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      Desarrollo y evaluación de material educativo dirigido a prevención de caídas en mujeres embarazadas Translated title: Development and evaluation of educational material directed to fall prevention in pregnant women

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          RESUMEN

          Fundamentos:

          Una de cada cuatro mujeres embarazadas tiene al menos una caída durante su período de gestación. El objetivo de esta investigación fue desarrollar un material educativo escrito sobre prevención de caídas para mujeres embarazadas, promoviendo la autoeficacia y las expectativas de resultados basados en la teoría social cognitiva. Igualmente se pretendió evaluar la validez del contenido del material educativo, su comprensión y capacidad de acción.

          Métodos:

          Este estudio metodológico se llevó a cabo en dos fases: la primera se fundamentó en el desarrollo del material educativo y su evaluación por dos paneles de personas expertas (n=13). En segundo lugar, el material educativo fue evaluado con respecto a la organización, claridad, apariencia, relevancia, contenido, autoeficacia y expectativas de resultados, utilizando una hoja de evaluación creada por las investigadoras, así como su comprensión y capacidad de acción utilizando el instrumento PEMAT. Se utilizaron estadísticas descriptivas para las variables sociodemográficas y los resultados de los instrumentos de evaluación.

          Resultados:

          Se atendieron las recomendaciones sobre la organización, claridad de la información, apariencia en términos de la calidad de las imágenes, relevancia, autoeficacia, expectativa de resultados y aspectos de seguridad. En la evaluación realizada por el panel de personas expertas en el contenido, se obtuvo un promedio del 87,8% y del 91,6% en los apartados de capacidad de acción y comprensión del PEMAT-P respectivamente.

          Conclusiones:

          Este estudio logra desarrollar un material educativo con validez de contenido, altamente comprensible y accionable sobre incidencia de las caídas, sus causas y consecuencias, estrategias para prevenirlas, los beneficios de ejercitarse y recomendación de ejercicios para prevenir caídas durante el embarazo.

          ABSTRACT

          Background:

          One in four pregnant women has at least one fall during their pregnancy. The objective of this research was to develop a written educational material on fall prevention for pregnant women, promoting self-efficacy and the expectations of results based on the social cognitive theory. It was also intended to evaluate the validity of the content of the educational material, its understanding and actionability.

          Methods:

          This methodological study was carried out in two phases: the first was based on the development of educational material and its evaluation by two panels of experts (n=13). Secondly, the educational material was evaluated for organization, clarity, appearance, relevance, content, self-efficacy and expectations of results, using an evaluation sheet created by the researchers, as well as its understanding and actionability using the PEMAT instrument. Descriptive statistics are used for sociodemographic variables and the results of the evaluation instruments.

          Results:

          Recommendations on the organization, clarity of information, appearance in terms of image quality, relevance, self-efficacy, expectation of results and safety aspects were met. In the evaluation carried out by the content expert panel, an average of 87.8% and 91.6% was obtained in the areas of actionability and understanding of PEMAT-P, respectively.

          Conclusions:

          This study develops an educational material with content validity, highly understandable and actionable on the falls incident, their causes and consequences, strategies to prevent them, the benefits of exercising and the recommendation of exercises to prevent falls during pregnancy.

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          Most cited references35

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          2019 Canadian guideline for physical activity throughout pregnancy

          The objective is to provide guidance for pregnant women and obstetric care and exercise professionals on prenatal physical activity. The outcomes evaluated were maternal, fetal or neonatal morbidity, or fetal mortality during and following pregnancy. Literature was retrieved through searches of MEDLINE, EMBASE, PsycINFO, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Scopus and Web of Science Core Collection, CINAHL Plus with Full Text, Child Development & Adolescent Studies, Education Resources Information Center, SPORTDiscus, ClinicalTrials.gov and the Trip Database from inception up to 6 January 2017. Primary studies of any design were eligible, except case studies. Results were limited to English-language, Spanish-language or French-language materials. Articles related to maternal physical activity during pregnancy reporting on maternal, fetal or neonatal morbidity, or fetal mortality were eligible for inclusion. The quality of evidence was rated using the Grading of Recommendations Assessment, Development and Evaluation methodology. The Guidelines Consensus Panel solicited feedback from end users (obstetric care providers, exercise professionals, researchers, policy organisations, and pregnant and postpartum women). The development of these guidelines followed the Appraisal of Guidelines for Research and Evaluation II instrument. The benefits of prenatal physical activity are moderate and no harms were identified; therefore, the difference between desirable and undesirable consequences (net benefit) is expected to be moderate. The majority of stakeholders and end users indicated that following these recommendations would be feasible, acceptable and equitable. Following these recommendations is likely to require minimal resources from both individual and health systems perspectives.
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            2013 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 31st Annual Report

