Plomo y mercurio en personas víctimas del conflicto armado en Bojayá, Chocó: estudio descriptivo / Lead and mercury in victims of the armed conflict in Bojayá, Chocó: a descriptive study / Chumbo e mercúrio em vítimas do conflito armado em Bojayá, Chocó: um estudo descritivo

Introducción: En los contextos del conflicto armado convergen actividades que potencialmente pueden producir toxicidad por metales pesados; inclusive, muchas víctimas de artefactos explosivos improvisados portan esquirlas residuales interiorizadas, de composición y potencial toxicidad desconocidas. Ello ha sido poco estudiado. Objetivo: Describir los niveles biológicos de plomo y mercurio en civiles supervivientes de la masacre de Bojayá, su eventual exposición actual, así como signos y síntomas compatibles con toxicidad crónica. Metodología: Estudio observacional descriptivo, tipo serie con 13 casos. Resultados: El 38.46 % de los casos tuvo niveles de plomo en sangre superiores o cercanos al valor límite superior, sin fuentes específicas identificadas. Un 46.15 % tuvo niveles mercuriales superiores o cercanos al límite de referencia, y se los considera exposición ambiental por minería aurífera regional. La valoración clínica toxicológica mostró síntomas y signos clínicos potencialmente asociados con toxicidad crónica por metales. Conclusión: Hubo presencia de residuos de artefactos explosivos en personas con hallazgos sugestivos de toxicidad por plomo o mercurio, sin que pueda afirmarse una relación directa y específica entre los dos aspectos; algunos casos sugieren exposición ambiental para mercurio, y exposición a proyectiles para el plomo, relacionadas con dinámicas del conflicto armado. Son necesarios estudios adicionales para afirmar la existencia de asociaciones causales.

Introduction: In the contexts of armed conflict, activities converge that can potentially produce heavy metal toxicity; including many victims of improvised explosive devices carry internalised residual shrapnel, of unknown composition and potential toxicity. This has been little studied. Objective: To describe the biological levels of lead and mercury in civilian survivors of the Bojayá massacre, their possible current exposure, as well as signs and symptoms compatible with chronic toxicity. Methodology: Descriptive observational study, serial type with 13 cases. Results: 38.46 % of the cases had blood lead levels above or close to the upper limit value, with no specific sources identified. 46.15 % had mercury levels above or close to the reference limit, and were considered environmental exposure from regional gold mining. Clinical toxicological assessment showed clinical signs and symptoms potentially associated with chronic metal toxicity. Conclusion: There was a presence of explosive ordnance residues in individuals with findings suggestive of lead or mercury toxicity, without a direct and specific relationship between the two; some cases suggest environmental exposure for mercury, and projectile exposure for lead, related to the dynamics of the armed conflict. Further studies are needed to affirm the existence of causal associations.

Introdução: Nos contextos de conflito armado, convergem atividades que podem potencialmente produzir toxicidade por metais pesados; Na verdade, muitas vítimas de dispositivos explosivos improvisados carregam lascas residuais internalizadas de composição desconhecida e potencial toxicidade. Isto tem sido pouco estudado. Objetivo: Descrever os níveis biológicos de chumbo e mercúrio em civis sobreviventes do massacre de Bojayá, sua eventual exposição atual, bem como sinais e sintomas compatíveis com toxicidade crônica. Metodologia: Estudo observacional descritivo, tipo série com 13 casos. Resultados: 38.46 % dos casos apresentaram níveis de chumbo no sangue superiores ou próximos ao valor limite superior, sem fontes específicas identificadas. 46.15 % apresentaram níveis de mercúrio superiores ou próximos ao limite de referência e são considerados exposição ambiental devido à mineração regional de ouro. A avaliação clínica toxicológica mostrou sintomas e sinais clínicos potencialmente associados à toxicidade crônica por metais. Conclusão: Houve presença de resíduos de artefatos explosivos em pessoas com achados sugestivos de toxicidade por chumbo ou mercúrio, sem que se pudesse afirmar uma relação direta e específica entre os dois aspectos; Alguns casos sugerem exposição ambiental ao mercúrio e exposição a projéteis de chumbo, relacionadas com a dinâmica do conflito armado. Estudos adicionais são necessários para confirmar a existência de associações causais.

Translation and cultural adaptation of the Positive Aspects of Caregiving Scale for caregivers of people living with dementia in Brazilian context: a methodological study

ABSTRACT BACKGROUND: The Positive Aspects of Caregiving (PAC) scale is used to assess psychosocial benefits provided to caregivers by the task of caring. The PAC scale consists of nine items, assessed using a five-point Likert scale, with higher values indicating greater positive perceptions and gains from the caregiving experience. OBJECTIVE: To translate and culturally adapt the PAC scale for informal Brazilian caregivers of people with dementia. DESIGN AND SETTING: A methodological study was conducted at the Federal University of São Carlos. METHODS: The following stages were carried out: Translation; Synthesis of the translations; Back-translation; Evaluation by an experts' committee; and Pre-test. RESULTS: Two independent professionals translated the PAC scale. The consensus version was obtained by merging both translations, which were back-translated into English by a third translator. The expert committee comprised three specialists in the area and project researchers. All scale items presented a Content Validity Index of 1 (CVI = 1.0), and thus remained in the pre-final version of the instrument. The instrument was pre-tested with seven caregivers of people with dementia, the majority of whom were women (57.1%), with a degree of kinship corresponding to sons/daughters (57.1%) and an average age of 55.2 (± 4.1) years. The caregivers considered it clear and understandable and made no suggestions for changes. CONCLUSION: The PAC scale was translated and culturally adapted for use by informal caregivers of people with dementia in Brazil. However, a psychometric analysis of the instrument is necessary to provide normative data for this population group.

