Digital health for treatment adherence in people with tuberculosis: a systematic review / Saúde digital para a adesão ao tratamento da pessoa com tuberculose: uma revisão sistemática / Salud digital para la adherencia al tratamiento en personas con tuberculosis: una revisión sistemática

Justifications and Objectives: the use of digital health, among people diagnosed with tuberculosis, can be an effective strategy, combined with health services, to increase adherence to treatment and impact the disease's epidemiological data in the country. As this topic has been widely discussed and improved in recent years, it is necessary to further investigate the research available on scientific bases. The objective of this study was to describe the use of digital health technologies to assist with adherence to tuberculosis treatment. Methods: this is a systematic literature review with a rapid review approach, following the PRISMA guidelines and the Cochrane guide. Evidence quality was assessed using the Mixed Methods Appraisal Tool. The studies were identified in PubMed, VHL, CINAHL, Cochrane Trial, SciELO, Scopus and Embase. Experimental, quasi-experimental studies and clinical trials were included, without language restrictions, published between 2020 and 2022. Content: nine studies were selected, which demonstrated that the implementation of digital technologies improved adherence rates to medication treatment and cure rates. Applications use strategies such as synchronous and asynchronous video, voice calls and text messages. Among the studies, only two technology/application names were mentioned. Conclusion: digital technologies have had a positive impact on the treatment of people diagnosed with tuberculosis.(AU)

Justificativas e Objetivos: a utilização da saúde digital, junto às pessoas diagnosticadas com a tuberculose, pode ser uma estratégia eficaz, aliada dos serviços de saúde, para aumentar a adesão ao tratamento e impactar os dados epidemiológicos da doença no país. Como esse tema tem sido amplamente discutido e aprimorado nos últimos anos, é necessário investigar mais a fundo as pesquisas disponíveis nas bases científicas. O objetivo deste estudo foi descrever o uso de tecnologias em saúde digital para auxiliar na adesão ao tratamento da tuberculose. Método: trata-se de revisão sistemática da literatura com abordagem de revisão rápida, seguindo as diretrizes do PRISMA e o guia da Cochrane. A qualidade das evidências foi realizada utilizando a ferramenta Mixed Methods Appraisal Tool. Os estudos foram identificados nas bases de dados PubMed, BVS, CINAHL, Cochrane Trial, SciELO, Scopus e Embase. Foram incluídos estudos experimentais, quase-experimentais e ensaios clínicos, sem restrição de idioma, publicados entre 2020 e 2022. Conteúdo: foram selecionados nove estudos, que demonstraram que a implementação de tecnologias digitais melhorou as taxas de adesão ao tratamento medicamentoso e as taxas de cura. Os aplicativos utilizam estratégias como vídeo síncrono e assíncrono, chamadas de voz e mensagens de texto. Entre os estudos, apenas dois nomes de tecnologia/aplicativo foram mencionados. Conclusão: as tecnologias digitais têm impactado de forma positiva no tratamento das pessoas com diagnóstico de tuberculose.(AU)

Justificaciones y objetivos: el uso de la salud digital entre las personas diagnosticadas con tuberculosis puede ser una estrategia eficaz y aliada de los servicios de salud para aumentar la adherencia al tratamiento e impactar los datos epidemiológicos de la enfermedad en el país. 3. Método: se realizó una revisión sistemática de la literatura con un enfoque de revisión rápida, siguiendo las pautas de PRISMA y la guía de Cochrane. La calidad de la evidencia se evaluó utilizando la herramienta Mixed Methods Appraisal Tool. Los estudios se identificaron en las siguientes bases de datos: PubMed, BVS, CINAHL, Cochrane Trial, SciELO, Scopus y Embase. Se incluyeron estudios experimentales, cuasiexperimentales y ensayos clínicos, sin restricciones de idioma, publicados entre 2020 y 2022. Contenido: se seleccionaron nueve estudios que demostraron que la implementación de tecnologías digitales mejoró las tasas de adherencia al tratamiento con medicamentos y las tasas de curación. Las aplicaciones utilizan estrategias como video sincrónico y asincrónico, llamadas de voz y mensajes de texto. Entre los estudios, sólo se mencionaron dos nombres de tecnologías/aplicaciones. Conclusión: las tecnologías digitales han tenido un impacto positivo en el tratamiento de personas diagnosticadas con tuberculosis.(AU)

Hormone therapy for sexual function in perimenopausal and postmenopausal women.

