Antecedents of the adoption of blockchain to enhance patients' health information management in South Africa

Background: Currently, the South African public healthcare system is hampered by a lack of effective patient data management. This leads to, amongst other challenges, a lack of transparency in the management of patients' health information and unsecure medical records. Blockchain, on the other hand, can make healthcare records more secure, easily auditable, and hence more reliable. These advantages, among others, make Blockchain an appealing technology for managing patients' health information in the South African context. Objectives: The study investigated the antecedents of the adoption of blockchain technology as a tool to improve the management of patients' health information in the South African public healthcare sector. Method: The four pillars of a health information system (strong leadership, contingency plan, security and privacy, and IT or vendor support) were adopted as the theoretical grounding for the study. Qualitative data were collected through interviews with IT specialists and healthcare professionals working in the public healthcare sector. Results: The study identified 11 antecedents that can be related to the four pillars of a health information system. These antecedents must be addressed for blockchain to contribute meaningfully to enhancing patients' health information management in South Africa. Conclusion: Although blockchain can contribute meaningfully to addressing health information management challenges in South Africa, contextual factors need to be considered for it to fulfil its promises. It is anticipated that the study findings will help stakeholders in the South African public healthcare sector to make informed decisions in their quest to deploy technology innovations like blockchain.

Digital health and self-management of chronic diseases in sub-Saharan Africa: A scoping review

Background: With the rise of noncommunicable diseases (NCDs) in sub-Saharan Africa (SSA), the concept of digital self-management presents great opportunities for relieving some of the burdens healthcare systems face. However, for this to be realised, effective use of digital health in self-management and assessment is essential. Objective: The objective of this scoping review was to identify social determinants and cognitive factors with potential influence on digital health use in self-management of chronic medical conditions associated with NCDs in SSA. Method: The 5-stage scoping review framework was used to search, identify, and filter publications over a 10-year period from two major databases, Google Scholar and Pubmed. Based on the inclusion criteria, a total of 12 documents were chosen for analysis. Results: Findings reveal that social determinants such as cultural values and societal practices demand a rethinking of how digital health for self-management of chronic diseases are designed and developed for use in SSA, whereas a cognitive factor such as self-efficacy is central in digital health use in self-management of chronic conditions, particularly in areas like adherence to medication, diet and exercise programmes. Conclusion: Owing to the unique characteristics of digital health users in SSA, technologies and content (particularly those for self-management of chronic diseases) should be tailored to the diverse needs of the population. It is through this that the region can fully benefit from the potential of digital health use in self-management of chronic diseases associated with NCDs.

A lealdade dos espectadores de futebol e seus antecedentes: uma revisão sistemática / Lealtad y antecedentes de los espectadores de fútbol: una revisión sistemática / Football spectator's loyalty and yours pedictors: a systematic review

O objetivo deste estudo foi identificar os antecedentes da lealdade dos torcedores de clubes de futebol. Foi realizada uma revisão sistemática utilizando artigos originais de 2009 a 2019, indexados na "Academic Search Ultimate", "Business Source Ultimate", "Scopus" e "Web of Science"; 166 foram encontrados e 21 incluídos. Nos resultados, a maio-ria dos artigos foi com base no contexto europeu. Em relação ao instrumento e análise, todos os estudos utilizaram questionário com escala Likert que variava entre 5 e 11 pontos. Análise de Equações Estruturais foi o principal método de análise dos dados. Como resultado, os principais preditores encontrados foram a satisfação e a identificação. Sugere-se análises no contexto das Américas, em especial no Brasil (AU).

This study aimed to identify the antecedents of soccer club fans' loyalty. A systematic review was carried out, using original articles from 2009 to 2019, indexed in "Academic Search Ultimate", "Business Source Ultimate", "Scopus" and "Web of Science", 166 were found and 21 were included. In the results, most of the articles were in the European context. Regarding the instrument and analysis, all studies used a questionnaire with a Likert scale that varied between 5 and 11 points. Structural Equation Modeling was the main method of data analysis. As a result, the main predictors found were satisfaction and identification. Analyzes are suggested in the context of the Americas, especially in Brazil (AU).