Chronic pain among older adults and its impact on satisfaction with social participation: development and validation of the "Instrument to Assess Older Adults' Social Participation". A descriptive quantitative study

ABSTRACT BACKGROUND: We aimed to develop and validate a practical instrument to assess older adults' satisfaction with their social participation (SP). DESIGN AND SETTING: This methodological validation study was conducted at a public higher education institution. METHODS: A two-phase study was designed, developed, and validated to assess older adults' satisfaction with their SP. In the first phase, we conceptualized SP and developed an "instrument to assess older adults' satisfaction with their SP (IAPSI)," as approved by a committee of specialists, pre-tested, and partially validated. Second, we determined the IAPSI's reproducibility using Cronbach's alpha to measure internal consistency, Pearson's and Spearman's coefficients to measure correlations, the Bland-Altman plot and intraclass correlation coefficient (ICC) to measure reproducibility. We also generated a receiver operating characteristic (ROC) curve. RESULTS: 102 older adults (mean age, 87.29) participated in the first phase. Moderate internal consistency (Cronbach's alpha 0.7) and significant moderate correlations with quality of life by World Health Organization Quality of Life (WHOQOL)-bref and by WHOQOL-old social domains (Pearson's coefficients 0.54 and 0.64, respectively; P < 0.001) were found. The ROC curve indicated an IAPSI score of 17 as the threshold for the impact of pain on satisfaction with SP (83.3% sensitivity and 88.9% specificity, P < 0.001). In the second phase, 56 older adults (between 81 and 90 years old) participated. We found adequate intra- and inter-observer reproducibility for the IAPSI (ICC 0.96 and 0.78, respectively). CONCLUSION: We have developed a practical instrument with appropriate psychometric properties to assess older adults' satisfaction with their SP.

Determinantes sociais de saúde de crianças em consulta de puericultura: das condições socioeconômicas aos aspectos relacionados à saúde bucal / Social determinants of health of children in child care consultation: from socioeconomic conditions to aspects related to oral health / Determinantes sociales de la salud de los niños en la consulta infantil: de las condiciones socioeconómicas a los aspectos relacionados con la salud bucal

A imaturidade do sistema imunológico, associado a Determinantes Sociais de Saúde (DSS), promove doenças na infância. Especificamente, na cavidade oral, os DSS, representados pelo consumo elevado de açúcar, limitado acesso aos serviços de saúde e deficiência na higiene bucal, favorecem transtornos locais e sistêmicos. Assim, o estudo objetivou associar os DSS, no contexto das condições socioeconômicas, do acompanhamento pelo serviço de saúde e dos aspectos relacionados à saúde bucal de crianças atendidas em Unidades Básicas de Saúde (UBS) de um município cearense. Trata-se de estudo observacional, analítico, transversal e de abordagem quantitativa, conduzido com crianças e suas mães em Acarape - CE. Após consentimento, essas preencheram um questionário. Os dados foram analisados. Das 70 mães, 87,14% e 90,00% tinham idade inferior ou igual a 30 anos e renda de até um salário mínimo, respectivamente. Das 70 crianças, 87,14% tinham seus dentes/gengiva higienizados por seus pais ou responsável. Do total, 94,29% nunca se submeteram a atendimento odontológico. Observou-se associação significativa entre a mãe ter escolaridade superior ao ensino fundamental incompleto e higienizar os dentes/gengiva do filho com escova dental e dentifrício. Constatou-se associação significativa entre a criança ingerir bolacha doce/recheada, não consumir refrigerante e usar escova dental e dentifrício na higienização oral. Conclui-se que as crianças eram acompanhadas nas UBS regularmente; no entanto, esse serviço não esteve relacionado ao atendimento odontológico. Apesar da ausência desse tipo de acompanhamento e do consumo de alimentos cariogênicos, as mães se preocupavam com a saúde bucal das crianças, higienizando a cavidade oral diariamente, com meios adequados.

The immaturity of the immune system, associated with Social Determi- nants of Health (SDH), promotes diseases in childhood. Specifically, in the oral cavity, SDH, represented by high sugar consumption, limited access to health services, and poor oral hygiene, favors local and systemic disorders. Thus, the study aimed to associate the SDH, in the context of socioeconomic conditions, monitoring by the health service and aspects related to children's oral health assisted in Basic Health Units (BHU) of a muni- cipality in Ceará. This is an observational, analytical, cross-sectional study with a quan- titative approach conducted with children and their mothers in Acarape - CE. After con- sent, they filled out a questionnaire. Data were analyzed. Of the 70 mothers, 87.14% and 90.00% were aged less than or equal to 30 years and had income up to one minimum wage, respectively. Of the 70 children, 87.14% had their teeth/gums cleaned by their pa- rents or guardian. Of the total, 94.29% never underwent dental care. There was a signifi- cant association between the mother having higher education than incomplete elementary school and cleaning the child's teeth/gums with a toothbrush and toothpaste. A significant association was found between the child eating sweet/stuffed biscuits, not consuming soft drink, and using a toothbrush and dentifrice for oral hygiene. It is concluded that the chil- dren were regularly monitored at the BHU; however, this service was not related to dental care. Despite the absence of this type of follow-up and the consumption of cariogenic foods, the mothers were concerned about their children's oral health, cleaning the oral cavity daily with adequate means.

La inmadurez del sistema inmunológico, asociada a los Determinantes So- ciales de la Salud (DSS), promueve enfermedades en la infancia. Específicamente, en la cavidad bucal, los DSS, representados por el alto consumo de azúcar, el acceso limitado a los servicios de salud y la mala higiene bucal, favorecen los trastornos locales y sisté- micos. Así, el estudio tuvo como objetivo asociar el DSS, en el contexto de las condicio- nes socioeconómicas, el seguimiento por el servicio de salud y los aspectos relacionados con la salud bucal de los niños atendidos en las Unidades Básicas de Salud (UBS) de un municipio de Ceará. Se trata de un estudio observacional, analítico, transversal con enfo- que cuantitativo, realizado con niños y sus madres en Acarape ­ CE. Después del consen- timiento, completaron un cuestionario. Los datos fueron analizados. De las 70 madres, 87,14% y 90,00% tenían edad menor o igual a 30 años e ingresos hasta un salario mínimo, respectivamente. De los 70 niños, al 87,14% se les limpió los dientes/encías por sus pa- dres o tutores. Del total, el 94,29% nunca realizó atención odontológica. Hubo una aso- ciación significativa entre la madre con educación superior a la primaria incompleta y la limpieza de los dientes/encías del niño con cepillo y pasta dental. Se encontró una asoci- ación significativa entre el niño que come galletas dulces/rellenas, no consume gaseosas y usa cepillo de dientes y dentífrico para la higiene bucal. Se concluyó que los niños eran monitoreados periódicamente en la UBS; sin embargo, este servicio no estaba relacionado con el cuidado dental. A pesar de la ausencia de este tipo de seguimiento y del consumo de alimentos cariogénicos, las madres se preocupan por la salud bucal de sus hijos, reali- zando la limpieza de la cavidad bucal diariamente, con medios adecuados.