BACKGROUND: The perimenopausal and postmenopausal periods are associated with many symptoms, including sexual complaints. This review is an update of a review first published in 2013. OBJECTIVES: We aimed to assess the effect of hormone therapy on sexual function in perimenopausal and postmenopausal women. SEARCH METHODS: On 19 December 2022 we searched the Gynaecology and Fertility Group Specialised Register, CENTRAL, MEDLINE, Embase, PsycINFO, CINAHL, LILACS, ISI Web of Science, two trials registries, and OpenGrey, together with reference checking and contact with experts in the field for any additional studies. SELECTION CRITERIA: We included randomized controlled trials that compared hormone therapy to either placebo or no intervention (control) using any validated assessment tool to evaluate sexual function. We considered hormone therapy: estrogen alone; estrogen in combination with progestogens; synthetic steroids, for example, tibolone; selective estrogen receptor modulators (SERMs), for example, raloxifene, bazedoxifene; and SERMs in combination with estrogen. DATA COLLECTION AND ANALYSIS: We used standard methodological procedures recommended by Cochrane. We analyzed data using mean differences (MDs) and standardized mean differences (SMDs). The primary outcome was the sexual function score. Secondary outcomes were the domains of sexual response: desire; arousal; lubrication; orgasm; satisfaction; and pain. We assessed the certainty of the evidence using the GRADE approach. MAIN RESULTS: We included 36 studies (23,299 women; 12,225 intervention group; 11,074 control group), of which 35 evaluated postmenopausal women; only one study evaluated perimenopausal women. The 'symptomatic or early postmenopausal women' subgroup included 10 studies, which included women experiencing menopausal symptoms (symptoms such as hot flushes, night sweats, sleep disturbance, vaginal atrophy, and dyspareunia) or early postmenopausal women (within five years after menopause). The 'unselected postmenopausal women' subgroup included 26 studies, which included women regardless of menopausal symptoms and women whose last menstrual period was more than five years earlier. No study included only women with sexual dysfunction and only seven studies evaluated sexual function as a primary outcome. We deemed 20 studies at high risk of bias, two studies at low risk, and the other 14 studies at unclear risk of bias. Nineteen studies received commercial funding. Estrogen alone versus control probably slightly improves the sexual function composite score in symptomatic or early postmenopausal women (SMD 0.50, 95% confidence interval (CI) (0.04 to 0.96; I² = 88%; 3 studies, 699 women; moderate-quality evidence), and probably makes little or no difference to the sexual function composite score in unselected postmenopausal women (SMD 0.64, 95% CI -0.12 to 1.41; I² = 94%; 6 studies, 608 women; moderate-quality evidence). The pooled result suggests that estrogen alone versus placebo or no intervention probably slightly improves sexual function composite score (SMD 0.60, 95% CI 0.16 to 1.04; I² = 92%; 9 studies, 1307 women, moderate-quality evidence). We are uncertain of the effect of estrogen combined with progestogens versus placebo or no intervention on the sexual function composite score in unselected postmenopausal women (MD 0.08 95% CI -1.52 to 1.68; 1 study, 104 women; very low-quality evidence). We are uncertain of the effect of synthetic steroids versus control on the sexual function composite score in symptomatic or early postmenopausal women (SMD 1.32, 95% CI 1.18 to 1.47; 1 study, 883 women; very low-quality evidence) and of their effect in unselected postmenopausal women (SMD 0.46, 95% CI 0.07 to 0.85; 1 study, 105 women; very low-quality evidence). We are uncertain of the effect of SERMs versus control on the sexual function composite score in symptomatic or early postmenopausal women (MD -1.00, 95% CI -2.00 to -0.00; 1 study, 215 women; very low-quality evidence) and of their effect in unselected postmenopausal women (MD 2.24, 95% 1.37 to 3.11 2 studies, 1525 women, I² = 1%, low-quality evidence). We are uncertain of the effect of SERMs combined with estrogen versus control on the sexual function composite score in symptomatic or early postmenopausal women (SMD 0.22, 95% CI 0.00 to 0.43; 1 study, 542 women; very low-quality evidence) and of their effect in unselected postmenopausal women (SMD 2.79, 95% CI 2.41 to 3.18; 1 study, 272 women; very low-quality evidence). The observed heterogeneity in many analyses may be caused by variations in the interventions and doses used, and by different tools used for assessment. AUTHORS' CONCLUSIONS: Hormone therapy treatment with estrogen alone probably slightly improves the sexual function composite score in women with menopausal symptoms or in early postmenopause (within five years of amenorrhoea), and in unselected postmenopausal women, especially in the lubrication, pain, and satisfaction domains. We are uncertain whether estrogen combined with progestogens improves the sexual function composite score in unselected postmenopausal women. Evidence regarding other hormone therapies (synthetic steroids and SERMs) is of very low quality and we are uncertain of their effect on sexual function. The current evidence does not suggest the beneficial effects of synthetic steroids (for example tibolone) or SERMs alone or combined with estrogen on sexual function. More studies that evaluate the effect of estrogen combined with progestogens, synthetic steroids, SERMs, and SERMs combined with estrogen would improve the quality of the evidence for the effect of these treatments on sexual function in perimenopausal and postmenopausal women.

Effectiveness of neurolysis as a treatment for complications of leprosy neuritis: a systematic review.

BACKGROUND: Complications of leprosy neuritis are considered serious and apparent, with the potential to disable and/or limit individuals. These complications affect not only a patient's physical functioning, but also their family and social lives, while directly impacting the ability to work and/or maintain financial independence, subsequently interfering with their overall quality of life. The present review, therefore, aimed to analyze the effectiveness of neurolysis as an alternative treatment for the complications associated with leprosy neuritis. METHODS: The present review was performed based on the Joanna Briggs Institute methodology, in an effort to answer the following research question: what is the effectiveness of neurolysis as a treatment for leprosy neuritis complications? This research question was defined using the patient-intervention-outcome (PIO) framework, where leprosy represents 'P', neurolysis for 'I', and neuropathic pain/motor function/sensorial function/physical disability/quality of life for 'O'. Randomized and non-randomized clinical trials and prospective observational cohort studies were included in the present review, with no time or date restrictions. RESULTS: The present review included 1 randomized clinical trial and 10 prospective studies, published between 1976 and 2020. All of the outcomes showed improvement, with relief from neuropathic pain being the primary finding. CONCLUSIONS: The evidence obtained in the present review suggested that neurolysis is an effective alternative for the treatment of physical disabilities, the recovery of sensory and motor function, the restoration of quality of life, and neuropathic pain relief.

Effectiveness of neurolysis as a treatment for complications of leprosy neuritis: a systematic review

ABSTRACT Background: Complications of leprosy neuritis are considered serious and apparent, with the potential to disable and/or limit individuals. These complications affect not only a patient's physical functioning, but also their family and social lives, while directly impacting the ability to work and/or maintain financial independence, subsequently interfering with their overall quality of life. The present review, therefore, aimed to analyze the effectiveness of neurolysis as an alternative treatment for the complications associated with leprosy neuritis. Methods: The present review was performed based on the Joanna Briggs Institute methodology, in an effort to answer the following research question: what is the effectiveness of neurolysis as a treatment for leprosy neuritis complications? This research question was defined using the patient-intervention-outcome (PIO) framework, where leprosy represents 'P', neurolysis for 'I', and neuropathic pain/motor function/sensorial function/physical disability/quality of life for 'O'. Randomized and non-randomized clinical trials and prospective observational cohort studies were included in the present review, with no time or date restrictions. Results: The present review included 1 randomized clinical trial and 10 prospective studies, published between 1976 and 2020. All of the outcomes showed improvement, with relief from neuropathic pain being the primary finding. Conclusions: The evidence obtained in the present review suggested that neurolysis is an effective alternative for the treatment of physical disabilities, the recovery of sensory and motor function, the restoration of quality of life, and neuropathic pain relief.

Identifying Hotspots of People Diagnosed of Tuberculosis with Addiction to Alcohol, Tobacco, and Other Drugs through a Geospatial Intelligence Application in Communities from Southern Brazil.

