Space-time clusters of severe acute respiratory syndrome and COVID-19 and hierarchical urban network in the state of Mato Grosso, Brazil, 2020-2021 / Clusters espaço-temporais de síndrome respiratória aguda grave e COVID-19 e rede urbana hierárquica no estado de Mato Grosso, Brasil, 2020-2021 / Agrupaciones espacio-temporales de síndrome respiratorio agudo severo y COVID-19 y red urbana jerárquica en el estado de Mato Grosso, Brasil, 2020-2021

Objective: to analyze the space-time distribution of COVID-19 in the state of Mato Grosso, Brazil. Methods: Weekly case records of Severe Acute Respiratory Syndrome were obtained from the Ministry of Health's Database related to this syndrome, including data from COVID-19. Temporal and spatiotemporal analysis using scanning statistics to identify clusters of severe acute respiratory syndrome cases were performed with the software SaTScan. Results: A total of 27,093 cases was observed, with an incidence of 768.33/100,000 inhabitants. The spatial distribution considering the period of study evidenced the heterogeneity of values in the state. The highest incidence rates were observed in more populous municipalities. Conclusion: We highlight priority areas for interventions, aiming at controlling the transmission of the disease and reducing transmission risks to more remote areas of the state of Mato Grosso.

Objetivo: Analisar distribuição espaço-temporal de COVID-19 no estado de Mato Grosso, Brasil. Métodos: Registros de casos semanais de Síndrome Respiratória Aguda Grave foram obtidos junto ao Banco de Dados dessa síndrome do Ministério da Saúde, incluindo dados de COVID-19. Análises temporal e espaço-temporal utilizando varreduras estatísticas para identificação de clusters de casos de síndrome respiratória aguda grave foram realizadas com o programa SaTScan. Resultados: Foram observados 27.093 casos, com incidência de 768,33/100.000 habitantes. A distribuição espacial considerando o período de estudo evidenciou heterogeneidade de valores no estado. As maiores taxas de incidência foram observadas em municípios mais populosos. Conclusão: Destacam-se áreas prioritárias para intervenções, priorizando controle da transmissão da doença e redução dos riscos de transmissão para áreas mais remotas do estado de Mato Grosso.

Objetivo: Analizar la distribución espacio-temporal de COVID-19 en la provincia estado de Mato Grosso, Brasil. Métodos: Se obtuvieron registros semanales de casos de Síndrome Respiratorio Agudo Severo (SRAG) de la Base de Datos SRAG del Ministerio de Salud, incluyendo datos de COVID-19. Se realizaron análisis temporales y espaciotemporales utilizando exploraciones estadísticas para identificar grupos de casos SRAG con el programa SaTScan. Resultados: se observaron 27.093 casos, con una incidencia de 768,33 / 100.000 habitantes. La distribución espacial considerando el período de estudio mostró heterogeneidad de valores en el estado. Las tasas de incidencia más altas se observaron en los municipios más poblados. Conclusión: Se destacan las áreas prioritarias para las intervenciones, priorizando el control de la transmisión de enfermedades y la reducción de los riesgos de transmisión a áreas más remotas del estado de Mato Grosso.

Estimación del peso conforme a la edad en niños y niñas ecuatorianos: validación de la ecuación APLS / Estimation of weight based on age in Ecuadorian boys and girls: a validation of the APLS formula

INTRODUCCIÓN: en niños y niñas, la aplicación de intervenciones terapéuticas, lo que incluye la administración de medicamentos, se basa en el peso corporal. OBJETIVO: validar las ecuaciones propuestas por "Advanced Pediatric Life Support - APLS" en 2011 (APLS 1) y 2001 (APLS 2) para estimar el peso de las niñas y niños ecuatorianos, considerando la diversidad étnica y los grupos de edad. MÉTODOS: estudio transversal que incluyó 21.735 niñas y niños pertenecientes a tres grupos étnicos -mestizo, indígena y otro (blancos, negros y mulatos)- con edades comprendidas entre 0 y 12 años y que habían participado en el estudio ENSANUT-ECU. Se calcularon las diferencias, la correlación de Spearman, los gráficos de Bland-Altman y el porcentaje error (PE). Los datos se procesaron y analizaron usando R. RESULTADOS: la APLS 1 tiende a sobrestimar el peso mientras que la APLS 2 lo subestima. El sesgo del peso estimado fue mayor para la ecuación clásica. Los grupos étnicos indígena y otro presentaron las diferencias más altas con respecto al peso medido. Las diferencias de peso estimado con respecto al medido aumentaron progresivamente con la edad. Con la APLS 1, el porcentaje de individuos con un PE > 10 % fue mayor que con la APLS 2. CONCLUSIONES: la APLS no estima con exactitud el peso en la población pediátrica ecuatoriana. La diferencia entre el peso estimado y el peso medido es sensible a las diferencias étnicas y de edad

INTRODUCTION: in children the use of therapeutic interventions, which includes the administration of medications, is based on body weight. OBJECTIVE: to validate the equations proposed by "Advanced Pediatric Life Support - APLS" in 2011 (APLS 1) and 2001 (APLS 2) to estimate weight in Ecuadorian girls and boys, considering their ethnic diversity and age groups. METHODS: a cross-sectional study which included 21,735 girls and boys belonging to three ethnic groups: mestizo, indigenous, and other (white, black, and mulatto), with ages between 0 and 12 years, who participated in the ENSANUT-ECU study. Differences, Spearman's correlation, Bland-Altman graphs, and percentage error (PE) were calculated. Data were processed and analyzed using R. RESULTS: APLS 1 tends to overestimate weight whereas APLS 2 underestimates it. The estimated weight bias was greater for the classical equation. The indigenous and "other" ethnic groups presented the highest differences with respect to measured weight. The differences between estimated weight and measured weight increased progressively with age. With APLS 1, the percentage of individuals with a PE > 10 % was greater than with APLS 2. CONCLUSIONS: APLS does not accurately estimate weight in the Ecuadorian pediatric population. The difference between estimated weight and measured weight is sensitive to ethnic and age differences

Correlations between clinical measures and symptoms: Report 2: Accommodative and vergence measures with symptoms

