Análisis de la competencia del profesor de Educación Física para la inclusión de escolares con discapacidad

El estudio se enmarca en la competencia percibida por propios profesores de Educación Física para la inclusión de escolares primarios con discapacidad física. Se formuló como objetivo analizar la competencia percibida por profesores de Educación Física para la inclusión de escolares primarios con discapacidad física, en dos municipios de la región central de Cuba. Los datos provienen de un cuestionario cumplimentado por 40 profesores de Educación Física de dos municipios de la Región central cubana (divididos en dos grupos de 20). Se utilizaron métodos teóricos como el analítico-sintético y el inductivo-deductivo; y empíricos como la entrevista, la observación y la encuesta; del nivel matemático y/o estadístico, la distribución empírica de frecuencia. El resultado de la investigación reflejó la descripción de la autopercepción de los profesores de ambas poblaciones, en las tres dimensiones, con resultados más favorables para el municipio de Cabaiguán. La autopercepción más favorable de los profesores del municipio de Cabaiguán, para realizar adaptaciones específicas, emitir instrucción a los iguales y seguridad en el proceso de inclusión de escolares con discapacidad en la clase de Educación Física.

O estudo enquadra-se na competência percebida pelos próprios professores de Educação Física para a inclusão de alunos do ensino fundamental com deficiência física. O objetivo foi formulado para analisar a competência percebida pelos professores de Educação Física para a inclusão de alunos do ensino fundamental com deficiência física, em dois municípios da região central de Cuba. Os dados provêm de um questionário respondido por 40 professores de Educação Física de dois municípios da região central de Cuba (divididos em dois grupos de 20). Foram utilizados métodos teóricos como analítico-sintético e indutivo-dedutivo; e empíricos, como entrevistas, observações e pesquisas; do nível matemático e/ou estatístico, a distribuição de frequência empírica. O resultado da pesquisa refletiu a descrição da autopercepção dos professores de ambas as populações, nas três dimensões, com resultados mais favoráveis para o município de Cabaiguán. A autopercepção mais favorável dos professores do município de Cabaiguán, para fazer adaptações específicas, dar instrução aos pares e segurança no processo de inclusão de alunos com deficiência nas aulas de Educação Física.

The study is part of the competence perceived by Physical Education teachers themselves for the inclusion of primary schoolchildren with physical disabilities. The objective was to analyze the competence perceived by Physical Education teachers for the inclusion of primary schoolchildren with physical disabilities, in two municipalities in the central region of Cuba. The data come from a questionnaire completed by 40 Physical Education teachers from two municipalities in the Cuban central region (divided into two groups of 20). Theoretical methods such as the analytical-synthetic and the inductive-deductive were used; as empirical ones the interview, the observation and the survey were used; and from the mathematical and/or statistical level, the empirical frequency distribution was used. The result of the research reflected the description of the self-perception of the teachers of both populations, in the three dimensions, with more favorable results for the municipality of Cabaiguán. The most favorable self-perception of teachers in the municipality of Cabaiguán, to make specific adaptations, issue instruction to equals and security in the process of inclusion of schoolchildren with disabilities in Physical Education class.

Programa del Adulto Mayor y su impacto integral en el municipio Trinidad, periodo 2020-2022 / Elderly Adult Program and its integral impact in Trinidad municipality, period 2020-2022

Fundamento: Con el aumento de la esperanza de vida en Cuba se hace necesario insertar al adulto mayor en la actividad física comunitaria, que es uno de los procesos de funcionamiento del Instituto Nacional de Deportes, Educación Física y Recreación, mediante el Programa del Adulto Mayor para mejorar la calidad de vida de este grupo etario. Objetivo: Determinar los rasgos distintivos que caracterizan el impacto integral del Programa del Adulto Mayor en la calidad de vida de los practicantes del municipio Trinidad en la provincia Sancti Spíritus. Metodología: Se realizó estudio exploratorio que incluyó a 10 directivos y 65 profesores que atienden directamente el Programa del Adulto Mayor en el municipio Trinidad y 64 adultos mayores practicantes sistemáticos; a profesores y directivos se les realizaron entrevistas. Se utilizaron los métodos inductivo-deductivo, análisis de documento, medición y la entrevista. Los métodos estadísticos matemáticos se aplicaron para el procesamiento de los datos, específicamente dentro de la estadística descriptiva se utilizaron tablas de distribución empírica de frecuencias. Resultados: El Programa e Indicaciones metodológicas no ofrecen información relacionada con el impacto integral del mismo, el 100 % de los directivos considera necesario que se investigue en relación con el impacto integral de este Programa, la totalidad de los profesores entrevistados expresaron que solo se evalúa la condición física del adulto mayor. El 80 % de los adultos mayores se sienten satisfechos con su estado de salud y el 98 % consideraron que el Programa mejora su calidad de vida. Conclusiones: Se ofrecen los rasgos distintivos que caracterizan el impacto integral del Programa del Adulto Mayor; las deficiencias detectadas orientan la necesidad de evaluar de forma integral el impacto del mismo en la calidad de vida de los practicantes sistemáticos.

