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Introduction: Heart failure, a disease with high prevalence and mortality, presents low incorporation of palliative care (PC) despite its necessity. In Colombia, the lack of indicators to monitor the integration of PC in the treatment of heart failure hinders the implementation of effective strategies. It is proposed to use a classification model to monitor the integration of palliative care in the Colombian health system. Objective: To reach a consensus on a set of indicators evaluated for their relevance and feasibility to monitor the integration of palliative care in heart failure in the Colombian health system. Method: A Delphi consensus process was carried out in two rounds, including experts from different regions of the country. An online survey was used on nine indicators related to the integration of palliative care in heart failure in the Colombian health system. Each indicator was evaluated for its relevance and feasibility. Results: Seventeen experts from all regions of Colombia participated, 76% were physicians and 24% nursing professionals; the vast majority (65%) belonged to scientific societies such as the Colombian Association of Palliative Care. All the indicators scored > 7.0 with respect to their relevance and feasibility. The Advance directives in people with heart failure indicator was considered the most relevant and feasible followed by home palliative care for people with heart failure. Conclusions: Based on feasibility and relevance there was consensus on eight of the nine indicators proposed to evaluate the integration of palliative care in the treatment of heart failure in Colombia. [ABSTRACT FROM AUTHOR]

Enquadramento: Para assegurar a eficácia e segurança, as aplicações devem ter conteúdos baseados em evidências, desenvolvidos e validados por especialistas. Objetivo: Validar diretrizes terapêuticas para a promoção do autocuidado com os pés em pessoas com diabetes tipo 2, a serem implementadas numa aplicação móvel com base na sua relevância e linguagem. Metodologia: Técnica Delphi para validação de orientações elaboradas a partir de guidelines recentes com duas rondas com 10 especialistas de comprovada experiência clínica, investigação ou docência. Considerou-se o índice de validade de conteúdo mínimo de 0,8. Utilizou-se a recomendação modificada para a condução e elaboração de relatórios dos estudos Delphi (CREDES). Resultados: Das 128 orientações, 125 atingiram consenso, abrangendo cuidados integrais com os pés, incluindo a manutenção saudável, calçado e meias adequadas. A linguagem foi simplificada para facilitar a compreensão. Conclusão: As orientações foram consideradas válidas, com linguagem adequada e poderão ser incluídas numa aplicação de suporte ao autocuidado com os pés

Introducción: La incontinencia urinaria (IU) se define como “cualquier queja de pérdida involuntaria de orina”. Varios estudios describen que la IU es un problema común entre mujeres jóvenes nulíparas que practican deportes de alto impacto de forma regular e intensa, teniendo un impacto significativo en su calidad de vida y rendimiento deportivo. Una estimación precisa de la prevalencia de la IU en las atletas nulíparas y cómo este problema afecta a su vida diaria y deportiva podría conducir al desarrollo de estrategias de prevención y tratamiento. Sin embargo, no existe una herramienta de recogida de datos enfocada en analizar la relación entre la IU y el deporte, siendo el método Delphi una herramienta muy útil para diseñar y validar nuevos instrumentos. Objetivos: Elaborar y validar un cuestionario, enfocado analizar la relación entre la práctica deportiva y la aparición temprana de IU en mujeres. Material y métodos: Se diseñó un cuestionario, con el método Delphi, a través de un grupo de expertos, formado por 9 profesionales. Con la versión definitiva se llevó a cabo un estudio piloto con 16 jugadoras de baloncesto. Resultados: Se llevó a cabo un total de 3 rondas y se obtuvo un cuestionario definitivo con 43 preguntas, con un valor alfa de Cronbach de 0,967 en el análisis de la fiabilidad. Conclusiones: Los resultados avalaron la fiabilidad y validez del cuestionario, diseñado mediante el método Delphi, para analizar la relación entre la práctica deportiva y la aparición temprana de IU en mujeres.

Background Autoimmune encephalitis (AIE) is a group of inflammatory diseases characterized by the presence of antibodies against neuronal and glial antigens, leading to subacute psychiatric symptoms, memory complaints, and movement disorders. The patients are predominantly young, and delays in treatment are associated with worse prognosis.

Introduction: Osteomyoarticular lesions among young people that render services for the defense are related to risk factors. The use of preventive models bases its approach on the identification of risk and development of actions for its prevention. Consent methods are used for their validation and participative models, interpretative and constructivist valuations on their processes back the evaluation of its impact. Objective: To evaluate the relevance of the preventive model for identifying the risk of osteomyoarticular lesions in young adults of an armed institution. Methods: An investigation was carried out on January 2024, which included 16 experts and 125 young adults from Santiago de Cuba province. For the model validation the experts' criteria method was used and for the evaluation of impact, the Guba and Lincoln Fourth Generation Model. Results: With similar percentage values and differences in the cut points, in both rounds, the consent got into groups in the categories of quite appropriate (25.0 %) and very appropriate (75.0 %). The result was interpreted as significant and the validation was concluded. The evaluation of impact in the preventive actions reached strong agreement (Me=8; IC 7-9) and appropriate degree of recommendation with value higher than 70.0 % of consent among assessors. Conclusions: The relevance of the model is demonstrated in the consent that reflects the capacity to guarantee precision when measuring the prospective results and the impact that projects an appropriate degree of recommendation on the proposed actions. [ABSTRACT FROM AUTHOR]

This article examines the elements of job creation among technical graduates and emphasizes the need for entrepreneurship and skill development in promoting economic growth. The study finds that technical graduates have a moderate perception of the elements of job creation and lack these elements in themselves. It suggests that curriculum development, administrators, and students should improve their skills and business knowledge to increase entrepreneurship and reduce unemployment rates. The article also discusses the skills and characteristics of job creators, such as leadership, communication, adaptability, and a focus on economic growth. It recommends that technical education institutions promote entrepreneurship and provide support for students to create their own job opportunities. [Extracted from the article]