(1) Background: tuberculosis (TB) is considered one of the leading causes of death worldwide by a single infectious agent. This study aimed to identify hotspots of people diagnosed with tuberculosis and abusive use of alcohol, tobacco, and other drugs in communities through a geospatial intelligence application; (2) Methods: an ecological study with a spatio-temporal approach. We considered tuberculosis cases diagnosed and registered in the Notifiable Diseases Information System, which presented information on alcoholism, smoking, and drug abuse. Spatial Variations in Temporal Trends (SVTT) and scan statistics were applied for the identification of Hotspots; (3) Results: between the study period, about 29,499 cases of tuberculosis were reported. When we applied the SVTT for alcoholism, three Hotspots were detected, one of which was protective (RR: 0.08-CI95%: 0.02-0.32) and two at risk (RR: 1.42-CI95%: 1.11-1.73; RR: 1.39-CI95%: 1.28-1.50). Regarding smoking, two risk clusters were identified (RR: 1.15-CI95%: 1.01-1.30; RR: 1.68-CI95%: 1.54-1.83). For other drugs, a risk cluster was found (RR: 1.13-CI95%: 0.99-1.29) and two protections (RR: 0.70-CI95%: 0.63-0.77; RR: 0.76-CI95%: 0.65-0.89); (4) Conclusion: it was evidenced that in the communities being studied, there exists a problem of TB with drug addiction. The disordered use of these substances may harm a person's brain and behavior and lead to an inability to continue their treatment, putting the community at further risk for TB.

Digital Health Opportunities to Improve Primary Health Care in the Context of COVID-19: Scoping Review.

BACKGROUND: The COVID-19 pandemic brought social, economic, and health impacts, requiring fast adaptation of health systems. Although information and communication technologies were essential for achieving this objective, the extent to which health systems incorporated this technology is unknown. OBJECTIVE: The aim of this study was to map the use of digital health strategies in primary health care worldwide and their impact on quality of care during the COVID-19 pandemic. METHODS: We performed a scoping review based on the Joanna Briggs Institute manual and guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. A systematic and comprehensive three-step search was performed in June and July 2021 in multidisciplinary health science databases and the gray literature. Data extraction and eligibility were performed by two authors independently and interpreted using thematic analysis. RESULTS: A total of 44 studies were included and six thematic groups were identified: characterization and geographic distribution of studies; nomenclatures of digital strategies adopted; types of information and communication technologies; characteristics of digital strategies in primary health care; impacts on quality of care; and benefits, limitations, and challenges of digital strategies in primary health care. The impacts on organization of quality of care were investigated by the majority of studies, demonstrating the strengthening of (1) continuity of care; (2) economic, social, geographical, time, and cultural accessibility; (3) coordination of care; (4) access; (5) integrality of care; (6) optimization of appointment time; (7) and efficiency. Negative impacts were also observed in the same dimensions, such as reduced access to services and increased inequity and unequal use of services offered, digital exclusion of part of the population, lack of planning for defining the role of professionals, disarticulation of actions with real needs of the population, fragile articulation between remote and face-to-face modalities, and unpreparedness of professionals to meet demands using digital technologies. CONCLUSIONS: The results showed the positive and negative impacts of remote strategies on quality of care in primary care and the inability to take advantage of the potential of technologies. This may demonstrate differences in the organization of fast and urgent implementation of digital strategies in primary health care worldwide. Primary health care must strengthen its response capacity, expand the use of information and communication technologies, and manage challenges using scientific evidence since digital health is important and must be integrated into public service.

Use of continuous subcutaneous insulin infusion in children and adolescents with type 1 diabetes mellitus: a systematic mapping review.

BACKGROUND: Among the treatments for type 1 diabetes mellitus (T1DM), Continuous Subcutaneous Insulin Infusion (CSII) is a device that infuses insulin through the subcutaneous tissue in an uninterrupted manner and that comes closest to the physiological secretion of insulin. The use of CSII can provide the family with greater security and children and adolescents have more autonomy in relation to the treatment of T1DM. There is a lack of reviews that systematically gather the mounting evidence about the use of CSII in children and adolescents with T1DM. Therefore, the aim of this review was to group and describe primary and secondary studies on the use of CSII in children and adolescents with T1DM. METHODS: A systematic mapping review was performed based on searches in the following databases: PubMed, Embase, CINAHL, Lilacs and PsycINFO, using a combination of descriptors and keywords. The screening of the studies was carried out with the aid of the Rayyan software and reading in full was conducted independently by two reviewers. The data extraction of the studies was performed using an extraction tool adapted and validated by researchers specialized in diabetes. The data were analyzed according to the content analysis technique. The map from geocoding of the studies was produced using the ArcGis 10.5 software. RESULTS: A total of 113 studies were included in the review, including primary studies, literature reviews and gray literature publications. The content analysis of the results of the studies allowed for the identification of four categories: 1) metabolic control; 2) support networks; 3) benefits of using CSII; and 4) challenges of using CSII, each category having its respective subcategories. The review also made it possible to conduct a rigorous mapping of the literature on the use of CSII considering the location of development and the design of the studies. CONCLUSIONS: The use of CSII should be indicated by health professionals able to prepare children, adolescents, and their families for the treatment of T1DM, and, despite being a technological device, it may not be suitable for the entire pediatric population.

Tuberculosis forecasting and temporal trends by sex and age in a high endemic city in northeastern Brazil: where were we before the Covid-19 pandemic?

BACKGROUND: The aim of this study was to describe the temporal trend of tuberculosis cases according to sex and age group and evidence the level of disease before the Covid-19 pandemic in a TB high endemic city. METHODS: This was a time series study carried out in a city in northeast Brazil. The population was composed of cases of tuberculosis, excluding those with HIV-positive status, reported between the years 2002 and 2018. An exploratory analysis of the monthly rates of tuberculosis detection, smoothed according to sex and age group, was performed. Subsequently, the progression of the trend and prediction of the disease were also characterized according to these aspects. For the trends forecast, the seasonal autoregressive linear integrated moving average (ARIMA) model and the usual Box-Jenkins method were used to choose the most appropriate models. RESULTS: A total of 1620 cases of tuberculosis were reported, with an incidence of 49.7 cases per 100,000 inhabitants in men and 34.0 per 100,000 in women. Regarding the incidence for both sexes, there was a decreasing trend, which was similar for age. Evidence resulting from the application of the time series shows a decreasing trend in the years 2002-2018, with a trend of stability. CONCLUSIONS: The study evidenced a decreasing trend in tuberculosis, even before the Covid-19 pandemic, for both sex and age; however, in a step really slow from that recommended by the World Health Organization. According to the results, the disease would have achieved a level of stability in the city next years, however it might have been aggravated by the pandemic. These findings are relevant to evidence the serious behavior and trends of TB in a high endemic scenario considering a context prior to the Covid-19 pandemic.