El objetivo fue identificar los antecedentes de la lealtad de los torcedores de clubes de fútbol. Fue realizóada una revisión sistemática, utilizando artículos originales de 2009 a 2019, indexados en "Academic Search Ultimate", "Business Source Ultimate", "Scopus" y "Web of Science", se encontraron 166 y se incluyeron 21. En los resultados, la mayoría de los artículos estaban en el contexto europeo. En cuanto al instrumento y análisis, todos los estudios utilizaron un cuestionario con escala Likert que varió entre 5 y 11 puntos. El Modelo de Ecuaciones Estructurales fue el principal método de análisis de datos. Los principales predictores encontrados fueron la satisfacción y la identificación. Se sugieren análisis en el contexto de las Américas, especialmente en Brasil (AU).

Uma análise dos antecedentes da confiança no líder numa unidade policial de operações especiais / Un análisis de los antecedentes de confianza en el líder en una unidad policial de operaciones especiales / An analysis of the antecedents of trust in the leader of a special operations police unit

Resumo Este artigo se propõe a aprofundar a compreensão dos elementos de coordenação informal na gestão de equipes que atuam em cenários complexos e imprevisíveis. Apresentamos os resultados de um estudo realizado numa unidade de operações especiais de polícia, o Batalhão de Operações Policiais Especiais do Rio de Janeiro (Bope/RJ), utilizando métodos quantitativos. Analisamos a relação entre os antecedentes da confiança e a dimensão distância de poder e a confiança pessoal e profissional no líder. Os resultados confirmam uma relação direta e negativa entre distância de poder e confiança profissional no líder, e uma relação direta e positiva com alguns antecedentes da confiança. Quanto maior a percepção da qualidade da comunicação interna e o compartilhamento e delegação de autoridade nos processos decisórios, maior é a confiança pessoal no líder.

Resumen Este artículo se propone profundizar en la comprensión de los elementos de coordinación informal en la gestión de equipos que actúan en escenarios complejos e imprevisibles. Presentamos los resultados de un estudio realizado en una unidad de operaciones especiales de policía, el Batalhão de Operações Policiais Especiais do Rio de Janeiro (Bope/RJ), utilizando métodos cuantitativos. Analizamos la relación entre los antecedentes de la confianza y la dimensión distancia de poder y la confianza personal y profesional en el líder. Los resultados confirman una relación directa y negativa entre distancia de poder y confianza profesional en el líder, y una relación directa y positiva con algunos antecedentes de la confianza. Cuanto mayor es la percepción de la calidad de la comunicación interna y el compartir y delegación de autoridad en los procesos decisorios, mayor es la confianza personal en el líder.

Abstract This article aims to widen the understanding of informal coordination elements in the management of teams working in complex and unpredictable scenarios. It presents the results of a study carried out in a special operations police unit, the Batalhão de Operações Policiais Especiais do Rio de Janeiro (Bope/RJ), using quantitative methods. The study analyzed the relationship between the antecedents of trust and power distance and personal and professional trust in the leader. The results confirm a direct and negative relationship between power distance and professional trust in the leader, and a direct and positive relationship with some antecedents of trust. The greater the perceptions of internal communication quality, and sharing and delegation of authority in the decision process, the greater the trust in the leader.

Características clínico-epidemiológicas de la Diabetes Mellitus tipo 2 en el Policlínico Milanes. Municipio Matanzas / Clinical-epidemiologic characteristics of Type 2 Diabetes Mellitus in the polyclinic Milanés. Municipality of Matanzas