Enquadramento: Os enfermeiros na urgência desempenham um papel fundamental na investigação de crimes, colaborando com os órgãos de Polícia Criminal na colheita de evidências forenses. Esta responsabilidade exige conhecimentos, técnicas e equipamentos adequados. A articulação entre os cuidados de saúde e o sistema jurídico processual, previne a destruição desnecessária de provas, melhorando os resultados na investigação. Objetivo: Construir um protocolo de intervenções de recolha e preservação de vestígios forenses para o serviço de urgência; validar o conteúdo do referido protocolo. Metodologia: Estudo metodológico quantitativo com abordagem descritiva, com recurso à Técnica Delphi realizado com 24 peritos (sete enfermeiros, dois elementos da Guarda Nacional Republicana, seis pertencentes à Polícia Judiciária e nove elementos da Polícia de Segurança Pública). Para a validade de conteúdo utilizou-se o índice de validade de conteúdo = 0,75. Resultados: Após a segunda ronda determinou-se um índice de validade de conteúdo de 0,89, para os 19 itens do protocolo. Conclusão: O protocolo foi considerado um instrumento essencial para melhorar a recolha e preservação de vestígios na urgência.

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Enquadramento: A prevalência do acidente vascular cerebral continua elevada, sendo recomendada a existência de procedimentos clínicos. Objetivo: Validar, através da técnica Delphi, intervenções de enfermagem na abordagem ao doente com suspeita de acidente vascular cerebral em fase aguda, com um painel de especialistas. Metodologia: Realizou-se uma pesquisa Survey, com base num estudo quantitativo-descritivo, sendo que uma revisão sistemática de literatura foi realizada previamente. Resultados: Amostra composta por seis especialistas. Realizadas duas rondas da técnica Delphi, foram validadas intervenções de Enfermagem ao doente com suspeita de acidente vascular cerebral, em fase aguda, nomeadamente: correto encaminhamento tendo em conta o tempo de evolução dos sintomas; abordagem em sala de emergência (baseada na avaliação ABCDEFGH); vigilância e resposta a reações adversas durante e após trombólise. Conclusão: A validação das intervenções de enfermagem na abordagem ao doente com suspeita de acidente vascular cerebral em fase aguda levou à elaboração de uma instrução de trabalho sólida, direcionada aos enfermeiros.

Background: Emergency nurses play a fundamental role in investigating crimes and collaborating with criminal police bodies to collect forensic evidence. This responsibility requires appropriate knowledge, techniques, and equipment. The link between health care and the procedural legal system prevents unnecessary destruction of evidence and improves investigation outcomes. Objective: To build a forensic evidence collection and preservation protocol for the emergency department and validate its content. Methodology: A quantitative methodological study with a descriptive approach was carried out with 24 experts: seven nurses, two officers of the National Republican Guard (GNR), six officers of the Portuguese Criminal Investigation Police (PJ), and nine officers of the Public Safety Police (PSP) using the Delphi technique. The content validity index ≥ 0.75 was used. Results: After Round 2, a content validity index of 0.89 was found for the 19 items included in the protocol. Conclusion: The protocol is considered an essential tool to improve the collection and preservation of forensic evidence in emergency settings. [ABSTRACT FROM AUTHOR]

Background: The prevalence of stroke remains high, where clinical procedures are recommended. Objective: To validate, using the Delphi technique, nursing interventions in the approach to patients with suspected stroke in the acute phase, with a panel of specialists. Methodology: A survey was carried out, based on a quantitative-descriptive study. A systematic literature review was carried out beforehand. Results: The sample consisted of six specialists. Two rounds of the Delphi technique were used to validate nursing interventions for patients with suspected stroke in the acute phase, namely: correct referral taking into account the time of symptom progression; emergency room approach (based on the ABCDEFGH assessment); monitoring and response to adverse reactions during and after thrombolysis. Conclusion: The validation of nursing interventions in the approach to patients with suspected acute strokes led to the development of a solid work instruction for nurses. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Nursing UFPE / Revista de Enfermagem UFPE is the property of Revista de Enfermagem UFPE and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: According to the literature 58.7% to 86.7% of hospitalized patients have a peripheral venous catheter. However, the use of this device is not without complications. The management of these devices generates a significant demand for care by the nursing team. Objective: Construct and validate a scale to determine the time interval for the evaluation of peripheral accesses using continuous infusion in pediatrics. Methodology: Methodological, observational, prospective, quantitative and convergent assistential study. Results: The scale was submitted to two phases for construct validation. The final sum of all scores had an agreement of 87.5%. The Linear Weighted Kappa Reliability Test showed almost perfect reliability 0.91, 0.87 and 0.88 for patient's clinical condition, vein characteristics and final score respectively. All indicators were statistically significant (p = 0.001). Conclusion: The time interval for the evaluation of peripheral accesses in continuous infusion, considering the specificity of each patient, is possible using the Maia e Castro scale, which helps the practice of nursing care in pediatric patients. [ABSTRACT FROM AUTHOR]

