Enfermedades raras en la infancia. Visión gastroenterológica / Rare Diseases in Childhood. Gastroenterological View

Introducción: Las enfermedades raras conforman las afecciones de baja prevalencia que asociadas a los medicamentos huérfanos representan un problema sanitario y social mundial. Objetivo: Revisar los aspectos más sobresalientes relacionados con las enfermedades raras, con una visión gastroenterológica, y su repercusión en la infancia. Métodos: Se realizaron búsquedas no estructuradas de publicaciones en español e inglés en PubMed, Google Scholar, Scimago, SciELO, desde enero 2010 hasta agosto 2021. Se usaron los términos: enfermedades raras, conceptualización, prevalencia, epidemiología, medicamentos huérfanos y ética. Análisis y síntesis de la información: Se revisaron las enfermedades raras en la infancia, criterios conceptuales, epidemiología global, enfermedades más reconocidas con énfasis en gastroenterología. Se destacó la prevalencia, vínculo genético, importancia social, dilema diagnóstico y categorías; repercusión de los tratamientos con medicamentos huérfanos, sus costos y problemas éticos. Se resaltó la incidencia de enfermedades digestivas y el valor de la endoscopia y la biopsia en el diagnóstico. Conclusiones: Se documentaron las enfermedades raras en la infancia, y se analizaron como problema mundial, sanitario y social. El desarrollo de la técnica y de la ciencia, resultaron contribuciones decisivas que variaron criterios sobre diferentes afecciones catalogadas como raras(AU)

Introduction: Rare diseases are the conditions of low prevalence associated with orphan drugs and they represent a global health and social problem. Objective: To review the most outstanding aspects related to rare diseases, with a gastroenterological view, and their impact on childhood. Methods: Unstructured searches for publications in Spanish and English in PubMed, Google Scholar, Scimago, SciELO were conducted, from January 2010 to August 2021. The terms rare diseases, conceptualization, prevalence, epidemiology, orphan drugs and ethics were used. Analysis and synthesis of information: Rare diseases in childhood, conceptual criteria, global epidemiology, and the most well-known diseases with emphasis on gastroenterology were reviewed. Prevalence, genetic link, social importance, diagnostic dilemma and categories, also the impact of orphan drug treatments, their costs and ethical problems were highlighted. The incidence of digestive diseases and the value of endoscopy and biopsy in diagnosis were highlighted. Conclusions: Rare diseases in childhood were documented and analyzed as a global health and social problem. The development of technique and science were decisive contributions that varied criteria on different conditions classified as rare(AU)

Anotaciones sobre conceptos y prácticas de territorio y comunidad en la Terapia Ocupacional colombiana / Notes on territory and community concepts and practices in Colombian occupational therapy / Apontamentos acerca dos conceitos e práticas sobre território e comunidade na Terapia Ocupacional colombiana

El artículo aborda el desarrollo teórico-práctico de los conceptos territorio y comunidad en la Terapia Ocupacional colombiana. El objetivo fue comprender el uso y la elaboración de tales conceptos e identificar cómo se expresan en la práctica. La recolección de datos se realizó en dos etapas: primera, revisión conceptual de la literatura publicada entre 1990 y 2020 en revistas y libros de amplia circulación en América Latina, así como entrevistas a dos autoras recurrentes en las publicaciones seleccionadas; segunda, observación participante de una pasantía profesional orientada a estudiantes de pregrado en Terapia Ocupacional de una universidad colombiana y entrevistas a actores sociales involucrados en esa práctica. Se identifica que los términos territorio y comunidad conforman el vocabulario técnico de las y los terapeutas ocupacionales en Colombia; se refieren históricamente a prácticas realizadas en contextos de pobreza, y adquirieron mayor relevancia con el desarrollo de políticas públicas. Se evidencia, además, una actuación territorial-comunitaria relacionada con el modo de vida comunitario y con la apropiación de los recursos materiales, sociales, culturales y relacionales del territorio, desde una perspectiva colectiva de la vida. Se reitera la necesidad de superar el uso de estos conceptos solo como espacios físicos de actuación profesional.