Aim: The aim of this study was to explore associations among clinical measures of accommodation and vergences with symptoms, which could facilitate the validation of the Convergence Insufficiency Symptoms Survey to screen for deficient clinical measures.MethodsUsing a multi-stage random cluster sampling, 1211 high school students (481 males and 730 females) between 13 and 18 years of age were selected and examined. Visual acuity, stereoacuity and suppression, refractive errors, near point of convergence, heterophoria and fusional vergences, as well as, amplitude of accommodation, accommodative response, facility and relative accommodation were evaluated. The validity of the Convergence Insufficiency Symptoms Survey to distinguish between children with and those without anomalies in the clinical measures were characterized using the Receiver Operation Curve, sensitivity and specificity of the tests.ResultsThe overall mean and standard deviation for symptoms score was 27.38 ± 11.04. Deficient accommodative measures revealed worse symptoms scores than did deficient vergence measures and children with deficient clinical measures had significantly higher mean symptoms scores. (p = 0.001) However, the correlations between defective clinical measures and symptoms were significant but relatively weak. The Receiver Operation Curve showed that the clinical measures with the highest sensitivities using the CISS (≥16) were: reduced amplitude of accommodation 0.63, 95% Confidence interval, 0.59−0.68%) accommodative facility 0.62 (95% Confidence interval, 0.58−0.67) and near point of convergence 0.60 (95% Confidence interval, 0.53−0.67).ConclusionDeficient clinical measures and symptoms of asthenopia are prevalent and correlated in the sample of school children studied. Overall, findings suggest that high school children with deficient clinical measures may be symptomatic when they perform intense near task compared to those without deficiencies. (AU)

Metodología cooperativa disminuye las actitudes disruptivas en educación física / Cooperative Methodologies Decrease Disruptive Attitudes in Physical Education

Las actitudes disruptivas suponen un gran problema para el profesorado en el transcurso de sus clases. Por ello, la finalidad del estudio es conocer y analizar las posibilidades que ofrece la metodología cooperativa como modelo pedagógico en la mejora de dichas actitudes. Se ha utilizado el cuestionario en su versión española validada de la versión corta original del Physical Education Classroom Instrument para la evaluación de conductas disruptivas en alumnado de secundaria. Se ha tomado una muestra de 114 sujetos de primer y segundo ciclo de ESO. Se realizaron dos sesiones de retos cooperativos en EF con un grupo (COOP); y con el otro grupo (CONTROL) se siguió la clase con normalidad. Tras la intervención, a diferencia del grupo control, se observan mejoras estadísticamente significativas en diversas variables tales como agresividad, desobediencia, irresponsabilidad y perturbación del ambiente de clase, favoreciendo así las relaciones interpersonales del grupo, tan sólo del grupo COOP

Disruptive attitudes are frequently an important issue to be manage for teachers during their classes. In the study, we will try to analyse the possibilities offered by cooperative learning as a pedagogical model for the decrease in these disruptive attitudes. We used the validated Spanish version of the questionnaire of the original short version of the Physical Education Classroom Instrument for the evaluation of disruptive behaviour in high school students. It was taken a sample of 114 subjects studying 1st, 2nd, 3rd or 4th grade. The study consisted on performing two sessions of cooperative challenges in a PE class with an experimental group (COOP); and with the other group (CONTROL) the classes were performed as usually. After the performance of these sessions, we found statistically significant improvement of the COOP group regarding several variables such as aggression, disobedience, irresponsibility and disruption of the classroom environment, encouraging the interpersonal relations of the COOP group, unlike the CONTROL group in which no improvement were found

Programa de Revitalización Geriátrica: efectos sobre la cognición en adultos mayores de 60 años / Geriatric revitalisation programme: Effects on cognition in adults over the age of 60

Antecedentes y objetivo: Las evidencias clínicas indican que los individuos mayores muestran con mayor frecuencia diversos cambios cognoscitivos, siendo leves y poco incapacitantes refiriéndose a las funciones mnésicas y a la rapidez de pensamiento y razonamiento. Numerosas evidencias científicas apoyan el papel del ejercicio físico aeróbico como pilar fundamental para prevenir o retrasar la aparición de deterioro cognitivo leve o demencia. El objetivo de este trabajo consiste en determinar el efecto duradero de la mejoría del estado cognitivo de los adultos mayores sanos a los 6 meses de la finalización de un programa de Revitalización Geriátrica (PRG). Material y métodos: La población de estudio fue tomada de los participantes en el PRG de la Universidad de Salamanca. Siguiendo las directrices de la Organización Mundial de la Salud, los sujetos realizaron 3 sesiones semanales de ejercicio físico moderado durante el periodo de intervención. Para la elección de la muestra se realizó un muestreo aleatorio por conglomerados, donde se eligieron al azar 3 asociaciones del total de asociaciones de la ciudad y en cada una de ellas del conjunto de personas que estaban dispuestas a seguir el PRG. La muestra estaba formada por 35 sujetos de ambos sexos mayores de 60 años. Para la valoración neuropsicológica de los sujetos se incluyeron una serie de pruebas neuropsicológicas validadas: Examen Cognoscitivo Mini-Mental; Test de Retención Visual de Benton; Aprendizaje Audioverbal de Rey; Test de Stroop; Test del Trazo A y B. Resultados: Los resultados nos indican la existencia de diferencias significativas entre las 3 valoraciones realizadas, obteniendo un mayor rendimiento tras la intervención, en las variables evaluadas, y volviendo a puntuaciones iniciales tras la inactividad física. Conclusiones: Se deben encontrar estrategias que limiten el tiempo de inactividad física o de sedentarismo de la población mayor de 65 años, buscando maneras de incentivar a la participación en Programas de Actividad Física

Background and aim: Clinical evidence shows that elder individuals display with greater frequency diverse cognitive changes, minor and slightly incapacitating, related to mnesic functions and speed of thought and reasoning. Much scientific evidence supports the role that aerobic physical activity plays as fundamental to prevent or delay the onset of minor cognitive damage or dementia. The aim of this paper is to determine the lasting effect of improved cognitive status in healthy older adults six months after completing a geriatric revitalization programme (GRP). Material and methods: The study population was recruited among participants in the Universidad de Salamanca GRP. Following the guidelines of the World Health Organization, subjects performed 3 weekly sessions of moderate physical exercise during the intervention period. The sample consisted of 35 subjects of both genders, all of them over 60 years old. For the selection of the sample, random sampling was carried out by conglomerates, where 3 associations of the total number of associations in the city were chosen at random, and in each of the group of people who were willing to follow the GRP. In order to assess the subjects' neuropsychological capacities, a series of validated neuropsychological tests were included: Mini-Mental State Examination; Benton Visual Retention Test; Rey Auditory Verbal Learning Test; Stroop Test; Trail Making Test. Results: The results show significant differences between the three assessments put into effect: after the intervention, performance improved in all variables assessed, and it returned to the initial scores after a period of physical inactivity. Conclusions: We must find strategies to limit spans of physical inactivity or sedentary lifestyles in people over 65 by looking for ways to encourage participation in physical activity programmes