Associação entre capital social e padrões alimentares em mulheres do Sul do Brasil / Association between social capital and food patterns in women from Southern Brazil

Resumo O presente estudo objetivou verificar a associação entre aspectos psicossociais (capital social) e padrões alimentares em mulheres adultas. Realizou-se um estudo transversal, de base populacional, com uma amostra representativa de 1.128 mulheres, de 20 a 69 anos de idade, residentes na área urbana do município de São Leopoldo, Rio Grande do Sul, em 2015. Os padrões alimentares foram identificados com base na frequência de consumo alimentar e classificados em: saudável (frutas, vegetais e alimentos integrais), de risco (alimentos ultraprocessados) e brasileiro (arroz e feijão), enquanto o capital social foi avaliado por meio de uma escala de eficácia coletiva. Observou-se que 18,9% da amostra foi classificada com alta eficácia coletiva. Após ajuste para potenciais fatores de confusão, observou-se uma probabilidade 44% maior para adesão ao padrão saudável (RP [razão de prevalência] = 1,44; IC95% [intervalo de confiança de 95%]: 1,01-2,03; p = 0,040) e 71% maior para o padrão brasileiro (RP = 1,71; IC95%: 1,18-2,47; p = 0,004) entre as mulheres com um maior nível de eficácia coletiva, quando comparadas às com baixo nível de eficácia coletiva. Assim, este estudo verificou uma relação significativa entre aspectos psicossociais e consumo alimentar em mulheres.

Abstract The present study aimed to verify the association between psychosocial aspects (social capital) and food patterns in adult women. A cross-sectional, population-based study was conducted with a representative sample of 1,128 women, aged 20 to 69 years, living in the urban area of the municipality of São Leopoldo, Rio Grande do Sul, Brazil, in 2015. The food patterns were identified based on the frequency of food intake and classified as: healthy (fruits, vegetables, and whole foods), at-risk (ultraprocessed foods), and Brazilian (rice and beans), while social capital was evaluated using a collective efficacy scale. It was observed that 18.9% of the sample was classified with high collective efficacy. After adjusting for potential confounding factors, a 44% higher probability was observed for adherence to the healthy pattern (PR [prevalence ratio] = 1.44; 95%CI [95% confidence interval]: 1.01-2.03; p = 0.040) and 71% higher for the Brazilian pattern (PR = 1.71; 95%CI: 1.18-2.47; p= 0.004) among women with a higher level of collective efficacy, when compared to those with a low level of collective efficacy. Thus, this study verified a significant relationship between psychosocial aspects and food intake in women.

Psychosocial aspects related to fruit and vegetable consumption in adolescents / Aspectos psicossociais relacionados ao consumo de frutas e hortaliças em adolescentes

Abstract This study aimed at assessing the association between psychosocial aspects and fruit and vegetable consumption in adolescents. Cross-sectional study developed with 327 adolescents from a public school in Brazil. A questionnaire developed for adolescents was applied to assess the influence of self-efficacy, family, peers, and body image on the consumption of fruits and vegetables. Specific questions assessed the intake frequency of fruits and vegetables, and the mean consumption was estimated using two 24-hour recalls. Scores related to psychosocial aspects were described as mean and median and the weight status was classified based on the body mass index. The average daily consumption of fruits and vegetables was 36.2 g and 45.4 g, respectively. Self-efficacy and the influence of peers were associated with an increase in the amount and frequency of fruits and vegetables consumption. Adolescents with higher scores of self-efficacy had greater average consumption of fruits and vegetables when compared to those with lower scores. The same was observed for the influence of peers. Self-efficacy and the influence of peers were the factors that most influenced the consumption of fruits and vegetables in adolescents.

Resumo O objetivo do estudo foi avaliar a associação entre aspectos psicossociais e o consumo de frutas e hortaliças em adolescentes. Estudo transversal desenvolvido com 327 adolescentes de uma escola pública do Brasil. Um questionário desenvolvido para adolescentes foi aplicado para avaliar a influência da autoeficácia, família, pares e imagem corporal sobre o consumo de frutas e hortaliças. Questões específicas avaliaram a frequência de ingestão de frutas e hortaliças e o consumo foi estimado por meio de dois recordatórios de 24 horas. Os escores relacionados aos aspectos psicossociais foram descritos por média e mediana e a condição de peso foi classificada com base no índice de massa corporal. O consumo diário médio de frutas e hortaliças foi de 36,2 g e 45,4 g, respectivamente. A autoeficácia e a influência dos pares associaram-se ao aumento da quantidade e da frequência de consumo de frutas e hortaliças. Os adolescentes com maiores valores no escore para autoeficácia apresentaram maior média de consumo de frutas e hortaliças quando comparados àqueles com menores escores. O mesmo foi observado para a influência dos pares. A autoeficácia e a influência dos pares foram os fatores que mais influenciaram o consumo de frutas e hortaliças em adolescentes.

Relação entre aspectos psicossomáticos e psoríase / Relationship between psychosomatic aspects and psoriasis / Relación entre aspectos psicosomáticos y psoriasis

Psoríase é uma dermatose de caráter inflamatório ligado a diversas composições do ser, sendo estas a genética, o sistema imune, o ambiente e o estado mental do paciente, apresentando evidências de ser um quadro clínico multifacetado. A composição da medicina psicossomática empenha-se na relação mental e emocional e do corpo, sendo importante mostrar a relação desta com a psoríase. Por isso, busca-se avaliar as evidências disponíveis na literatura sobre a relação entre a psoríase e os aspectos psicossomáticos. Foi realizado uma a revisão de literatura, por meio de seleção de artigos das base de dados Medical Literature Analysis and Retrieval System Online (PubMed/Medline), biblioteca virtual em saúde Scientific Electronic Library Online (SciElo), UpToDate e Google acadêmico. A busca por artigos científicos resultou em 20 artigos selecionados. Foi possível concluir, que há estudos fundamentados correlacionando a medicina psicossomática e a psoríase, além de que diversos fatores que afetam a homeostase corporal, provocam alterações nervosas, e consequentemente afetam as células da pele. Além disso, foi encontrado evidências que a estigmatização que os pacientes sofrem influenciam no aumento da gravidade da doença, sendo necessário a realização de um tratamento psico cognitivo-comportamental juntamente com o tratamento dos sinais e sintomas gerais da doença. Desta forma, o presente trabalho pôde olhar para a patologia com um olhar ampliado relacionado ao aspecto mental e emocional o que promove melhor compreensão e as consequências disto são a maior capacidade de intervenção sobre a psoríase.