            ABSTRACT Background: This is the 31st Annual Report of the American Association of Poison Control Centers’ (AAPCC) National Poison Data System (NPDS). As of January 1, 2013, 57 of the nation's poison centers (PCs) uploaded case data automatically to NPDS. The upload interval was 8.08 [7.10, 11.63] (median [25%, 75%]) minutes, creating a near real-time national exposure and information database and surveillance system. Methodology: We analyzed the case data tabulating specific indices from NPDS. The methodology was similar to that of previous years. Where changes were introduced, the differences are identified. Poison center (PC) cases with medical outcomes of death were evaluated by a team of 38 medical and clinical toxicologist reviewers using an ordinal scale of 1–6 to assess the Relative Contribution to Fatality (RCF) of the exposure to the death. Results: In 2013, 3,060,122 closed encounters were logged by NPDS: 2,188,013 human exposures, 59,496 animal exposures, 806,347 information calls, 6,116 human-confirmed nonexposures, and 150 animal-confirmed nonexposures. Total encounters showed a 9.3% decline from 2012, while health care facility human exposure calls were essentially flat, decreasing by 0.1%.All information calls decreased 21.4% and health care facility (HCF) information calls decreased 8.5%, medication identification requests (drug ID) decreased 26.8%, and human exposures reported to US PCs decreased 3.8%. Human exposures with less serious outcomes have decreased 3.7% per year since 2008 while those with more serious outcomes (moderate, major or death) have increased by 4.7% per year since 2000. The top five substance classes most frequently involved in all human exposures were analgesics (11.5%), cosmetics/personal care products (7.7%), household cleaning substances (7.6%), sedatives/hypnotics/antipsychotics (5.9%), and antidepressants (4.2%). Sedative/hypnotics/antipsychotics exposures as a class increased most rapidly (2,559 calls/year) over the last 13 years for cases showing more serious outcomes. The top five most common exposures in children of 5 years or less were cosmetics/personal care products (13.8%), household cleaning substances (10.4%), analgesics (9.8%), foreign bodies/toys/miscellaneous (6.9%), and topical preparations (6.1%). Drug identification requests comprised 50.7% of all information calls. NPDS documented 2,477 human exposures resulting in death with 2,113 human fatalities judged related (RCF of 1, undoubtedly responsible; 2, probably responsible; or 3, contributory). Conclusions: These data support the continued value of PC expertise and need for specialized medical toxicology information to manage the more severe exposures, despite a decrease in calls involving less severe exposures. Unintentional and intentional exposures continue to be a significant cause of morbidity and mortality in the United States. The near real-time, always current status of NPDS represents a national public health resource to collect and monitor US exposure cases and information calls. The continuing mission of NPDS is to provide a nationwide infrastructure for public health surveillance for all types of exposures, public health event identification, resilience response and situational awareness tracking. NPDS is a model system for the nation and global public health.
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              A systematic review and meta-analysis of social cognitive theory-based physical activity and/or nutrition behavior change interventions for cancer survivors

              Purpose Little is known about how to improve and create sustainable lifestyle behaviors of cancer survivors. Interventions based on social cognitive theory (SCT) have shown promise. This review examined the effect of SCT-based physical activity and nutrition interventions that target cancer survivors and identified factors associated with their efficacy. Methods A systematic search of seven databases identified randomized controlled trials that (i) targeted adult cancer survivors (any point from diagnosis); (ii) reported a primary outcome of physical activity, diet, or weight management; and (iii) included an SCT-based intervention targeting physical activity or diet. Qualitative synthesis and meta-analysis were conducted. Theoretical constructs and intervention characteristics were examined to identify factors associated with intervention efficacy. Results Eighteen studies (reported in 33 publications) met review inclusion criteria. Meta-analysis (n = 12) revealed a significant intervention effect for physical activity (standardized mean difference (SMD) = 0.33; P < 0.01). Most studies (six out of eight) that targeted dietary change reported significant improvements in at least one aspect of diet quality. No SCT constructs were associated with intervention effects. There were no consistent trends relating to intervention delivery method or whether the intervention targeted single or multiple behaviors. Conclusions SCT-based interventions demonstrate promise in improving physical activity and diet behavior in cancer survivors, using a range of intervention delivery modes. Further work is required to understand how and why these interventions offer promise for improving behavior. Implications for Cancer Survivors SCT-based interventions targeting diet or physical activity are safe and result in meaningful changes to diet and physical activity behavior that can result in health improvements.
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                Author and article information

                Journal
                Rev Esp Salud Publica
                Rev Esp Salud Publica
                resp
                Revista Española de Salud Pública
                Ministerio de Sanidad, Consumo y Bienestar social
                1135-5727
                2173-9110
                02 November 2020
                2020
                : 94
                : 202001009
                Affiliations
                [1 ] originalUniversidad de Puerto Rico. Recinto de Ciencias Médicas. San Juan. Puerto Rico. orgnameUniversidad de Puerto Rico orgdiv1Recinto de Ciencias Médicas San Juan, Puerto Rico
                Author notes
                Correspondencia: Migdalis Soto Méndez. HC-05 Box 25295, 00627 Camuy, Puerto Rico. migdalis.soto@ 123456upr.edu

                Las autoras declaran que no existe ningún conflicto de interés.

                Article
                e202001009
                11567070
                8208368f-6ecd-4284-b585-d879ab823c0a

                Este es un artículo publicado en acceso abierto bajo una licencia Creative Commons

                History
                : 27 August 2019
                : 11 October 2019
                : 21 January 2020
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 24
                Categories
                Originales Breves

                embarazo,prevención de caídas,fisioterapia,validez de contenido,teoría social cognitiva,autoeficacia,expectativas de resultados,pemat,pregnancy,fall prevention,physiotherapy,social cognitive theory,auto efficacy,expectation of results

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