Introducción: la diabetes mellitus tiene prevalencia nacional cercana al 60% y sus complicaciones se producen fundamentalmente por mal control metabólico por lo que el manejo y reducción de este, es objetivo principal de los programas de control para la enfermedad. Objetivo: caracterizar algunas variables clínicas y epidemiológicas de los pacientes con diabetes mellitus tipo 2 en 3 Consultorios Médicos de la Familia del Policlínico "Milanés" del municipio de Matanzas durante el periodo comprendido de mayo del 2013 a mayo del 2014. Materiales y Métodos: se realizó un estudio descriptivo-transversal, con un universo conformado por 129 pacientes dispensarizados con diabetes mellitus tipo 2 en 3 consultorios médicos de la familia del policlínico "Milanes", la muestra quedó integrada por 85 pacientes seleccionados por muestreo aleatorio simple. Las variables objeto de estudio fueron: edad, sexo, hábitos tóxicos y antecedentes patológicos personales. Resultados: el mayor % de diabéticos correspondió al sexo femenino y a los pacientes mayores de 70 años, según antecedentes patológicos personales prevaleció la hipertensión arterial con 57 pacientes para el 67,1% de la muestra. Al distribuir los pacientes según hábitos tóxicos se aprecian una baja prevalencia del hábito de fumar con un 14,1% y 3,5% para el consumo de alcohol. Conclusiones: hubo un predominio del sexo femenino con aumentos de la incidencia de la enfermedad a partir de los 60 años de edad. Entre los antecedentes patológicos personales se asocia la hipertensión arterial, seguido de las enfermedades cerebrovascular. Al distribuirse los pacientes según hábitos tóxicos, predominó el hábito de fumar (AU).

Introduction: diabetes mellitus shows a national prevalence of around 60 % and its complications are produced mainly due to a bad metabolic control; therefore the metabolic control management and reduction is the main objective of this disease's control programs. Aim: to characterize several clinical and epidemiologic variables of the patients with type 2 diabetes mellitus in three Family Physician Offices of the Policlinic "Milanés", municipality of Matanzas, during the period from May 2013 to May 2014. Material and Methods: a cross sectional, descriptive study was carried out in a universe of 129 patients with type 2 diabetes mellitus in three Family Physician Offices of the Polyclinic "Milanes"; the sample was formed by 85 patients chosen by simple randomized sampling. The studied variables were: age, sex, toxic habits and personal pathological antecedents. Results: the highest percent of diabetic patients were female ones and patients aged more than 70 years. According to the personal pathologic antecedents, arterial hypertension prevailed with 57 patients, for 67.1 % of the sample. When grouping the patients according to their toxic habits, it was found a low prevalence of smoking (14.1 %) and alcohol consumption (3.5 %). Conclusions: the female sex prevailed with an increase of the disease's incidence beginning after the age of 60 years. Among other personal pathologic antecedents, arterial hypertension is associated, followed by vascular brain diseases. When grouping the patients according to their toxic habits, smoking predominated (AU).

Antecedentes académicos como predictores de Burnout en estudiantes de primer año de Odontología / Academic antecedents as burnout predictors in first-year Dentistry students

Introducción: en los últimos años, el bienestar psicológico del estudiante ha sido motivo de estudio debido a su influencia en el rendimiento académico y adaptación a la educación universitaria. Objetivo: asociar los antecedentes académicos de los estudiantes de primer año de Odontología y sus niveles de Burnout. Métodos: se aplicó un cuestionario sociodemográfico y el Inventario de Burnout de Maslach para estudiantes, luego de un proceso de consentimiento informado, a una muestra de 79 estudiantes de primer año de la carrera de Odontología de la Universidad de Concepción obtenida mediante muestreo no probabilístico por accesibilidad. A partir de la base de datos universitaria, se obtuvo información sobre los antecedentes académicos de los participantes. Resultados: se encontraron relaciones estadísticamente significativas entre puntajes de Prueba de Selección Universitaria de matemáticas y niveles de Agotamiento emocional y Falta de realización personal y entre las calificaciones promedio de enseñanza secundaria y niveles de Agotamiento emocional (p< 0,05). Asimismo, los antecedentes académicos entregaron predicciones estadísticamente significativas para el factor Agotamiento emocional (p< 0,05), dando cuenta de un 10,5 por ciento de variación de él, donde sólo la calificación promedio de enseñanza secundaria (p< 0,05) fue un predictor estadísticamente significativo explicando 6,59 por ciento de la variación del nivel de Agotamiento emocional. Conclusiones: antecedentes académicos como el puntaje en la Prueba de Selección Universitaria de matemáticas y las calificaciones promedio de enseñanza secundaria se vieron asociados a los niveles de Burnout de los estudiantes de Odontología de primer año de la Universidad de Concepción(AU)