Systematic Reviews to Strengthen Evidence-based Nursing Practice / Revisiones sistemáticas para el fortalecimiento de la práctica de enfermería basada en evidencias / Revisões sistemáticas para fortalecer a prática de enfermagem baseada em evidências

Systematic reviews are essential to developing evidence-based nursing practice. The JBI, formerly known as the Joanna Briggs Institute, has contributed significantly to research through technical training on reviews. Cochrane Living Systematic Reviews and Systematic Reviews of Measurement Instruments have been approaches recently used by the scientific community. The purpose of Living Systematic Reviews is to continuously update priority issues, while Systematic Reviews of Measurement Instruments condense evidence on the validity of measurement instruments. This article overviews the JBI Systematic Review approaches and provides critical information about Cochrane Living Systematic Reviews and Systematic Reviews of Measurement Instruments. The use of these new approaches is necessary to maintain the evidence-based nursing practice and advance nursing knowledge.

Las revisiones sistemáticas son esenciales para el desarrollo de la práctica de enfermería basada en la evidencia. El JBI, conocido anteriormente como Joanna Briggs Institute, ha contribuido significativamente al desarrollo de la investigación mediante el entrenamiento técnico sobre revisiones. Las Revisiones Sistemáticas Vivas Cochrane y las Revisiones Sistemáticas de Instrumentos de Medición han sido enfoques recientemente utilizados por la comunidad científica. Las Revisiones Sistemáticas Vivas tienen como propósito generar actualizaciones continuas de temas prioritarios y las Revisiones Sistemáticas de Instrumentos de Medición aportan síntesis de evidencias relacionadas con la validez de los instrumentos de medida. Este artículo es una overview, que tiene como objetivo proporcionar una visión general sobre los abordajes de Revisiones Sistemáticas del JBI y brindar informaciones claves acerca de las Revisiones Sistemáticas Vivas Cochrane y las Revisiones Sistemáticas de Instrumentos de Medición. La utilización de estos nuevos abordajes es necesaria para mantener la práctica de enfermería basada en la evidencia y aportar al desarrollo del conocimiento enfermero.

As revisões sistemáticas são essenciais para o desenvolvimento da prática de enfermagem baseada em evidências. O JBI, conhecido anteriormente como Jhoanna Briggs Institute, contribuiu significativamente para o desenvolvimento da pesquisa mediante o treinamento técnico sobre revisões. As Revisões Sistemáticas Vivas Cochrane e as Revisões Sistemáticas de Instrumentos de Medição vêm sendo abordagens recentemente utilizadas pela comunidade científica. As Revisões Sistemáticas Vivas têm como objetivo gerar atualizações contínuas de temas prioritários e as Revisões Sistemáticas de Instrumentos de Medição contribuem com sínteses de evidências relacionadas com a validade dos instrumentos de medida. Este artigo é um overview, que tem como objetivo proporcionar uma visão geral sobre as abordagens de Revisões Sistemáticas do JBI e oferecer informações-chave sobre as Revisões Sistemáticas Vivas Cochrane e as Revisões Sistemáticas de Instrumentos de Medição. A utilização dessas novas abordagens é necessária para manter a prática de enfermagem baseada em evidências e contribuir para o desenvolvimento do conhecimento em enfermagem.

Inequality of gender, age and disabilities due to leprosy and trends in a hyperendemic metropolis: Evidence from an eleven-year time series study in Central-West Brazil.

The present study aimed to investigate the epidemiological situation of leprosy (Hansen's Disease), in a hyperendemic metropolis in the Central-West region of Brazil. We studied trends over eleven years, both in the detection of the disease and in disabilities, analyzing disparities and/or differences regarding gender and age. This is an ecological time series study conducted in Cuiabá, capital of the state of Mato Grosso. The population consisted of patients diagnosed with leprosy between the years 2008 and 2018. The time series of leprosy cases was used, stratifying it according to gender (male and female), disability grade (G0D, G1D, G2D, and not evaluated) and age. The calendar adjustment technique was applied. For modeling the trends, the Seasonal-Trend decomposition procedure based on Loess (STL) was used. We identified 9.739 diagnosed cases, in which 58.37% were male and 87.55% aged between 15 and 59 years. Regarding detection according to gender, there was a decrease among women and an increase in men. The study shows an increasing trend in disabilities in both genders, which may be related to the delay in diagnosis. There was also an increasing number of cases that were not assessed for disability at the time of diagnosis, which denotes the quality of the services.

Telemedicine in primary healthcare for the quality of care in times of COVID-19: a scoping review protocol.

INTRODUCTION: Telemedicine gained strength in primary healthcare (PHC) during the COVID-19 pandemic. Thus, there is a need to know its scope, technologies used and impacts on people's health. This study will map telemedicine use in PHC around the world and its impacts on quality of care in the context of the COVID-19 pandemic. METHODS: This is a scoping review protocol developed according to Arksey and O'Malley and Levac et al, based on the Joanna Briggs Institute manual, and guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). The records will be mapped in the following multidisciplinary health sciences databases: Virtual Health Library, PubMed, Scopus, Web of Science, CINAHL and Embase. Searches will also be conducted on Google Scholar, preprint repositories and specific COVID-19 databases (grey literature). Quantitative data will be analysed using descriptive statistics, while thematic analysis will be performed for qualitative data. Preliminary findings will be presented to stakeholders to identify missing studies and develop effective dissemination strategies. ETHICS AND DISSEMINATION: Results will be disseminated through publication in an open access scientific journal, scientific events, and academic and community newspapers. Ethical approval was obtained due to stakeholder consultation, but will not involve the direct participation of patients. Link to the protocol record in the Open Science Framework (OSF) (osf.io/q94en).

Impact of social protection programs on adults diagnosed with Tuberculosis: systematic review.

OBJECTIVES: to analyze the impact of social protection programs on adults diagnosed with Tuberculosis. METHODS: systematic review conducted by PRISMA, with registration PROSPERO CRD42019130884. The studies were identified in the VHL, PubMed, Scielo, CINAHL and Scopus databases, using the descriptors "Social Protection" and "Tuberculosis", in combination with keywords combined with Boolean operators AND and OR. Observational and interventional studies published until October 23, 2019, in Portuguese, English and Spanish, were included. RESULTS: social protection programs improve the treatment of tuberculosis, cure rates, adherence to treatment, the provision of services for the control of TB and reduce poverty. CONCLUSIONS: social protection programs have a positive impact on the treatment and control of people diagnosed with Tuberculosis.

Social inequalities and their association with the leprosy burden in a Brazilian city of low endemicity: An ecological study.