The article focuses on the theoretical-practical development of the territory and community concepts in Colombian Occupational Therapy. The objective was to understand the use and conception of territory and community and to identify how they are expressed in practice. Data collection was carried out in two stages: (1) conceptual review of the literature in journals and books with great circulation in Latin America, between 1990 and 2020, and interviews with the two most recurrent authors in the publications selected; (2) participant observation in place where a professional internship is held for occupational therapy graduation students affiliated with a university, associated to interviews with the social actors involved in that practice. It was identified that the terms make up the professional vocabulary of occupational therapists, historically refer to practices carried out in contexts of poverty and acquired greater emphasis to public policies development. The results show a territorial-community action related to the community way of life and appropriation of the material, social, cultural and relational resources of the territory, from a collective perspective of life. The need to overcome the use of concepts only as physical spaces of professional action is emphasized.

O artigo aborda o desenvolvimento teórico e prático dos conceitos território e comunidade na Terapia Ocupacional colombiana. O objetivo foi compreender o uso e a elaboração dos conceitos de território e comunidade e identificar como eles se expressam na prática profissional. A reunião dos dados foi realizada em duas etapas: na primeira, foi feita uma revisão conceitual da literatura nos periódicos e livros de grande circulação na América Latina, entre 1990 e 2020, e entrevistas com as duas autoras mais recorrentes nas publicações selecionadas; na segunda, foi produzida uma observação-participante em um local em que se realiza estágio profissional para estudantes de graduação de Terapia Ocupacional, filiados a uma universidade, bem como uma entrevista com atores sociais envolvidos naquela prática. Identificou-se que os termos compõem o vocabulário técnico das terapeutas ocupacionais; também fazem historicamente referência às práticas realizadas em contextos de pobreza, e ganharam maior ênfase com o desenvolvimento de políticas públicas focalizadas após os anos de 1990. Os resultados demonstram uma atuação territorial-comunitária específica relacionada ao modo de vida comunitário e à apropriação dos recursos materiais, sociais, culturais e relacionais do território, a partir de uma perspectiva coletiva da vida. Ressalta-se a necessidade de superação no uso dos conceitos apenas como espaços físicos da atuação profissional.

Conceptualizaciones, perspectivas y referentes de la participación en la educación primaria, México / Conceptualizations, perspectives and reference points for participation in elementary schools, Mexico / Conceitos, perspectivas e referências da participação na educação primária no México

Resumen (analítico) Se analizan las conceptualizaciones sobre participación que refieren niñas y niños (entre cinco y ocho años de edad), así como las de sus profesores y familiares, en tres escuelas de educación primaria de zonas urbano-marginales en México. El método cuasietnográfico fue utilizado para describir e interpretar los significados obtenidos de las entrevistas individuales, grupos focales y el dibujo infantil. La información fue analizada por medio del análisis de contenido categorial. Los resultados muestran que, conforme la infancia avanza en su escolarización, los significados sobre participación se acotan a emitir opiniones cuando le son solicitadas por los profesores. Se identifica al adultocentrismo y obediencia como los obstáculos de la construcción de escuelas inclusivas, concluyendo que es imperativo generar diálogos entre los referentes conceptuales sobre participación provenientes del espacio familiar y educativo.

Abstract (analytical) This paper reviews the conceptualizations of participation among children aged between five and eight years old, their teachers and their family members in three elementary schools in urban marginalized areas of Mexico. A quasi-ethnographic method was used for the description and interpretation of the meanings identified in individual interviews, focal groups and children's drawings. The information was reviewed using a process involving categorical content analysis. The results indicate that as the children progress through their schooling process, the meanings related to participation are limited to issuing opinions when requested by teachers. Adult-centrism and obedience norms are identified as obstacles that limit the construction of inclusive schools. The authors conclude that it is imperative to generate dialogues between the conceptual reference points about child participation in family and educational spaces.