Purpose: This research presents a multicriteria benchmarking participatory model able to classify Federal Higher Education Institutions (FHEIs) into three levels of process management maturity. Design/methodology/approach: The research was conducted into three stages: (i) assessment model development using the Delphi technique, (ii) data collection through a self-assessment process, and (iii) classification of the FHEIs using PROMSORT. Findings: The results showed that, regardless of the adoption of an optimistic or pessimistic perspective, most FHEIs (51.6% in the optimistic perspective and 54.8% in the pessimistic one) were classified as regular. It is also noteworthy that approximately 80% of the research participating FHEIs maintained their classifications in the sensitivity analysis. Among the six alternatives that presented classification variations, only three varied significantly, confirming the results obtained stability. Research limitations/implications: The use of a participatory approach promotes a consistent benchmark in terms of indicators and metrics to measure performances. Practical implications: PROMSORT provided flexibility to the model, since it is possible to modify the parameters and thresholds in order to adjust the model strictness. Originality/value: The development of a model through which the Federal Higher Education Institutions (FHEIs) can be continually evaluate their process management maturity level. [ABSTRACT FROM AUTHOR]

Copyright of Retos: Nuevas Perspectivas de Educación Física, Deporte y Recreación is the property of Federacion Espanola de Asociaciones de Docentes de Educacion Fisica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of RIE: Revista de Investigacion Educativa is the property of RIE: Revista de Investigacion Educativa and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cultura, Ciencia y Deporte is the property of Cultura, Ciencia y Deporte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Emperor Goose (Anser canagicus) harvest in Alaska was re-opened in 2017 after a 30-year closure, but goose numbers available for a sustainable harvest remain limited. We used a Delphi process, an iterative group communication technique, to elicit expert opinion across 3 successive survey rounds to identify priorities for research, harvest management, and conservation of Emperor Goose. We identified 115 potential participants representing research and management by federal and state agencies, universities, Alaska Native representation in management, and non-governmental conservation organizations. Seventy participants responded to the first survey round (response rate = 61%). We compared responses between 4 participant groups to identify diverse perspectives. All groups, except Native Management, rated the impacts of spring-summer hunting on the Emperor Goose population more highly than impacts of fall-winter hunting. In round 1, the top-rated information and research priorities focused on harvest assessment. In the following rounds, refining survival estimates and population survey methods for Emperor Goose emerged as the two top-ranked research priorities. Improving education and outreach for hunters was the top-ranked conservation and harvest management priority. Formally identifying areas of agreement and disagreement among stakeholders is key for collaborative management, especially with contentious topics, although this step is often overlooked. The Delphi process allowed us to broaden perspectives by including individuals beyond the core entities involved with Emperor Goose management. Because stakeholder groups and individuals may provide input in diverse ways and at differing rates, ensuring that management processes have complementary paths for participation and decision-making helps safeguard against the shortcomings of individual processes. This study will inform ongoing discussions in the context of the revision of the Emperor Goose management plans led by committees within the Alaska Migratory Bird Co-Management Council and the Pacific Flyway Council. [ABSTRACT FROM AUTHOR]

Background: Medication reconciliation is relevant in transitional care, however, given limited resources, it is necessary to identify the patients who benefit most from this activity., Aim: To validate criteria to identify patients at high risk of medication errors undergoing major orthopedic surgery., Method: Delphi Method in 3 phases, April-June 2023, to obtain consensus on the inclusion criteria, previously defined. Each expert rated criteria according to a 5-point Likert scale. Consensus was assumed in round 1 if the rate average was ≥4 (inclusion) or <2 (exclusion) and in rounds 2 and 3 if 50% of the responses were ≥4 (inclusion) or <2 (exclusion). It was possible to suggest the inclusion of new criteria., Results: 10 experts from Faculties of Pharmacy and Medicine participated. In the first phase, consensus was reached on 18 criteria: polypharmacy, anticoagulants, oral chemotherapy (not hormone), immunosuppressants, antiretrovirals, antimyasthenics, insulin, corticoids, neuroleptics, antiarrhythmics, digoxin, carbamazepine, phenytoin, valproate, thyroid drugs, antiglaucoma, antiaggregants, and urgent surgery. Systemic antifungals and opioids were suggested. In the second phase, consensus was reached on 11 criteria: antiparkinsonics, beta-blockers, age ≥ 65 years, length of stay ≥5 days, lamotrigine, diuretics, antidepressants, angiotensin converting enzyme inhibitors, angiotensin II receptor antagonists, anxiolytics, opioids, and systemic antifungals. In the last phase, 1 criterion reached consensus (sulfonylureas) and 1 criterion did not reach consensus (calcium channel blockers)., Conclusions: We develop and validate a list of 30 criteria to identify patients at high risk of experiencing medication errors undergoing major orthopedic surgery. These may help improve human resource management for clinical pharmacy activities by prioritizing patients who would benefit most., Competing Interests: Declaration of competing interest This word has been presented previously at International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Congress in 2023., (Copyright © 2024. Publicado por Elsevier España, S.L.U.)

Introduction: The Community Pharmacy Survey on Patient Safety Culture (CPSOPSC) is a tool created by the Agency for Healthcare Research and Quality and used in the United States to assess the patient safety culture among community pharmacy workers. This survey has been adapted for use in hospital pharmacies in other countries. However, it has not yet been implemented in Spanish hospital pharmacies due to the lack of an applicable version in Spain. This project aims to adapt and reach a consensus on the CPSOPSC for its subsequent use as a tool to improve patient safety in hospital pharmacies in Spain., Methods: This non-clinical study will be developed in different phases: obtaining the necessary permissions, reviewing the literature to identify studies on the use of the CPSOPSC in hospital pharmacies, adapting the survey's questions to the sociocultural context, reaching a consensus on the questions using the Delphi-Rand/UCLA methodology with a panel of patient safety experts. These experts, who are hospital pharmacists, will evaluate the adapted survey in several rounds, using a Likert scale and telematic workshops to adjust the questions. Finally, a software application will be developed for the implementation, completion, and data management of the survey., Discussion: Adapting the CPSOPSC to hospital pharmacies in Spain may be a useful tool for measuring the patient safety culture in this context. Through the Delphi-Rand/UCLA methodology, expert consensus and the relevance of the survey are ensured. Additionally, the creation of a computer application will facilitate data collection and analysis, promoting its use among professionals. The resulting survey from this project can identify specific needs and areas for improvement in Spanish hospital pharmacies, being useful for future actions aimed at improving patient safety., (Copyright © 2024. Publicado por Elsevier España, S.L.U.)

