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IntroductionThe increase in school violence following the COVID-19 pandemic underscores the need for schools to adopt a multilevel whole-school approach. This study examines a national program designed by the Chilean Ministry of Education, in collaboration with universities, as part of the Ministry’s Educational Reactivation Plan, aimed at improving school climate management across Chile.MethodsThe “Learning to Live Together Program” (LLT) was implemented across all 16 regions of Chile, focusing on establishing school climate networks, providing direct intensive university technical assistance, and enhancing professional development and training. The feasibility, acceptability, and appropriability of the LLT program were assessed through a survey distributed to 1,561 staff members from 783 schools. Participants responded to a comprehensive set of instruments measuring acceptability, appropriability, feasibility, attitudes toward implementation, fidelity, and initial perceived results.ResultsThe results indicate high initial adoption rates and significant improvements in the assessed dimensions. The enhancement of school climate practices and strengthening school collaboration networks were of considerable relevance.DiscussionThese findings support the efficacy of the multilevel whole-school approach as a viable strategy for Latin American countries, providing critical data for educational and governmental decision-making. Furthermore, this study provides evidence that these outcomes may be applicable to the implementation of similar policies in different contexts and countries.

Acantholeberis smirnovi Paggi & Herrera-Martinez, 2020 (Cladocera: Acantholeberidae) was recently described from Andean habitats in South America. The presence of a population on the eastern coast of the continent brought the hypothesis of a new Neotropical species different from A. smirnovi. This hypothesis was confirmed from morphological, ecological and biogeographic evidence. Acantholeberis accolismaris Sousa, Elmoor-Loureiro & Álvarez-Silva sp. nov. differs from A. smirnovi in the morphology of the head, the valves and the limbs (especially the second and third limbs). Species of Acantholeberis are adapted to live in acid water bodies, with A. accolismaris sp. nov. presenting the same ecological requirements. However, the new species is adapted to live in temporary ponds near the Atlantic Ocean in Brazil in altitudes ranging between 4 and 15 meters above sea level. Considering that Acantholeberidae is an ancient taxon with a pre-Mesozoic origin, geological and environmental changes may have been relevant to speciation and to the observed biogeographic pattern of species of Acantholeberis in Neotropics.

The COVID-19 pandemic continues to impact schools and how education is conveyed to students. One of the aspects that has gained strength is supporting the wellbeing of educational communities. The purpose of this study was to describe and understand the construction of school wellbeing during the pandemic, based on the notion of collective and sustainable wellbeing. Through a qualitative design, we conducted a study in four Chilean low-SES schools in which a national school mental health program is implemented. A total of 41 in-depth interviews and one group interview were conducted with students, parents, teacher, teacher assistants, school principals, psychosocial professionals, and the school mental health officers during the second half of the 2020 school year. Thematic content analyses showed that, while facing the school closure challenges, schools strived to protect students’ and teachers’ wellbeing. However, participants highlighted necessary conditions for sustaining the school community’s wellbeing and mental health in the context of the COVID-19 pandemic: assuring digital connectivity for all students; coordinated work with families and within the school; strengthening networks; curriculum adaptation and diversified pedagogical strategies; and emotional support toward teachers, families, and students. We discuss these findings and their implications for a sustainable and collective perspective of the wellbeing of school communities in low-SES schools, as well as for policy, practice, and research from the perspective of schools for social justice and health promotion.

Diabetes mellitus is considered a chronic non-communicable disease with high morbidity, presents to its high prevalence, social, family, and economic costs. Interventions aimed at life-style changes are fundamental in managing; due to this, patients must receive education. The aim of the study was to identify the beliefs and practices of the persons with diabetes mellitus, to propose nurse care according to these precepts. This was a descriptive study of systematic literature review, searching for articles in databases, Springer Science, Elsevier, ProQuest, Science Direct, Index, Pubmed, SciELO, Medigraphic, and Medline during 2016 to 2018, published between 2001 and 2018, in Spanish, English, and Portuguese. A total of 49 studies were contributing to fulfilling the objective. Within the beliefs for the management of disease, is the use of herbs, some consider as cause "fright"; Others take into account risk factors such as heredity, obesity, poor eating habits. Various beliefs are presented in relation to insulin treatment. Spirituality is emphasized; seeking refuge in God and prayer. Is important to understand the person, from their values, beliefs, customs and feelings. Education is a fundamental tool to control the disease, but health beliefs must be taken into account in order to achieve favorable results.