Resumo (analítico) Neste trabalho são analisados conceitos sobre a participação de crianças, entre cinco e oito anos de idade, e a participação de professores e familiares em três escolas de Ensino Fundamental de áreas urbanas marginalizadas do México. O método quase etnográfico foi utilizado para descrever e interpretar os significados a partir de entrevistas individuais e grupais, bem como de desenhos infantis. A informação foi estudada por meio de uma Análise de conteúdo categorial. Os resultados mostram que conforme as crianças avançam na sua escolaridade, os resultados sobre participação se limitam a emitir opiniões quando lhe são solicitadas pelos professores no espaço escolar. O centrismo adulto e a obediência são identificados como obstáculos à construção de escolas inclusivas, concluindo que é imprescindível gerar diálogos entre os referentes conceituais sobre a participação proveniente da família e do espaço educacional.

La atribución intelectual en las revistas médicas cubanas / Intellectual attribution in Cuban medical journals

La identificación de la autoría de los argumentos en la escritura médica afecta imperativos de la ciencia como la precisión y la transparencia, la reproductibilidad y la responsabilidad legal. El objetivo aquí fue describir su comportamiento en revistas médicas cubanas certificadas como científicas por el CITMA, toda vez que las distintas formas de su expresión afectan imperativos de la ciencia como la precisión, la transparencia, la reproductibilidad y la responsabilidad legal por lo dicho y lo hecho. Para lograrlo se realizó el análisis cualitativo de una muestra de 50 secciones Discusión de artículos originales de investigación que fueron publicados entre el año 2007 y el 2011. Los datos fueron recolectados mediante hojas de codificación y luego analizados en el marco teórico de la pragmalingüística y la retórica de la ciencia. Hubo un 5 por ciento de enunciados con atribución intelectual inequívoca al autor del texto, manifiesta mediante el uso referencial de la persona gramatical; un 25 por ciento de enunciados atribuidos a terceras personas específicas mediante referencias bibliográficas, y un 70 por ciento de enunciados con atribución ambigua (47 por ciento de ellos atribuibles a terceras personas no especificadas y 23 por ciento de enunciados cuyo posible conceptualizador es la comunidad científica). En conclusión, la autoadscripción de los argumentos al hablante, preferiblemente mediante la primera persona gramatical, permite diferenciar en la ciencia entre juicio personal y acuerdo intersubjetivo, toda vez que la autoría de un artículo no presupone la autoría de todos los argumentos en él incluidos. La elevada proporción de enunciados emitidos por sus autores sin atribución intelectual explícita o con medios ambiguos, a pesar del alto grado de especialización textual, merece ulterior investigación y atención editorial(AU)

Acknowledgment of the authorship of arguments in medical writing affects science imperatives such as accuracy and transparency, reproducibility and legal responsibility. The purpose of the study was to describe its behavior in Cuban medical journals certified as scientific by CITMA. To achieve this end, a qualitative analysis was conducted of a sample of 50 Discusión (Discussion) sections dealing with original research papers published from 2007 to 2011. Data were collected onto coding sheets and analyzed within the theoretical framework of pragmalinguistics and science rhetoric. 5 percent of the statements were found to contain unequivocal intellectual attribution to the author of the text, made manifest by the referential use of the grammatical person; 25 percent of the statements were attributed to specific third persons by bibliographic references, and in 70 percent of the statements attribution was ambiguous (47 percent attributable to non-specified third persons and 23 percent in which the possible conceptualizer is the scientific community). In conclusion, self-ascription of arguments by the speaker, preferably through the use of the first grammatical person, makes it possible to distinguish personal judgment from inter-subjective arrangement, since authorship of a paper does not presuppose the authorship of all the arguments therein included. The high proportion of statements issued by their authors without intellectual attribution or by ambiguous means, despite the high degree of textual specialization, deserves further research and editorial attention(AU)

Implementation and Evaluation of Case-Based Learning Approach in Microbiology and Immunology