Background: There is a new technological paradigm in health care which has been reinforced following the outbreak of the Covid-19 pandemic. Technological innovations create both challenges and opportunities to which citizens, healthcare professionals, and healthcare organisations must adapt to this reality. Although most health services have charters of citizens' general rights and commitments, there is no specific charter concerning eHealth., Objectives: To develop and validate a proposal of a minimum set of citizens' rights and commitments to e-Health., Methods: Experts in a discussion group developed a charter composed of twenty items, ten rights and ten commitments to e-Health. Two rounds of consensus were necessary to obtain a final version of the charter. The twenty items were validated for content and assessed for appropriateness, relevance, and understandability using an internet-based 2-round Delphi approach in which 134 experts, patients and healthcare professionals participated. They rated the assessed attributes for each item on a 5-point Likert scale for consensus. The content validity index was calculated with kappa statistic, a consensus measure of inter-rater agreement., Results: In the first round, 18 items were validated, leaving only two commitments with unacceptable indices. Both were modified using the experts' contributions and entered a second round of evaluation, after which the indices met the established requirements., Conclusions: A proposal for a chart of patient rights and commitments to eHealth was developed and showed adequate content validity and inter-observer reliability. This chart is expected to become a starting point for the debate on the role of technology in the way patients, professionals, and health services interact in the current context., Competing Interests: Declaration of Competing Interest The authors declare that there is no conflict of interest., (Copyright © 2024. Published by Elsevier España S.L.U.)

Objective: To study the level of agreement among health professionals and managers in Catalonia on the benefits of nurse prescribing (NP). Method: An online Real Time Delphi was conducted to collect the level of agreement of health professionals and managers. Participants voted in a 6-point scale (1 low benefit and 6 high benefit) for 12 items describing benefits of NP. A total of 1332 professionals participated. The level of consensus was calculated applying interquartile ranges of scores and standardized mean differences among subgroups using effect sizes (ES) and their corresponding 95% confidence intervals. Results: The scores indicate a general agreement on the perceived benefits of NP among participants. Standardized differences among scores on the perceived benefits among professionals were small to high (ES range between 0.2 and 1.2) between nurses and medical doctors and high between nurses and pharmacists (ES range: 1.2 and 2.4). Differences between scores of nurses and those of managers or other professionals in the present study were smaller for most voted benefits. Conclusions: The study shows an agreement on the benefits of NP. Nevertheless, when standardized scores are taken into consideration, differences among professionals’ perceptions emerged, and aligned with documented barriers identified in the literature such as corporative aspects, cultural limitations, institutional and organisational inertia, beliefs and unawareness of what NP implies. Resumen: Objetivo: Estudiar el nivel de consenso entre profesionales de salud y gestores en Cataluña sobre los beneficios de la prescripción enfermera (PE). Método: Se realizó un Delphi en tiempo real en línea para recoger el nivel de acuerdo de profesionales de la salud y gestores. Las personas participantes votaron en una escala de 6 puntos (1 bajo beneficio y 6 alto beneficio) en 12 ítems que describen los beneficios de la PE. Participaron 1332 profesionales. El nivel de consenso se calculó aplicando rangos intercuartílicos de puntuaciones y diferencias de medias estandarizadas entre subgrupos a partir de tamaños del efecto (ES) y sus correspondientes intervalos de confianza del 95%. Resultados: Las puntuaciones indican un acuerdo general sobre los beneficios percibidos de la PE entre las personas participantes. Las diferencias estandarizadas entre las puntuaciones sobre los beneficios percibidos entre profesionales fueron de pequeñas a altas (rango ES: 0,2 a 1,2) entre enfermeras y médicos, y altas entre enfermeras y farmacéuticos (rango ES: 1,2 a 2,4). Las diferencias entre las puntuaciones de profesionales de enfermería y gestión clínica u otros profesionales en el presente estudio fueron menores para los beneficios más votados. Conclusiones: El estudio muestra un acuerdo sobre los beneficios de la PE. Sin embargo, cuando se tienen en cuenta las puntuaciones estandarizadas se encontraron algunas diferencias entre las percepciones de profesionales y se alinearon con las barreras documentadas identificadas en la literatura, como aspectos corporativos, limitaciones culturales, inercia institucional y organizativa, creencias y desconocimiento de lo que implica la PE.

En los últimos años se ha investigado mucho sobre la aplicación y los efectos de la Planificación Centrada en la Persona (PCP), pero no se han encontrado instrumentos estandarizados adaptados al contexto español para hacerlo de forma rigurosa. Este estudio busca diseñar y validar la Escala de Planificación Centrada en la Persona (E-PCP) con el fin de ofrecer un instrumento válido y fiable que permita hacerlo. Para su diseño y validación de contenido se ha utilizado la revisión bibliográfica y se ha aplicado la técnica Delphi. La escala resultante se ha aplicado a una muestra de 102 profesionales que trabajan en centros de atención a personas con discapacidad intelectual en Asturias, lo que ha permitido el análisis de sus propiedades psicométricas. Para analizar la validez de constructo se ha realizado una validación cruzada mediante análisis factorial exploratorio (AFE) y análisis factorial confirmatorio (AFC). Los resultados ofrecen una escala con una buena fiabilidad (α = ,96), que explica el 58 % de la varianza, y con una estructura unifactorial integrada por 16 ítems. Su brevedad, fiabilidad y validez indican que este instrumento puede ser de utilidad para la investigación y la práctica profesional.