Psoriasis is an inflammatory dermatosis linked to several compositions of the being, which are genetics, the immune system, the environment and the patient's mental state, that is, it shows evidence of being a multifaceted clinical picture. Since the composition of psychosomatic medicine is committed to the relationship between the mental, emotional, and body, it is important to show its relationship with psoriasis. Therefore, we sought to evaluate the available evidence in the literature on the relationship between psoriasis and psychosomatic aspects. A literature review was conducted by selecting articles from the Medical Literature Analysis and Retrieval System Online (PubMed/Medline), Scientific Electronic Library Online (SciElo), UpToDate and Google Scholar databases. The search for scientific articles resulted in 20 selected articles. It was possible to conclude that there are well-founded studies correlating psychosomatic medicine and psoriasis, and that several factors that affect the body's homeostasis cause nervous alterations, and consequently affect the skin cells. Moreover, it was found evidence that the stigmatization that patients suffer influences the increase of the severity of the disease, being necessary the realization of a psycho cognitive-behavioral treatment along with the treatment of the general signs and symptoms of the disease. Thus, the present work could look at the pathology with a broader view related to the mental and emotional aspect, which promotes better understanding and the consequences of this are a greater ability to intervene on psoriasis.

La psoriasis es una dermatosis inflamatoria vinculada a varias composiciones del ser, que son la genética, el sistema inmunitario, el medio ambiente y el estado mental del paciente, es decir, muestra evidencias de ser un cuadro clínico multifacético. Dado que la composición de la medicina psicosomática está comprometida con la relación entre lo mental, lo emocional y el cuerpo, es importante mostrar su relación con la psoriasis. Por lo tanto, se buscó evaluar la evidencia disponible en la literatura sobre la relación entre la psoriasis y los aspectos psicosomáticos. Se realizó una revisión bibliográfica seleccionando artículos de las bases de datos Medical Literature Analysis and Retrieval System Online (PubMed/Medline), Scientific Electronic Library Online (SciElo), UpToDate y Google Scholar. La búsqueda de artículos científicos dio como resultado 20 artículos seleccionados. Se pudo concluir que existen estudios bien fundamentados que correlacionan la medicina psicosomática y la psoriasis, y que diversos factores que afectan a la homeostasis del organismo provocan alteraciones nerviosas y, en consecuencia, afectan a las células de la piel. Además, se encontraron evidencias de que la estigmatización que sufren los pacientes influye en el aumento de la gravedad de la enfermedad, siendo necesaria la realización de un tratamiento psico cognitivo- conductual junto con el tratamiento de los signos y síntomas generales de la enfermedad. Así, el presente trabajo pudo contemplar la patología con una visión más amplia relacionada con el aspecto mental y emocional, lo que favorece una mejor comprensión y las consecuencias de ello son una mayor capacidad de intervención sobre la psoriasis.

Bartonelose: doença de importância para a saúde pública envolvendo a tríade homem-ambiente-animal / Bartonellosis: disease of importance for public health involving the man-environment-animal triad / Bartonelosis: enfermedad de importancia para la salud pública que involucra la triada hombre-ambiente-animal

A relação hospedeiro-parasita é caracterizada como uma interação alelobiótica construída por meio de processos evolutivo-adaptativos com hospedeiros assintomáticos. No ambiente silvestre é notório o equilíbrio desta relação, porém quando há intervenção antropogênica um ciclo enzoótico pode se estabelecer proporcionando o surgimento de enfermidades emergentes ou reemergentes. Dentre estes agentes etiológicos, a Bartonella spp. é um bacilo gram-negativo da classe Proteobacteria que apresentam tropismo por eritrócitos e células endoteliais, com infecção já descrita em animais das Ordens: Rodentia, Lagomorpha, Carnivora, Artiodactyla, Eulipotyphla e Chiroptera. A infecção pela bactéria pode estar associada à linfadenite, endocardite, angiomatose bacilar e peliose hepática em humanos. Treze espécies de Bartonella spp. são tidas como zoonóticas. O objetivo desta revisão está em apontar para a comunidade científica a bartonelose como uma doença de notificação obrigatória, assim como, os possíveis hospedeiros em animais domésticos e silvestres e sua etiopatogenia.(AU)

The host-parasite relationship is characterized as an allelobiotic interaction built through evolutionary-adaptive processes with asymptomatic hosts. In the wild environment, the balance of this relationship is notorious, but when there is anthropogenic intervention, an enzootic cycle can be established, providing the emergence of emerging or reemerging diseases. Among these etiologic agents, Bartonella spp. is a gram-negative bacillus of the Proteobacteria class that presents tropism for erythrocytes and endothelial cells, with infection already described in animals of the Orders: Rodentia, Lagomorpha, Carnivora, Artiodactyla, Eulipotyphla and Chiroptera. Infection by the bacterium may be associated with lymphadenitis, endocarditis, bacillary angiomatosis and peliosis hepatica in humans. Thirteen species of Bartonella spp. are considered zoonotic. The objective of this review is to point out to the scientific community bartonellosis as a notifiable disease, as well as the possible hosts in domestic and wild animals and their etiopathogenesis.(AU)

La relación hospedador-parásito se caracteriza por ser una interacción alelobiótica construida mediante procesos evolutivo-adaptativos con hospedadores asintomáticos. En el medio silvestre, el equilibrio de esta relación es notorio, pero cuando hay intervención antropogénica, puede establecerse un ciclo enzoótico, propiciando la aparición de enfermedades emergentes o reemergentes. Entre estos agentes etiológicos, Bartonella spp. es un bacilo gramnegativo de la clase Proteobacteria que presenta tropismo por eritrocitos y células endoteliales, con infección ya descrita en animales de los Órdenes: Rodentia, Lagomorpha, Carnivora, Artiodactyla, Eulipotyphla y Chiroptera. La infección por la bacteria puede estar asociada a linfadenitis, endocarditis, angiomatosis bacilar y peliosis hepática en humanos. Trece especies de Bartonella spp. se consideran zoonóticas. El objetivo de esta revisión es señalar a la comunidad científica la bartonelosis como enfermedad de declaración obligatoria, así como los posibles hospedadores en animales domésticos y salvajes y su etiopatogenia.(AU)

Clinical ethnographic narrative interview about the experience of women discharged from the prison system / Entrevista narrativa clínica etnográfica sobre la experiencia de mujeres salidas del sistema penitenciario / Entrevista narrativa etnográfica clínica sobre a experiência de mulheres egressas do sistema prisional

ABSTRACT Objectives to analyze the perception of women discharged from the prison system about the main stressors that marked their life trajectories and to discuss the feasibility of the Clinical Ethnographic Narrative Interview technique to facilitate the narrative of this group. Method narrative research developed in a social protection center in the interior of São Paulo. Data were collected in 2021 (January and February) using the Clinical Ethnographic Narrative Interview technique, which intersperses narratives and visual aids. The synergy between the concepts of vulnerability and stress was adopted as a theoretical framework, and content analysis was performed. The discussion of viability was based on the criteria of acceptability and expansion. Results The narratives addressed psychosocial difficulties prior to incarceration and the hostile environment of the overcrowded prison as a place of conflict and abuse of power. Family helplessness, estrangement from children, negative emotions, somatic symptoms and traumas were mentioned as consequences of seclusion. The participants also reported coping processes with words that referred to the ideas of overcoming, hope, new beginning and gratitude. It is understood that this high point of the narratives may reflect the potential of the interview technique and corroborates its adequacy. Conclusion The undoubted painful character of the narratives about the different adversities experienced, especially as a result of seclusion, was also permeated by aspects that denoted resilient processes. The adoption of this interview technique made data collection more sensitive, welcoming and timely to expand the repertoire of words in the expression of feelings and revisit painful experiences, envisioning positive possibilities for the future.