Background: Medical education in the last two decades has shifted from teacher-centered methods to studentcentered methods, where students are learning through active participation. Clinical case-based learning (CBL) was found to be one of the excellent approaches to promote students learning. It enhances their critical thinking, problem-solving ability, knowledge retention, and exam preparation. The objective of the current study was to assess students’ perception on the usefulness of CBL approach in Microbiology and Immunology course. Methodology: This study was conducted at College of Medicine and Health Sciences among 5th-year medical students of 2017- 2018 batch. The study design included pretest, CBL discussion on selected topics, and the posttest after the CBL session. The data were collected, tabulated, and statistically analyzed using Microsoft Excel and SPSS version 22. The student’s “t” test was used to compare pretest and posttest results and the p<0.05 was considered as statistically significant. Results: A total of 114 fifth year medical students participated in the study. Majority of the students were in favor of CBL activity. More than 85% of the students stated that they enjoyed the activity and about 80% indicated CBL activity improved their critical thinking, problem-solving skills, and clinical reasoning. Majority of the students (90.35%) said it improved their knowledge retention and about 64.04% stated that it improved their exam grades. The difference between pretest and posttest scores was statistically significant with p<0.05. Conclusion: CBL is an excellent educational tool to motivate and promote students learning. It enhances students’ analytical thinking, clinical reasoning, conceptualization, and knowledge retention. It also benefits students in terms of their better examination preparation and performance.

Adição à internet ou uso problemático da internet? Qual dos termos usar? / Dépendance à Internet ou utilisation problématique d'Internet? Quel terme utiliser? / Adición a Internet o uso problemático de Internet: ¿Qué término usar? / Internet addiction or problematic internet use? Which term should be used?

Resumo O uso da internet tem aumentado exponencialmente a nível mundial. Ainda que ele não seja por si só negativo, já que integra benefícios vários, alguns indivíduos parecem exibir problemas relacionados com o seu uso excessivo, descontrolado e disfuncional. Consequentemente, tem sido crescente, particularmente nas últimas duas décadas, o interesse dos investigadores em explorar este uso, quando excessivo e pouco saudável. Porém, e sendo um tema/constructo tratado por diferentes autores com quadros teóricos também diferentes, são vários os termos usados na literatura para descrever este fenómeno. Neste sentido, este artigo propõe-se a apresentar o trabalho uma revisão de literatura de dois dos conceitos mais usados e espartilhados na literatura científica, ou seja, adição à internet e uso problemático da internet.

Résumé L'utilisation d' Internet a augmenté de manière exponentielle dans le monde. Bien que l'utilisation d' Internet ne soit pas négative en soi, étant donné qu'elle intègre plusieurs avantages, certaines personnes semblent présenter des problèmes liés à son utilisation excessive, incontrôlée et dysfonctionnelle. En conséquence, l'intérêt des chercheurs pour exploiter cet usage, qu'il soit excessif ou malsain, a augmenté, particulièrement au cours des deux dernières décennies. Cependant, étant un thème/construit traité par différents auteurs avec différents cadres théoriques, plusieurs termes sont utilisés dans la littérature pour décrire ce phénomène. En ce sens, nous proposons de présenter dans cet ouvrage une analyse de deux des concepts les plus utilisés et les plus partagés dans la littérature scientifique, à savoir l'addition à internet et son utilisation problématique.

Resumen El uso de Internet ha aumentado exponencialmente a nivel mundial. Aunque esto no es por sí solo negativo ya que integra diversos beneficios, algunos individuos parecen presentar problemas relacionados con su uso excesivo, descontrolado y disfuncional. En consecuencia, en las últimas dos décadas ha aumentado cada vez más el interés de los investigadores en estudiar este uso, cuando es excesivo o poco saludable. Sin embargo, y siendo un tema/constructo tratado por diferentes autores con cuadros teóricos también diferentes, son varios los términos usados en la literatura para describir este fenómeno. En este sentido, nos proponemos presentar en este trabajo una revisión de dos de los conceptos más usados y más divididos en la literatura científica, es decir, adición a Internet y uso problemático de Internet.

Abstract Internet use has increased exponentially worldwide. Although the use itself is not negative, since it integrates several benefits, some individuals seem to show problems related to its excessive, uncontrolled, and dysfunctional use. Therefore, the interest of researchers in exploring this use, when it is excessive and unhealthy, has been growing, especially in the last two decades. However, being a subject/construct treated by different authors with different theoretical frameworks, several terms are used in the literature to describe this phenomenon. Regarding this, this article proposes to present a literature review of two of the most used and shared concepts in the scientific literature, that is, internet addiction and problematic internet use.

