Objective: Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives.Methods: Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO Citation Index, and grey literature. Two researchers conducted screening and eligibility phases. Data were thematically analyzed.Results: The review included 219 documents. Diabetes was the most studied condition; most of the evidence comes from patients and the United States. Affordability and availability of medicines were the most reported dimension and specific barrier respectively, both cross-cutting concerns. Among high- and middle-income countries, identified barriers were cost of medicines, accompaniment by professionals, long distances to facilities, and cultural aspects; cost of transportation emerges in low-income settings. Facilitators reported were financial accessibility, trained health workers, medicines closer to communities, and patients’ education.Conclusion: Barriers and facilitators are determined by socioeconomic and cultural conditions, highlighting the role of health systems in regulatory and policy context (assuring financial coverage and free medicines); providers’ role bringing medicines closer; and patients’ health education and disease management.

The continuous development in telecommunication tech­nologies has created opportunities for health professionals to optimise healthcare delivery by adopting digital tools into rehabilitation programs (i.e., telerehabilitation). These tech­nological advances, along with the demographic and social characteristics of each country, have made the implementa­tion of telerehabilitation a disparate process across regions. We have gathered the experience of four countries (Australia, Chile, Brazil, and Colombia) in two different regions (Ocea­nia and South America) to recompile the history pre- and post-Covid-19 outbreak until January of 2021, the barriers to, and facilitators of telerehabilitation, and outline the future challenges for these countries.

Objetivo: Determinar la prevalencia de Escoliosis Idiopática del Adolescente (EIA), riesgo de progre- sión (RP) y Calidad de vida (CdV) en estudiantes entre 10 a 18 años. Pacientes y Método: Estudio descriptivo transversal. Se incluyeron estudiantes de 10 a 18 años de cinco comunas de Región Metropolitana (RM), Chile. Se realizó Prueba de Adams y con escoliómetro se midió el ángulo de rotación del tronco (ART) a nivel de columna torácica, toracolumbar y lumbar. Si ART era ≥ 6°, se realizó exploración radiológica de columna completa anteroposterior y lateral, midiendo posteriormente ángulo de Cobb. Se confirmó escoliosis con ángulo de Cobb ≥ 10° con rotación vertebral. Se calculó factor de progresión mediante fórmula de Lonstein & Carlston. Para evaluar la CdV se utilizaron los cuestionarios de CdV en deformidades del raquis y escala de percepción de apariencia del tronco. Resultados: 1200 estudiantes fueron examinados. 54,92% mujeres. 8,17% tenía ART ≥ 6°. Se encontró escoliosis leve en 2,91%; moderada en 0,75% y severa en 0,17%. La prevalencia total fue 3,83% (IC 95%: 2,74 - 4,92). El 82,61% de los casos de EIA pesquisados correspondieron a diagnóstico tardío, cuando los estudiantes habían superado el estirón del crecimiento. De los casos de escoliosis, 21,74% tenían RP ≥ 50%. La CdV se correlacionó positivamente con gravedad de la curva, sin diferencias estadísticamente significativas. Conclusiones: Prevalencia de EIA fue 3,83%. La mayoría de las EIA fueron pesquisados cuando los estudiantes habían superado el estirón del crecimiento, con alto riesgo de progresión. La CdV de vida se correlacionó positiva y débilmente con gravedad de la curva.

History of child abuse among patients with bipolar disorders Background: A history of child abuse is common and has a significant impact in the clinical course of patients diagnosed with bipolar disorders (BD). Aims: To assess the frequency of child abuse experiences in patients BD type I and to evaluate its association with clinical course and cognitive functioning variables. Material and Methods: 117 patients with BD aged 45 ± 14 years (66% women) answered the Childhood Trauma Questionnaire (CTQ). The clinical course (illness onset, history of suicide attempts and number of hospitalizations) was obtained from medical records. Cognitive functioning was evaluated through social and non-social cognition tasks. Results: 64% of participants reported some type of child abuse. This variable was associated with an early onset of the disease (Odds ratio (OR) = 3.3; p < 0.02), increased risk of suicide attempts (OR = 2.4; p < 0.04) and specific disturbances in social cognitive tasks. Conclusions: Our study supports evidence of a common history of child abuse in patients with BD. Although child abuse predicts a worse clinical course, major clinical practice guidelines, as well as research designs, do not highlight this evidence.