Entrenamiento en Conducta Pro- Social y Asertiva en Observadores de Bullying escolar / Training in Pro-Social and Assertive Behavior in School Bullying Observers

El estudio permite identificar el efecto del entrenamiento a observadores en conductas pro-sociales y asertivas en el bullying escolar en un colegio de la ciudad de Bogotá ubicado en la localidad de Bosa. Se tomaron 64 estudiantes entre 12-14 años de 6°, 7° y 8°grado de secundaria, seleccionados mediante muestreo por conglomerados. El diseño fue cuasi-experimental pre-test pos-test con grupo control. Se aplicó el Cuestionario sobre Intimidación y Maltrato entre Iguales- INSEBULL (Avilés y Elices, 2007) seleccionando la población y homogenizando los grupos, se vincularon participantes mediante asignación aleatoria en grupos. Se aplicó la Escala de habilidades pro-sociales para adolescentes EHPA (Morales y Suárez, 2011) y la Escala de comportamiento asertivo para niños (CABS) (Wood, 1978), a partir de lo anterior se desarrolló el entrenamiento al GE, evaluándolo a través del pos-test del INSEBULL, EPHA y CABS. Los resultados permiten rechazar la hipótesis de trabajo establecida para el estudio, y se acepta la hipótesis nula, la cual especifica que el entrenamiento en observadores en conductas pro-sociales y asertivas no establece diferencias significativas en sus medidas, por lo cual no se observa cambios en la dinámica del fenómeno del Bullying Escolar

The study allows us to identify the effect of observer training on pro-social and assertive behaviors in school bullying in a school in the city of Bogotá located in the town of Bosa. 64 students were taken between 12-14 years of 6th, 7th and 8th grade of high school, selected by sampling by conglomerates. The design was quasi-experimental pre-test post-test with control group. The Questionnaire on Intimidation and Maltreatment between Equals was applied- INSEBULL (Avilés & Elices, 2007) selecting the population and homogenizing the groups, participants were linked by random assignment in groups. The Scale of pro-social skills for adolescents EHPA (Morales & Suárez, 2011) and the Assertive Behavior Scale for Children (CABS) (Wood, 1978) was applied, from the above the GE training was developed, evaluating it through the post-test of the INSEBULL, EPHA and CABS. The results allow to reject the hypothesis of work established for the study, and the null hypothesis is accepted, which specifies that the training in observers in pro-social and assertive behaviors does not establish significant differences in their measurements, for which no changes are observed. in the dynamics of the phenomenon of School Bullying

Intervalo de confianza para las normas del cefalograma resumido de Ricketts en niños de cubanos / Confidence interval for the standards of the Ricketts´summarized cephalogram in Cuban children

Introducción: en hallazgos cefalométricos de diferentes países en poblaciones con patrones de crecimientos y oclusión normal, se reportan diferencias estadísticamente significativas a los valores dados en los cefalogramas de Ricketts, Steiner, Downs, Jarabak y otros. En Cuba no existen estudios de estos patrones en niños con dentición mixta los que favorecerían un mejor diagnóstico de las anomalías dento-maxilofaciales. Objetivo: proponer el perfeccionamiento de las normas del cefalograma resumido de Ricketts para los niños. Materiales y Métodos: investigación observacional, descriptiva en cuatro poblaciones pertenecientes a las siguientes zonas del país: Matanzas, Cárdenas, Camagüey y Sancti Spíritus. El universo estuvo constituido por 1 657 niños de 9 años de edad. La muestra 163 niños, seleccionados por el método estratificado por conglomerados con oclusión dentaria normal. Se utilizó el análisis del cefalograma resumido de Ricketts y la prueba t de media para determinar los valores de las variables estudiadas y se hicieron estimaciones puntuales y por intervalos de confianza. Resultados: tres variables mostraron medias iguales a las normas de Ricketts: eje facial (90°), profundidad facial (87°) y profundidad maxilar (90°). En las restantes fueron comprobadas diferencias significativas. Se obtuvo un intervalo de confianza para cada una de las variables del cefalograma resumido de Ricketts. Conclusiones: solamente tres variables presentaron valores similares a los planteados por Ricketts, las restantes presentaron valores que difieren significativamente de los planteados por Ricketts. Se propone utilizar el intervalo de confianza obtenido en esta investigación en las variables del cefalograma resumido de Ricketts para diagnosticar las anomalías dento-maxilofaciales en niños cubanos (AU).

Introduction: in cephalometric findings from different countries in populations with normal growing and occlusion patterns, significant statistic differences are reported in relation to the values given in the cephalograms of Ricketts, Steiner, Downs, Jarabak, and others. In Cuba there are not studies of these patterns in children with mixed dentition that might allow a better diagnosis of dental, maxilla-facial anomalies. Objective: to propose the improvement of the standards of the Ricketts abridge cephalogram for children. Materials and methods: descriptive, observational research in four populations belonging to different regions of the country: Matanzas, Cárdenas, Camagüey and Sancti Spíritus. The universe was formed by 1675 children aged 9 years old; the sample, 163 children with normal dental occlusion, was chosen by the stratified method per conglomerate. The analysis of the Ricketts summarized cephalogram and the mean T test were used to determine the values of the studied variables; punctual estimates and estimates by confidence interval were carried out. Results: three variables showed equal means than Ricketts' standards: facial axis (90o), facial depth (87o) and maxillary depth (90o). In the remaining variables there were found significant differences. A confidence interval was obtained for every one of the Ricketts' summarized cephalogram variable. Conclusions: only three variables showed values similar to those given by Ricketts. The remaining ones presented values significantly differing from those established by Ricketts. The proposition is using the confidence interval obtained in this research in the variables of the Ricketts' summarized cephalogram to diagnose the dental-maxillafacial anomalies in Cuban children (AU).