RESUMEN Objetivos analizar la percepción de mujeres egresadas del sistema penitenciario sobre los principales estresores que marcaron sus trayectorias de vida y discutir la viabilidad de la técnica de Entrevista Narrativa Etnográfica Clínica para facilitar la narrativa de este grupo. Método investigación narrativa desarrollada en un dispositivo de protección social del interior de São Paulo. Los datos fueron recolectados en 2021 (enero y febrero) utilizando la técnica de Entrevista Narrativa Etnográfica Clínica, que intercala narrativas y ayudas visuales. Se adoptó como marco teórico la sinergia entre los conceptos de vulnerabilidad y estrés y se realizó un análisis de contenido. La discusión de viabilidad se basó en los criterios de aceptabilidad y expansión Resultados Las narrativas abordaron las dificultades psicosociales previas al encarcelamiento y el ambiente hostil de la prisión superpoblada como locus de conflicto y abuso de poder. Se mencionaron como consecuencias de la reclusión el desamparo familiar, el alejamiento de los hijos, las emociones negativas, los síntomas somáticos y los traumas. Los participantes también relataron procesos de afrontamiento con palabras que hacían referencia a las ideas de superación, esperanza, nuevo comienzo y gratitud. Se entiende que este punto alto de las narraciones puede reflejar el potencial de la técnica de la entrevista y corrobora su adecuación. Conclusión El indudable carácter doloroso de las narrativas sobre las diferentes adversidades vividas, especialmente a raíz del encierro, también estuvo permeado por aspectos que denotaban procesos resilientes. La adopción de esta técnica de entrevista hizo que la recolección de datos fuera más sensible, acogedora y oportuna para ampliar el repertorio de palabras en la expresión de sentimientos y revivir experiencias dolorosas, vislumbrando posibilidades positivas para el futuro.

RESUMO Objetivos analisar a percepção de mulheres egressas do sistema prisional sobre os principais estressores que marcaram suas trajetórias de vida e discutir a viabilidade da técnica Entrevista Narrativa Etnográfica Clínica para facilitar a narrativa desse grupo. Método pesquisa narrativa desenvolvida em um dispositivo de proteção social do interior de São Paulo. Os dados foram coletados em 2021 (janeiro e fevereiro) utilizando a técnica Entrevista Narrativa Etnográfica Clínica, que intercala narrativas e recursos visuais. A sinergia entre os conceitos de vulnerabilidade e estresse foi adotada como referencial teórico, tendo sido realizada a análise de conteúdo. A discussão da viabilidade foi pautada nos critérios aceitabilidade e expansão. Resultados As narrativas abordaram dificuldades psicossociais pregressas ao encarceramento e o ambiente hostil do cárcere superlotado como lócus de conflitos e abuso de poder. Desamparo familiar, distanciamento dos filhos, emoções negativas, sintomas somáticos e traumas foram mencionados como consequências da reclusão. As participantes também relataram processos de enfrentamento com palavras que remetiam às ideias de superação, esperança, recomeço e gratidão. Entende-se que esse ponto alto das narrativas pode ter reflexos do potencial da técnica de entrevista e corrobora a sua adequação. Conclusão O indubitável caráter doloroso das narrativas sobre as diferentes adversidades vivenciadas, sobretudo em decorrência da reclusão, também foi perpassado por aspectos que denotaram processos resilientes. A adoção da referida técnica de entrevista tornou a coleta de dados mais sensível, acolhedora e oportuna para ampliar o repertório de palavras na expressão dos sentimentos e revisitação de experiências dolorosas, vislumbrando possibilidades positivas para o futuro.

Dance therapy and free dance with a focus on the psychological aspects of patients in adjuvant treatment of breast cancer - study protocol for randomized clinical trial

Abstract Aim: To propose a dance therapy and free dance protocol for women undergoing adjuvant treatment of breast cancer and to compare its effectiveness with the control group and the healthy group. Method: Protocol for a 12-week randomized clinical trial with a frequency of 2 times at progressive intensity, in which the participants will be allocated into 4 groups: (a) dance therapy intervention; (b) free dance intervention; (c) control group and (d) healthy group. Information related to personal and clinical characteristics as well as psychological aspects will be collected. The primary outcome will be analyzed through depressive symptoms while secondary outcomes include the variables: body image, anxiety, mood, perceived stress, and optimism. Assessments will be carried out in the pre-intervention period (baseline) and after 12 weeks of intervention in all groups. Discussion: As a hypothesis, there are improvements in psychological aspects after dance therapy interventions and free dance, reaching the level of healthy women, given the benefits of that protocol.

Aspects épidémiologique et clinique des uvéites au Niger: analyse rétrospective d'une série de 127 cas colligés sur 5 ans / Epidemiological and clinical aspects of uveitis in Niger: A retrospective analysis of a series of 127 cases collected during 5 years

Contexte & objectif L'uvéite est peu très peu documentée en Niamey. L'objectif de la présente étude était de décrire les aspects épidémiologique et clinique des uvéites. Méthodes. Il s'agissait d'une étude rétrospective et descriptive portant sur 127 dossiers des patients suivis pour uvéites à la clinique lumière de Niamey sur une période de 5 ans (2015 ­ 2020). Les paramètres sociodémographiques, cliniques et thérapeutiques ont été recueillis. Résultats. La fréquence hospitalière des uvéites était de 0,21 %. Le sex-ratio était de 1,01. L'âge moyen des patients était de 40,76 ans. La douleur oculaire représentait le motif de consultation le plus fréquent avec 51 ,97 %. La majorité des patients avait présenté 2 épisodes d'uvéites soit 57,48 %. L'atteinte était unilatérale dans 70,97 % et les uvéites antérieures étaient les plus fréquentes 66,93 %. Les étiologies étaient identifiées chez seulement 7,87 % des patients dont près de la moitié était la tuberculose. 33,07 % des patients avaient présenté des complications. Conclusion. Il ressort de cette étude que l'uvéite touche plus des jeunes adultes, ses étiologies sont indéterminées dans la majorité de cas. Les formes antérieures sont plus fréquentes.