Background: Due to the increase in life expectation in Cuba, it becomes necessary to insert the elderly adults in community physical activity, which is one of National Institute of Sports, Physical Education and Recreation functioning processes, by means of the Elderly Adult Program to improve quality of life in this age group. Objective: To determine the distinguishing features that characterize the integral impact of the Elderly Adult Program on the quality of life of the participants of the Municipality of Trinidad in the Province of Sancti Spiritus. Methodology: An exploratory study was conducted that included 10 managers and 65 teachers who directly attend the Elderly Adult Program in the municipality of Trinidad and 64 systematically practicing elderly adults; interviews were conducted with teachers and managers. Inductive-deductive methods, document analysis, measurement and interview were used. Mathematical-statistical methods were applied to process the data, specifically, within the descriptive statistics, empirical frequency distribution tables were used. Results: The Program and Methodological Indications do not offer information relating to the integral program impact, 100% of the managers consider necessary to investigate the integral impact of the program, most of the teachers interviewed said that only the physical condition of elderly adults is evaluated. The 80% of them are satisfied with their health and 98% believe the program improves their quality of life. Conclusions: The features that characterize the integral impact of the Senior Program are offered; the deficiencies detected suggest the need for a comprehensive evaluation of its impact on the life quality of systematic practitioners.

Confiabilidade teste-reteste de um protocolo de coleta do sinal eletromiográfico do músculo masseter em indivíduos com disfunção temporomandibular / Test-retest reliability of a protocol for recording the electromyographic signal from the masseter muscle on patients with temporomandibular disorders

Introdução: A eletromiografia (EMG) tem sido utilizada para avaliar alterações no sistema mastigatório proporcionada pela disfunção temporomandibular (DTM). Objetivos: Verificar a confiabilidade teste-reteste de um protocolo de coleta do sinal EMG do músculo masseter em indivíduos com DTM. Métodos: Estudo transversal composto por 20 indivíduos com DTM. Os testes foram realizados em duas sessões com 7 dias de intervalo. O sinal EMG foi avaliado pelas variáveis integral (iEMG) e a raiz quadrada da média do sinal (RMS). Resultados: Na análise intradia a confiabilidade para o RMS (ICC2,k: 0.85 a 0.96 ) e iEMG ICC2,k: 0.85 a 0.95) foi excelente, enquanto que a confiabilidade teste/reteste foi pobre para ambas as variáveis RMS (ICC2,1: 0.03 a 0.29) e iEMG (ICC2,1: 0.08 a 0.39). Conclusões: O protocolo de coleta do sinal EMG do músculo masseter em indivíduos com DTM demonstrou que os dados são reprodutíveis somente na mesma sessão de coletas enquanto que, para coletas em dias alternados a confiabilidade foi pobre.

Introduction: Electromyography (EMG) has been used to assess alterations in the masticatory system caused by temporomandybular disorders (TMD). Objectives: The aim of this study was to verify the test-retest reliability of a protocol for recording the EMG signal from masseter muscle in TMD patients. Methods: This is a cross-sectional study comprising 20 individuals with TMD. Tests were performed in two sessions 7 days apart. The EMG signal was evaluated by the variables integral (iEMG) and the root mean square of the signal (RMS). Results: In the intraday analysis the reliability for the RMS (ICC2,k: 0.85 to 0.96) and iEMG (ICC2,k: 0.85 to 0.95) was excellent, while the test/retest reliability was poor for both RMS (ICC2,1: 0.03 to 0.29) and iEMG (ICC2,1: 0.08 to 0.39) variables. Conclusions: The protocol for collecting the EMG signal from the masseter muscle in an individual with TMD demonstrated that the data are reproducible only in the same recording session, whereas for c recording on alternate days, the reliability was poor.

El paisaje lingüístico en los baños de mujeres de la Universidad Nacional de Cuyo, Mendoza - Argentina

R E S U M E N En este artículo se apunta a analizar los (micro)discursos que se encuentran en los baños públicos de la Facultad de Filosofía y Letras de la Universidad Nacional de Cuyo, Mendoza - Argentina Se focalizan las temáticas que se abordan, la clase de diálogos que se establecen y las valoraciones que se ponen de manifiesto. Se trata de una investigación de tipo cualitativo y exploratorio. Se trabaja con un corpus de imágenes recopilado en los baños públicos de la Facultad de Filosofía y Letras de la Universidad Nacional de Cuyo en el mes de junio de 2022.

A B S T R A C T This article aims to describe and interpret the (micro)discourses that are found in the public bathrooms of the Faculty of Philosophy and Letters of the National University of Cuyo. In particular, the focus of this study is in the topics that are addressed, the kind of dialogues that are established and the assessments that are revealed. It is a qualitative and exploratory research. It works with a corpus of images collected in the public bathrooms of the Faculty of Philosophy and Letters of the National University of Cuyo in the month of June 2022.

Este artigo tem como objetivo analisar os (micro)discursos encontrados nos banheiros públicos da Faculdade de Filosofia e Letras da Universidade Nacional de Cuyo. Focalizam-se os temas que são abordados, o tipo de diálogos que se estabelecem e as avaliações que se revelam. Trata-se de uma pesquisa qualitativa e exploratória. O trabalho explora um corpus de imagens coletadas nos banheiros públicos da Faculdade de Filosofia e Letras da Universidade Nacional de Cuyo no mês de junho de 2020.