Intervalo de confianza para las normas del cefalograma resumido de Ricketts en niños de cubanos / Confidence interval for the standards of the Ricketts´summarized cephalogram in Cuban children

Introducción: en hallazgos cefalométricos de diferentes países en poblaciones conpatrones de crecimientos y oclusión normal, se reportan diferencias estadísticamentesignificativas a los valores dados en los cefalogramas de Ricketts, Steiner, Downs,Jarabak y otros. En Cuba no existen estudios de estos patrones en niños con denticiónmixta los que favorecerían un mejor diagnóstico de las anomalías dento-maxilofaciales.Objetivo: proponer el perfeccionamiento de las normas del cefalograma resumido deRicketts para los niños.Materiales y Métodos: investigación observacional, descriptiva en cuatropoblaciones pertenecientes a las siguientes zonas del país: Matanzas, Cárdenas,Camagüey y Sancti Spíritus. El universo estuvo constituido por 1 657 niños de 9 añosde edad. La muestra 163 niños, seleccionados por el método estratificado porconglomerados con oclusión dentaria normal. Se utilizó el análisis del cefalogramaresumido de Ricketts y la prueba t de media para determinar los valores de las variables estudiadas y se hicieron estimaciones puntuales y por intervalos deconfianza.Resultados: tres variables mostraron medias iguales a las normas de Ricketts: ejefacial (90°), profundidad facial (87°) y profundidad maxilar (90°). En las restantesfueron comprobadas diferencias significativas. Se obtuvo un intervalo de confianzapara cada una de las variables del cefalograma resumido de Ricketts.Conclusiones: solamente tres variables presentaron valores similares a los planteadospor Ricketts, las restantes presentaron valores que difieren significativamente de losplanteados por Ricketts. Se propone utilizar el intervalo de confianza obtenido en estainvestigación en las variables del cefalograma resumido de Ricketts para diagnosticarlas anomalías dento-maxilofaciales en niños cubanos (AU).

Introduction: in cephalometric findings from different countries in populations withnormal growing and occlusion patterns, significant statistic differences are reported inrelation to the values given in the cephalograms of Ricketts, Steiner, Downs, Jarabak,and others. In Cuba there are not studies of these patterns in children with mixeddentition that might allow a better diagnosis of dental, maxilla-facial anomalies.Objective: to propose the improvement of the standards of the Ricketts abridgecephalogram for children.Materials and methods: descriptive, observational research in four populationsbelonging to different regions of the country: Matanzas, Cárdenas, Camagüey andSancti Spíritus. The universe was formed by 1675 children aged 9 years old; thesample, 163 children with normal dental occlusion, was chosen by the stratifiedmethod per conglomerate. The analysis of the Ricketts summarized cephalogram andthe mean T test were used to determine the values of the studied variables; punctualestimates and estimates by confidence interval were carried out.Results: three variables showed equal means than Ricketts standards: facial axis(90o), facial depth (87o) and maxillary depth (90o). In the remaining variables therewere found significant differences. A confidence interval was obtained for every one ofthe Ricketts summarized cephalogram variable.Conclusions: only three variables showed values similar to those given by Ricketts.The remaining ones presented values significantly differing from those established byRicketts. The proposition is using the confidence interval obtained in this research inthe variables of the Ricketts summarized cephalogram to diagnose the dental-maxillafacial anomalies in Cuban children (AU).

Avaliação da cobertura vacinal e do conhecimento das mensagens divulgadas no âmbito do Programa de Demonstração da vacinação contra o HPV no distrito de Manhiça, 2014 / Evaluation of vaccination coverage and knowledge of the messages disseminated under the Demonstration Program for HPV Vaccination in Manhiça District, 2014

In May 2014, Mozambique launched a vaccination demonstration program against cervical cancer focusing on 10 year old girls according to WHO recommendations. Although the acceptability study revealed a high level of theoretical acceptability of the vaccination in the Manhiça district, it did not guarantee the real level of coverage because the census data did not report specifically on the population of the relevant age groups used by the implementers to calculate the target group to be reached and the respective coverage. It was also important to assess the level of knowledge about the disease and how the target population received their information to assess the impact of the social mobilization component associated with vaccination. Methods: A cross-sectional descriptive study was conducted between March and May 2015 to evaluate the vaccine coverage of the 2014 HPV vaccination campaign which included girls born after 2004 and their caregivers. Cluster sampling was conducted according to WHO guidelines. The data were collected through a semi-structured survey, inserted by double entry using the CISM RED CAP platform and analyzed using SPSS software version 21 in which categorical variable frequency tables and bi-variated analysis were performed. Results: Of the 727 households analyzed, the majorities were located in rural areas where the caregivers surveyed were predominantly biological parents, female (71%), and had primary education (57%). The girls were mostly students (98.5%), concentrated in the fourth and fifth grades 68.8%. 91.3% of the girls received at least one dose of the vaccine and 73% had received all doses. 93.4% were vaccinated in schools. The majority of the unvaccinated girls were 4th and 5th grade students living in the districts of Maciana, Manhiça Sede and Palmeiras, who reported lack of information about vaccination and lack of proof of age. More than 80% of those in charge of education had heard of cervical cancer but less than 3% knew how to define it, and only 15% said that the transmission route is sexual. Health facilities, television, and informal talks were the most prominent sources of information. Most girls (65%) had heard about cervical cancer, but only 4% knew the mode of transmission and 25% knew how to prevent it. Only 11% of girls heard of HPV. Conclusion: Most of the caregivers had a primary level of education, were domestic and agricultural practitioners, and the girls were mostly students concentrated in the 4th and 5th grades. A challenge with the mobilization messages was that they were not appropriate for children and people with low schooling. The program proved to be efficient in locating and fully vaccinating 73.3% of eligible girls. It was found that schools are the ideal place to hold the vaccinations. Non-vaccination depended more on geographic area than schooling. Recommendations: Improve the communication strategy taking into account the target group for vaccination and the low level of caregiver education