Conceitualização cognitiva para casais: um modelo didático para formulação de casos em terapia conjugal / Cognitive conceptualization for couples: a didactic model for formulating cases in marital therapy

A Terapia Cognitivo-Comportamental utiliza de uma formulação de caso específica (Conceitualização Cognitiva). Esse método de avaliação permite, a partir de um modelo baseado em evidências, compreender o funcionamento do indivíduo sob termos cognitivo-comportamentais. Atualmente, o diagrama de Conceitualização Cognitiva ainda avalia sujeitos individualmente sem um modelo específico para a relação conjugal. Todavia, ao se trabalhar com o casal, é fundamental verificar como a díade interage e como os conflitos são instalados nesta interação formulando um modo de processamento cognitivo do casal. Este estudo teórico teve como objetivo fornecer um modelo de Conceitualização Cognitiva para Casais e dar suporte a terapeutas e clientes sobre a compreensão dos conflitos e estratégias que são utilizados para resolução de problemas na conjugalidade. Para isso, explanou, de modo didático, a descrição de cada elemento do modelo e ilustrou o processo de conceitualização com um caso clínico fictício.(AU)

Cognitive-Behavioral Therapy uses a specific case formulation (Cognitive Conceptualization). This method of evaluation allows, from an evidence-based model, to understand the functioning of the individual under cognitive-behavioral terms. Currently, the Cognitive Conceptualization Diagram still evaluates subjects individually without a specific model for the conjugal relationship. However, when working with couple, it is fundamental to verify how the dyad interacts and how the conflicts are installed in this interaction, formulating a model of cognitive processing of the couple. This theoretical study aimed to provide a model of Cognitive Conceptualization for Couples and to support therapists and clients on understanding the conflicts and strategies that are used to solve problems in conjugality. To do this, he explained, in a didactic way, the description of each element of the model and illustrated the process of conceptualization with a fictious clinical case.(AU)

Normas y Creencias de la Permanencia Relacional: Diseño y Validación de una Medida / Rules and Beliefs of Relationship Permanence: Design and Validation of a Measure

Con base en los postulados por Díaz Guerrero (2003) acerca de las creencias, normas y valores que gobiernan los sentimientos, pensamientos y conductas involucrados en el desarollo, mantenimiento y disolución de las relaciones de pareja (Díaz Loving, & Sánchez Aragón, 1998), el propósito de este estudio fue evaluar las premisas histórico socio- culturales respecto a la permanencia relacional. Para cumplir con el objetivo se elaboró un instrumento a través de dos estudios: 1) exploratorio, se aplicó un cuestionario de preguntas abiertas a una muestra de 200 personas de la Ciudad de México. 2) A partir de las respuestas proporcionadas por los participantes se diseñó una medida con formato de respuesta tipo Likert y se aplicó a 334 adultos. Siguiendo el orden establecido en el procedimiento propuesto por Reyes Lagunes y García y Barragán (2008), la escala se conformó por 32 reactivos agrupados en cinco factores: Relación ideal, Tradición, Lealtad, Interacción satisfactoria y Coincidir, que explican en conjunto el 69.88% de la varianza total, y un coeficiente Alpha de Cronbach de .81. Los hallazgos coinciden con los fundamentos de las diferentes perspectivas teóricas del estudio de la permanencia relacional y engloban aspectos culturales particulares al contexto de la socio-cultura mexicana, los resultados se discutirán en este sentido.

Based on the perspective of Diaz-Guerrero (2003) concerning beliefs, norms, and values that control feelings, thoughts, and behaviors involved in the development, maintenance and dissolution of couple relationships, the study was conducted to assess the historical socio-cultural premises regarding to relational permanence in such relationships. To address this goal pair of studies was designed: 1) an exploratory study where 200 participants from Mexico City answered an open ended question. Based on the answers to the first study, an objective instrument with a Likert format was designed and administered to a sample of 334 adults. Following the procedure proposed by Reyes Lagunes & García y Barragán (2008), the scale consists of 32 grouped into five factors: Ideal relationship, Tradition thoughts, Loyalty, Satisfactory interaction and Coincide, these factors explained 69.88% of the total variance and have a .81 Cronbach's Alpha Coefficient. The findings coincide with the foundations of the different theoretical perspectives of the study of relational permanence and included cultural aspects particular to the context of Mexican socio-culture, the findings and implications for future research are discussed in this way.

