New psychoactive substances: A new barrier to the provision of paIIiative care?

Qn 1-2 February, the United Nations Office on Drugs and Crime (UNODC) heid the First Regional Meeting on New Psychoactive Substances (NPS) in the Western Hemisphere. Held in Bogotá, Colombia, the meeting brought together technical experts from countries and organizations in the region as well as international experts concerned by the emergence and use of NPS. Different topics were discussed including: legislation, early warning systems, trafficking and public health risks. NPS are substances that can be misused that are not controlled by the International Drug Conventions but which may represent a public health threat. They may not necessarily be new but may have become available recently. They are associated with increased misuse, hospital admissions and also fatalities. Since they are not controlled substances they represent an alternative and inadvertently may place people at serious risk

Plan estratégico de implementación de las TICS en el instituto para el deporte y la recreación de Tauramena- INDERTA

A partir de la importancia generada en las organizaciones del estado, con la implementación del Gobierno en línea se presenta el Plan estratégico de implementación de las Tics, en el Instituto para el Deporte y la Recreación de Tauramena- INDERTA, para generar valor en la Gestión Pública, se busca optimizar los recursos tecnológicos como las Tics, para dar cumplimiento a los objetivos de la organización, a su vez a partir de los parámetros investigativos de la especialización en Gestión Pública de la UNAD.Based on the importance generated in state organizations, with the implementation of the Government online, the Strategic Plan for the implementation of Tics is presented at the Institute for Sports and Recreation of Tauramena- INDERTA, to generate value in Management Public, it seeks to optimize technological resources such as Tics, to comply with the objectives of the organization, in turn from the research parameters of the specialization in Public Management of the UNAD

Concepciones y prácticas evaluativas de los docentes en educación física en la básica secundaria y media

La presente investigación muestra la realidad de la evaluación de los docentes. La investigación “concepciones y prácticas evaluativas de los docentes de Educación Física en la básica secundaria y media”; tiene como objetivo principal, caracterizar las concepciones y prácticas evaluativas, especialmente en docentes del área de Educación Física en la básica secundaria y media. Además, develar los usos pedagógicos que tiene este ejercicio, los aspectos que se tienen en cuenta y las estrategias metodológicas para una evaluación formativa. Profundizando en todo el proceso la evaluación de un fundamento crítico y emancipador.Magister en EducaciónMaestrí

Plano de intervenção para a dislipidemia em hipertensos e diabéticos pela equipe de saúde da família Mocambeiro, município de Matozinhos - Minas Gerais

Matozinhos é um município da Região Metropolitana de Belo Horizonte localizado no Estado de Minas Gerais.A Equipe de Saúde da Família Mocambeiro identificou como principal problema da área de abrangência o alto número de indivíduos comdislipidemias.Assim, considerando os riscos da dislipidemia como conseqüência para outras doenças e agravos não transmissíveiso objetivo deste trabalho é apresentar um plano de intervenção para reduzir o número de pacientes hipertensos e diabéticos com dislipidemias na área de abrangência daEquipe de Saúde da Família Mocambeiros.Doenças como a hipertensão arterial, diabetes e dislipidemia configuram importantes problemas de saúde coletiva no Brasil. Observa-se que a falta de informação por parte dos hipertensos e diabéticos sobre o problema, bem como, os hábitos de vida inadequados dos mesmos, perpetuam a doença entre eles. A metodologia foi baseada no Planejamento Estratégico Situacional, e após processados os problemas identificados no diagnóstico situacional da área de abrangência,foi elaborado um plano de ação para enfrentamento do respectivo problema. Na elaboração do plano de intervenção procurou-se compreender a gênese do problema priorizado, as soluções e estratégias para o enfrentamento do mesmo. Pretende-se com este estudo reduzir o percentual de hipertensos e diabéticos com dislipidemia através do aumento do nível de informação dos pacientes,melhora dos hábitos de vidae promoção da qualidade de vidadesses usuários

Funciones cognitivas en la descendencia de pacientes con trastorno bipolar I

Objective: To describe the neuropsychological characteristics of offspring children and adolescents of patients with bipolar disorder type 1 diagnosis through the application of a standardized intelligence test. Materials and methods: In this descriptive cross-sectional observational study, the authors investigated aspects such as Intelligence Quotient, Verbal Comprehension Index, Perceptual Reasoning Index, Working Memory Index, and Processing Speed Index. Here, 30 descendants were evaluated by applying several subtests of the Wechsler Intelligence Scale for Children (WISC-IV). Results: The Total  Intelligence Quotient of 63.3% of the participants is below the average of the Normal Distribution curve according to the standardization of the intelligence test applied which classifies the tendency of the sample as a low normal average. The working memory and verbal comprehension indexes were the cognitive functions with the lowest scores in the sample. Discussion: Our findings suggest a risk in children of patients with Bipolar Disorder type I, which may contribute to a quantitative increase of cognitive disorders, especially in terms of working memory and verbal comprehension indexes. These findings may indicate a possible endophenotype of Bipolar Disorder type I patients and their offspring in regards to the early manifestation of cognitive disorders in this risk group. These children could be a target for studies that determine prediction and thus perform an early treatment.Objetivo: Describir las características neuropsicológicas de niños y adolescentes descendientes de padres con antecedentes de TB I,  respecto a la aplicación de una prueba estandarizada de inteligencia. Materiales y métodos: Estudio observacional descriptivo de corte transversal, en donde los autores investigaron  el Coeficiente Intelectual Total; Índice de compresión verbal; Índice de Razonamiento Perceptual; Índice de Memoria de trabajo; Índice de Velocidad de Procesamiento. Se evaluaron  (n=30) descendientes al aplicar varias subpruebas de la Escala de inteligencia de Weschler para niños, (WISC –IV). Resultados: El Coeficiente Intelectual Total de los participantes con un  63,3% está por debajo del promedio de la curva de distribución normal, según la estandarización del test de inteligencia aplicado. Clasificando la tendencia de la muestra como un promedio normal bajo, en cuanto a la muestra evaluada. Los índices de memoria de trabajo y compresión verbal fueron las funciones cognitivas con puntuaciones más bajas en la muestra. Discusión: Nuestros hallazgos sugieren un riesgo en hijos de pacientes con TBI, que puede contribuir a un incremento cuantitativo de las alteraciones cognitivas, especialmente el índice de memoria de trabajo y compresión verbal. Estos hallazgos pueden sugerir un posible endofenotipo del TB I y su descendencia, en relación a la presentación temprana de alteraciones cognitivas en este grupo de riesgo. Dichos hijos podrían ser un punto de partida para realizar estudios que determinen predicción y realizar así un abordaje temprano

