en la ciudad de Santiago. Se tomó una muestra de suero de 100 pacientes entre junio de 2016 y mayo de 2019. Se les realizó ELISA IgG T. gondii. RESULTADOS: Se analizaron 100 muestras, 51% de sexo masculino. Resultaron 12 positivas, 84 negativas y 4 indeterminadas. Los sueros de los pacientes se estratificaron por edad: 0-5 años 43%, 6-10 años 29%, 11-15 años 20% y > 15 años, 8%. El 61% eran pacientes con leucemia aguda. El porcentaje de mujeres con IgG positiva fue de 21% en comparación a 4% en hombres (P < 0,0011). CONCLUSIÓN: El 84% de los niños en tratamiento por cáncer son seronegativos para T. gondii, por lo que es importante educar en la prevención de la adquisición de este parásito en esta población, por el riesgo de desarrollar enfermedad grave con riesgo de muerte.

BACKGROUND: Toxoplasma gondii is a protozoan that affects a third of the world population and whose updated seroprevalence in children with cancer in our environment is unknown. AIM: To describe the seroprevalence of IgG anti-T. gondii in pediatric population with cancer treated in hospitals of the Metropolitan Region, Chile. METHOD: Cross-sectional study of the population of pediatric cancer patients treated in Santiago city, A serum sample was taken from 100 patients between June 2016 and May 2019. ELISA IgG T. gondii was performed. RESULTS: Of 100 children, 51% male. 12 were positive (12%), 84 negative (84%) and 4 indeterminate (4%). The stratification by age showed 43% patients between 0-5 years, 29% between 6-10 years, 20% in the group of 11-15 years and 8% in patients > 15 years. Sixty one percent of the samples came from patients with acute leukemia. The percentage of women who tested positive for IgG was 21% compared to 4% in men (P < 0.0011). CONCLUSION: 84% of children undergoing cancer treatment are seronegative for T. gondii, so it is important to educate on the prevention of the acquisition of this parasite in this population, due to the risk of developing serious and fatal disease.

Monitoring progress of maternal and neonatal immunization in Latin America and the Caribbean.

INTRODUCTION: The Americas committed to strengthening maternal and neonatal immunization (MNI) through the Pan American Health Organization (PAHO) Regional Immunization Action Plan (RIAP) 2016-20. We describe the progress toward RIAP MNI-related targets and those related to improvement of data quality and information systems; analyze national MNI policies and vaccination coverages; and identify enablers and challenges of monitoring and reporting MNI vaccination coverage in Latin America and the Caribbean (LAC). METHODOLOGY: Descriptive study of national MNI policies, vaccination coverage, and information systems. Sources of information included PAHO-World Health Organization (WHO) / UNICEF Joint Reporting Forms on immunization (JRF) 2013-2019, and other reports. RESULTS: LAC has met two of three RIAP targets related to MNI (countries with universal hepatitis B birth dose introduction and elimination of maternal and neonatal tetanus) and is on track to meet the other (countries with vaccination of pregnant women). As of 2018, of the 49 countries and territories in LAC, 32 vaccinate pregnant women against influenza and 29 provide tetanus-containing vaccine. Twenty-five countries offer universal hepatitis B birth dose vaccine and 31 offer BCG vaccine. In 2018, regional influenza vaccine coverage among pregnant woman was 75%. Regional coverages for BCG and hepatitis B birth dose (<24 h) vaccines were 93% and 79%, respectively. Countries have exceeded RIAP targets related to the quality of vaccination coverage data and the establishment of electronic immunization registries (EIRs). Challenges in monitoring MNI coverage include estimation of denominators and difficulties disaggregating data by group (e.g., pregnant women versus other groups). CONCLUSION: Despite progress in improving MNI in LAC, countries must further strengthen immunization monitoring systems and data quality to better report vaccination coverage among pregnant women and newborns. EIR and MNI information systems must be integrated, such that countries can use accurate data to design more timely and effective vaccination strategies.

HPV vaccination introduction worldwide and WHO and UNICEF estimates of national HPV immunization coverage 2010-2019.