Introduction: In recent years, students' psychological well-being has been studied because of its influence on academic achievement and adaptation to university education. Objective: To associate the academic antecedents of first-year Dentistry students and their burnout levels. Method: A sociodemographic questionnaire and the Maslach Burnout Inventory were applied to students, after an informed consent process, to a sample of 79 first-year Dentistry students at the University of Concepción, obtained through non-probabilistic sampling by accessibility. From the university database, information was obtained as based on the academic antecedents of the participants. Results: Statistically significant relationships were found between the scores of university admission tests in Mathematics and emotional exhaustion levels, as well as lack of personal achievement; and between average secondary school grades and emotional exhaustion levels (p< 0.05). Also, the academic antecedents provided statistically significant predictions for the emotional exhaustion factor (p< 0.05), accounting for its 10.5 percent variation, where only the average secondary education score (p< 0.05) was a statistically significant predictor explaining that 6.59 percent of the variation in the emotional exhaustion level. Conclusiones: Academic antecedents such as the scores in university admission tests in Mathematics and the average secondary school grades were associated with burnout levels of first-year Dentistry students at the University of Concepción(AU)

The saga of psychoanalysis in Eastern Europe: repression and rebirth in Hungary, and in former Czechoslovakia and Yugoslavia / A saga da psicoanálise no leste eutopeu: repressão e renascimento na Hungria e nas antigas Tchecoslováquia e Iugoslávia

Abstract The paper shortly presents the early roles of Budapest, Prague, and Belgrade in the development of psychoanalytic movement in Central-Europe before the Second World War. Mapping this historical heritage, it suggests how psychoanalysts of former Soviet Bloc countries could restore their own psychoanalytic communities. The study investigates the consequences of these dictatorial and authoritarian regimes for psychoanalysis and for psychoanalysts focusing on similarities and differences in Hungary, in former Czechoslovakia, and Yugoslavia. Furthermore, it emphasizes the contribution of the international professional organizations - the International Psychoanalytic Association, and the European Psychoanalytic Federation - for reintegration of Budapest, Prague, and Belgrade to the international psychoanalytic community.

Resumo O artigo apresenta brevemente os papéis de Budapeste, Praga e Belgrado no desenvolvimento do movimento psicoanalítico na Europa central antes da Segunda Guerra Mundial. Mapeando essa herança histórica, o artigo sugere como psicanalistas do antigo bloco soviético puderam restaurar suas próprias comunidades psicoanalíticas. O estudo investiga as consequências desses regimes ditatoriais e autoritários para a psicanálise e para os psicanalistas focalizando as semelhanças e diferenças na Hungria e nas antigas Tchecoslováquia e Iugoslávia. Além disso, destaca a contribuição das organizações profissionais internacionais - a International Psychoanalytic Association e a European Psychoanalytic Federation - na reintegração de Budapeste, Praga e Belgrado à comunidade psicoanalítica internacional.

Bosquejo del desarrollo de la psicología y su relación con la salud en Cuba 1900-1958 / Outline of psychology development and its relationships with health in Cuba in the 1900-1958 period

El objetivo de este trabajo es describir algunos antecedentes de la psicología en Cuba relacionados con la salud. Se utilizaron los métodos heurístico, hermenéutico y de la historia crítica; la consulta de fuentes primarias y secundarias de información así como testimonios de los autores. Se consultó bibliografía en bibliotecas públicas y privadas, hemerotecas, centros de información y en Internet. Se obtuvo una descripción documentada y crítica de los orígenes de la psicología y su relación con la salud en Cuba durante el periodo de 1900-1958, los escenarios de formación, algunos profesionales destacados en lo científico y lo político así como las teorías y explicaciones del papel de lo psicológico en la determinación de la salud, la afiliación a paradigmas de las ciencias, publicaciones, los primeros puntos de encuentro de la psicología o de los psicólogos relacionados con la salud en Cuba así como los inicios de la enseñanza de la psicología hasta la fundación de las primeras escuelas. Se concluye que existió un determinado nivel de desarrollo de la psicología clínica y psicopedagógica en el periodo estudiado, que predominó el positivismo como concepción teórica aunque existieron algunos críticos a esta corriente y al mercantilismo en la salud, proveniente de la influencia norteamericana durante la república mediatizada. Las personalidades relevantes descritas posibilitaron la posterior formación masiva de psicólogos que constituyen antecedentes del surgimiento de la psicología de la salud en Cuba en la década de los 60 del siglo XX(AU)