Context and objective Little is known about Uveitis in Niamey. This study aimed to analyze the epidemiological and clinical aspects of uveitis. Methods. This was a retrospective, descriptive study of 127 records of patients followed up for uveitis at the Niamey Lumière Clinic over a 5-year period (2015 ­ 2020). Sociodemographic, clinical and therapeutic parameters were collected. Results. The hospital frequency of uveitis was 0.21%. The sex ratio was 1.01. The mean age of patients was 40.76 years. Ocular pain was the most frequent reason for consultation, accounting for 51.97 %. The majority of patients (57.48%) had presented with 2 episodes of uveitis. Involvement was unilateral in 70.97 %, and anterior uveitis was the most frequent, at 66.93 %. Etiologies were identified in only 7.87 % of patients, of which tuberculosis accounted for almost half. Complications occurred in 33.07 % of patients. Conclusion. This study shows that uveitis affects mainly young adults, and its etiologies are undetermined in most cases. Anterior forms are more frequent.

Current situation of Investigator-Initiated Clinical Trial quality management: A scoping review / 中华医学科研管理杂志

Objective:To systematically identify and summarizes the weaknesses of the key aspects of Investigator-Initiated Clinical Trial (IIT) quality management in China, and quantitatively assess these weaknesses with a synthesis of relevant evidence, thereby providing references for the subsequent establishment of a complete IIT quality management system in China.Methods:According to the Scoping review report checklist (PRISMA-ScR statement), we conducted a systematic literature retrieval and screening, data extraction, and result synthesis of IIT quality management issues after defining the research questions.Results:73 eligible studies were eventually included. It was found that the most frequently explored issues were a lack of guidance and support from methodological and statistical experts at the project initiation stage (60.9%), a lack of research funding or improper funding management at the project implementation stage (49.3%), mismanagement of archival materials at the project completion stage (70.0%). Meta-analysis results showed that after evidence synthesis, the incidence of irregular informed consent signing, untraceable raw data, delayed study progress, and protocol violation were all above 40%, but there was heterogeneity in the results.Conclusion:Some outstanding issues in IIT quality management need to be addressed. Future studies should conduct more practical research to obtain quantitative data, undertake demonstrative application of management protocols, further carry out pioneering exploration and research in the field of IIT quality management, and propose effective solutions and strategies to improve IIT quality.

Application of Theory of ''Pathogen Invading Nutrient and Blood Aspects'' in Precancerous Lesions of Gastric Cancer / 中国实验方剂学杂志

Gastric cancer is one of the most common malignant tumors of the digestive system， with a high incidence， a low overall survival rate， and poor prognosis after treatment. It has become a major public health problem that threatens the lives and health of people. Since the pathogenesis of gastric cancer is still not fully unraveled， it is difficult to implement primary prevention. Therefore， the research on secondary prevention of gastric cancer， i.e.， precancerous lesions of gastric cancer， is extremely important and has become the focus of many researchers. Precancerous lesions of gastric cancer are the key pathological links in the transformation of inflammatory lesions of gastric mucosa into gastric cancer， including chronic atrophic gastritis， intestinal metaplasia， and dysplasia. Relevant studies have confirmed that with the aggravation of gastric mucosal lesions， the incidence and risk of gastric cancer also increase. Therefore， early diagnosis and effective intervention in the pathological link of gastric precancerous lesions is a key measure to prevent and reduce the incidence of gastric cancer， with great significance. More studies have shown that traditional Chinese medicine （TCM） can truncate and reverse the pathological grading of gastric mucosa， and can also effectively improve the clinical symptoms and quality of life of patients， with few adverse reactions and low recurrence rate， which has unique advantages and characteristics. The theory of ''pathogen invading nutrient and blood aspects'' was first proposed by WU Youxing， a febrile disease doctor， in Treatise on Pestilence （《温疫论》）. It was originally used for the treatment of syndrome changes in the late stage of febrile epidemics， but after being enriched and developed by different doctors， it is now mostly used to guide the treatment of various chronic diseases. Precancerous lesions of gastric cancer are a common and difficult disease in clinical practice. Its evolution process is characterized by asthenia in origin and sthenia in superficiality and deficiency-excess in complexity， which is consistent with the core pathogenesis of ''pathogen invading nutrient and blood aspects''， namely， positive deficiency and intruding pathogen， and intruding pathogen cementation in the blood vessels. They are also interlinked in terms of treatment principles. Therefore， with the theory of ''pathogen invading nutrient and blood aspects'' as the breakthrough point， this article expounded the intervention effect of TCM on precancerous lesions of gastric cancer from the perspective of this theory， reflecting its important guidance and application value and providing new ideas for clinical treatment of diseases.

Abordagem do paciente terminal: aspectos psicodinâmicos - "A morte como símbolo de transformação" / Approach to terminally ill patients: Psychodynamic aspects - "Death as a symbol of transformation" / Abordaje del paciente terminal: aspectos psicodinámicos - "La muerte como símbolo de transformación"

O autor discute a importância de se resgatar a morte como algo natural, tirando-a do interdito em que se encontra. Tenta mostrar o quanto este aspecto cria distorções para a vida, determinando uma série de distúrbios na conduta médica, em especial na abordagem do paciente terminal. Defende a ideia de que é uma doença da nossa cultura ocidental e a situação que leva a esta repressão é negação da morte. Dentro das referências teóricas da Psicologia Analítica de Jung, o autor propõe condutas para se tentar resgatar a vivência simbólica da morte restituindo-se a polaridade dialética Vida-Morte. Defende a proposição de que a vida só pode ter um sentido pleno se não negarmos a morte. Propõe que, como no parto, o progresso da Medicina se harmonize com respeito aos limites da Vida e da personalidade do paciente, frequentemente desrespeitados. Discute a morte como símbolo fundamental dentro do processo de individuação.