Juegos tradicionales para niños con discapacidad visual: un conocimiento necesario en educación médica / Traditional games for visually impaired children: a necessary knowledge in medical education

Fundamento: los juegos tradicionales resultan motivantes y de fácil ejecución para los escolares con necesidades educativas especiales porque favorecen la movilidad y orientación espacial de niños con discapacidad visual. Objetivo: proponer un grupo de juegos tradicionales adaptados para mejorar la movilidad y orientación espacial de niños con discapacidad visual en la Escuela Especial "Fructuoso Rodríguez" de Santa Clara, Villa Clara, Cuba. Métodos: se realizó un estudio descriptivo transversal, entre los meses de mayo-septiembre de 2021. Se emplearon métodos teóricos: analítico-sintético, inductivo-deductivo e histórico-lógico; y empíricos: análisis de documentos, observación, cuestionario y entrevista. Resultados: el diagnóstico realizado corroboró que los sujetos estudiados presentaban dificultades en la movilidad y la orientación espacial; desconfianza, inseguridad y pocas iniciativas relacionadas con la recreación en su cotidianeidad familiar, por lo que se adaptaron 10 juegos tradicionales conocidos, pero poco jugados por los niños con discapacidad visual, con el fin de alcanzar otras vías que contribuyan a mejorar su movilidad y orientación espacial, luego de una etapa de confinamiento provocada por la Covid-19. Conclusiones: la propuesta de juegos tradicionales adaptados responde a la necesidad detectada y potencia la recreación e inclusión de estos infantes en actividades escolares y extraescolares después de la pandemia.

Background: traditional games are motivating and easy to play for schoolchildren with special educational needs because they favor the mobility and spatial orientation of visually impaired children. Objective: to propose a group of traditional games adapted to improve the mobility and spatial orientation of visually impaired children at "Fructuoso Rodríguez" Special School in Santa Clara, Villa Clara, Cuba. Methods: a cross-sectional descriptive study was carried out, from May to September 2021. Theoretical methods were used: analytical-synthetic, inductive-deductive and historical-logical; and empirical ones: document analysis, observation, questionnaire and interview. Results: the diagnosis made corroborated that the subjects studied presented difficulties in mobility and spatial orientation; distrust, insecurity and few initiatives related to recreation in their family daily life, for which 10 known traditional games were adapted, but little played by children with visual disabilities, in order to reach other ways that contribute to improving their mobility and orientation space, after a stage of confinement caused by Covid-19. Conclusions: the proposal of adapted traditional games responds to the detected need and enhances the recreation and inclusion of these infants in school and extracurricular activities after the pandemic.

La pedagogía de la inclusión aplicada a la clase de Educación Física / The pedagogy of inclusion applied to the Physical Education class

La pedagogía de la inclusión persigue formar personas desde la perspectiva de su individualidad, teniendo en cuenta su interacción social. Para la escuela cubana es un reto porque requiere cambios en la forma de interactuar, investigar y ofrece oportunidades de aprendizaje considerando la diversidad de necesidades y las diferencias de contextos, como alternativa más viable para proporcionar una respuesta educativa individualizada, comprensiva y diversificada. La Educación Física es una de las materias del currículo que tiene una alta responsabilidad de educar desde la diversidad, pero para ello los docentes deben capacitarse en las exigencias educativas a satisfacer. Los autores proponen algunas acciones metodológicas ya aplicadas a fin de que constituyan experiencias compartidas entre los docentes de la especialidad en sus clases.

The pedagogy of inclusion seeks to train people from the perspective of their individuality, taking into account their social interaction. For the Cuban school it is a challenge because it requires changes in the way of interacting, investigating and offering learning opportunities considering the diversity of needs and the differences in contexts, as a more viable alternative to provide an individualized, comprehensive and diversified educational response. Physical Education is one of the subjects in the curriculum that has a high responsibility to educate from diversity, but for this, teachers must be trained in the educational demands to be met. The authors propose some methodological actions already applied so that they constitute shared experiences among the teachers of the specialty in their classes.

Use and management of disinfectants by dentists in San Luis Potosi, Mexico, during the covid-19 pandemic / Uso y manejo de desinfectantes por odontólogos de San Luis Potosí, México durante la pandemia covid-19

Introduction: Chlorine, ethyl alcohol, and quaternary ammonium are disinfectants with antiviral activity against SARS-Cov2. However, there are no previous reports of their use and handling for cleaning and disinfection in dental offices. Objetive: To determine the use and management of disinfectants in critical and non-critical areas used by dentists in San Luis Potosí, Mexico, during the COVID-19 pandemic. Material and Methods: A validated cross-sectional survey was applied online to 100 dentists in San Luis Potosí between February and June 2021. Participants were informed about the handling of personal data according to the standard DOF regulations (DOF 07-05-2010). Results: A total of 100 dentists were included in the study, 63% female and 37% male, with a mean age of 26 years. The most widely used disinfectants during the pandemic in critical areas were Lysol® and 0.1% sodium hypochlorite in non-critical areas. Eighty-five percent of dentists know the adverse effects of inappropriate use of disinfectants, 72% did not have any sign or symptom associated with the use of disinfectants. The most used protection barrier was gloves (97%). Sixty-seven per cent of dentists disposed of disinfectant waste down the drain. Conclusion: Sodium hypochlorite and quaternary ammonium compounds and/or ethanol are used to clean non-critical and critical areas in dental offices. However, appropriate measures for their management are not adopted. It is necessary to implement educational strategies to improve the use and management of disinfectants in dental practice.