OBJECTIVE: To analyse the association between social inequalities and the leprosy burden in a low endemicity scenario in the state of São Paulo, Brazil. METHODS: This ecological study was carried out in the city of Ribeirão Preto, state of São Paulo, Brazil, considering leprosy cases notified from 2006 to 2016. Regarding social inequalities, dimensions related to high household density, literacy, home occupation conditions, health conditions, household income, ethnicity and age were considered. The generalised additive model for location, scale and shape (GAMLSS) was used to verify the association between the social inequalities and leprosy burden. RESULTS: The increase in men and women with no education and people with an income of 1 to 2 minimum wages was associated with a relative increase in the number of leprosy cases (7.37%, 7.10% and 2.44%, respectively). Regarding the ethnicity variables, the increase in the proportion of men (black) and women (mixed race) with no schooling was associated with a relative increase in the number of cases of the disease (10.77% and 4.02%, respectively). Finally, for people of mixed race or ethnicity, the increase in the proportion of households with 1/2 to 1 minimum wage was related to a relative decrease in the total number of cases (-4.90%). CONCLUSION: The results show that the determinants associated with the increase in leprosy cases are similar to those in Brazilian hyperendemic regions, and that even in cities with low endemicity, social inequality is one of the main determinants of the disease.

Impact of social protection programs on adults diagnosed with Tuberculosis: systematic review / Impacto de los programas de protección social en adultos diagnosticados con Tuberculosis: revisión sistemática / Impacto dos programas de proteção social em pessoas adultas com diagnóstico de Tuberculose: revisão sistemática

ABSTRACT Objectives: to analyze the impact of social protection programs on adults diagnosed with Tuberculosis. Methods: systematic review conducted by PRISMA, with registration PROSPERO CRD42019130884. The studies were identified in the VHL, PubMed, Scielo, CINAHL and Scopus databases, using the descriptors "Social Protection" and "Tuberculosis", in combination with keywords combined with Boolean operators AND and OR. Observational and interventional studies published until October 23, 2019, in Portuguese, English and Spanish, were included. Results: social protection programs improve the treatment of tuberculosis, cure rates, adherence to treatment, the provision of services for the control of TB and reduce poverty. Conclusions: social protection programs have a positive impact on the treatment and control of people diagnosed with Tuberculosis.

RESUMEN Objetivos: analizar el impacto de los programas sociales de adultos con diagnóstico de Tuberculosis. Métodos: se trata de una revisión sistemática conducida por PRISMA, con registro PROSPERO n° CRD42019130884. Los estudios se identificaron en las bases de datos BVS, PubMed, Scielo, CINAHL y Scopus, a partir de los descriptores "Protección Social" y "Tuberculosis", y palabras clave combinadas con operadores booleanos AND y OR. Estaban incluidos los estudios observacionales y de intervención, publicados hasta el día 23 de octubre de 2019, en los idiomas portugués, inglés y español. Resultados: los programas de protección social mejoran el tratamiento de la tuberculosis, las tasas de curación, la adhesión al tratamiento, la prestación de servicios para el control de la TB, además de reducir la pobreza. Conclusiones: los programas sociales tienen un impacto positivo en el tratamiento y control de las personas diagnosticadas de tuberculosis.

RESUMO Objetivos: analisar o impacto dos programas de proteção social em pessoas adultas com diagnóstico de Tuberculose. Métodos: revisão sistemática conduzida pelo PRISMA, com registro PROSPERO n° CRD42019130884. Os estudos foram identificados nas bases de dados BVS, PubMed, Scielo, CINAHL e Scopus, a partir dos descritores "Proteção Social" e "Tuberculose", em combinação com palavras-chave combinadas com operadores booleanos AND e OR. Incluíram-se estudos observacionais e de intervenção, publicados até o dia 23 de outubro de 2019, nos idiomas português, inglês e espanhol. Resultados: os programas de proteção social melhoram o tratamento da Tuberculose, as taxas de cura, a aderência ao tratamento, a prestação de serviços para o controle da TB, além de reduzirem a pobreza. Conclusões: os programas de proteção social impactam de forma positiva no tratamento e controle das pessoas com diagnóstico de Tuberculose.

Impact of social protection programs on adults diagnosed with Tuberculosis: systematic review / Impacto de los programas de protección social en adultos diagnosticados con Tuberculosis: revisión sistemática / Impacto dos programas de proteção social em pessoas adultas com diagnóstico de Tuberculose: revisão sistemática

ABSTRACT Objectives: to analyze the impact of social protection programs on adults diagnosed with Tuberculosis. Methods: systematic review conducted by PRISMA, with registration PROSPERO CRD42019130884. The studies were identified in the VHL, PubMed, Scielo, CINAHL and Scopus databases, using the descriptors "Social Protection" and "Tuberculosis", in combination with keywords combined with Boolean operators AND and OR. Observational and interventional studies published until October 23, 2019, in Portuguese, English and Spanish, were included. Results: social protection programs improve the treatment of tuberculosis, cure rates, adherence to treatment, the provision of services for the control of TB and reduce poverty. Conclusions: social protection programs have a positive impact on the treatment and control of people diagnosed with Tuberculosis.

RESUMEN Objetivos: analizar el impacto de los programas sociales de adultos con diagnóstico de Tuberculosis. Métodos: se trata de una revisión sistemática conducida por PRISMA, con registro PROSPERO n° CRD42019130884. Los estudios se identificaron en las bases de datos BVS, PubMed, Scielo, CINAHL y Scopus, a partir de los descriptores "Protección Social" y "Tuberculosis", y palabras clave combinadas con operadores booleanos AND y OR. Estaban incluidos los estudios observacionales y de intervención, publicados hasta el día 23 de octubre de 2019, en los idiomas portugués, inglés y español. Resultados: los programas de protección social mejoran el tratamiento de la tuberculosis, las tasas de curación, la adhesión al tratamiento, la prestación de servicios para el control de la TB, además de reducir la pobreza. Conclusiones: los programas sociales tienen un impacto positivo en el tratamiento y control de las personas diagnosticadas de tuberculosis.