The author discusses the importance of readdressing death as something natural, retrieving it from the interdict in which it finds itself. He attempts to show the extent to which this aspect creates distortions to life, determining a series of disorders in medical conduct, especially in the approach to terminally ill patients. He defends the idea that it is a disease of our Western culture and that the situation that leads to this repression is the negation of death. In line with the theoretical references of Jung's Analytical Psychology, the author proposes conducts to try to rescue the symbolic experience of death and restore the life-death dialectical polarity. He supports the proposition that life can only have a full meaning if we do not negate death. He proposes that, as in childbirth, the progress of medicine should harmonize with respect to the limits of life and the patient's personality, which are often disrespected. He discusses death as a fundamental symbol within the individuation process.

El autor discute la importancia de rescatar la muerte como algo natural, sacándola del entredicho en que se encuentra. Intenta mostrar cuánto este aspecto crea distorsiones para la vida, determinando una serie de perturbaciones en la conducta médica, especialmente en el abordaje del paciente terminal. Defiende la idea de que es una enfermedad de nuestra cultura occidental y la situación que lleva a esta represión es la negación de la muerte. Dentro de los referentes teóricos de la Psicología Analítica de Jung, el autor propone conductas para tratar de rescatar la experiencia simbólica de la muerte, restituyendo la polaridad dialéctica Vida-Muerte. Defiende la proposición de que la vida sólo puede tener pleno sentido si no negamos la muerte. Propone que, como en el parto, el progreso de la Medicina debe armonizar respecto a los límites de la Vida y de la personalidad del paciente, que muchas veces son irrespetados. Se habla de la muerte como símbolo fundamental dentro del proceso de individuación.

Influência do apoio social e capital social no consumo alimentar de adultos no sul do Brasil / Influence of social support and social capital on food consumption of adults in southern Brazil

Resumo Introdução As escolhas alimentares podem ser influenciadas por apoio social e capital social. Objetivo Investigar as relações do apoio social e capital social com o consumo alimentar. Método Trata-se de um estudo transversal, de base populacional, com uma amostra aleatória de 1.098 adultos (≥ 18 anos de idade) de uma cidade no Sul do Brasil. O apoio social foi mensurado por meio da escala Medical Outcomes Study (MOS), e o capital social contemplou a avaliação dos indicadores de coesão social, apoio dos vizinhos, controle social informal, eficácia política e ação social. Para o consumo alimentar, utilizou-se de uma escala com base nas orientações do guia alimentar para a população brasileira. Resultados A média de idade da amostra foi de 44 anos (DP[Desvio-padrão] = 15,8), e identificou-se um consumo alimentar adequado em 38,6% (IC95%: 35,7 a 41,5). Após ajuste, observou-se uma probabilidade 40% maior para adoção de consumo alimentar adequado (saudável) entre os indivíduos com maior nível de apoio social (OR = 1,47; IC95%: 1,07 a 2,03), coesão social (OR = 1,40; IC95%: 1,02 a 1,92) e apoio dos vizinhos (OR = 1,45; IC95%: 1,04 a 2,02). Conclusão Os aspectos psicossociais, tanto individual quanto contextual, podem desempenhar um papel importante no consumo alimentar saudável em adultos.

Abstract Background Food choices can be influenced by psychosocial factors. Objective To investigate the relationships between social support and social capital with food consumption. Method This is a population-based cross-sectional study with a random sample of 1098 adults (≥18 years old) from a medium-sized city in southern Brazil. Social support was measured by Medical Outocomes Study (MOS) scale and social capital was assessed by social cohesion, neighbor support, informal social control, political effectiveness, and social action. For the assessment of food consumption was applied a scale based on the food guide for the Brazilian population. Results The mean age of the sample was 44 years (SD [Standard Deviation] = 15.8) and adequate food consumption was identified in 38.6% (95% CI: 35.7 to 41.5). After adjustment, there was a 40% higher probability of adopting adequate (healthy) food consumption among individuals with higher level of social support (OR = 1.47; 95% CI: 1.07 to 2.03), cohesion. social (OR = 1.40; 95% CI: 1.02 to 1.92) and support from neighbors (OR = 1.45; 95% CI: 1.04 to 2.02). Conclusion Both individual and contextual psychosocial aspects can play an important role in healthy food consumption in adults.

Información, narrativas y vivencias de los equipos de salud del Hospital Vilardebó ante la nueva Ley de Salud Mental No 19529 / Information, narratives and experiences of the health teams of the Hospital Vilardebó before the new Law of Mental Health N.o 19.529

La nueva Ley de Salud Mental N.o 19.529 promueve el cierre paulatino de los establecimientos asilares y monovalentes en todo el país. Dentro del sector público se encuentra el Hospital Vilardebó. En esta investigación se exploraron los significados que los equipos de salud de dicho hospital construyen sobre la implementación de la Ley N.o 19.529. Para esto se diseñó un estudio descriptivo. A partir de un muestreo teórico estratificado, la población quedó conformada por 69 personas con formación en medicina general, psiquiatría, psicología, trabajo social y enfermería. A través de un cuestionario autoadministrado, se indagó la información sobre la nueva ley, el reconocimiento de cambios institucionales, la modificación de las prácticas laborales, y los afectos movilizados. De los resultados se destaca un manejo heterogéneo de la información sobre la nueva normativa. Se advierte, asimismo, un proceso de transición institucional donde se observan narrativas contradictorias sobre los cambios en curso.

The new Mental Health Law N 19.529 promotes gradual closure of asylums and monovalent institutions throughout the country. Hospital Vilardebó is the public health psychiatric hospital. This research explores the meanings that health teams assign to this law's implemen tation by means of a descriptive study. Based on a theoretical stratified sample, 69 workers with training in general medicine, psychiatry, psychology, social work and nursing answered a self-administered questionnaire regarding the new law, institutional and work practice changes, and affects involved. The results highlight a heterogeneous handling of information on new regulations. Likewise, an institutional transitional process is noted, with contradictory narratives regarding ongoing changes.

Evaluación del estado emocional de personas con diabetes mellitus en la práctica ambulatoria / Evaluation of the emotional state of people with diabetes mellitus in outpatient practice

La aparición de una enfermedad crónica, como la diabetes mellitus (DM), pone a prueba la respuesta del universo físico y psíquico de un individuo. Como objetivo general, se propone evaluar el estado emocional de las personas con DM en la consulta ambulatoria. Como objetivo particular, detectar y monitorear las necesidades psicológicas que deben formar parte integral del cuidado de la DM mediante el uso de métodos validados. El cuestionario WHO-5 se incluye como índice de bienestar general, el PAID-5 revela la existencia de una posible angustia emocional vinculada a la enfermedad, y el PHQ- 9 como índice de depresión. Ante esta situación, el Comité de Aspectos Psicosociales recomienda explorar estos aspectos para optimizar el control y el tratamiento de la enfermedad, proponiendo estas herramientas para que el equipo de salud las emplee en la detección y el reconocimiento del estado emocional de las personas con DM

Occurrence of a chronic disease, such as diabetes, prove the response of the physical and psychic universe of individuals. As a general objective, is proposed to evaluate emotional state of people with diabetes in the outpatient clinic. As principal objective, detection and monitoring the psychological needs should be a main part of diabetes care, using validated tools to evaluate this aspect. WHO-5 questionnaire is included as an index of general well-being, PAID-5, reveals the existence of a possible emotional distress linked to disease, and PHQ-9 is used as an index of depression. At this situation, the Committee on Psycho-Social Aspects recommends explore these psychological aspects, as a way to optimize the control and treatment of disease, and propose the cited tools, to be used by the health team, in detection and recognition of emotional state in people with diabetes.