Higher mortality of hospitalized haematologic patients with COVID-19 compared to non-haematologic is driven by thrombotic complications and development of ARDS: An age-matched cohorts study

Background and Objectives: The characteristics of COVID-19 in haematologic patients compared to non-haematologic patients have seldom been analyzed. Our aim was to analyze whether there are differences in clinical characteristics and outcome of haematologic patients with COVID-19 as compared to non-haematologic. Patients and methods: Retrospective cohort study in 2 University hospitals of patients admitted with laboratory-confirmed COVID-19 included in the SEMICOVID19 database. The cohort with underlying haematologic disease was compared to a cohort of age and date-of-COVID-19-matched controls without haematologic disease (1:2). Results: 71 cases and 142 controls were included from March-May 2020. Twenty (28.1%) had received recent chemotherapy. Twelve (16.9%) were stem cell transplant recipients (SCT). Eleven (15.5%) were neutropenic concurrently with COVID-19 diagnosis. Haematologic patients presented ARDS (58.5 vs 20.7%, p = 0.0001), thrombotic complications (15.7 vs 2.1%, p = 0.002), DIC (5.7 vs 0.0%, p = 0.011), heart failure (14.3 vs 4.9%, p = 0.029) and required ICU admission (15.5 vs 2.8%, p = 0.001), MV (14.1% vs 2.1%, p 0.001), steroid (64.8 vs 33.1%, p = 0.0001), tocilizumab (33.8 vs 8.5%, p = 0.0001) or anakinra treatment (9.9% vs 0%, p = 0.0001) more often. In-hospital mortality was significantly higher (38.0% vs 18.3%, p = 0.002). Conclusions: Our results suggest COVID-19 has worse outcomes in haematologic patients than in non-haematologic, independently of age, and that the development of ARDS and thrombotic complications drive the higher in-hospital mortalit

Acceso a medicamentos controlados en Panamá

El presente estudio analiza las barreras que limitan el acceso a medicamentos controlados en Panamá. Esta investigación se desarrolló mediante una metodología descriptiva que incluyó la aplicación de encuestas a 65 farmacéuticos y 39 médicos, 7 grupos focales y entrevistas a 19 actores claves en tres ciudades de Panamá. Los resultados obtenidos señalan que existe temor a la prescripción, dispensación y administración de medicamentos controlados, desconocimiento de aspectos claves en el manejo de dolor, restricciones regulatorias que son visualizadas como serias y limitantes en la cadena de suministro y costo de los medicamentos controlados. Los participantes de este estudio plantean que la forma de mejorar el acceso a medicamentos controlados en Panamá es a través de la educación

Recommendations for SARS-CoV- 2/ COVID-19 testing: a scoping review of current guidance

Background Testing used in screening, diagnosis and follow-up of COVID-19 has been a subject of debate. Several organisations have developed formal advice about testing for COVID-19 to assist in the control of the disease. We collated, delineated and appraised current worldwide recommendations about the role and applications of tests to control SARS-CoV- 2/COVID-19. Methods We searched for documents providing recommendations for COVID-19 testing in PubMed, EMBASE, LILACS, the Coronavirus Open Access Project living evidence database and relevant websites such as TRIP database, ECRI Guidelines Trust, the GIN database, from inception to 21 September 2020. Two reviewers applied the eligibility criteria to potentially relevant citations without language or geographical restrictions. We extracted data in duplicate, including assessment of methodological quality using the Appraisal of Guidelines for Research and Evaluation-II tool. Results We included 47 relevant documents and 327 recommendations about testing. Regarding the quality of the documents, we found that the domains with the lowest scores were ‘Editorial independence’ (Median=4%) and ‘Applicability’ (Median=6%). Only six documents obtained at least 50% score for the ‘Rigour of development’ domain. An important number of recommendations focused on the diagnosis of suspected cases (48%) and deisolation measures (11%). The most frequently recommended test was the reverse transcription-PCR (RT-PCR) assay (87 recommendations) and the chest CT (38 recommendations). There were 22 areas of agreement among guidance developers, including the use of RT-PCR for SARS-Cov- 2 confirmation, the limited role of bronchoscopy, the use chest CT and chest X-rays for grading severity and the co-assessment for other respiratory pathogens. Conclusion This first scoping review of recommendations for COVID-19 testing showed many limitations in the methodological quality of included guidance documents that could affect the confidence of clinicians in their implementation. Future guidance documents should incorporate a minimum set of key methodological characteristics to enhance their applicability for decision making.Instituto de Salud Carlos III 2017/CD17/00219European Social Fund 2014-2020, 'Investing in your future'Spanish Governmen