RESUMO Objetivos: analisar o impacto dos programas de proteção social em pessoas adultas com diagnóstico de Tuberculose. Métodos: revisão sistemática conduzida pelo PRISMA, com registro PROSPERO n° CRD42019130884. Os estudos foram identificados nas bases de dados BVS, PubMed, Scielo, CINAHL e Scopus, a partir dos descritores "Proteção Social" e "Tuberculose", em combinação com palavras-chave combinadas com operadores booleanos AND e OR. Incluíram-se estudos observacionais e de intervenção, publicados até o dia 23 de outubro de 2019, nos idiomas português, inglês e espanhol. Resultados: os programas de proteção social melhoram o tratamento da Tuberculose, as taxas de cura, a aderência ao tratamento, a prestação de serviços para o controle da TB, além de reduzirem a pobreza. Conclusões: os programas de proteção social impactam de forma positiva no tratamento e controle das pessoas com diagnóstico de Tuberculose.

[Areas with declining vaccination coverage for BCG, poliomyelitis, and MMR in Brazil (2006-2016): maps of regional heterogeneity]. / Áreas com queda da cobertura vacinal para BCG, poliomielite e tríplice viral no Brasil (2006-2016): mapas da heterogeneidade regional.

Immunization is known to be one of the most successful and cost-effective health interventions, resulting in the eradication and control of various diseases in the world. However, Brazil has experienced a worrisome drop in vaccination coverage, associated with the resurgence of various previously controlled or eradicated diseases. This study thus conducted a situational diagnosis weighing Brazil's different regions and time trends in vaccination coverage in order to identify areas with reduction in vaccination coverage for BCG, poliomyelitis, and MMR. This ecological study collected data on the number of children up to one year of age who had been vaccinated with these three vaccines from 2006 to 2016, according to municipality (county). Data were obtained from the Brazilian Health Informatics Department. A spatial scan was performed, analyzing spatial variations in the time trends for vaccination coverage. Downward trends were seen in the number of immunizations in Brazil, with reductions of 0.9%, 1.3%, and 2.7% per year for BCG, poliomyelitis, and MMR, respectively. Significant decreases were also seen in all five major geographic regions with time trends in the reduction of vaccination coverage. The study evidenced an important reduction in vaccination coverage in recent years, with major heterogeneity between municipalities. Thus, focused attention and strategic planning in keeping with each local area's characteristics are necessary to address both the reduction of vaccination coverage and the resurgence of vaccine-preventable diseases in Brazil.

A imunização é reconhecida como uma das intervenções mais bem-sucedidas e custo-efetivas, resultando na erradicação e no controle de diversas doenças em todo o mundo. Todavia, uma preocupante redução na cobertura vacinal tem sido observada no Brasil, trazendo o recrudescimento de algumas doenças até então superadas. Dessa forma, no intuito de realizar um diagnóstico situacional que pondere as diferentes regiões do país e a tendência temporal de cobertura vacinal, o presente estudo teve o objetivo de evidenciar áreas com queda da cobertura vacinal de BCG, poliomielite e tríplice viral no Brasil por meio de um estudo ecológico que coletou informações acerca do número crianças de até um ano de idade imunizadas para essas três vacinas, no período entre 2006 e 2016, por município brasileiro. Os dados foram adquiridos por meio do Departamento de Informática do SUS. Foi realizada uma varredura espacial, analisando as variações espaciais nas tendências temporais de cobertura vacinal. Foi observada uma tendência de redução no número de imunizações no Brasil, com quedas de 0,9%, 1,3% e 2,7% ao ano para BCG, poliomielite e tríplice viral, respectivamente. Ademais, aglomerados significativos com tendências temporais de redução da cobertura vacinal foram verificados em todas as cinco regiões brasileiras. O estudo evidencia uma importante redução na cobertura vacinal nos últimos anos, constatando heterogeneidades consideráveis entre os municípios. Dessa forma, uma atenção singular e planejamento estratégico condizente com as características de cada localidade são necessários para o controle tanto da redução de cobertura vacinal como do reaparecimento de doenças no Brasil.

La inmunización está reconocida como una de las intervenciones más exitosas y costo-eficientes, consiguiendo la erradicación y control de diversas enfermedades en todo el mundo. Sin embargo, se ha observado una preocupante reducción en la cobertura de la vacunación en Brasil, conllevando el recrudecimiento de algunas enfermedades hasta entonces superadas. De esta forma, con el fin de realizar un diagnóstico situacional, que pondere las diferentes regiones del país y la tendencia temporal de cobertura vacunación, el presente estudio tuvo como objetivo evidenciar áreas con una caída de la cobertura vacunación respecto a BCG, poliomielitis y triple vírica en Brasil. Se trata de un estudio ecológico, que recabó información acerca del número de niños de hasta un año de edad inmunizados con estas tres vacunas, durante el período entre 2006 y 2016, por municipios brasileños. Los datos se consiguieron a través del Departamento de Informática del SUS. Se realizó un barrido espacial, analizando las variaciones espaciales en las tendencias temporales de cobertura de vacunación. Se observó una tendencia de reducción en el número de inmunizaciones en Brasil, con caídas de 0,9%, 1,3% y 2,7% al año, en el caso de BCG, poliomielitis y triple vírica, respectivamente. Además, se verificaron aglomerados significativos con tendencias temporales de reducción en la cobertura de vacunación dentro de las cinco regiones brasileñas. El estudio evidencia una importante reducción en la cobertura de vacunación durante los últimos años, constatando heterogeneidades considerables entre los municipios. De esta forma, una atención singular y planificación estratégica, acorde con las características de cada localidad, son necesarias para el control, tanto de la reducción de la cobertura de vacunación, como del resurgimiento de enfermedades en Brasil.

Magnitud de los determinantes sociales en el riesgo de mortalidad por tuberculosis en el Centro-Oeste de Brasil / Magnitude of social determinants in the risk of death from tuberculosis in Central-west Brazil

OBJETIVO: Evaluar la magnitud de los determinantes sociales en áreas de riesgo para la mortalidad por tuberculosis en una ciudad de alta incidencia de esta enfermedad. MÉTODO: Estudio ecológico que recogió los casos de muerte por tuberculosis registrados entre 2006 y 2016 en la capital del Estado de Mato Grosso (Brasil). Los determinantes sociales se obtuvieron de las Unidades de Desarrollo Humano. Se utilizó la estadística de barrido para identificar las áreas de riesgo de muerte por tuberculosis. Se realizó un análisis de componentes principales para identificar dimensiones de determinantes sociales, y se aplicó regresión logística múltiple para verificar asociaciones entre las dimensiones de los determinantes sociales y el riesgo de muerte por tuberculosis. El error estándar se estableció en un 5% para todas las pruebas estadísticas. RESULTADOS: Se registraron 225 muertes por tuberculosis en el periodo, distribuidas heterogéneamente en el espacio. Se identificó un conglomerado de riesgo para la mortalidad por tuberculosis, con un riesgo relativo de 2,09 (intervalo de confianza del 95% [IC95%]: 1,48-2,94; p = 0,04). Los determinantes sociales «bajo nivel escolar» y «pobreza» se mostraron asociados al riesgo de muerte por tuberculosis (odds ratio [OR]: 2,92; IC95%: 1,17-7,28). La renta presentó asociación negativa con el riesgo de muerte por tuberculosis (OR: 0,05; IC95%: 0,00-0,70). El valor de la curva ROC del modelo fue del 92,1%. CONCLUSIONES: Los resultados confirman que el riesgo de muerte por tuberculosis es un problema asociado a los determinantes sociales. Las políticas de salud y los programas de protección social pueden contribuir a enfrentarse a este problema