Motivating Persons Living with Diabetes for Insulin/Injectable Therapy

Motivating patients to initiate or intensify insulin is a challenging aspect of diabetes practice. This paper reviews certain motivational strategies and methods used for insulin initiation/intensification. It places various domains of motivational interviewing in perspective, under a single umbrella, making it easier for practitioners to understand the art and science of insulin motivation.

Psychological aspects of soccer and futsal players: A systematic review / Aspectos psicológicos em jogadores de futebol e futsal: Uma revisão sistemática

Abstract Introduction: The present systematic review aimed to compile the information available in the literature having to do with sport psychology regarding futsal and soccer players, in order to identify which psychological constructs are being investigated in these athletes and by means of which instruments and analysis techniques. Method: The search was carried out in the APA (PsycINFO), EBSCO (SportDiscus), PubMed, Web of Science, Scielo, Science Direct, Scopus, BVS and EMBASE databases, with the following descriptors: psychological construct; psychological factor; psychological variable; psychological phenomenon; soccer; futsal and athlete, in English, Spanish and Portuguese. Results: Initially, 66 studies met the established eligibility criteria. Of these, 46 studies were conducted with soccer players, 19 with futsal players and one with athletes who participate in both sports. The psychological constructs most studied in the soccer modality were anxiety, stress, motivation, coping, motivational climate, depression, self-efficacy and group cohesion. With regard to the futsal modality, the most studied psychological constructs were group cohesion, perfectionism, motivation, athlete satisfaction, leadership style, perceived parenting styles and burnout. Conclusions: Group cohesion was associated with several other psychological aspects of an individual nature, with cohesion being the construct of both modalities which is of the greatest interest to researchers possibly because it is a collective modality. It can be established that important psychological factors have not been studied in soccer and futsal modalities, especially among female athletes. Therefore, it is recommended that the research carried out with male athletes be extended to include female populations.

Resumo Introdução: O presente estudo de revisão sistemática procurou compilar informações disponibilizadas na literatura quanto aos estudos da psicologia do esporte em jogadores de futsal e futebol, com a finalidade de identificar quais construtos psicológicos estão sendo estudados nesse público e por quais instrumentos e técnicas de análise. Método: A busca foi realizada nas bases de dados APA (PsycINFO), EBSCO (SportDiscus), PubMed, Web of Science, Scielo, Science Direct, Scopus, BVS e EMBASE, com os seguintes descritores: construto psicológico; fator psicológico; variável psicológica; fenômeno psicológico; futebol; futsal e atleta, nos idiomas inglês, espanhol e português. Resultados: Foram selecionados 66 estudos por meio dos critérios de elegibilidade estabelecidos. Destes, 46 estudos foram conduzidos com jogadores de futebol, 19 com jogadores de futsal e um com atletas de ambas as modalidades. Os construtos psicológicos mais estudados na modalidade de futebol foram ansiedade, estresse, motivação, coping, clima motivacional, depressão, autoeficácia e coesão grupal. Os construtos psicológicos mais estudados na modalidade de futsal foram coesão de grupo, perfeccionismo, motivação, satisfação do atleta, estilo de liderança, estilos parentais percebidos e burnout. Conclusão: A coesão grupal foi associada a diversos outros aspectos psicológicos de natureza individual, sendo a coesão o construto de maior interesse dos pesquisadores de ambas as modalidades, possivelmente, por serem modalidades coletivas. Pode-se identificar que fatores psicológicos importantes não foram estudados nas modalidades de futebol e futsal, em especial junto a atletas do sexo feminino. Recomenda-se, assim, que pesquisas realizadas com atletas do sexo masculino sejam também conduzidas com a população feminina.

Aspectos neuropsicológicos y psicológicos de las competencias profesionales: incógnitas en la Educación Superior / Neuropsychologic and psychologic aspects of professional competence: unknown in Higher Education / Aspectos neuropsicológicos e psicológicos das habilidades profissionais: incognitas no Ensino Superior

El objetivo es descubrir aspectos neuropsicológicos y psicológicos de las competencias profesionales en educación superior con deducciones de la teoría histórico cultural. Los aspectos que se analizaron: relación psiquis competencia, dimensión externa, fuente de asimilación e integración. Se utilizaron aportes de Vygotski (1987), Leontiev (1974) y Arias (2017). La investigación fue tipo básica con diseño documental y método deductivo. Como instrumento de registro se utilizó la matriz de categorías. Concluye con que la competencia profesional es una formación psicológica como el resto de ellas, por lo que tiene que explicarse su naturaleza y origen por los principios y leyes del desarrollo humano.

The objective was to discover neuropsychologist and psychologist aspects of professional competences in higher education, with deductions of historic cultural theory. The aspects analyzed: psiquis and competence relation, external and internal dimensions, source of stimulation and integration. They were utilized the theory of Vygotski (1987), Leontiev (1974) and Arias (2017). The investigation was basic with documental design and deductive method. It was used a matrix of categories as instrument to understand the particularities of aspects selected. As a conclusion, it is expressed that the professional competence is a psychological formation same as others, then it will be explaining with the principles and laws of human development.

O objetivo é conhecer os aspectos neuropsicológicos e psicológicos das competências profissionais no ensino superior com deduções da teoria histórico-cultural. Os aspectos analisados: psique, relação de competência, dimensão externa, fonte de assimilação e integração. Contribuições de Vygotski (1987), Leontiev (1974) e Arias (2017) foram usadas. A pesquisa foi do tipo básico com desenho documental e método dedutivo. A matriz de categorias foi utilizada como instrumento de registro. Conclui que a competência profissional é um treinamento psicológico como os demais, portanto sua natureza e origem devem ser explicadas pelos princípios e leis do desenvolvimento humano.