The use of ICT, and particularly network technologies, has expanded the possibilities of access to new learning spaces and resources beyond traditional formal school settings. However, these combinations of multiple and different environments add an element of complexity, which requires learners to make a greater effort in their role as directors of their own learning. The Delphi research described in this article focuses precisely on the role of self-direction in the field of learning ecologies, positioning the learner as an active agent, producer and conductor of her own strategies, capable of orchestrating the vari)ous contexts, resources, activities and personal relationships into a coherent and appro)priate whole for the achievement of a learning goal over time. Similarly, the need for procedures aimed at fostering the learner’s autonomy, self-regulation and capacity for learn)ing to learn is also highlighted. [ABSTRACT FROM AUTHOR]

Introduction: It is considered a clinical goal to employ assessment tools designed to measure core symptom changes within persons with Autism Spectrum Disorder (ASD), while they receive therapeutical interventions. The Autism Impact Measure (AIM) has shown its ability for that task, but it has not been validated in Spanish population. Objective: To adapt this scale and validate modifications proposed within the Hospital Clínic of Barcelona mental health department. Materials and method: A Delphi study was carried out to gather feedback and to preliminarily validate this adaptation. Professionals within the Children and Adolescent Department of Psychology and Psychiatry were invited as experts. Three modifications of the AIM instrument were presented in three successive rounds. The experts had to evaluate those modifications according to its content and presentation. Subsequently, a survey was administered to relatives of children and adolescents with ASD to assess the improvements. Results: 15 experts participated in the first round; 12 in the second and third one. The experts valued positively those modifications proposed and reached consensus arguing AIM would possess apparent validity. ASD relatives (n = 11) rated the instrument positively, although a marked variability of opinions regarding behavior description was found. Conclusions: A version of the AIM instrument was adapted to Spanish population, with greater language fit and validity. This opens the possibility to further validate this version with greater and more heterogeneous number of consultants, thereby developing an easy-to-use, exhaustive measurement tool. [ABSTRACT FROM AUTHOR]

Copyright of Desenvolvimento e Meio Ambiente is the property of Universidade Federal do Parana and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

El trabajo que aquí se presenta describe la metodología que se siguió en la elaboración y validación de un instrumento diseñado para evaluar el estrés y malestar en docentes de una universidad mexicana. Utilizando la técnica Delphi, la elaboración del instrumento se llevó a cabo desde la perspectiva de los implicados y este fue validado por expertos. Mediante tres rondas de interacción entre los participantes, se buscó el consenso a través de la retroalimentación de sus respuestas. El resultado fue un cuestionario conformado por cuatro secciones: 1) información personal y profesional; 2) escala Maslach Burnout Inventory (MBI-ES) adaptada para contexto educativo; 3) escala de determinantes de estrés y malestar docente, y 4) escala de satisfacción laboral. Mediante la aplicación del instrumento a una muestra de 46 docentes, se obtuvo la validez y confiabilidad de cada escala que para el caso del MBI-ES fue de 0.62, la escala de fuentes de estrés y malestar docente fue de 0.97 y en la escala de fuentes de satisfacción laboral se obtuvo un valor de 0.91; se concluyó que las tres escalas tienen validez técnica de 0.93 por Alfa de Cronbach.

El uso de las TIC y, particularmente, las tecnologías de redes han ampliado las posibilidades de acceder a nuevos espacios y recursos para el aprendizaje, más allá del tradicional campo formal escolar. Sin embargo, estas combinaciones de múltiples y distintos ambientes añaden un elemento de complejidad que exige al estudiante un mayor esfuerzo en su papel de director de su propio aprendizaje. La investigación Delphi que se describe en este artículo atiende precisamente al papel de la autodirección en el campo de las ecologías del aprendizaje, posicionando al alumno como agente activo, productor y conductor de sus propias estrategias, capaz de orquestar los diversos contextos, recursos, actividades y relaciones personales en un conjunto coherente y adecuado para la consecución de un objetivo de aprendizaje a lo largo del tiempo. En este sentido, se señala también la necesidad de poner en práctica procedimientos encaminados a fomentar la autonomía del aprendiz, su autorregulación y su capacidad de aprender a aprender.

Resumo Objetivo: como profissão orientada à atenção da saúde, focada no cuidado às pessoas, a Enfermagem precisa desenvolver habilidades de comunicação sólidas. Com base em um consenso internacional de especialistas, apresenta-se uma proposta sobre os resultados de aprendizagem na comunicação clínica para planos de estudos em cursos de Enfermagem em países hispanofalantes. Método: um comitê orientador, composto por 5 enfermeiros e especialistas em comunicação em ciências de atenção à saúde, elaborou a primeira lista de habilidades comunicacionais específicas para o curso de Enfermagem. Outro comitê de 7 assessores científicos internacionais revisou e melhorou a referida proposta. Foram selecionados 70 especialistas de 14 países pelo procedimento de amostragem “bola de neve”, sendo convidados para participar em um processo de consenso Delphi modificado a distância em duas rodadas de pesquisa. Foi realizada a análise estatística para estabelecer o nível de consenso final correspondente a cada item. Resultados: foi apresentado um questionário com 68 resultados de aprendizagem em comunicações clínicas para serem avaliados pelo painel. Na primeira rodada Delphi, o painel chegou a um consenso estatístico em todos os itens avaliados. Não foi necessária uma segunda rodada para conciliar posições. Conclusão: apresenta-se uma proposta acadêmica aprovada com um elevado nível de consenso internacional a fim de orientar e unificar os resultados de aprendizagem nos planos de estudo sobre comunicação clínica para cursos de Enfermagem em países hispanofalantes.