Introducción: Cloro, alcohol etílico y amonio cuaternario son desinfectantes que muestran actividad antiviral contra el SARS-Cov2, sin embargo, no existen reportes previos de su uso y manejo para la limpieza y desinfección en clínicas dentales. Objetivo: Determinar el uso y manejo de los desinfectantes en áreas críticas y no críticas empleados por los odontólogos en San Luis Potosí durante la COVID-19. Material y Métodos: Encuesta transversal validada y aplicada on-line a 100 odontólogos de San Luis Potosí durante febrero-junio 2021. Se informó a los participantes sobre el manejo de datos personales de acuerdo a la norma (DOF 05-07-2010). Resultados: Se incluyeron un total de 100 odontólogos, 63% del sexo femenino y 37% del sexo masculino, con una edad promedio de 26 años. Los desinfectantes más utilizados durante la pandemia en las áreas críticas fueron el Lysol® y el hipoclorito de sodio al 0.1% en áreas no críticas. El 85% de los odontólogos conocen los efectos adversos del uso inadecuado de los desinfectantes, 72% no tuvieron algún signo o síntoma asociado al uso de desinfectantes. La barrera de protección más utilizada fueron los guantes (97%). El 67% de los odontólogos eliminó los desechos de desinfectantes por la coladera. Conclusión: Para la limpieza de las áreas no críticas y críticas en las clínicas dentales se utilizan el hipoclorito de Sodio y compuestos de amonio cuaternario y/o etanol, sin embargo, no se utilizan las medidas adecuadas para su manejo. Es necesario implementar estrategias educativas para mejorar el uso y manejo de desinfectantes en la práctica dental.

Ratio between maximum jaw opening and lateral excursion in brazilians with and without temporomandibular disorder / Razão entre abertura máxima e excursão lateral mandibular em brasileiros com e sem disfunção temporomandibular

Background: Mandibular movements (MM) can offer important information regarding temporomandibular joint health. Objective: Evaluate MM and the ratio between maximum jaw opening and mandibular lateral excursion in Brazilians with and without temporomandibular disorder (TMD). Methods: A cross-sectional study was conducted with 801 individuals between five and 80 years. All individuals answered a screening questionnaire; and MM were measured using digital calipers. The Mann-Whitney test was used to compare the differences between the sexes and groups with and without TMD. The Kruskal-Wallis test was used to determine differences in MM among age groups. Results: MM were smaller in individuals with TMD than in those without TMD. The ratio between jaw opening and lateral excursion was 5.23 in women without TMD and 5.59 in women with TMD. In males, the ratio was 4.75 and 5.52 in individuals without and with TMD, respectively. Conclusion: MM are smaller in Brazilians with TMD, whereas the ratio between jaw opening and lateral excursion is larger.

Introdução: Os movimentos mandibulares (MM) podem oferecer informações importantes sobre a articulação temporomandibular. Objetivo: Avaliar os MM e a relação entre abertura máxima e excursão lateral mandibular em brasileiros com e sem disfunção temporomandibular (DTM). Métodos: Estudo transversal com 801 brasileiros entre cinco e 80 anos. Os indivíduos responderam um questionário de triagem; e os MM foram medidos com paquímetro digital. O teste de Mann-Whitney foi utilizado para comparar diferenças entre sexos e grupos com e sem DTM. O teste de Kruskal-Wallis foi aplicado para determinar diferenças nos MM entre faixas etárias. Resultados: Os MM foram menores nos indivíduos com DTM. A razão entre abertura mandibular e excursão lateral foi de 5,23 em mulheres sem DTM e 5,59 em mulheres com DTM. Nos homens, a proporção foi de 4,75 e 5,52 em indivíduos sem e com DTM, respectivamente. Conclusão: Os MM são menores em brasileiros com DTM, enquanto que a relação entre abertura mandibular e excursão lateral é maior.

Consumo de frutas y verduras en mujeres Jefas de Hogar. Un estudio cualitativo

RESUMEN Introducción: La ingesta de frutas y verduras (FV) es reconocida como un factor protector de la salud cardiovascular y ciertos tipos de cáncer. Objetivo: identificar las opiniones de mujeres chilenas, asociadas al consumo de FV. Métodos: estudio de investigación cualitativa, mediante el empleo del análisis del discurso y la interpretación del lenguaje. La muestra estuvo constituida por 40 mujeres de edades entre los 20 y 65 años, con Nivel Socioeconómico (NSE) medio y medio bajo que participaban en el Programa Mujeres Jefas de Hogar (PMJH) en Chillán. A través de cuatro grupos de discusión se identificaron las opiniones de mujeres en torno a motivaciones, barreras, gastos asociados y conocimientos respecto al consumo de FV. Resultados: Entre las principales motivaciones para el consumo de FV por parte de las mujeres, se encontraron los beneficios para la salud y calidad de vida. Respecto a los obstáculos para no consumir FV, se encontró el costo económico. Las mujeres manifestaron conocer las recomendaciones de consumo, reconociendo el papel del personal de salud. Las mujeres destacaron a los niños como principales consumidores de FV en el hogar. Conclusiones: Las mujeres reconocen la importancia de consumir FV para mantener un óptimo estado de salud, sin embargo, el precio condiciona su consumo

ABSTRACT Introduction: Fruit and vegetable (FV) consumption is a recognized protective factor for cardiovascular health and certain types of cancer. Objective: to identify the opinions of Chilean women associated with the consumption of FV. Methods: Qualitative research study, using discourse analysis and language interpretation. The sample consisted of 40 women aged between 20 and 65 from a medium to low-medium socioeconomic level who participated in the Female Headed Household survey (abbreviation per name in Spanish, PMJH) in Chillán. Through four discussion groups, the opinions of women regarding motivations, barriers, associated costs, and knowledge regarding the consumption of FV were identified. Results: Among the main motivations for the consumption of FV by women were benefits for health and quality of life. Regarding the obstacles to not consuming FV, economic cost was noted; women stated knowing dietary recommendations, recognizing the role of health personnel. Women highlighted children as the main consumers of PV in the home. Conclusions: Women recognized the importance of consuming VF to maintain optimal health, however, price determined consumption

Comportamiento de indicadores psicomotores en niños prescolares vinculados a la atención primaria de salud / Behavior of psychomotor indicators in preschool children linked to primary health care