The objective of this paper is to describe some antecedents of psychology related to health in Cuba. The heuristics, hermeneutic and critical history methods were used in addition to consulting primary and secondary data sources and authors´ testimonies. Bibliography found in public and private libraries, newspaper and periodical archives, information centers and Internet was reviewed. There was obtained documented critical description of the origins of psychology and its relationship with health in Cuba in the 1900-1958 period, the formative settings, some outstanding professionals in the scientific and the political fields as well as theories and explanations about the role of the psychological elements in determination of health, about the affiliation to paradigms of sciences; publications, the first points of meeting of psychology and of psychologists related to health in Cuba, and the beginning of psychology teaching in Cuba until the foundation of the first schools. It was concluded that there was certain level of development of clinical and psychopedagogic psychology in the studied period when positivism prevailed as a theoretical concept, although there were some people who criticized this trend and health mercantilism as a result of the US influence before 1959. The outstanding personalities described in this paper made the subsequent massive formation of psychologists possible, which represent antecedents of the emergence of health psychology in Cuba in the 60´s of the 20th century(AU)

O registro imaginário nos antecedentes lacanianos / The imaginary register in the Lacanian background

Antes da introdução do registro simbólico em seu ensino, algo que marcou de forma indelével os primeiros seminários, Lacan deteve-se desde a publicação de sua tese, em 1932, até o memorável Discurso de Roma, em 1953, com as questões relativas à formação do eu em sua dependência da imagem do outro. Na esteira da proposta de uma psicologia concreta, presente na tese, Lacan aborda como fundamentais os conceitos de complexo, imago e identificação, em suas inflexões no complexo de desmame, complexo de Édipo, e principalmente o complexo de intrusão, que foi posteriormente elaborado como o estádio do espelho.

The imaginary register in the Lacanian antecedents. Prior to the introduction of the symbolic register in his teaching, something that left an indelible mark in his first seminars, Lacan focused his research, since the publication of his thesis in 1932 until the memorable Speech of Rome in 1953, on the issues related to the formation of the Ego (moi) in the dependence of the image of the other. In the wake of the proposal for a concrete psychology in his thesis, Lacan discusses the fundamental concepts of complex, imago and identification in their inflections in the weaning complex, the Oedipus complex, and especially the intrusion complex, which later was developed as the mirror stage.

Factores de riesgo cardiovascular y su relación con la hipertensión arterial en adolescentes / Cardiovascular risk factor and their relationship with the hypertension in adolescents

Introducción: cada día las crisis de aterosclerosis se manifiestan en personas de menor edad y está demostrada la importancia de conocer los principales factores que la originan, entre ellos la obesidad. En los niños y adolescentes cubanos el sobrepeso y la obesidad se han incrementado de manera notable. Objetivo: identificar los factores de riesgo cardiovascular en adolescentes supuestamente sanos. Métodos: se realizó un estudio descriptivo transversal en adolescentes supuestamente sanos de la secundaria básica "Protesta de Baraguá". La muestra estuvo constituida por 687 estudiantes. Se aplicó el modelo de recolección de dato primario del Centro de Investigaciones y Referencia en Aterosclerosis de La Habana. Se realizaron mensuraciones de peso, talla y circunferencia de la cintura. Se evaluó el estado nutricional por percentiles de índice de masa corporal y circunferencia de la cintura. Las cifras de tensión arterial se clasificaron según los percentiles de tensión arterial ajustados para edad, sexo y talla. Resultados: se halló que 46 adolescentes (6,6 %) eran fumadores, la relación fue estadísticamente significativa en relación con el sexo; 96 (13,9 %) tenían sobrepeso y 64 (9,3 %) eran obesos; la circunferencia de la cintura mostró que 98 (14,2 %) tenían posible situación de riesgo y 56 (8,1%) eran francamente atípicos (percentil>97) ; 4 % de los adolescentes tenían tensión arterial alta En todos los casos predominó el sexo masculino. El antecedente familiar de obesidad se presentó en 73 (10,6 %) y la relación resultó estadísticamente significativa en varones. Conclusiones: predominó el hábito tabáquico, la hipertensión arterial, el sobrepeso, la obesidad y los antecedentes familiares de obesidad, en el sexo masculino y en las féminas predominaron los antecedentes familiares de hipertensión arterial y de diabetes mellitus.