Understanding the benefits of green and blue areas in a city is a key aspect for urban management to simultaneously meet multiple sustainability goals. In this work, the capacity of the ecological infrastructure (EI) of the city of Mar del Plata (Buenos Aires province, Argentina) to provide fourteen types of urban ecosystemservices (UES) was analyzed. To collect the existing knowledge on the subject, an approach based on obtaining local expert knowledge mediated by the Delphi technique was used. The work dynamics consisted of two rounds of anonymous online surveys and an open synchronous workshop in which the previously obtained results were discussed. Twenty-nine local experts from different disciplines were consulted, and they were divided into two groups that worked simultaneously. The results showed the relationships between the EI components and their ability to provide regulation cultural and regulation and maintenance UES. Based on the workshop carried out with local experts it was possible to investigate some properties of the EI that could intervene in the capacity to provide said UES. The local interdisciplinaryknowledge framework developed in this work represents a useful source of information in the current debate that is taking place in the city regarding the planning of sustainable urban contexts. In this sense, the work carried out allowed the extraction of a series of key learnings in the advancement of this research framework that could be useful in the adoption of specific interventions. [ABSTRACT FROM AUTHOR]

Comprender los beneficios que brindan las áreas verdes y azules de una ciudad es un aspecto clave para que la gestión urbana cumpla de manera simultánea múltiples objetivos de sostenibilidad. En este trabajo se analizó la capacidad que tiene la infraestructura ecológica (IE) de la ciudad de Mar del Plata (provincia de Buenos Aires, Argentina) para brindar 14 tipos de servicios ecosistémicos urbanos (SEU). Para recoger el conocimiento existente en la materia se utilizó un enfoque basado en la obtención de conocimiento experto local mediado por la técnica Delphi. La dinámica de trabajo consistió en dos rondas de encuestas anónimas en línea y un taller sincrónico abierto en el que se discutieron los resultados obtenidos previamente. Se consultaron 29 expertos locales provenientes de distintas disciplinas, quienes se dividieron en dos grupos que trabajaron de manera simultánea. Los resultados mostraron las relaciones entre los componentes de la IE y su capacidad para brindar SEU de regulación y mantenimiento y culturales. A partir del taller realizado con los expertos locales fue posible indagar en algunas propiedades de la IE que podrían intervenir en la capacidad de proveer dichos SEU. El marco de conocimiento interdisciplinario local desarrollado en este trabajo significa una fuente de información útil en el actual debate que se está desarrollando en la ciudad respecto a la planificación de contextos urbanos sostenibles. En este sentido, el trabajo realizado permitió extraer una serie de aprendizajes claves en el avance de este marco de investigación que podrían ser útiles para adoptar intervenciones específicas.

Objective: Provide consensus recommendations for the optimal management of fixed-dose combination therapies (FCT) in patients with cardiovascular risk factors (CVRF) in primary care (PC)., Material and Methods: A modified Delphi technique was used. A scientific committee wrote 80 statements addressing controversial issues regarding adherence and the use of FCT in patients with CVRF. A panel of 52 PC specialists, experts in CVRF management and adherence evaluated the questionnaire in two rounds. The work was promoted by the Network of Experts in Adherence in Primary Care (REAAP)., Results: Agreement was reached on 66 of the 80 issues (82.5%). The panellists considered that the adherence of patients with CVRF treated in PC was inadequate, which could have clinical implications. The use of FCT might increase adherence compared to separate treatments. FCT usage promotion in PC was considered necessary, especially in polymedicated patients. Measures such as establishing specific protocols or improving the training of professionals in the FTC use are necessary. The FTC use was recommended as a reduction in long-term cardiovascular events in hypertension was observed, together with changes of the concept of high-intensity statins to high-intensity lipid-lowering therapy in dyslipidemia, or considering the use of FCT if the option was available in type 2 diabetes mellitus., Conclusions: The expert consensus recommendations from this work may facilitate the use of FCT in patients with CVRF in PC., (Copyright © 2024 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España, S.L.U. All rights reserved.)

Objective: This research aims to develop a nursing assessment tool, based on Gordon's Health Functional Patterns, through a content validation by a committee of experts, applying a Delphi technique., Design: An assessment instrument with 53 items has been designed. SITE: It is carried out within the framework of a doctoral thesis, for its implementation by midwives of Primary Health Care., Participants: The committee was made up of 16 professionals with a hide clinical, teaching and research experience who all participated in the entire validation process., Intervention: It has been assessed as a whole and in each of the items through four rounds of consultations, establishing a positive assessment of more than 60% to accept each item, as well as incorporating the suggestions provided by the committee. The final version had to reach a unanimous consensus., Main Measurements: All items were accepted with a score higher than 60%., Results: There were no contradictions between the inputs provided by the experts, so all of them were integrated into the final version that has a 100% approval by the committee., Conclusion: After this process, a new assessment tool is presented to be applied by primary care midwives in the pregnancy monitoring. The questionnaire has been piloted with 50 pregnant women, determining the most prevalent nursing diagnoses, establishing the workload for the midwife of her implementation of individualized care plans to improve some health indicators of pregnant women., (Copyright © 2024 The Authors. Publicado por Elsevier España S.L.U. All rights reserved.)