Em Maio de 2014, Moçambique lançou um programa de demonstração de vacinação contra o CCU as meninas de 10 anos segundo recomendações da OMS. Embora o estudo de aceitabilidade tenha revelado um alto nível de aceitabilidade teórica da vacinação no distrito da Manhiça, não existiam dados específicos do número de meninas elegíveis para a vacinação. Era importante também verificar o nível de conhecimento desta população em relação a doença e a fonte de informação mais usada, tendo em conta que houve uma componente de mobilização social associada a vacinação. Métodos: Foi realizado um estudo descritivo transversal para avaliar a cobertura vacinal da vacinação contra o HPV do ano 2014 entre Março a Maio de 2015 incluindo meninas nascidas em 2004 e seus encarregados de educação. A amostragem foi feita por conglomerados segundo as directrizes da OMS. Os dados foram colhidos através de um inquérito semi-estruturado e analisados usando o software SPSS versão 21 na qual fez-se tabelas de frequências das variáveis categóricas e a análise bivariada. Resultados: Dos 727 agregados analisados, a maioria localiza-se na região rural nos quais os encarregados de educação são maioritariamente pais biológicos, do sexo feminino (71%), com nível de escolaridade primária (57%). As meninas eram maioritariamente estudantes (98,5%), concentradas na 4ª e 5ª classe 68,8%, 91,3% recebeu pelo menos uma dose da vacina, sendo 73% com vacinação completa, 93,4% foram vacinadas nas escolas. A maioria das meninas não vacinadas eram estudantes da 4ª e 5ª classe, residentes nos bairros de Maciana, Manhiça Sede e Palmeiras, alegavam falta de informação sobre a vacinação, falta de comprovativo da idade. Mais de 80% dos encarregados de educação tinha ouvido falar do cancro do colo do útero mas menos de 3% sabia definir, 15% referiu que a via de transmissão é sexual. As unidades sanitárias, televisão, e conversas informais foram os meios de comunicação mais destacados. A maior parte das meninas (65%) já tinha ouvido falar do CCU, 4% conhecia o modo de transmissão e 25% sabia como prevenir. Somente 11% das meninas ouviram falar do HPV. Conclusão: A maioria dos encarregados de educação tinham um nível de escolaridade primário, domésticas, as meninas eram maioritariamente estudantes da 4ª e 5ªclasses. Embora abrangentes, as mensagens de mobilização não eram adequadas para crianças e pessoas com escolaridade baixa. O programa mostrou-se eficiente ao localizar e vacinar completamente 73,3% das meninas elegíveis. A escola é o local ideal para encontrar as meninas. A não vacinação dependeu mais da proveniência e da escolarização. Recomendações: Melhorar a estratégia de comunicação tendo em conta o grupo alvo para a vacinação

Plano de amostragem em inquéritos de saúde, município de São Paulo, 2015 / Sampling plan in health surveys, city of São Paulo, Brazil, 2015

OBJETIVO: Avaliar o plano de amostragem do Inquérito de Saúde do Município de São Paulo (ISA-Capital 2015) em relação à precisão das estimativas e à conformação de domínios de estudo pelas coordenadorias de saúde do município de São Paulo. MÉTODOS: Descrição de população e domínios de estudo, procedimentos de amostragem, incluindo estratificação, cálculo do tamanho da amostra e sorteio de unidades amostrais do Inquérito de Saúde do Município de São Paulo, 2015. As estimativas de proporções foram analisadas em relação à precisão, por meio do coeficiente de variação e do efeito do delineamento. Foram considerados adequados coeficientes menores do que 30% no nível regional e 20% no municipal, e efeitos do delineamento menores do que 1,5. Para considerar adequada a estratégia de estabelecimento das Coordenadorias de Saúde como domínios, foi verificado que, dentro das coordenadorias, as estimativas de proporções para grupos de idade e sexo tinham a precisão mínima aceitável. Os parâmetros estimados referiram-se aos temas: uso de serviços, morbidade e autoavaliação em saúde. RESULTADOS: Foram sorteados 150 setores censitários, 30 em cada Coordenadoria de Saúde, sorteados e visitados 5.469 domicílios ocupados, e realizadas 4.043 entrevistas. Das 115 estimativas feitas para os domínios de estudo, 97,4% apresentaram coeficientes de variação menores do que 30% e 82,6% menores do que 20%. Das 24 estimativas feitas para o total do município, 23 apresentaram coeficiente de variação menor do que 20%. Mais de dois terços das estimativas do efeito do delineamento foram inferiores a 1,5, valor previsto no cálculo do tamanho da amostra, e o efeito do delineamento foi menor do que dois para 88%. CONCLUSÕES: A amostra do ISA-Capital 2015 gerou estimativas situadas nos patamares previstos de precisão, tanto as de nível municipal como regional. Foi acertada a decisão de estabelecer as coordenadorias regionais de saúde do município de São Paulo como domínios de estudo.

Riqueza y abundancia de peces arrecifales en el Caribe de Guatemala utilizando Estaciones Remotas de Video Subacuático con Carnada / Richness and abundance of reef fish in the Caribbean of Guatemala using Baited Remote Underwater Video Stations

El mar Caribe de Guatemala forma parte del Sistema Arrecifal Mesoamericano (SAM), el cual alberga una alta diversidad de especies marinas. Dichas poblaciones son importantes para el bienestar de las comunidades humanas que habitan en la zona marino-costera de los países que conforman el SAM, y que dependen de manera directa o indirecta de estos recursos. El objetivo de este estudio fue determinar la riqueza y abundancia tanto de las especies de peces herbívoros presentes en el área, como de aquellas que son atraídas por carnada de sábalo y atún, utilizando la metodología de Estaciones Remotas de Video Subacuático con Carnada BRUVS en sitios con presencia de arrecifes. El muestreo se realizó en siete sitios ubicados fuera de la Bahía de Amatique, Izabal, en abril, junio y septiembre de 2016. Se grabaron 26.06 h, en 21 sets de BRUVS. Se contabilizaron 778 organismos, correspondientes a dos clases, 20 familias, 31 géneros y 59 especies. Las especies más abundantes en el estudio fueron Scarus spp. (19.67 %), Clepticus parrae (9.64 %), Aluterus scriptus (6.04 %), Scarus iserti (5.14 %) y Caranx ruber (5.01 %). Los sitios Quetzalito 1 y 2 presentaron una riqueza de especies significativamente mayor (p < 0.006) al resto de sitios de muestreo. Quetzalito 1, 2 y King Fish presentaron una abundancia significativamente mayor (p < .038) al resto de sitios. El dendrograma derivado de la abundancia por especie para los sitios de muestreo, mostró cinco agrupaciones (similaridad de Bray-Curtis del 43 %). Finalmente se observó una baja presencia de peces de importancia comercial en los siete puntos evaluados.