Introduction: everyday atherosclerosis crises manifest in younger people and it is demonstrated the importance of knowing the main factors that cause it, including obesity. In Cuban children and adolescents, overweight and obesity have dramatically increased. Objective: to identify cardiovascular risk factors in supposedly healthy adolescents. Method: a descriptive cross-sectional study was conducted in supposedly healthy adolescents from 12 to 15 years from a secondary basic school. The objective was identifying cardiovascular risk factor and their relationship with hypertension. The sample was constituted by 687 students. Data were registered in the primary data collection form of Havana Research and Reference Centre on Atherosclerosis. Measurements of weight, height and waist circumference were performed. Nutritional status by percentiles of body mass index and waist circumference were also evaluated. The blood pressure levels were classified according to the percentiles of blood pressure adjusted for age, sex, and height. Results: 46 adolescents (6.6 %) were found to be smokers, the relationship was statistically significant in relation to gender, 96 (13.9 %) were overweight and 64 (9.3 %) were obese; circumference waist showed that 98 (14.2 %) had possible risks, and 56 (8.1 %) were frankly atypical, 4% adolescents had high blood pressure. Male adolescents predominated in all parameters. Family history of obesity occurred in 73 (10.6 %) and the relationship was statistically significant in males. Conclusions: predominance of smoking, hypertension, overweight, obesity and family history of obesity prevailed in male adolescents males; whereas family history of hypertension and diabetes mellitus prevailed in female adolescents.

"Quem dá mais, cobra mais!": Uma análise das normas antecedentes do ofício de motorista de ônibus em um contexto específico / "Who gives more, charges more!": An analysis about the job of bus driver in a specific context

O objetivo deste artigo é analisar o trabalho prescrito e as normas antecedentes do trabalho dos motoristas de ônibus de uma empresa de transporte urbano do município de Rio de Janeiro. O referido estudo baseou-se em conceitos vindos da Ergonomia e da Ergologia e em dados de outra pesquisa já realizada sobre o ofício de motorista de ônibus (CAIAFA, 2002). Contou ainda com uma pesquisa de metodologia qualitativa que buscou analisar a linguagem utilizada pelos responsáveis por transmitir as normas antecedentes e prescrições de trabalho de certa empresa de ônibus aos seus funcionários. O material para análise foi colhido a partir de duas situações: uma entrevista com um inspetor, que pelas atribuições de seu cargo tem como rotina observar, controlar e corrigir aspectos do trabalho dos motoristas e cobradores, e a participação em um processo de integração para funcionários recém-admitidos na referida empresa.

The goal of this article is analyze the prescribed work norms and the antecedent norms of the bus drivers work in a specific context. The reported study was inspired in the concepts given respectively for the Ergonomy and the Ergology, and in the observations from another research about bus journeys in Rio de Janeiro (CAIAFA, 2002). It counted also with a qualitative research methodology that sought to analyze the language used by the person responsible for the transmission of prescribed work norms and the antecedent norms of a certain company to its employees. The content for analyze was collected from two situations: an interview held with an inspector, with the assignments to observe, monitor and correct aspects of the bus driver’s work and conductor’s work, and the participant observation of a process of integration for admitted workers in the already mentioned company.