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El objetivo de este estudio es proponer y legitimar junto a los especialistas de bibliotecas de la región sur de Brasil un modelo formal multicriterio para la implementación de un programa de gestión de la innovación en bibliotecas. La importancia de esta investigación está justificada por la escasez de estudios empíricos para la implementación de la gestión de la innovación en las bibliotecas, así como por la participación de los responsables de la toma de decisiones en este proceso. Respecto a los procedimientos metodológicos, se caracterizan por su naturaleza cualitativa, exploratoria en cuanto al objeto de estudio y hace uso de la metodología muticritério en apoyo a la decisión constructivista (MCDA-C). Por último, la técnica Delphi fue utilizada para legitimar elmodelo propuesto, contando con la participación de especialistas/ administradores bibliotecarios. Los resultados apuntaron a la robustez del modelo teórico por la concordancia con 40 elementos y alertaron sobre dos puntos críticos.

Introduction: Acute viral bronchiolitis (AB) is one of the most common respiratory diseases in infants. However, diagnostic criteria for AB are heterogeneous and not very well known. Objective: To identify the diagnostic criteria for AB used by experts and clinical paediatricians in Spain. Methods: Delphi study with Spanish AB experts, looking for the points of agreement about AB diagnosis. A subsequent cross-sectional study was conducted by means of an online questionnaire addressed to all Spanish paediatricians, reached through electronic mail messages sent by nine paediatric scientific societies. Descriptive and factorial analyses were carried out, looking for any association of diagnostic criteria with demographic or geographic variables, or with paediatric subspecialty. Results: Agreement was reached by 40 experts in many issues (first episode of respiratory distress and high respiratory frequency, diagnosis in any season of the year, and usefulness of virus identification in making diagnosis), but opposite views were maintained on key characteristics such as the maximum age for diagnosis. The online questionnaire was completed by 1297 paediatricians. Their diagnostic criteria were heterogeneous and strongly associated with their paediatric sub-specialty. Their agreement with the Spanish expert consensus and with international standards was very poor. Conclusions: Diagnostic criteria for AB in Spain are heterogeneous. These differences could cause variability in clinical practice with AB patients. Resumen: Introducción: La bronquiolitis vírica aguda (BA) es una de las enfermedades respiratorias más frecuentes en los lactantes. Sin embargo, los criterios utilizados para su diagnóstico son heterogéneos e insuficientemente conocidos. Objetivo: Identificar los criterios de diagnóstico de BA empleados en España, tanto por expertos como por pediatras clínicos. Métodos: Estudio de metodología Delphi con expertos españoles en BA, buscando los puntos de consenso sobre el diagnóstico de BA. Posteriormente se realizó un estudio transversal mediante encuesta online dirigida a todos los pediatras españoles, contactados a través de mensajes de correo electrónico enviados por nueve sociedades científicas pediátricas. Se hizo análisis descriptivo y análisis factorial de los resultados de la encuesta, buscando si los criterios diagnósticos empleados se relacionaban con variables demográficas, geográficas o con la subespecialidad pediátrica. Resultados: Los 40 expertos participantes alcanzaron un consenso en muchos aspectos (primer episodio de dificultad respiratoria y aumento de la frecuencia respiratoria, diagnóstico en cualquier estación del año, y utilidad de la identificación de virus para el diagnóstico), pero manteniendo opiniones enfrentadas en cuestiones importantes como la edad máxima aceptable para el diagnóstico. A la encuesta online respondieron 1297 pediatras. Los criterios diagnósticos que aplican son heterogéneos y están fuertemente asociados con la subespecialidad pediátrica. Su acuerdo con el consenso de expertos y con estándares internacionales es muy bajo. Conclusiones: Los criterios usados en España para el diagnóstico de BA son heterogéneos. Esas diferencias pueden causar variabilidad en la práctica clínica en pacientes con BA.

Much research has been developed concerning the application and effects of Person-Centered Planning (PCP). Nevertheless, there are no standardized instruments adapted to the Spanish context. This study seeks to design and validate the Person Centered Planning Scale (E-PCP) in order to offer a valid and reliable instrument to do so. For its construction and content validation, the bibliographic review has been used and the Delphi technique has been applied. The resulting scale has been applied to a sample of 102 professionals who work in intellectual disability care centers in Asturias, which has allowed the analysis of their psychometric properties. In order to analyze the construct validity, a cross-validation was carried out, using exploratory factor analysis (AFE) and confirmatory factor analysis (CFA). Results show a scale with a good reliability (a = ,96), explaining the 58 % of variance and with a Single-factor structure made up by 16 items. Its short length, reliability and validity indicate that this instrument can be useful for both research and professional practice. [ABSTRACT FROM AUTHOR]

We aimed to reach a consensus on the best instruments to monitor disease activity in patients with psoriatic arthritis (PsA) and to develop a consensus definition of remission. A modified Delphi approach was used. A scientific committee provided statements addressing the definition of remission and the monitoring of PsA in clinical practice. The questionnaire was evaluated in 2 rounds by rheumatologists with experience in managing PsA patients. A panel of 77 rheumatologists reached agreement on 62 out of the 86 proposed items (72.0%). The most recommended index for monitoring disease activity was DAPSA (cut-off values: ≤4 for remission and >4–14 for low disease activity ([LDA]), MDA (at least 5/7 criteria). In cases with axial involvement, ASDAS was the preferred index (cut-off values: <1.3 for remission and <2.1 for LDA). BASDAI (cut-off values: ≤2 for remission and ≤4 for LDA) may be used as an alternative. PsAID was the preferred tool to assess disease impact. We propose a definition of remission in PsA as the absence of disease activity evaluated by DAPSA or MDA (ASDAS and/or BASDAI in patients with axial involvement), which would imply absence of signs or symptoms of inflammation, physical well-being, lack of disease impact, and absence of inflammation as measured by biological markers. [ABSTRACT FROM AUTHOR]