The Guatemalan Caribbean Sea forms part of the Mesoamerican Reef System (MAR), which harbors a great marine biodiversity. These populations are important for the wellness of humans who live in communities at coastal areas located in the MAR region, and who directly or indirectly depend on these resources to survive and thrive. The main objective of this study was to determine not only species richness and abundance of herbivorous fish, but also those who are attracted by shad and tuna bait when used in the Baited Remote Underwater Video Stations (BRUVS) in sites with coral reef presence. Monitoring was held at seven spots located outside Bahía de Amatique, Izabal, in April, June and September 2016. In 21 sets of BRUVS, 26.06 h of video were recorded, counting a total of 778 organisms which belongs to two classes, 20 families, 31 genera and 59 species. The most abundant species were Scarus spp. (19.67 %), Clepticus parrae (9.64 %), Aluterus scriptus (6.04 %), Scarus iserti (5.14 %) and Caranx ruber (5.01 %). The sites that presented higher richness of species were Quetzalito 1 y 2 (p < 0.006 compared to the rest of the sampled sites). Quetzalito 1, 2 and King Fish showed higher abundance (p < .038) compared to the rest of the sites. Abundance per specie dendrogram showed five groups (Bray-Curtis similarity of 43 %). Finally, low presence of commercial fish species was seen at the seven monitored sites.

Selección de sintomáticos respiratorios en la Habana de enero a abril del 2016 utilizando el muestreo por conglomerado / Detection of symptomatic respiratory in Havana of January to April of 2016 using a sampling aggregate

En la actualidad la Tuberculosis (TB) es una enfermedad que mantiene a nivel mundial altos índices de mortalidad y morbilidad y la principal arma para su control es la detección rápida y la curación de los casos infecciosos.¹ En Cuba su tasa de incidencia la ubica dentro de los países con mayor posibilidad de eliminación,² de ahí lo necesario de hacer énfasis en la identificación y estudio de los Sintomáticos Respiratorios de 21 días y más (SR+21) que clasifican en algún Grupo Vulnerable (GV). El trabajo presenta la identificación pacientes pertenecientes a grupos vulnerables con SR+21 en la Habana en el cuatrimestre enero abril del 2016. Se utilizaron métodos teóricos, empíricos y estadísticos matemáticos. Los resultados mostraron que la mitad de los SR+21 estudiados posee algún factor de riesgo, resaltando la tercera edad. El empleo del muestreo por conglomerado resultó una técnica factible de aplicación en este contexto(AU)

At the present time Tuberculosis (TB) is an illness manteining worldwide level high mortality and morbility and the principal weapon for his control is the fast detection and the cure of infectious cases.¹ In Cuba its rate of incidence locates tuberculosis within the countries with bigger possibility of elimination² for what is necessary to emphasize in the identification and study of the Symptomatic Respiratory the patients with 21 days and more (SR+21) because they classify in some Vulnerable Group (GV). He work we did shows that the apoplication of Conglomerate sampling method is useful in this kind of research. Half of the patients classified as SR+21 were GV, highlighting third age patients. Our country has rate of hushed incidence with possibilities of elimination of illness² from there whatever is needed to do emphasis in the identification and study of the Symptomatic Respiratory of 21 days and more (SR+ 21) that they classify in some Vulnerable Group (GV)(AU)

Sarcopenia en ancianos con antecedente de EPOC/asma: resultados del estudio SABE - Bogotá / Sarcopenia in the elderly with a history of COPD/asthma: results of the SABE-Bogotá study

Introducción. La coexistencia de EPOC/asma y sarcopenia en los ancianos puede ser común. Estas asociaciones se han visto que hacen sinergia en el deterioro de la calidad de vida y en la dificultad para controlar las enfermedades crónicas. El objetivo del estudio es describir la asociación entre la EPOC/asma y la sarcopenia. Material y métodos. Se analizaron los datos del estudio SABE-Bogotá, que incluyó 2.000 personas de 60 años o más en una muestra transversal probabilística por conglomerados con una cobertura del 81,9%. La variable dependiente fue EPOC/asma y se buscó su asociación con sarcopenia. Asimismo, se estimó la independencia de la asociación a partir de modelos de regresión logística ajustados a variables de confusión. Resultados. De un total de 2.000 personas, la prevalencia autorreferida de EPOC/asma fue de 16,7%, y la de sarcopenia del 6,96%, mientras que en los pacientes con EPOC/asma esta última fue del 11,2% (p=0,004). En el modelo de regresión logística ajustado se encontró una asociación independiente de aumento del riesgo de sarcopenia dado que se padece de EPOC/asma, con una OR de 2,01 (IC 95%:1,21-3,35). Conclusiones. Encontramos una asociación significativa independiente entre presentar EPOC/asma y padecer sarcopenia. Estos resultados orientan la conveniencia de descartar sarcopenia en pacientes con EPOC/asma para plantear intervenciones como soporte nutricional y programas de ejercicio, idealmente en el marco de programas de rehabilitación pulmonar (AU)

Introduction. It has been reported that sarcopenia frequently co-exists with COPD/asthma, and can significantly affect quality of life and the control of chronic diseases. The aim of this study is to describe the association between COPD/asthma and sarcopenia. Material and methods. Data was used from the SABE-Bogotá study, which included 2,000 older adults aged 60 years or more. It is a cross-probabilistic cluster sample with 81.9% coverage. The dependent variable was COPD/asthma. An analysis was performed to determine the association with sarcopenia and the other variables using univariate and bivariate analysis and logistic regression adjusted to confusion variables. Results. The self-reported prevalence of COPD/asthma in the total sample was 16.7%, and Sarcopenia was estimated as 6,96%, but in COPD/asthma patients it was 11.2% (P=.004). In the multivariate analysis an association was found between COPD/asthma and sarcopenia (2.01, 95% CI: 1,21-3,35). Conclusions. Screening of sarcopenia in older adults with COPD/asthma, as well as interventions such as nutrition and exercise, are important, and ideally in the context of pulmonary rehabilitation programs, due the significant independent association that was found between COPD/asthma and sarcopenia (AU)

Non-Normal data: Isa nova still a valid option? / Datos no normales: ¿es el ANOVA una opción válida?