Antecedentes familiares y sintomatología en mujeres con Trastorno de la Conducta Alimentaria / Family Eating Disorders antecedent and symptomatology in women with an Eating Disorder (ED)

Los objetivos fueron: 1) detectar la presencia de antecedentes familiares de sintomatología alimentaria en una muestra de pacientes mexicanas con trastorno alimentario, y 2) de que forma influyen dichos antecedentes en la patología de este trastorno. La muestra estuvo formada por n=44 mujeres. Los resultados mostraron que el 40% reportó antecedentes de trastorno alimentario en la familia. Fue en este mismo grupo que se detectó mayor puntaje en el total del EAT-40 así como en los factores: motivación para adelgazar, evitación de alimentos engordantes, preocupación por la comida, obsesiones y compulsiones, y conductas compensatorias, al compararlo con el grupo sin antecedentes familiares de trastorno alimentario. Este hallazgo permite concluir que la magnitud de la sintomatología es mayor cuando existen antecedentes entre la familia.

The purposes of study were: 1) To detect the family eating disorders in mexican patients with eating disorders and 2) In which ways this family antecedent affects its development in this pathology. The sample was formed by n= 44 women. The results showed that 40% reported family eating disorders antecedent. It also revealed that this group has the highest EAT-40 total, and in the factors: motivation to loose weight, avoidance of fattening food, constant concern about food, obsessions and compulsions, and compensatory behaviors, compared to the group that doesn't present family eating disorder antecedent. This discovery allows concluding that the magnitude of the symptomatology is bigger whit the presence oh this antecedent.

Cáncer de mama en mujeres jóvenes: evaluación de los factores de riesgo / Breast cancer in young women: risk factor evaluation

El cáncer de mama en mujeres jóvenes tiene características biológicas y comportamiento clínico al compararlo con el cáncer de mama en mujeres de la tercera edad. Estudio prospectivo de factores de riesgo para cáncer de mama tomando en cuenta estos dos grupos. 36 pacientes < 40 años y 100 pacientes > 64 años de 515 pacientes evaluados entre abril de 2006 y abril de 2007. Se analizaron: antecedentes familiares de cáncer de mama y ovario, factores de riesgo hormonales (endógenos y exógenos), antecedentes de patología mamaria. Antecedentes familiares de cáncer de mama (31 por ciento < 40 años vs. 14 por ciento > 64 años, P= 0,015), antecedentes familiares de cáncer de ovario (25 por ciento < 40 años vs. 15 por ciento > 64 años, P = 0,04), promedio edad primer embarazo a término (21,11 > 64 años vs. 23,0 < 40 años, P=0,05), promedio número de embarazos a término (5,1 > 64 años vs. 2,2 < 40 años, P=0,00014), ingestión de anticonceptivos orales (67 por ciento < 40 años vs. 13 por ciento > 64 años, P=0,0000001). Antecedentes familiares de cáncer de mama y ovario, edad del primer embarazo a término, número de embarazos a término e ingestión de anticonceptivos orales fueron factores de riesgo más relevantes en mujeres jóvenes con cáncer de mama, siendo la primera vez que se reportan los antecedentes familiares de cáncer de ovario y el número de embarazos a término.

Breast cancer in young women has different biological and clinical characteristics when is compared with breast cancer in third age women. A prospective study of risk factors for development breast cancer was done comparing both age groups. Thirty six patients < 40 years and 100 patients > 64 years from a total of 515 breast cancer patients were included between april 2006 and april 2007. Family history of breast and ovary cancer, hormonal risk factors (endogenous and exogenous) previous history of breast disease were studied. The significant results were as follows: Family history of breast cancer (31 percent < 40 years vs. 14 percent > 64 years, P=0.015), family history of ovary cancer (25 percent < 40 years vs. 15 percent > 64 years, P=0.04), mean age of first terminal pregnancy (21.11 years > 64 years vs. 23.0 years < 40 years, P = 0.05), mean number of terminal pregnancies (5.1 > 64 years vs. 2.2 < 40 years, P=0.00014), and oral contraceptives ingestion (67 percent < 40 years vs. 13 percent > 64 years, P=0.0000001). We concluded that family history of breast and ovary cancer, age of first terminal pregnancy, number of terminal pregnancies, and oral contraceptives ingestion were the most important risk factors in young women with breast cancer, being the first time that family history of ovary cancer and number of terminal pregnancies are reported.