Introduction. Feeding and eating disorders represent a serious problem especially in young population. Nutritional education is essential in its treatment and prevention. Among the actions developed in Spain the NAOS strategy highlights, which frames the Perseo educational program for schoolchildren. However, there are few tools to evaluate the knowledge after these programs are implemented. The aim of the study was to create and to validate a questionnaire that allows the evaluation of the acquired knowledge on young population diagnosed of eating disorders after participating on Perseo program. Methodology. The on-line modified e-Delphi technique was applied, 26 mental health and nutrition experts took part, evaluating the consensus level on adequacy and relevance through a 4-points Likert scale and a field for comments. Basic and supplementary criteria for the development of the technique were previously established. Results. On the basis of the Perseo program and the adapted version of GNKQ for Portuguese teenagers, an initial version of the questionnaire was developed with 30 items and 4 possible answers. After three rounds 26 of the items reached the required consensus both in adequacy and relevance. Eventually a new questionnaire of 26 items was obtained with a high degree of general agreement according to the experts. Conclusions. The questionnaire has demonstrated a strong validity of content that allows to evaluate an educational intervention on nutrition based on the Perseo program, among young population with eating disorders. [ABSTRACT FROM AUTHOR]

Introduction: Breastfeeding has unique health benefits. Exclusive breastfeeding is recommended during the first six months of life and should be maintained during complementary feeding. Alternatively, infant formulas, which are designed to mimic human breastmilk to promote similar metabolic and growth profiles, can be used. This study aimed to assess the opinion of Portuguese paediatricians with expertise in nutrition on the composition, benefits and indications of commercialised infant formulas. Material and Methods: A survey based on the Delphi method with application of a questionnaire developed by a scientific committee was issued to a panel of paediatricians with expertise in nutrition. An initial questionnaire that included 65 items covering 11 areas was administered in two rounds. Results: Twenty-one experts participated, and the final response rate was 87.5%. The panel was in agreement in 68.3% of the enquired items, namely that infant formulas should be used only when breastfeeding is not possible. Notwithstanding, the opinion of the panel was heterogeneous on a number of issues, particularly those related to the advantages and indications of ‘special’ or modified infant formulas (partially hydrolysed formulas and anti-colic, anti-constipation and anti-regurgitation formulas) and of young child formulas (‘growing-up formulas’). Discussion: A wide consensus was recorded on the nutritional quality, food safety and indications attributed to commercialized infant formulas. Conclusion: The opinion of Portuguese experts was consensual in most of the enquired topics. The absence of consensus was mostly related to issues that remain under debate in the literature and lack robust scientific evidence.

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Copyright of Revista de Estudios Cooperativos is the property of Universidad Complutense de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Futures analyses and scenario-building exercises have received scant attention from scientific literature on the planning and management of tourist destinations. This article emphasizes the importance of a territorial foresight strategy and scenario building in the planning and management of tourist destinations, demonstrating how it is methodologically possible to combine the Delphi technique with a scenario-building exercise. The findings suggest that the knowledge provided by stakeholders operating within the tourism system can benefit the planning and management of tourist destinations. [ABSTRACT FROM AUTHOR]

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Objetivo: Adaptar un cuestionario conductual para la vigilancia de segunda generación del VIH/sida en mujeres trabajadoras sexuales (MTS) de la Región Metropolitana, Chile. Métodos: Estudio cualitativo de validación de instrumento. Se validó un cuestionario español adaptado en Cataluña (España) mediante traducción y retrotraducción del instrumento original. La validación de contenido se realizó a través de un grupo Delphi modificado, constituido por expertos en MTS y VIH, representantes de los ámbitos comunitario, político e institucional. Se evaluaron aspectos relacionados con la aplicabilidad del instrumento en terreno, encuestando a MTS de la Región Metropolitana. Resultados: El cuestionario, escrito en español de España, fue satisfactoriamente adaptado al español de Chile. En el proceso de validación de contenido se logró definir las secciones que abordan el VIH en la población MTS. El cuestionario adaptado tiene un tiempo de aplicación de menos de 15 minutos, por lo que es utilizable en terreno. Las 61 mujeres encuestadas presentan características diversas, tanto en país de origen (todas eran latinoamericanas) como en nivel de estudios, lo que permitió captar potenciales problemas en su aplicación. Discusión: El cuestionario adaptado para Chile contiene todos los indicadores para MTS recomendados por ONUSIDA, así como los recomendados por el Familly Health International para la vigilancia bioconductual. El instrumento definitivo emerge como una herramienta para la vigilancia de segunda generación del VIH y otras infecciones de transmisión sexual en Chile, y como un aporte al abordaje de políticas preventivas en la población de MTS.

This paper presents the analysis and assessment of the Education Area of the Plan of Action for Persons with Disabilities in the Autonomous Community of Madrid (2012-2015), carried out after using a Delphi Method with a group of six experts. This work was aimed to make a formative evaluation of the Plan implemented, so that the analysis generated could be used by both managers of the next plan in project, as for educational stakeholders involved in the education field, but obviously, by people with disabilities as well, in order to support them to exercise effectively their rights. The synthesis document shows synthetically the main strengths of the plan but, mostly, the weaknesses or points to improve. Among these should be noted the need of a more efficient structure of programs and actions with clear indicators of achievement. Also there is a need of rethinking current models and areas of intervention, in order to those were much more consistent and coherent with the right to an education inclusive that has been established in the Convention of Rights of People with Disability, and with the models of understanding and intervention to improve their quality of life.