WHO/UNICEF estimates for HPV vaccination coverage from 2010 to 2019 are analyzed against the backdrop of the 90% coverage target for HPV vaccination by 2030 set in the recently approved global strategy for cervical cancer elimination as a public health problem. As of June 2020, 107 (55%) of the 194 WHO Member States have introduced HPV vaccination. The Americas and Europe are by far the WHO regions with the most introductions, 85% and 77% of their countries having already introduced respectively. A record number of introductions was observed in 2019, most of which in low- and middle- income countries (LMIC) where access has been limited. Programs had an average performance coverage of around 67% for the first dose and 53% for the final dose of HPV. LMICs performed on average better than high- income countries for the first dose, but worse for the last dose due to higher dropout. Only 5 (6%) countries achieved coverages with the final dose of more than 90%, 22 countries (21%) achieved coverages of 75% or higher while 35 (40%) had a final dose coverage of 50% or less. When expressed as world population coverage (i.e., weighted by population size), global coverage of the final HPV dose for 2019 is estimated at 15%. There is a long way to go to meet the 2030 elimination target of 90%. In the post-COVID era attention should be paid to maintain the pace of introductions, specially ensuring the most populous countries introduce, and further improving program performance globally.

Formation in Interprofessional Education in Nursing and Medical Students Globally. Scoping review.

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

[Humoral immune response induced by influenza vaccine in children with acute lymphoblastic leukemia]. / Respuesta inmune humoral inducida por la vacuna influenza en niños con diagnóstico de leucemia linfoblástica aguda.

BACKGROUND: Patients with acute lymphoblastic leukemia (ALL) have high risk of severe influenza infection and vaccination is highly recommended. The immunogenicity and effectiveness of vaccination are lower than in healthy people. AIM: To evaluate the immune response induced by influenza vaccine in children with ALL and observe effectiveness. METHOD: Children with ALL in maintenance phase and healthy children were recruited. Blood samples were taken at vaccination day (D0) and at day 28 (D28). Humoral response was evaluated by hemaglutination inhibition test (HAI) against H1N1. Patients were followed up for one year, clinical data and influenza episodes were recorded. RESULTS: 34 children with ALL and 9 healthy children were included. Concerning HAI on D28, 12/34 patients and 5/8 healthy children had titers ≥ 1/40, with seroprotection rates of 35 and 63% respectively. Seroprotected children were older than non-seroprotected ones. During follow-up, only 3 patients non seroprotected, presented influenza infection, without oxygen supplementation or critical care support. DISCUSSION: Children with ALL had a lower seroprotection rate than healthy children. Nevertheless, none of the seroprotected children presented influenza infection, reinforcing the annual vaccination recommendation.

Formation in Interprofessional Education in Nursing and Medical Students Globally. Scoping review

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

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

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

Respuesta inmune humoral inducida por la vacuna influenza en niños con diagnóstico de leucemia linfoblástica aguda / Humoral immune response induced by influenza vaccine in children with acute lymphoblastic leukemia

Resumen Introducción: Los pacientes con leucemia linfoblástica aguda (LLA) tienen alto riesgo de influenza grave y la vacunación es altamente recomendada. La inmunogenicidad y efectividad de la vacuna es menor comparada a los sujetos sanos. Objetivo: Evaluar la respuesta inmune inducida por vacuna anti-influenza en niños con LLA y observar su efectividad. Métodos: Se reclutaron niños con LLA en terapia de mantención y niños sanos. Se tomaron muestras de sangre el día de la vacuna (D0) y al día 28 (D28), y se realizó test de inhibición de hemaglutinación (IHA) contra H1N1. Los pacientes fueron seguidos por un año, registrando datos clínicos y episodios de influenza. Resultados: Se incluyeron 34 niños con LLA y 9 niños sanos. Respecto al IHA en D28, 12/34 pacientes y 5/8 niños sanos presentaron títulos ≥ 1/40, resultando una tasa de seroprotección de 35 y 63%, respectivamente. Los niños seroprotegidos eran significativamente mayores. Durante el seguimiento, sólo tres pacientes, no seroprotegidos, presentaron infección por influenza, ninguno requirió oxigeno o cuidados intensivos. Discusión: Los niños con LLA alcanzaron una tasa seroprotección más baja que la observada en niños sanos. Sin embargo, ninguno de los niños seroprotegidos presentó infección por influenza, reforzando la recomendación de vacunación anual.

Abstract Background: Patients with acute lymphoblastic leukemia (ALL) have high risk of severe influenza infection and vaccination is highly recommended. The immunogenicity and effectiveness of vaccination are lower than in healthy people. Aim: To evaluate the immune response induced by influenza vaccine in children with ALL and observe effectiveness. Method: Children with ALL in maintenance phase and healthy children were recruited. Blood samples were taken at vaccination day (D0) and at day 28 (D28). Humoral response was evaluated by hemaglutination inhibition test (HAI) against H1N1. Patients were followed up for one year, clinical data and influenza episodes were recorded. Results: 34 children with ALL and 9 healthy children were included. Concerning HAI on D28, 12/34 patients and 5/8 healthy children had titers ≥ 1/40, with seroprotection rates of 35 and 63% respectively. Seroprotected children were older than non-seroprotected ones. During follow-up, only 3 patients non seroprotected, presented influenza infection, without oxygen supplementation or critical care support. Discussion: Children with ALL had a lower seroprotection rate than healthy children. Nevertheless, none of the seroprotected children presented influenza infection, reinforcing the annual vaccination recommendation.