The infections and deaths resulting from Coronavirus Disease 2019 (COVID-19) triggered the need for some governments to make COVID-19 vaccines mandatory. The present study aims to analyze the position of 3026 adults in Colombia, El Salvador, and Spain regarding the possibility of making COVID-19 vaccine mandatory and the intention to be vaccinated with the booster or possible successive doses. Data from an online survey conducted from August to December 2021 among a non-representative sample of Spanish-speaking countries were collected. Multinomial Logistic Regression Models were used. A total of 77.4% of Colombians were in favor of mandatory vaccination compared to 71.5% of Salvadorians and 65.4% of Spaniards (p < 0.000). Women and people over 65 years of age were the groups most in favor of making the vaccine mandatory (p < 0.000). A total of 79.4% said they had received a third dose or would intend to receive the third dose or future doses, if necessary, compared with 9.4% who expressed doubts and 9.9% who refused to be vaccinated or did not intend to be vaccinated. Among the measures that could be taken to motivate vaccination, 63.0% and 60.6% were in favor of requiring a negative test to enter any place of leisure or work, respectively, compared to 16.2% in favor of suspension from work without pay. The acceptance of mandatory vaccination and of third or future doses varies greatly according to sociodemographic characteristics and work environment. As such, it is recommended that policy makers adapt public health strategies accordingly.

Objective. To analyze the report of the experience of the person with high blood pressure, in light of the theory proposed by Kristen Swanson. Methods. This was a qualitative research with autobiographical-type narrative design. To collect and analyze the information, the work used open in-depth interview with 12 individuals, participant observation, and field notes. Results. The study recognized the beliefs, customs, and cultural practices of the person living with high blood pressure and identified the care needs. The participants shared their feelings, finding that each confronts this disease differently and learns to care for themselves in particular manner. Conclusion. In the analysis of the narratives of the experience of people with high blood pressure, five care processes by Swanson were recognized: maintaining the beliefs, knowing, being with, doing for, and permitting.

RESUMEN: Introducción: La ketamina se ha utilizado en dosis sub-anestésicas en pacientes no obesos sugiriendo que su uso disminuye el consumo de morfina postoperatoria, sin embargo, la evidencia en la literatura es contradictoria. Objetivo: Determinar efecto de ketamina intraoperatoria en el consumo de morfina durante las primeras 24 horas postoperatorias de pacientes obesos operados de manga gástrica laparoscópica. Material y método: Ensayo Clínico Controlado, Aleatorizado, doble ciego de grupos paralelos unicéntrico realizado entre septiembre del 2015 y Enero de 2017. Se incluyeron pacientes entre 18 y 60 años de ambos sexos, obesos con indicación de quirúrgica de Manga Gástrica Laparoscópica, ASA II. Se aleatorizó la intervención a un grupo experimental (ketamina) y uno placebo (suero fisiológico). Se administró ketamina 0.5 mg/kg 1 como dosis de carga después de la inducción anestésica y luego una infusión de 0.1 mg/kg/h hasta el final de la cirugía. Al ingreso a la Unidad de Post Anestesia, en ambos grupos se inició una bomba de infusión de morfina programada con 1 mg de bolo y con un bloqueo de tiempo de 10 minutos entre dosis, durante 24 horas. Resultados: Se analizaron 63 pacientes. Treinta y dos pacientes en el grupo ketamina y 31 en el grupo placebo. La mediana de consumo de morfina del grupo ketamina fue de 20 mg (ric 11 mg/min:5-máx.:57 y 19 mg (ric:11/min.:8-máx.:82) en el grupo placebo, diferencia estadísticamente no significativa (p = 0.412). No se encontraron diferencias estadísticas entre los grupos en cuanto a efectos adversos a los opioides, sedación y deambulación. Conclusión: La administración de ketamina en cirugía laparoscópica de manga gástrica no disminuyó el consumo de morfina durante las primeras 24 horas postoperatorias, ni la proporción de efectos adversos a los opioides y no demoró la deambulación de los pacientes postoperados en este estudio.Este estudio se realizó con fondos concursables de la Dirección Académica de Clínica Las Condes. Ninguno de los investigadores participantes en este estudio declaró conflictos de interés de ninguna clase. ABSTRACT: Introduction: Ketamine has been used in sub-anesthetic doses in non-obese patients suggesting that its use decreases postoperative morphine consumption. however, the evidence in the literature is contradictory. Objective: To determine the effect of intraoperative ketamine on postoperative morphine consumption during the first 24 hours postoperatively in obese patients operated on laparoscopic gastric sleeve. Material and method: Controlled, randomized, double-blind, unicentric clinical trial, approved by the health research ethics committee of our institution. We included obese patients 18 to 60 years old of both sexes, obese with an indication of laparoscopic Gastric Sleeve, ASA II. The intervention was randomized to an experimental group (ketamine) and a placebo (saline).Ketamine 0.5 mg/kg was administered as a loading dose after anesthetic induction and then an infusion of 0.1 mg/kg/h until the end of surgery. On admission to the Post Anesthesia Unit, in both groups, a morphine infusion pump was started, programmed with 1 mg of bolus and with a time block of 10 minutes between doses, for 24 hours. Results: 63 patients were analyzed. Thirty-two patients in the ketamine group and 31 in the placebo group. The median morphine consumption of the ketamine group was 20 mg (ric 11 mg / min: 5-max .: 57 and 19 mg (ric: 11 / min .: 8-max .: 82) in the placebo group, nonsignificant statistical difference (p = 0.412). No statistical differences were found between the groups in terms of adverse effects to opioids, sedation and ambulation Conclusion: The administration of ketamine in laparoscopic gastric sleeve surgery does not decrease morphine consumption during the first 24 postoperative hours, nor the proportion of adverse effects to opioids and does not delay the ambulation of postoperative patients in this studio. This study was carried out with funds from the Academic Department of Clinica Las Condes. None of the researchers participating in this study declared conflicts of interest of any kind. Palabras clave: Morfina, Obesidad, Ketamina, Keywords: Morphine, Obesity, Ketamine