Cognitive behavioral therapy for social anxiety disorder: A case report based on conceptualization / 中国心理卫生杂志

To introduce the cognitive behavioral therapy-orientated case conceptualization and process for social anxiety disorder. Based on the detailed and integrated case conceptualization, 15 sessions of the systematic and standardized CBT treatments were conducted for maladaptive cognitive and behavioral problems. The results showed that the Liebowit Social Anxiety Scale (LSAS) score was reduced from 49 to 26, and the initial treatment goal was achieved. This case report suggests that "cognitive reconstruction combined with exposure" therapy strategy could be used to treat social anxiety disorder.

Cognitive and behavioral case conceptualization report of a case with obsessive-compulsive disorder / 中国心理卫生杂志

To explore how to formulate the case conceptualization of obsessive-compulsive disorder (OCD) in the perspective of cognitive theory and behavioral theory. The current study utilized the cognitive behavioral conceptualization model to account for the development and maintenance of obsessive-compulsive symptoms of a college student with OCD. An intervention strategy combining exposure and reaction prevention (ERP) with cognitive techniques was implemented within a 17-session individual counseling in 13 weeks. Client's anxious, depressive and obsessive-compulsive symptoms were assessed at baseline and after 13-week intervention with the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS), respectively. Results showed a significant decrease in anxiety and depressive symptoms. The score of Y-BOCS decreased from 25 to 11 after intervention, which indicated normal social functioning. These findings suggested that the cognitive theory and behavioral theory of OCD could effectively guide the process of case conceptualization and the counselling practice.

Defining and conceptualizing general practice:The comprehensiveness of primary care / 中国卫生政策研究

Comprehensiveness of care is one of the core attributes of primary health care, and it has a great impact on the first diagnosis,accessibility,coordination and continuity to form the primary health care high perform-ance mechanism. Comprehensiveness of care has been playing an increasingly significant role in case when faced with the challenges of the aging of Chinese population,the high prevalence of chronic diseases,and the rapidly rising cost of health care. It is a fundamental problem for researchers,policy makers,and practitioners to clarify the definition of comprehensiveness of primary health care,which is the basis for managing comprehensive services. This article has systematically reviewed the current researches on definitions of comprehensiveness of basic health care, ascertained the key elements of comprehensiveness,and pinpointed the relationship between the dominant and recessive elements. Then,it defined the conception and the boundary of comprehensiveness of care in the context of primary health care,ac-cording to three principles-controllability, exhaustion, and exclusiveness, and finally conceptualized the primary health care comprehensiveness for further study on the operational definition of primary health care attributes.

Una aproximación a la conceptualización que poseen los docentes respecto del fenómeno de cyberbullying / An approach to teachers conceptualization with regard to the phenomenon of cyberbullying

El objetivo de este trabajo se orienta a indagar y describir las conceptualizaciones que docentes que ejercen su trabajo en escuelas de Educación Secundaria ubicadas en la Provincia de Buenos Aires (Argentina) poseen acerca del fenómeno de cyberbullying. A su vez, busca conocer y describir si dichos docentes cuentan con estrategias de intervención para abordar este fenómeno y su percepción acerca de la formación o capacitación para intervenir ante él. Mediante la realización de entrevistas semiestructuradas y el empleo de una metodología de enfoque cualitativo se construyeron categorías de análisis de la información recolectada. Los resultados hallados en este estudio sugieren la necesidad de brindar a los docentes información específica sobre la problemática, a fin de que puedan adquirir herramientas efectivas y contribuir con su adecuada prevención y abordaje.

The objective of this work is to investigate and describe the conceptualization that teachers who work in secondary schools in the Province of Buenos Aires (Argentina) have about the phenomenon of cyberbullying. At the same time, it pursues two more aims: to know if these teachers have intervention strategies to approach this phenomenon and to describe their perception about the training to intervene on it. Categories of analysis of the information collected were constructed through semi-structured interviews and the use of a methodology of qualitative approach. The results found in this study suggest the need to provide teachers with specific information on the problem, so that they can acquire effective tools and contribute to their adequate prevention and approach.