Estilos de aprendizaje y rendimiento académico de estudiantes de la carrera de obstetricia / Learning Styles and Academic Performance of Obstetrics' Students / Estilos de aprendizagem e rendimento acadêmico de estudantes do curso de obstetrícia

Resumen Introducción : el presente estudio analizó los estilos de aprendizaje de estudiantes universitarios de obstetricia de Concepción y su relación con las variables edad, año de la carrera que cursa y rendimiento académico. Se planteó como hipótesis que el estilo de aprendizaje que incrementa en mayor medida el rendimiento de los estudiantes es el estilo reflexivo. Materiales y métodos : se realizó un estudio descriptivo, transversal y relacional en 208 alumnos matriculados entre los años 2015 a 2018. Se utilizó el cuestionario CHAEA de Estilos de Aprendizaje de Honey y Alonso. Para el análisis estadístico se utilizó la prueba ji Cuadrado y la prueba ANOVA con comparaciones planificadas, para determinar si existían diferencias significativas entre rendimiento académico y estilo de aprendizaje. Resultados : los resultados muestran predominancia del estilo reflexivo en el 50 % de los estudiantes y en un 48 % en la predominancia combinada reflexivo-teórico. El análisis inferencial determinó que existen diferencias estadísticamente significativas entre rendimiento académico y estilo de aprendizaje predominante (p = .001). Conclusión : no existe relación entre estilos de aprendizaje y edad o año de carrera que cursan los estudiantes, sin embargo, sí existe relación entre estilos de aprendizaje y rendimiento, la cual podría estar determinada por el vínculo entre características del estilo reflexivo y competencias genéricas a desarrollar en esta carrera de salud.

Abstract Introduction : The present study analyzed the learning styles of university students of obstetrics of Concepción, and its relationship with age, year of career and academic performance variables. Researchers hypothesized that the learning style that increases student performance the most is the reflective style. Materials and Methods : A descriptive, cross-sectional and correlational study was carried out on 208 students enrolled between 2015 and 2018. The research used CHAEA questionnaire of Learning Styles of Honey and Alonso. For the statistical analysis, the Pearson Chi Square test and the ANOVA test with planned comparisons were used to determine if there were significant differences between academic performance and learning style. Results : The results showed that 50 % of students have a predominance of reflective style, while 48 % showed a combined reflective-theoretical dominance. The inferential analysis determined that there are statistically significant differences between the academic performance and predominant learning style (p = .001). Conclusion : There is no relationship between learning styles and age or career year students; however, there is a relation between it and the performance which could be determined by the link between both reflective style and generic abilities developed in this health program.

Resumo Introdução : o presente estudo analisou os estilos de aprendizagem de estudantes universitários de obstetrícia de Concepción, e sua relação com as variáveis idade, ano do curso, e rendimento acadêmico. Se apresentou como hipótese que o estilo de aprendizagem que incrementa em maior medida o rendimento dos estudantes é o estilo reflexivo. Materiais e métodos : se realizou um estudo descritivo, transversal e relacional em 208 alunos matriculados entre os anos 2015 a 2018. Se utilizou o questionário CHAEA de Estilos de Aprendizagem de Honey e Alonaso. Para a análise estatística empregou-se a prova Chi Quadrado de Pearson e a prova ANOVA com comparações planificadas, para determinar se existiam diferenças significativas entre rendimento acadêmico e estilo de aprendizagem. Resultados : os resultados mostram predominância do estilo reflexivo no 50 % dos estudantes e em um 48 % na predominância combinada reflexivo-teórico. A análise inferencial determinou que existem diferenças estatisticamente significativas entre rendimento acadêmico e estilo de aprendizagem predominante (p = .001). Conclusão : não existe relação entre estilos de aprendizagem e idade ou ano de curso dos estudantes, no entanto, sim existe relação entre estilos de aprendizagem e rendimento, a qual poderia estar determinada pelo vínculo entre características do estilo reflexivo e competências genéricas a desenvolver neste curso de saúde.