It highlighted the importance of both respecting and taking advantage of each context-and the specific arrangements and patterns in the relationships between researchers and decisionmakers-through incentives for embedded research.

To identify barriers to the implementation of National Childbirth Guidelines in Brazil from the women’s perspective.

A descriptive exploratory study was performed using a qualitative approach and an interpretive perspective. The hermeneutic unit of analysis was established based on the contribution of users to a public online consultation about the National Childbirth Guidelines in Brazil, performed in 2016 by the National Committee for Health Technology Incorporation into the Unified Health System (CONITEC). Content analysis techniques were used to examine the answers provided to the following specific question “Considering your local reality, what would hinder the implementation of this protocol or guideline?”

Of 396 contributions recorded by CONITEC, 55 were included in the content analysis. The mean age of women was 31 years, with most self-declared as white (69%) and living in the Southeast of Brazil (56.3%). Coding revealed seven barrier categories, which were grouped into three families – barriers related to 1) professional training and culture (which highlighted the centrality of physicians, not women, in childbirth), 2) social culture (general population not well informed), and 3) political and management issues (little interest on the part of managers, lower physician compensation for vaginal childbirth vs. cesarian section, and poor hospital infrastructure).

Aspects of professional training and culture, social culture, and political as well as management issues are critical points to be considered in future interventions aiming at overcoming or weakening the barriers to implementing childbirth recommendations in Brazil.

Aspects of professional training and culture, social culture, and political as well as management issues are critical points to be considered in future interventions aiming at overcoming or weakening the barriers to implementing childbirth recommendations in Brazil.

To determine the distribution of cesarean sections performed in teaching hospitals participating in the Project for Improvement and Innovation in the Care and Teaching of Obstetrics and Neonatology (Apice ON) using the Robson Classification.

Cross-sectional descriptive study on cesarean sections performed at Apice ON hospitals according to the Robson Classification, using secondary data from the 2017 Live Births Information System on the year prior to project implementation, hence a baseline study. HDAC inhibitor Hospitals are described according to their geographic distribution and cesarean section rates, using absolute and relative frequencies.

The proportions of newborns by Robson groups were similar to those proposed by the World Health Organization, except for Group 5 (with previous cesarean section) and Group 10 (preterm), with regional differences. The teaching hospitals’ average cesarean section rates ranged from 24.8% to 75.1%, exceeding by far the recommended values, even in Robson groups considered low riskthe Robson Classification can be an important tool to guide management and propose actions to reduce rates. Countries with high cesarean section rates might explore this hypothesis in their teaching hospitals in order to define policies for the reduction of their rates.

Evaluate the predictive validity of a functional classification (FC) method for the use of emergency services and hospitalization, mortality, and health care costs among older adults.

Retrospective cohort study that included 2 168 older adults in a chronic noncommunicable disease (CNCD) care program in Medellin, Colombia. Patients were stratified according to a FC method based on functional status, presence of risk factors, and control of comorbidity. During one year of follow-up, the predictive validity of the FC method was assessed for the studied outcomes. Discrimination and calibration were measured with the C-statistic and Hosmer-Lemeshow (HL) test, respectively.

The average age was 74.6 ± 7.9 years; 40.8% (n = 884) were men and 7.7% (n = 168) died. The risk of death (odds ratio [OR] 1.767; 3.411; 8.525), hospitalization (OR 1.397; 2.172; 3.540) and high cost of health care (OR 1.703; 2.369; 5.073) increased in proportion to a deterioration in functional classification (classes 2B, 3, and 4, respectively). The predictive model for the outcome of death showed good capacity for discrimination (C-statistic = 0.721) and calibration (HL statistic 10.200;

= 0.251).

There is a dose-response relationship between deterioration in FC and a higher risk of death, hospitalization, and high cost. FC has predictive validity for the mortality rate and could be used to stratify older adults in CNCD care programs with a view to guiding interventions.

There is a dose-response relationship between deterioration in FC and a higher risk of death, hospitalization, and high cost. FC has predictive validity for the mortality rate and could be used to stratify older adults in CNCD care programs with a view to guiding interventions.

Compare the diagnostic properties of five case definitions of suspected COVID-19 that were used or proposed in Chile during the first eight months of the pandemic.

An analysis was done of the diagnostic properties (sensitivity, specificity, and positive and negative predictive values) of three case definitions of suspected COVID-19 used in Chile between March and October 2020, as well as two alternative proposed definitions. The sample was 2,019 people with known results for the polymerase chain reaction (PCR) test for SARS-CoV-2. Stepwise logistic regression was used to develop criterion 5, optimizing sensitivity and specificity values. Multifactor logistic regression was used to explore the association between demographic variables, symptoms and signs, and PCR positivity. Different positivity scenarios were analyzed and ROC curves were compared.

The presence of anosmia (OR = 8.00; CI95% 5.34-11.99), fever (OR = 2.15; CI95% 1.28-3.59), and having been in close contact with a person sick with COVID-19 (OR = 2.