RESUMEN Fundamento: la atención al desarrollo psicomotor en los niños desde la atención primaria de salud es un aspecto a considerar multidisciplinariamente en aras de garantizar una vida más autónoma e independiente. Objetivo: describir el comportamiento de indicadores psicomotores en niños del área de salud correspondiente al Policlínico Universitario "Roberto Fleites" en Santa Clara, como indicio de competencia motriz. Métodos: se realizó un estudio descriptivo durante el curso 2019-2020 en la Facultad de Cultura Física de la Universidad Central "Marta Abreu" de Las Villas. Se utilizaron métodos teóricos para la fundamentación de la investigación y empíricos; análisis documental, observación y entrevista, así como la triangulación metodológica y la distribución empírica de frecuencia. Resultados: en el comportamiento general de la evaluación de los indicadores estudiados, resultó que los infantes del consultorio médico 19-13 presentaron mejores resultados, al ser evaluados de bien más del 50 % de los indicadores; y el resto, de regular; mientras en los niños y niñas del consultorio médico 19-13, predominaron las categorías de regular y mal de 60 % y 20 % respectivamente. Conclusiones: se describieron los indicadores psicomotores en infantes de la mencionada área de salud, destacando su relación con la competencia motriz. Se enfatiza en la importancia de la investigación desde la atención primaria en función de la promoción y educación de salud desde edades tempranas a través de los programas establecidos a tales efectos por el sistema de salud cubano.

ABSTRACT Background: attention to psychomotor development in children in a multidisciplinary manner from primary health care is an aspect to consider in order to guarantee a more autonomous and independent life. Objective: to describe the behavior of psychomotor indicators in children from the health area corresponding to the "Roberto Fleites" University Polyclinic in Santa Clara, as an indication of motor competence. Methods: a descriptive study was carried out during the 2019-2020 academic year at the Faculty of Physical Culture of Las Villas "Marta Abreu" Central University. Theoretical and empirical methods were used for the foundation of the investigation; documentary analysis, observation and interview, as well sources checking and empirical frequency distribution. Results: in the general behavior of the evaluation of the studied indicators, it turned out that the infants of the medical office 19-13 presented better results, being evaluated as good more than 50% of the indicators; and the rest, average; while in the boys and girls of the doctor's office 19-13, the ranks of average and bad predominated of 60% and 20% respectively. Conclusions: the psychomotor indicators in infants of the aforementioned health area were described, highlighting their relationship with motor skills. Emphasis is placed on the importance of research from primary care in terms of health promotion and education from an early age through the programs established for this purpose by the Cuban health system.

Prevalencia y características de objetores de conciencia a la Ley 21. 030 en instituciones públicas / Prevalence and characteristics of conscientious objectors to Law 21. 030 in public institutions

INTRODUCCIÓN: La Ley 21.030 permite la objeción de conciencia al personal de salud al interior del pabellón y a las instituciones privadas. Ha sido considerada conflicto de intereses no monetario, al anteponer los valores personales, afectando el cumplimiento del deber profesional. OBJETIVOS: Establecer la prevalencia de funcionarios/as objetores/as en los hospitales de la red pública del país y caracterizarles según edad, género y nacionalidad. MÉTODO: Estudio cuantitativo, analítico y transversal. Se utilizaron medidas de tendencia central y dispersión. Para medir la asociación entre variables sociodemográficas, profesión y causal objetada, se utilizaron las pruebas de χ2, exacta de Fisher y de Kruskal-Wallis. RESULTADOS: En 57 hospitales, se observa una mayor frecuencia de objetores en causal 3. En 443 objetores, la mediana de edad fue de 43 años, el 64,8% mujeres y el 87,4% de nacionalidad chilena. En las zonas centro y sur del país se concentra la mayor proporción de hospitales con más del 50% de objetores. CONCLUSIONES: La dificultad para obtener información impide conocer cabalmente la magnitud de la objeción de conciencia. Resulta preocupante la alta prevalencia de objetores, específicamente en la causal violación. La objeción no puede operar como barrera que vulnere los derechos y la dignidad de las mujeres.

INTRODUCTION: Law 21.030 incorporates conscientious objection for health personnel inside the surgical ward and allows its invocation by private institutions. It has been considered a conflict of interest, not monetary, by putting personal values first, affecting the fulfillment of professional duty. OBJECTIVE: To establish the prevalence of objectors in the countrys public network hospitals and characterize them according to age, gender, and nationality. METHOD: Quantitative, analytical, and cross-sectional study. Central and dispersion trend measures were used. For measuring the association between sociodemographic variables, profession and causal objected, test χ2, Fisher exact and Kruskal-Wallis test were used. RESULTS: In 57 hospitals, a higher frequency of objectors were observed in the third causal. In 443 objectors, the median age was 43 years, 64.8% are women, and 87.4% are Chilean. The central and southern areas of the country have the highest proportion of hospitals, with more than 50% objectors. CONCLUSIONS: The difficulty for obtaining the information prevents fully knowing the magnitude of conscientious objection in Chile. The high prevalence of objectors, specifically in the causal violation is worrying. The conscientious objection cannot operate as a barrier that violates the rights and dignity of women.