Frequência de antecedentes familiares e análise de queixas em crianças com dificuldades de aprendizagem / Frequency of family antecedents and analysis of complaint in children with learning disabilities

Considerando que as dificuldades de aprendizagem nos pais representam fator de risco para a ocorrência nos filhos, o presente trabalho teve como objetivo realizar um levantamento dos antecedentes familiares de crianças com queixas de dificuldades escolares. Participaram 76 crianças de ambos os sexos (57 meninos e 19 meninas) com idade média de 8,7 anos, encaminhadas ao Laboratório de Neuro-Dificuldades de Aprendizagem - DISAPRE/UNICAMP para realização de avaliação multidisciplinar. Os dados foram obtidos a partir dos registros de anamnese com os pais e analisados descritivamente. Houve prevalência do sexo masculino (72%). As idades variaram entre 5 e 13 anos, com prevalência de crianças na faixa etária de 8 anos (26,3%) e estudantes do Ensino Fundamental (80,26%). Houve relatos de antecedentes familiares com dificuldades de aprendizagem em 78,9% dos casos analisados. Com relação ao grau de parentesco dos antecedentes, em 36% dos casos os pais apresentavam dificuldades escolares, seguidos pelos tios (24%), irmãos (19%), primos (16%) e avós (5%). As queixas apresentadas envolveram oito categorias de dificuldades: aprendizagem, atenção e/ou memória, fala, sociais, orgânicas, psicológicas e motoras.

As learning disabilities in parents represent a risk factor for its occurrence in children, the present work aimed at doing a survey of the family antecedents of children with complaints of difficulties at school. A number of 76 children (57 boys and 19 girls) with average of 8.7 years of age participated in the research; all of them were sent to the Laboratory of Learning Disabilities - DISAPRE/UNICAMP - for multidisciplinary evaluation. The data were obtained from the children's registers provided by parents and analyzed descriptively. There was prevalence of boys (72%). The ages varied between 5 and 13 years old, with prevalence of children aged 8 years old (26,3%) and basic school students (80,26%). Family antecedents with learning disabilities were reported in 78,9% of the cases. In relation to the position in family line of the antecedents, in 36% of the cases parents were the ones with difficulties at school, followed by uncles (24%), siblings (19%), cousins (16%), and grandparents (5%). The complaints involved eith categories: learning, attention and/or memory, speech, social, organic, psychological, and motor difficulties.

The prognostic factors of seizure recurrence in newly diagnosed epilepsy

BACKGROUND: To evaluate the prognostic factors of seizure recurrence in newly diagnosed epilepsy at 1 year follow up. METHODS: From the IUED (Inje University Epilepsy Database) we retrieved the epilepsy patients who had never before taken any antiepileptics (AED) and were followed up for 1 year. We retrospectively reviewed the medical records with special attention to : a) age of onset, b) history of antecedents, c) seizure frequency before starting AED, d) abnormal neurological examination, e) MRI findings, f) EEG findings, g) epileptic syndrome classification. We defined seizure recurrence as any seizure occurring during the 1 year evaluation follow up except during the AED titra-tion period, having only an aura and being in poor compliance. We analyzed the prognostic factors that could reliably predict the seizure recurrence at 1 year follow up. RESULTS: We found 104 patients (64 male, 40 female) who met the inclusion criteria. The mean age of onset was 23.7 years. Of 104 patients 19 had generalized epilepsy, 82 had partial epilepsy and 3 had unclassified epilepsy. Thirteen percent (13/104) developed seizure recurrence at the 1 year follow up. Significant univariate associations were noted between seizure recurrence and these factors: presence of antecedents [odds ratio (OR) 4.8; 95% confidence interval (CI) 1.2-18.5 ], post-encephalitic epilepsy (OR 7.7; 95% CI 2.1 ~ 28), and abnormal neurological examination(OR 14.6; 95% CI 3.9-55). With multivariate logistic regression, the independent predictor of seizure recurrence was the abnormal neurological examination (OR 9.7; 95% CI 2.4 ~ 39.4). CONCLUSIONS: The chance of developing a seizure recurrence at the 1 year follow up was 13 percent and the prognostic factors were the presence of antecedents, post-encephalitic epilepsy and an abnormal neurological examination.