OBJECTIVE: To evaluate the magnitude of social determinants in areas of risk of mortality due to tuberculosis in a high incidence city. METHOD: Ecological study, which recruited the cases of tuberculosis deaths registered between 2006 and 2016 in the capital of Mato Grosso-Brazil. The social determinants were obtained from the Human Development Units. Sweep statistics were used to identify areas of risk of mortality due to tuberculosis. Principal component analysis was carried out to identify dimensions of social determinants. Multiple logistic regression was applied to verify associations between the dimensions of social determinants and the risk of mortality from tuberculosis. A 5% error was fixed. The standard error was established at 5% for all statistical tests. RESULTS: A total of 225 deaths due to tuberculosis were registered in the period, distributed heterogeneously in the space. A cluster of risk for tuberculosis mortality was identified, with RR=2.09 (95%CI: 1.48-2.94; p = 0.04). Social determinants, low educational level and poverty were associated with the risk of mortality due to tuberculosis (OR: 2.92; 95%CI: 1.17-7.28). Income had a negative association with the risk of mortality due to tuberculosis (OR: 0.05; 95%CI: 0.00-0.70). The value of the ROC curve of the model was 92.1%. CONCLUSIONS: The results confirmed that the risk of mortality due to tuberculosis is a problem associated with social determinants. Health policies and social protection programmes can collaborate to address this problem

[Magnitude of social determinants in the risk of death from tuberculosis in Central-west Brazil]. / Magnitud de los determinantes sociales en el riesgo de mortalidad por tuberculosis en el Centro-Oeste de Brasil.

OBJECTIVE: To evaluate the magnitude of social determinants in areas of risk of mortality due to tuberculosis in a high incidence city. METHOD: Ecological study, which recruited the cases of tuberculosis deaths registered between 2006 and 2016 in the capital of Mato Grosso-Brazil. The social determinants were obtained from the Human Development Units. Sweep statistics were used to identify areas of risk of mortality due to tuberculosis. Principal component analysis was carried out to identify dimensions of social determinants. Multiple logistic regression was applied to verify associations between the dimensions of social determinants and the risk of mortality from tuberculosis. A 5% error was fixed. The standard error was established at 5% for all statistical tests. RESULTS: A total of 225 deaths due to tuberculosis were registered in the period, distributed heterogeneously in the space. A cluster of risk for tuberculosis mortality was identified, with RR=2.09 (95%CI: 1.48-2.94; p=0.04). Social determinants, low educational level and poverty were associated with the risk of mortality due to tuberculosis (OR: 2.92; 95%CI: 1.17-7.28). Income had a negative association with the risk of mortality due to tuberculosis (OR: 0.05; 95%CI: 0.00-0.70). The value of the ROC curve of the model was 92.1%. CONCLUSIONS: The results confirmed that the risk of mortality due to tuberculosis is a problem associated with social determinants. Health policies and social protection programmes can collaborate to address this problem.

Áreas com queda da cobertura vacinal para BCG, poliomielite e tríplice viral no Brasil (2006-2016): mapas da heterogeneidade regional / Areas with declining vaccination coverage for BCG, poliomyelitis, and MMR in Brazil (2006-2016): maps of regional heterogeneity / Áreas con una caída de la cobertura de vacunación para BCG, poliomielitis y triple vírica en Brasil (2006-2016): mapas de la heterogeneidad regional

A imunização é reconhecida como uma das intervenções mais bem-sucedidas e custo-efetivas, resultando na erradicação e no controle de diversas doenças em todo o mundo. Todavia, uma preocupante redução na cobertura vacinal tem sido observada no Brasil, trazendo o recrudescimento de algumas doenças até então superadas. Dessa forma, no intuito de realizar um diagnóstico situacional que pondere as diferentes regiões do país e a tendência temporal de cobertura vacinal, o presente estudo teve o objetivo de evidenciar áreas com queda da cobertura vacinal de BCG, poliomielite e tríplice viral no Brasil por meio de um estudo ecológico que coletou informações acerca do número crianças de até um ano de idade imunizadas para essas três vacinas, no período entre 2006 e 2016, por município brasileiro. Os dados foram adquiridos por meio do Departamento de Informática do SUS. Foi realizada uma varredura espacial, analisando as variações espaciais nas tendências temporais de cobertura vacinal. Foi observada uma tendência de redução no número de imunizações no Brasil, com quedas de 0,9%, 1,3% e 2,7% ao ano para BCG, poliomielite e tríplice viral, respectivamente. Ademais, aglomerados significativos com tendências temporais de redução da cobertura vacinal foram verificados em todas as cinco regiões brasileiras. O estudo evidencia uma importante redução na cobertura vacinal nos últimos anos, constatando heterogeneidades consideráveis entre os municípios. Dessa forma, uma atenção singular e planejamento estratégico condizente com as características de cada localidade são necessários para o controle tanto da redução de cobertura vacinal como do reaparecimento de doenças no Brasil.

Immunization is known to be one of the most successful and cost-effective health interventions, resulting in the eradication and control of various diseases in the world. However, Brazil has experienced a worrisome drop in vaccination coverage, associated with the resurgence of various previously controlled or eradicated diseases. This study thus conducted a situational diagnosis weighing Brazil's different regions and time trends in vaccination coverage in order to identify areas with reduction in vaccination coverage for BCG, poliomyelitis, and MMR. This ecological study collected data on the number of children up to one year of age who had been vaccinated with these three vaccines from 2006 to 2016, according to municipality (county). Data were obtained from the Brazilian Health Informatics Department. A spatial scan was performed, analyzing spatial variations in the time trends for vaccination coverage. Downward trends were seen in the number of immunizations in Brazil, with reductions of 0.9%, 1.3%, and 2.7% per year for BCG, poliomyelitis, and MMR, respectively. Significant decreases were also seen in all five major geographic regions with time trends in the reduction of vaccination coverage. The study evidenced an important reduction in vaccination coverage in recent years, with major heterogeneity between municipalities. Thus, focused attention and strategic planning in keeping with each local area's characteristics are necessary to address both the reduction of vaccination coverage and the resurgence of vaccine-preventable diseases in Brazil.