Background: The robustness of F-test to non-normality has been studied from the 1930s through to the present day. However, this extensive body of research has yielded contradictory results, there being evidence both for and against its robustness. This study provides a systematic examination of F-test robustness to violations of normality in terms of Type I error, considering a wide variety of distributions commonly found in the health and social sciences. Method: We conducted a Monte Carlo simulation study involving a design with three groups and several known and unknown distributions. The manipulated variables were: Equal and unequal group sample sizes; group sample size and total sample size; coefficient of sample size variation; shape of the distribution and equal or unequal shapes of the group distributions; and pairing of group size with the degree of contamination in the distribution. Results: The results showed that in terms of Type I error the F-test was robust in 100% of the cases studied, independently of the manipulated conditions (AU)

Antecedentes: las consecuencias de la violación de la normalidad sobre la robustez del estadístico F han sido estudiadas desde 1930 y siguen siendo de interés en la actualidad. Sin embargo, aunque la investigación ha sido extensa, los resultados son contradictorios, encontrándose evidencia a favor y en contra de su robustez. El presente estudio presenta un análisis sistemático de la robustez del estadístico F en términos de error de Tipo I ante violaciones de la normalidad, considerando una amplia variedad de distribuciones frecuentemente encontradas en ciencias sociales y de la salud. Método: se ha realizado un estudio de simulación Monte Carlo considerando un diseño de tres grupos y diferentes distribuciones conocidas y no conocidas. Las variables manipuladas han sido: igualdad o desigualdad del tamaño de los grupos, tamaño muestral total y de los grupos; coeficiente de variación del tamaño muestral; forma de la distribución e igualdad o desigualdad de la forma en los grupos; y emparejamiento entre el tamaño muestral con el grado de contaminación en la distribución. Resultados: los resultados muestran que el estadístico F es robusto en términos de error de Tipo I en el 100% de los casos estudiados, independientemente de las condiciones manipuladas (AU)

Desarrollo psicomotor y dificultades del aprendizaje en preescolares con probable trastorno por déficit de atención e hiperactividad. Estudio epidemiológico en Navarra y La Rioja / Psychomotor development and learning difficulties in preschool children with probable attention deficit hyperactivity disorder: An epidemiological study in Navarre and La Rioja

Introducción: Los síntomas del TDAH emergen a partir de la edad preescolar. El TDAH en preescolares implica una importante repercusión académica posterior. En España no hay instrumentos normalizados (idioma y cultura) para la detección del TDAH en preescolares ni disponemos de datos de su impacto. Objetivos: Evaluar factores de desarrollo y dificultades de aprendizaje asociados con probable TDAH y valorar la repercusión del probable TDAH en el ámbito escolar en niños preescolares. Métodos: Estudio poblacional en el que se aplicó un muestreo polietápico-estratificado proporcional por conglomerados. Resultados: Detectamos diferencias significativas entre probable TDAH y percepción parental de dificultades en el desarrollo del lenguaje expresivo, comprensión y psicomotricidad fina y en el área de emociones, concentración, conducta y relaciones. El 34% de preescolares con probable TDAH presentaban dificultades en el aprendizaje global. La interferencia se manifestó predominantemente en el subtipo inatento. En el análisis multivariante, las dificultades en el aprendizaje se asociaron a la presencia de un desarrollo psicomotor retrasado en los 3 primeros años de vida (OR: 5,57) valorado por los progenitores y al probable TDAH (OR: 2,34). Conclusiones: El probable TDAH en preescolares se ve asociado a la percepción parental de dificultades en varias dimensiones del desarrollo y el aprendizaje. Es importante realizar una detección precoz del TDAH en la época preescolar para iniciar de forma temprana intervenciones clínicas y educativas efectivas (AU)

Introduction: ADHD symptoms begin to appear at preschool age. ADHD may have a significant negative impact on academic performance. In Spain, there are no standardized tools for detecting ADHD at preschool age, nor is there data about the incidence of this disorder. Objective: To evaluate developmental factors and learning difficulties associated with probable ADHD and to assess the impact of ADHD in school performance. Methods: We conducted a population-based study with a stratified multistage proportional cluster sample design. Results: We found significant differences between probable ADHD and parents’ perception of difficulties in expressive language, comprehension, and fine motor skills, as well as in emotions, concentration, behaviour, and relationships. Around 34% of preschool children with probable ADHD showed global learning difficulties, mainly in patients with the inattentive type. According to the multivariate analysis, learning difficulties were significantly associated with both delayed psychomotor development during the first 3 years of life (OR: 5.57) as assessed by parents, and probable ADHD (OR: 2.34). Conclusions: There is a connection between probable ADHD in preschool children and parents’ perception of difficulties in several dimensions of development and learning. Early detection of ADHD at preschool ages is necessary to start prompt and effective clinical and educational interventions (AU)

Asthma education taught by physical education teachers at grade schools: A randomised cluster trial

Objective: Assess whether the Asthma, Sport and Health (ASAH) programme taught by teachers improves asthmatics’ quality of life, asthma knowledge, and reduces school absenteeism. Design: Randomised cluster trial parallel group. Participants: 2293 students (203 asthmatic) in the Intervention School group (IS) and 2214 in the Comparison School (CS) (224 asthmatic) belonging to primary school. Intervention: Implementation of the educational programme ‘Asthma, Sport and Health’ at grade schools, taught by physical education teachers. Main outcome: Quality of life according to the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Secondary outcomes: Asthma knowledge, asthma control, school absenteeism. Results: After implementing the programme in the IS group, global quality of life improved significantly (p < 0.001) as did their domains, symptoms (p < 0.001), emotional function (p < 0.001) and activity limitations ( p < 0.01), while in the CS group improvement was seen in global life quality (p < 0.01) without any significant changes in the domains for emotional function and activity limitations. Asthma knowledge only increased in IS, among asthmatic students from 16.51 (CI 95% 16.04-16.98) to 18.16 (CI 95% 17.69-18.62) (p < 0.001) and students without asthma from 15.49 (CI95% 15.36-15.63) to 17.50 (CI95% 17.36-17.64) (p < 0.001). The multiple regression analysis showed that quality of life and its domains depend on asthma knowledge and above all, having well-controlled asthma. We found no decrease in school absenteeism. Conclusions: The ASAH programme improved certain quality of life aspects regarding asthma (emotional function and limitation of activities) and asthma knowledge, but it failed to reduce school absenteeism NCT01607749 (AU)