RESUMEN: La dependencia o adicción a sustancias de uso profesional es un problema que puede afectar gravemente a médicos de diferentes especialidades. En la anestesiología hay mayor riesgo de dependencia a opioides e hipnóticos que en otras especialidades y puede llegar a afectar al 1% de los médicos anestesiólogos.La fisiopatología del trastorno por uso de sustancias tiene hechos comunes para diferentes drogas. Interactúan la vulnerabilidad genética y factores psicosociales como predisponentes y los efectos psicobiológicos de la sustancia como factor gatillante. En el caso de los anestesiólogos, la sustancia se encuentra en el lugar de trabajo y por lo tanto, el individuo está constantemente expuesto.Una disfunción previa del sistema de recompensa en el circuito mesocorticolímbico o causada por la exposición a la sustancia adictiva es la piedra central de la neurobiología de las adicciones. Los opioides, anfetaminas, canabinoides, alcohol y nicotina, son algunas de las sustancias exógenas que activan el circuito y causan inicialmente un efecto hedónico que reforzará la conducta por repetir la experiencia. Con el tiempo la interacción con la droga será para evitar los síntomas de abstinencia.Dada la exposición laboral de los anestesiólogos, es necesario prevenir, detectar y tratar precozmente a quienes están abusando de sustancias durante su ejercicio profesional.Por las características de estos fármacos, aspectos psicológicos especiales de los médicos y el contexto laboral se hace necesario un tratamiento especializado y en anestesiólogos la reinserción laboral debe ser un proceso controlado, gradual y con un seguimiento prolongado. SUMMARY: Prescription drugs dependence seriously impairs doctors from differents fields of medicine. Anesthesiology has greater risk than other specialties to opioids and hypnotics dependence, with prevalence up to 1%.Substances use disorder has common mechanisms of disease regardless which drug has been abused. There are interactions between genetic vulnerability and psychosocial facts as a risk factor and psychobiological effects of the substance as a triggering factor. Anesthesiologists use addictive substances in their patients at work everyday, therefore individual is constantly exposed.Previous reward dysfunction or triggered by drugs exposure on mesocorticolimbic circuit is central stone of the neurobiology of addictions. Opioids, amphetamines, cannabinoids, alcohol and nicotine, are exogenous agents whose activates the reward circuit generating a hedonic effect that reinforces drug-seeking behavior. Meanwhile a rising tolerance ocurs and positive reinforcement decreases. Finally substance will be used to avoid withdrawal.Because anesthesiologists are occupationally exposed, it is necessary to reduce risk by preventing strategies and early detection who are abusing substances in a professional frame.Because drugs characteristics and physicians psychological aspects a specialized treatment team is required and reentry to labor should be in a controlled and long follow-up. Palabras clave: Adicción, drogas, médicos, prescripción, Keywords: Drug, addiction, physician, prescription

A través de un estudio cuasietnográfico en una escuela primaria con altos índices de intimidación de los estudiantes hacia sus profesores, se busca analizar las concepciones de infancia implícitas en los discursos de la comunidad escolar y su sentido para la validación de prácticas e interacciones escolares violentas. Para ello, se realizaron observaciones persistentes, entrevistas individuales y grupales y análisis de documentos oficiales, los que fueron analizados bajo el análisis de contenido categorial temático. Los resultados muestran cómo la Escuela activa diversos mecanismos para validar la infancia como espacio de tránsito, y coloca como referente una forma de adultocentrismo que se expresa en prácticas de control y discriminación. Se discuten los sentidos construidos acerca de la niñez y sus implicancias para la construcción de subjetividades infantiles.