La inmunización está reconocida como una de las intervenciones más exitosas y costo-eficientes, consiguiendo la erradicación y control de diversas enfermedades en todo el mundo. Sin embargo, se ha observado una preocupante reducción en la cobertura de la vacunación en Brasil, conllevando el recrudecimiento de algunas enfermedades hasta entonces superadas. De esta forma, con el fin de realizar un diagnóstico situacional, que pondere las diferentes regiones del país y la tendencia temporal de cobertura vacunación, el presente estudio tuvo como objetivo evidenciar áreas con una caída de la cobertura vacunación respecto a BCG, poliomielitis y triple vírica en Brasil. Se trata de un estudio ecológico, que recabó información acerca del número de niños de hasta un año de edad inmunizados con estas tres vacunas, durante el período entre 2006 y 2016, por municipios brasileños. Los datos se consiguieron a través del Departamento de Informática del SUS. Se realizó un barrido espacial, analizando las variaciones espaciales en las tendencias temporales de cobertura de vacunación. Se observó una tendencia de reducción en el número de inmunizaciones en Brasil, con caídas de 0,9%, 1,3% y 2,7% al año, en el caso de BCG, poliomielitis y triple vírica, respectivamente. Además, se verificaron aglomerados significativos con tendencias temporales de reducción en la cobertura de vacunación dentro de las cinco regiones brasileñas. El estudio evidencia una importante reducción en la cobertura de vacunación durante los últimos años, constatando heterogeneidades considerables entre los municipios. De esta forma, una atención singular y planificación estratégica, acorde con las características de cada localidad, son necesarias para el control, tanto de la reducción de la cobertura de vacunación, como del resurgimiento de enfermedades en Brasil.

Implicaciones de los estilos de aprendizaje en el uso de didácticas en la práctica docente / Implications of learning styles in the use of teaching approach in teaching practice

Resumen Objetivo: analizar los estilos de aprendizaje de los estudiantes de enfermería y discutir sus implicaciones en el uso de didácticas en la práctica docente. Metodología: a través de un muestreo consecutivo se reclutaron estudiantes de primero, segundo, tercero y cuarto año de enfermería. Se aplicó el Cuestionario Honey-Alonso de Estilos de Aprendizaje y un cuestionario demográfico. Se efectuó análisis descriptivo y test de normalidad en todas las variables. Se emplearon las pruebas Mann-Whitney y Kruskal-Wallis para el análisis entre los estilos de aprendizaje y las variables demográficas. Se examinaron correlaciones interestilo mediante el coeficiente de Pearson Finalmente, se discutió la influencia de los estilos de aprendizaje en el uso de didácticas en la práctica docente. El error tipo I fue fijado en < 0,05 % en todos los test. Resultados: participaron 169 estudiantes con edad media de 24,5 años y predominancia de sexo femenino (81,7 %). El estilo de aprendizaje predominante fue reflexivo (53,8 %). Se identificó que la edad influye en la preferencia de los estilos de aprendizaje (p = 0,03) y que los estilos activo y pragmático; reflexivo, teórico y mixto se correlacionan positivamente (p < 0,05). Conclusiones: el estilo de aprendizaje reflexivo fue el más utilizado, sin embargo, existen múltiples preferencias de estilos de aprendizaje entre los estudiantes de enfermería. El docente tiene el desafío de hacer uso de diversas estrategias didácticas para facilitar el aprendizaje individual y grupal.

Resumo Objetivo: analisar os estilos de aprendizagem dos estudantes de enfermagem e discutir as implicações no uso das didáticas na prática docente. Metodologia: por meio da amostragem consecutiva, foram reclutados estudantes do primeiro, segundo, terceiro e quarto ano de enfermagem. Aplicou-se o Questionário de Estilos de Aprendizagem Honey-Alonso e um questionário demográfico. Foi realizada análise descritiva e teste de normalidade em todas as variáveis. Foram aplicados os testes de Mann-Whitney e Kruskal-Wallis para a análise entre os estilos de aprendizagem e as variáveis demográficas. Correlações interestilo foram analisadas usando o coeficiente de Pearson. Por fim, foi discutida a influência dos estilos de aprendizagem na utilização das didáticas na prática docente. O erro do tipo I foi fixado em < 0,05 % em todos os testes. Resultados: participaram 169 estudantes, com média de idade de 24,5 anos e predomínio do sexo feminino (81,7 %). O estilo de aprendizagem predominante foi o reflexivo (53,8 %). Foi identificado que a idade afeta a preferência dos estilos de aprendizagem (p = 0,03) e que os estilos ativo e pragmático; reflexivo, teórico e misto; se correlacionam positivamente (p < 0,05). Conclusões: o estilo de aprendizagem reflexivo foi o mais utilizado, no entanto, existem múltiplas preferências por estilos de aprendizagem entre os estudantes de enfermagem. O professor tem o desafio de usar várias estratégias de ensino para facilitar a aprendizagem individual e de grupo.

Abstract Objective: to analyze the learning styles of nursing students and discuss their implications in the use of teaching approach in teaching practice. Methodology: first, second, third and fourth-year nursing students were recruited through consecutive sampling. The Honey-Alonso Learning Styles Questionnaire and a demographic questionnaire were applied. Descriptive analysis and test of normality in all variables were carried out. Mann-Whitney and Kruskal-Wallis tests were used for the analysis of learning styles and demographic variables. Correlations among styles were examined using the coefficient of Pearson. Finally, it was discussed the influence of learning styles in the use of teaching approach in teaching practice. The type I error was fixed in < 0.05 % on all tests. Results: 169 students with average age of 24.5 years old and predominance of female gender (81.7 %) participated. The predominant learning style was reflective (53.8 %). It was identified that age impacts the preference of learning styles (p = 0.03), and that active and pragmatic styles and reflective, theoretical and mixed styles, were positively correlated (p <0.05). Conclusion: the reflective learning style was the most widely used; however, there are several preferences on learning styles among nursing students. The teacher has the challenge of using different teaching strategies to facilitate individual and group learning.