Propiedades psicométricas de la versión argentina de la Escala Revisada de Ansiedad y Depresión Infantil (RCADS) / Psychometric properties of the Argentinian version of the Revised Children Anxiety and Depression Scale (RCADS)

Resumen El principal objetivo de este estudio fue evaluar la validez y confiabilidad de la Escala Revisada de Ansiedad y Depresión Infantil (RCADS). Específicamente, se analizó la validez de contenido, la validez de constructo y la validez de criterio, además de reportar los índices de confiabilidad. La muestra estuvo conformada por 284 escolares, cuyas edades oscilaban entre 8 y 12 años, residentes de la provincia de Mendoza, Argentina. Se emplearon los siguientes instrumentos: Escala Revisada de Ansiedad y Depresión Infantil, el Cuestionario de Depresión Infantil (CDI), y el Cuestionario de Emociones Positivas (CIEP). Para evaluar la validez de contenido se convocaron a 10 jueces expertos, y se encontró un grado de acuerdo aceptable con respecto a la congruencia de los ítems a los factores evaluados. La validez de constructo fue evaluada comparando modelos alternativos de la RCADS, encontrando índices de ajuste adecuados para un modelo de cinco factores y 25 ítems, así como índices aceptables de confiablidad. Por último, se encontraron correlaciones significativas positivas entre las dimensiones del RCADS con el CDI y correlaciones significativas negativas con los factores del CIEP. Se discuten los resultados en función de los antecedentes, y se señalan limitaciones de la presente investigación.

Abstract The main objective of this study was to evaluate the validity and reliability of the Revised Child Anxiety and Depression Scale (RCADS). Specifically, content validity, construct validity and criterion validity were assessed, in addition to reporting the reliability index. The sample was composed of 284 schoolchildren whose ages ranged from 8 to 12 years. All of them were from the state of Mendoza, Argentina. The following instruments were used: Revised Child Anxiety and Depression Scale, the Child Depression Questionnaire (CDI), and the Positive Emotions Questionnaire (CIEP). To evaluate content validity, 10 expert judges were summoned, and an acceptable degree of agreement was found regarding the congruence of the items to the evaluated factors. The construct validity was evaluated by comparing alternative models of the RCADS, finding adequate fit indices for a model of five factors and 25 items, as well as an acceptable index of reliability. Finally, significant positive correlations were found between the dimensions of the RCADS with the CDI and significant negative correlations with the factors of the CIEP. The results are discussed based on the previous research, and the weakness of this research are pointed out.

Correlation between tactile acuity, pain intensity, and functional capacity in individuals with chronic neck pain

SUMMARY OBJECTIVE: The aim of this study was to verify the correlation between tactile acuity, intensity of pain at rest, and movement and functional capacity in individuals with chronic neck pain. METHODS: This was a cross-sectional study composed of two groups: individuals with chronic neck pain and individuals without neck pain. Evaluations were performed using the Numerical Rating Pain Scale at rest and movement, Neck Disability Index, and two-point discrimination test. RESULTS: The final sample consisted of 100 volunteers, 50 in each group. The groups did not show significant differences (p>0.05) in personal characteristics. It was observed that volunteers with cervical pain presented alterations in tactile care, with a significant and clinical increase in the perceived distance (Median 6.66; 95%CI 6.29-7.02; Cohen's d 7.22; 95%CI 6.15-8.30), and yet, positive, moderate, and significant correlation between two-point discrimination test, intensity of pain at rest and movement, and neck disability index (r=0.778-0.789, p<0.05). CONCLUSION: Tactile acuity is associated with pain intensity at rest and movement and functional capacity in individuals with chronic neck pain.

¿Es necesaria la prueba confirmatoria para COVID-19 prequirúrgica? Experiencia preliminar de un departamento de otorrinolaringología / ¿Is there a really a need for preoperative PCR testing for COVID-19? Preliminary experience of an ENT Department

Introducción: la enfermedad por el nuevo coronavirus de 2019 (COVID-19) ha cambiado la practica quirúrgica. Su aparición en nuestro país ha provocado el aplazamiento masivo de las cirugías electivas. La evidencia actual sobre los desenlaces de las cirugías electivas de otorrinolaringología durante la pandemia de COVID-19 es limitada. Objetivo: describir la experiencia quirúrgica durante la pandemia de COVID-19 en un departamento de otorrinolaringología en Bogotá, Colombia. Métodos: estudio retrospectivo que incluyó las historias clínicas y las descripciones quirúrgicas de los pacientes que fueron llevados a cirugía de otorrinolaringología durante la pandemia de COVID-19 en dos hospitales, entre el 5 de mayo y el 15 de agosto de 2020 en Bogotá, Colombia. Resultados: Se incluyeron 199 pacientes (122 hombres con una mediana de edad de 28 años). Ningún paciente falleció o requirió del ingreso a una unidad de cuidados intensivos (UCI). El 97,5 % de las cirugías fueron electivas. 19,5 % pacientes desarrollaron síntomas relacionados con COVID-19 en el posoperatorio; de los pacientes evaluados, solo uno obtuvo un resultado positivo posquirúrgico para COVID-19 y no desarrolló ninguna complicación. Seis pacientes desarrollaron complicaciones después de la cirugía y uno tuvo neumonía con resultado negativo en la prueba de reacción en cadena de la polimerasa nasofaríngeo (PCR) para COVID-19. Conclusiones: a pesar de la alta exposición a aerosoles durante las cirugías de otorrinolaringología y la alta transmisibilidad del virus, los resultados sugieren que estas cirugías, con el uso apropiado del equipo de protección personal (EPP), y la adecuada selección de los pacientes son seguras para el paciente y para el otorrinolaringólogo.