This study analyzes and compares the experience of school victimization by peers and school staff, between students with and without diagnosis of special educational (SEN). 5,527 elementary school students studying in public schools with School Integration Programs (SIP) in one city of Valparaíso, Chile, participated in this study. Of these, 77 were students with SEN participating in the SIP. Odds-ration and logistic regression analyses revealed higher levels of peer and school staff victimization for the subgroup of students with SEN in SIP programs, as compared to their non-SEN peers. The odds ratio was 2 to 1 for peer victimization and 3 to 1 for school staff victimization. Whereas for the general population of students, the odds that a student might inform at least one type of peer victimization increased 3 times if that student informed some type of school staff victimization, the same odds increased 18 to 20 times for the SEN students in SIP. These results suggest that students with SEN are an at-risk population with respect to school victimization, both from their peers as well as from school staff. Of special concern is the protective role that school staff is able to provide, if they themselves actively participate in victimizing these students. The results are discussed considering the need to focus on promoting protective factors that may favor the development of a caring and protective community for all students.

Se realizó un estudio descriptivo y comparativo de la literatura antigua relacionada directa e indirectamente con el tema de la Medicina en Pinar del Río en el año 1958. Además se hizo una revisión bibliográfica de los materiales más actualizados que tiene el sector en el Municipio, donde pudimos evaluar la situación crítica de la salud en 1958 y compararla con la del año 2008. En ese año se registraron datos sobresalientes, como la mortalidad infantil de 5.5 por cada 1000 nacidos vivos, muy inferior a la del año 1958, la cual fue de 60.5, lo que demuestra la superioridad de la salud en el año 2008. Como resultado tenemos un documento que puede convertirse en material de consulta para docentes y alumnos, especialmente para los que reciben la Historia de Cuba II y III, que de hecho no cuentan con una bibliografía abundante ni específica del tema.

La variación de la composición, abundancia y diversidad del zooplancton fue analizada durante la fase de llenado del embalse Amaní en un gradiente horizontal y vertical, a partir de trece muestreos semanales realizados entre junio y agosto de 2002. La composición del zooplancton es similar a otros ecosistemas lénticos tropicales de baja altitud y fue registrado un total 32 taxa, de los cuales se destaca el rotífero Keratella por su elevada abundancia durante junio y julio. Rotifera fue el grupo que presentó la mayor riqueza de especies (16) así como una sobresaliente dominancia numérica sobre copépodos y cladóceros, con una abundancia relativa superior al 60%. La densidades promedio del zooplancton fluctuaron de manera significativa (6 a 1525 org l-1), y de forma diferencial entre los brazos del embalse y los sectores de confluencia y presa, que presentaron los menores intervalos (14-208 org l-1 y 6-108 org l-1, respectivamente). En el presente trabajo se incluyen los patrones de comportamiento de la abundancia de los géneros más frecuentes de zooplancton así como de aspectos relacionados con la dinámica poblacional de los copépodos Thermocyclops decipiens y Mesocyclops aspericornis. Se discuten los cambios en la estructura de la comunidad del zooplancton y se mencionan las posibles interacciones y fenómenos de regulación entre los diferentes taxa zooplanctónicos y de estos con el fitoplancton. Finalmente se presenta un catalogo de microfotografías de los organismos registrados. Este trabajo constituye un aporte importante de ecología descriptiva del zooplancton limnético y da pautas para posteriores monitoreos en este embalse.

Objetivo: Determinar el nivel de incertidumbre de las usuarias que acuden a la toma de citología cervico uterina según la teoría de Mishel. Materiales y métodos: Estudio de corte transversal de tipo descriptivo, realizado durante el año 2019 a partir de una muestra por conveniencia, no probabilística conformada por 151 mujeres a quienes se les aplicó la Escala de Incertidumbre en la enfermedad de Mishel adaptada para procedimientos diagnósticos en Colombia en el año 2017 por la enfermera Leidy Yazmin Díaz Moreno. Tiene validez de contenido de 0.861 y Alfa de Cronbach de 0.90. Se realizó análisis univariado a través de frecuencias y distribución porcentual para las características sociodemográficas y para obtener los niveles de incertidumbre se efectuó la sumatoria de ítems y chi cuadrado para identificar asociación. Resultados: La edad promedio fue 39 años, el 17,3% de mujeres manifestó acudir a toma de citología por primera vez. Aproximadamente el 95% de las mujeres presentó niveles de incertidumbre alto o moderado. Conclusiones: La incertidumbre provocada por un posible diagnóstico de cáncer, puede hacer que las personas evalúen inadecuadamente una situación estresante como la toma de citología cervico uterina; es por eso que, la aplicación de la teoría de Mishel lleva a que se identifiquen las primeras percepciones del paciente para realizar un plan de cuidado enfocado en controlar esta situación y luego alcanzar que la persona o familiar afronten y se adapten a la enfermedad.