No disponible

Proyecto RECALCAR. La atención al paciente en las unidades de cardiología del Sistema Nacional de Salud, 2011-2014 / The RECALCAR project. Healthcare in the cardiology units of the Spanish National Health System, 2011 to 2014

El proyecto RECALCAR (Recursos y Calidad en Cardiología) realiza una encuesta de las unidades de cardiología y analiza el Conjunto Mínimo Básico de Datos del Sistema Nacional de Salud. Se ha encontrado una notable estabilidad (2011-2014) en todos los indicadores generales, así como una importante variabilidad entre unidades de cardiología y servicios de salud de las comunidades autónomas. La implantación de la gestión por procesos y de redes asistenciales es baja (el 14 y el 17% de las unidades). Las unidades con servicios de cardiología estructurados tienden a tener mejores indicadores de eficiencia y resultados. No se han encontrado diferencias significativas en relación con la estancia media (5,5 ± 1,1 días) o la razón consultas sucesivas/primeras (2:1) entre los diferentes tipos de unidades. La frecuentación promedio de las unidades es de 5/1.000 habitantes/año y la tasa media de consultas primeras, 16 ± 4/1.000 habitantes/año. No existe guardia de presencia física de cardiología en el 30% de las unidades con 24 o más camas y el 45% de estas no tienen asignadas camas de cuidados críticos. Los hallazgos en la línea de investigación en resultados avalan las recomendaciones de regionalizar los servicios de cardiología y desarrollar redes asistenciales del área del corazón (AU)

The RECALCAR project (Spanish acronym for Resources and Quality in Cardiology Units) uses 2 data sources: a survey of cardiology units and an analysis of the Minimum Basic Data set of all hospital discharges of the Spanish National Health System. From 2011 to 2014, there was marked stability in all indicators of the availability, utilization, and productivity of cardiology units. There was significant variability between units and between the health services of the autonomous communities. There was poor implementation of process management (only 14% of the units) and scarce development of health care networks (17%). Structured cardiology units tended to have better results, in terms of both quality and efficiency. No significant differences were found between the different types of unit in the mean length of stay (5.5 ± 1.1 days) or the ratio between successive and first consultations (2:1). The mean discharge rate was 5/1000 inhabitants/y and the mean rate of initial consultations was 16 ± 4/1000 inhabitants/y. No duty or on-call cardiologist was available in 30% of cardiology units with 24 or more beds; of these, no critical care beds were available in 45%. Our findings support the recommendation to regionalize cardiology care and to promote the development of cardiology unit networks (AU)

Riesgo percibido sobre el consumo ocasional de tabaco tradicional y electrónico en adolescentes / Perceived risk of occasional use of traditional and electronic tobacco in adolescents

Introducción: existe una relación entre la percepción de riesgo asociada al consumo de una sustancia y la probabilidad de consumirla. Objetivo: conocer la percepción de peligrosidad del consumo ocasional de tabaco convencional y electrónico en adolescentes entre 13 y 18 años escolarizados en Castilla y León (España) (curso 2014-15), así como su relación con otros factores sociodemográficos. Material y métodos: estudio descriptivo transversal con un muestreo aleatorio bietápico por conglomerados. Para calcular el tamaño de la muestra se estimó una probabilidad del 50% en todas nuestras respuestas, un margen de confianza del 95,5% y una probabilidad de error en contraste bilateral del 1,7%. Se utilizó un cuestionario estandarizado, telemático y anónimo, con preguntas análogas a las utilizadas en programas nacionales e internacionales para conocer la percepción de riesgo sobre el consumo de drogas en adolescentes. Resultados: la muestra final fue de 3311 adolescentes (media de edad 14,8 ± 1,3 años). Encontramos una elevada percepción de peligrosidad del consumo ocasional de tabaco en adolescentes (lo consideran muy peligroso el 44,2%, n = 1469). Sin embargo, el cigarrillo electrónico goza de una menor percepción de riesgo (lo consideran muy peligroso el 18,5%, n = 616), sin diferencias estadísticamente significativas en relación con la edad ni con la funcionalidad familiar. Las mujeres (odds ratio: 1,28) y los adolescentes de centros públicos (odds ratio: 1,32) presentan menor percepción de peligrosidad (p < 0,05 respectivamente). Conclusiones: los cigarrillos electrónicos podrían convertirse en una vía adicional de iniciación al tabaquismo en adolescentes por su accesibilidad, sus atractivos sabores y la baja percepción de peligrosidad asociada a su consumo en la adolescencia temprana (AU)

Introduction: research into drug consumption agrees on the relationship between the perception of the risk associated with the consumption of a substance and the probability of consuming it. Objective: To find out the perception of danger in the occasional consumption of conventional and electronic cigarettes in adolescents aged between 13 and 18 attending school in Castile & Leon (academic year 2014-2015), as well as their relation with other sociodemographic factors. Material and methods: a standardized, telematic and anonymous questionnaire was used with analogous questions to those used in national and international programmes to discover the risk perception concerning the consumption of drugs among adolescents. A descriptive, cross-sectional study with a random, two-stage cluster sample was also used. A probability of 50% was estimated in all our answers, with a confidence interval of 95.5% and an error probability in bilateral contrast of 1.7%. The final sample was made up of 3,311 adolescents (mean age 14.8±1.3 years). Results: we found a high perception of risk for the occasional consumption of tobacco among adolescents (74.3% considering it very dangerous, n = 2458). However, with the electronic cigarette there is a lower perception of risk (only 65.9% considered it to be very dangerous), with no statistically significant differences in relation to age or family functionality (p < 0.005 respectively). Women (odds ratio: 1.28) and adolescents from public centres (p ≤ 0.01 respectively) show a lower perception of danger. Conclusions: the e-cigarettes could become an additional way of initiatiating tobacco smoking in adolescents due to their accessibility, their attractive flavours and the low perception of danger associated with their consumption in early adolescence (AU)