Introduction: The 2019 novel coronavirus disease (COVID-19) has changed global surgical activity causing massive elective surgery postponement. Current evidence surrounding surgical outcomes after otorhinolaryngological surgical procedures during COVID-19 pandemic is limited. Objective: To describe our surgical experience during COVID-19 outbreak in an otolaryngology department in Bogotá, Colombia. Methods: This retrospective study analysed the records and surgical information of adults and children's patients who underwent an elective or emergency ENT surgery during COVID-19 outbreak at two hospitals between May 5 to August 15, 2020 in Bogotá, Colombia. Results: A total of 199 patients were enrolled (122 males, median age of 28 years). No patients died or required intensive unit care (ICU). Elective surgery represented the 97.5% surgeries. 19.5% patients had COVID-19 related symptoms in the postoperative period, from the tested patients only one obtained a positive COVID-19 polymerase chain reaction (PCR) test result and did not develop any associated respiratory complication. Six patients developed complications after surgery, and one had pneumonia with a negative COVID-19 PCR nasopharyngeal swab result. Conclusions: This study shows that despite the high exposure to droplets during otorhinolaryngologic surgeries and the inherent high transmissibility from the virus, the surgical procedures with correct patient selection and appropriate use of PPE can be safe for both the patient and the otolaryngologist.

Hábitos parafuncionais e sintomatologia de pacientes submetidos a intervenções buco-maxilo-faciais em uma clínica escola de fisioterapia: um estudo retrospectivo de 15 anos / PARAFUNCTIONAL HABITS AND SYMPTOMATOLOGY OF PATIENTS SUBMITTED TO BUCO-MAXILLO-FACIAL INTERVENTIONS IN A PHYSIOTHERAPY SCHOOL CLINIC: A RETROSPECTIVE STUDY OF 15 YEARS

Objetivo: Comparar clinicamente os pacientes com desordens buco-maxilo-faciais (DBMF) atendidos em uma clínica-escola de fisioterapia da cidade de Fortaleza. Materiais e métodos: Dentre 5.357 prontuários, foram coletados os dados de 315 prontuários referentes aos pacientes acometidos por DBMF, dentre eles, 62 homens e 253 mulheres. Resultados: O estudo adotou perfil predominante de pacientes do gênero feminino, solteiros, entre 21 a 30 anos, estudantes, que fizeram uso de relaxante muscular; mulheres sentiram dor irradiada, já homens, dor do tipo fina. Bruxismo/endentações/desgaste dentário foram prevalentes em ambos os sexos e os sintomas que apresentaram diferença estatística entre homens e mulheres foram cervicalgia (p=0,0051), cefaleia (p<0,0001), formigamento de membros superiores (p=0,0371) e dor corporal (p=0,0234). Conclusão: Bruxismo/endentações/desgaste dentário foram os prevalentes em ambos os sexos. Entre os homens, o sintoma mais prevalente foi a dor ou cansaço ao mastigar, já entre as mulheres foi a cefaleia.

Evaluation of mental health and occupational stress in Mexican medical residents / Evaluación de la salud mental y el estrés laboral en médicos residentes mexicanos

Abstract Introduction Since mental health disorders are an emerging problem in medical residents, its detection and attention must be a priority. Objetive To compare the frequency of psychopathology in residents according to sociodemographic and clinical characteristics. Method We conducted a cross-sectional study evaluating the presence of psychopathology, as well as sociodemographic and clinical characteristics in 644 residents through online questionnaires. Results Among participants, 55.7% reported a psychiatric disorder at some point and 29.2% a current one; only 41.5% were under treatment. Additionally, 8.1% had attempted suicide, of which 32.4% attempted it during residency. We found that 6.5% of women and 3.3% of men presented "risk of psychopathology," with a higher percentage of men presenting "severe psychopathology." Individuals with "risk of psychopathology" presented significantly higher scores on all of the questionnaires, compared to those with "absence of psychopathology." Discussion and conclusion Residents with occupational stress also presented higher risks of psychopathology, suicide, and substance use. Being under psychiatric treatment significantly improved the scores on the different scales. Because residency is a period that may increase the probability of suffering psychopathology, interventions should be aimed at reducing occupational stress and bringing specialized care.

Resumen Introducción Dado que los trastornos de salud mental son un problema emergente en los médicos residentes, su detección y atención deben ser una prioridad. Objetivo Comparar la frecuencia de psicopatología en médicos residentes de acuerdo con las características clínicas y sociodemográficas. Método Realizamos un estudio transversal donde evaluamos la presencia de psicopatología, así como características clínicas y sociodemográficas en 644 médicos residentes por medio de cuestionarios en línea. Resultados Entre los participantes, el 55.7% reportó haber tenido un trastorno psiquiátrico en algún momento de su vida y el 29.2% al momento del estudio, de los cuales solo el 41.5% estaba bajo tratamiento psiquiátrico. Asimismo, el 8.1% había intentado suicidarse a lo largo de su vida y el 32.4% lo intentó durante la residencia. Encontramos que el 6.5% de las mujeres y el 3.3% de los hombres presentaban "riesgo de psicopatología", y un mayor porcentaje de hombres presentaron "psicopatología grave". Las personas con "riesgo de psicopatología" contaron con puntuaciones significativamente más altas en todos los cuestionarios, en comparación con los individuos con "ausencia de psicopatología". Discusión y conclusión Los residentes con estrés laboral también presentaron mayor riesgo de psicopatología, suicidio y uso de sustancias. Estar bajo tratamiento psiquiátrico mejoró significativamente los puntajes en las diferentes escalas. Debido a que la residencia es un período que puede aumentar la probabilidad de sufrir psicopatología, las intervenciones deben estar dirigidas a reducir el estrés ocupacional y brindar atención especializada.

Comparación de recidiva posterior a hernioplastía diafragmática con cierre directo versus colocación de parche / Comparison of recurrence after diaphragmatic hernioplasties with direct closure versus patch placement

Resumen Objetivo: Investigar con cuál técnica quirúrgica, cierre directo o con parche de Goretex, las hernias diafragmáticas congénitas operadas tienen más recidiva. Metodología: Los datos de los pacientes sometidos a reparación por hernia diafragmática congénita en el Hospital Nacional de Niños, entre enero 2008 y el 31 diciembre de 2017, fueron revisados retrospectivamente. De los 94 pacientes, solo 59 cumplen con los criterios de inclusión. Para la comparación de las variables cuantitativas se empleó pruebas de T de Student e intervalos de confianza al 95 %; las variables cualitativas se analizaron por la prueba de Fisher con un nivel de significancia de 0,05. Resultados: La mayoría de las hernias diafragmáticas operadas fueron izquierdas (78 %) y posterolaterales (91 %). La técnica de reparación más frecuente utilizada fue el cierre directo (68%). Hubo más recidivas posteriores a cierre con parche de Goretex. Se presentaron entre 1 y 12 meses postoperatorio. No hubo diferencia estadísticamente significativa entre recidivas con técnica de cierre directo versus cierre con parche de Goretex. Conclusión: Realizar un cierre directo del diafragma es una buena opción quirúrgica para reparación de hernia diafragmática congénita. No hubo en este estudio diferencias estadísticamente significativas en cuanto a recidiva entre utilizar técnica con cierre directo o con parche.

Abstract Objective: To investigate with which surgical technique, direct closure or use of a Goretex patch, congenital diaphragmatic hernias recurre more. Methodology: The data of the patients who underwent repair of congenital diaphragmatic hernia at the National Children's Hospital from January 2008 to December 31, 2017, were reviewed retrospectively. Of the 94 patients, only 59 met the inclusion criteria. For the comparison of the quantitative variables, Student's t-test and 95% confidence intervals were used, the qualitative variables were analyzed by the Fisher's test with a significance level of 0.05. Results: Most of the operated diaphragmatic hernias were left 78% and posterolateral 91%. The most frequent repair technique used was direct closure, 68%. There were more recurrences after closing when a Goretex patch was used. They occurred between 1 and 12 months post-operatively. There was no statistically significant difference between recurrences with the direct closure technique versus closure with the Goretexpatch. Conclusion: Performing a direct closure of the diaphragm is a good surgical option for surgical repair of congenital diaphragmatic hernias. There were no statistically significant differences in relapse in this study between using the direct closure or patch technique.

Cresta neural, cuarta hoja, germinativa embrionaria / Neural crest, fourth embryonary germinative leaf

RESUMEN Las células de la cresta neural son pluripotenciales y son llamadas la cuarta hoja germinativa del embrión. Con el objetivo de estructurar los referentes teóricos actualizados que sustenten la afirmación precedente y que constituirá material de estudio para los estudiantes de las Ciencias Médicas, se realizó la revisión de 28 referencias bibliográficas, de ellas 89% actualizadas. Estas células aparecen durante la neurulación y pasado este proceso transitan de epitelial a mesenquimatosa; migran siguiendo señales de la matriz extracelular a todo el cuerpo del embrión diferenciándose en tejidos disimiles. Muy vinculados en su evolución a mecanismos epigenéticos, hacen a esta población celular vulnerables a ser dañadas invocándose en la etiología de diferentes defectos congénitos y enfermedades crónicas no trasmisibles como cáncer. Como conclusión por su pluripotencialidad y por los mecanismos moleculares que distinguen su evolución son consideradas por muchos autores la cuarta hoja germinativa del embrión (AU).

SUMMARY Neural crest cells are pluripotentials, and are called the fourth germinative leaf of the embryo. With the objective of structuring the updated theoretical referents backing up the precedent affirmation that will be study material for the students of Medical Sciences, the authors reviewed 28 bibliographic references, 89 % of them updated. These cells appear during neurulation and after this process they transit from epithelial to mesenchymal; following extracellular matrix signals, they migrate to the whole embryo body differentiating themselves in dissimilar tissues. Tightly related in their evolution to epigenetic mechanisms, this cell population is very likely to be damaged and so they are invoked in the etiology of different congenital defects and noncommunicable chronic diseases like cancer. In conclusion, due to their pluripotentiality and the molecular mechanisms distinguishing their evolution, many authors consider them the embryo´s fourth germinative leaf (AU).

Aspectos cognitivos y legales en personas mayores: "Sano Juicio"

In Chile, 7.1% of people aged over 60 years have some type of cognitive disorder. The frequency of the latter increases to 13% in people between 75-79 years and 36.2% in people over 85 years. The concept of mild cognitive impairment (MCI) and dementia have evolved over time. The 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) uses the term minor and major neurocognitive disorder, replacing the DCL and dementia respectively. Major cognitive disorder impairs functional performance while minor disorders does not. There is an arbitrary discrimination against the elderly. A form of discrimination is the request made by some notaries of a medical certification of the cognitive function for older people willing to carry out a legal procedure. This request has the sole effect of pre-establishing evidence in favor of the notary and not protecting the testator or the vulnerable person. Assessing the ability of older people to care for themselves and their possessions has important implications for them and their families, since there is a serious risk of prejudice when someone is declared as disabled. Thus, considering the epidemiology of cognitive disorders in our country we propose a series of legal and medical discussion points aimed to protect autonomy and to protect individuals and their possessions when they have difficulties to control their decisions.