Study on defining and conceptualizing of general practice: The accessibility of primary care / 中国卫生政策研究

Accessibility is one of the core attributes of primary care, which is closely associated with first-contact, positively interacts with comprehensiveness, and is very influential to continuity and coordination.This paper first reviews the current literature on definition and concept of accessibility and highlights the characteristics and contents of primary care accessibility, then simplifies the overlapping between accessibility and other core attributes of primary care, and finally provides the definition of primary care accessibility and its core elements to lay the foundation for the development of measurement and evaluation tools for the core attributes of general practice.

Study on defining and conceptualizing of general practice: The continuity of primary care / 中国卫生政策研究

Continuity of care is one of the core attributes of primary care, which interacts with first-contact, accessibility, coordination and comprehensiveness in a mutual, supportive, and strengthening way to form an interactive mechanism of primary care.This paper first reviews the current literature on definitions and concepts of continuity of care, ascertain the key elements of continuity, and pinpoint the relationship between the dominant and recessive elements.Then, it defines the connotations of continuity of care and their boundaries in the context of primary care, according to the principles of controllability, exhaustion and exclusiveness.Finally it conceptualizes the primary care continuity to lay the foundation for further studies on operationally defining the primary care attributes of general practice.

Estado desarrollista humano: Los retos de una conceptualización multidimensional

Durante más de un siglo el concepto de Estado desarrollista se ha enfocado desde la perspectiva unidimensional del desarrollo económico. Sin embargo, la progresiva evolución de la teoría del desarrollo hacia enfoques multidimensionales ha propiciado su incipiente reconcep-tualización como Estado desarrollista humano. Este trabajo plantea, mediante la revisión de la literatura reciente, algunos de los retos conceptuales, teóricos y metodológicos que surgen en este proceso de integrar la multidimensionalidad en el Estado desarrollista. Entre estos, destacan: 1. la elección de enfoque conceptual ante la heterogeneidad multidimensional, 2. la construcción de marcos teóricos y analíticos comunes en un contexto multidisciplinar, 3. la tensión entre enfoques metodológicos deductivo-normativos e inductivo-descriptivos y 4. la necesidad de desarrollar métodos e indicadores cuantitativos para ampliar el análisis comparado. En conclusión, se plantea una serie de retos de distinto orden que exigirán progresos en distintas disciplinas hasta alcanzar un cuerpo teórico y analítico sólido que permita hablar de una conceptualización unificada y consolidada del Estado desarrollista humano. Este trabajo trata de dar un paso en este sentido mediante una propuesta de sistematización conceptual y operacionalización analítica.

For more than one century Developmental State has been conceptualized from the unidimensional approach of economic development. However, development theory evolution towards multidimensional approaches has led to its conceptualization as Human Developmental State. This paper poses the main conceptual, theoretical and methodological challenges for this approach. These are: i) choosing the conceptual approach within the multidimensional heterogeneity, ii) constructing common theoretical and analytical frameworks in a multidisciplinary context, iii) resolving the tension between inductive-normative and deductive-descriptive methodological approaches and developing methods and quantitative indicators for international comparisons. In conclusion, a series of challenges of different order are presented and will demandprogress in different disciplines until reaching a solid theoretical and analytical body that allows to speak of a unified and consolidated conceptualization of the human developmental state. This paper tries to take a step in this direction through a proposal of conceptual systematization and analytical operationalization.

La satisfacción laboral y profesional de los profesores

La especial relevancia e incidencia de la profesión docente en las generaciones jóvenes hace especialmente pertinente estudiar su satisfacción, ya que ello incide de forma directa en el desempeño y eficacia de su profesión. El objetivo de este trabajo es proceder a una revisión de los principales estudios sobre satisfacción laboral y profesional de los profesores, partiendo de una conceptualización por autores y usando una visión determinada de la forma en que obtienen los datos y las categorías de medida. La metodología ha consistido en seleccionar tres bases de datos temáticas y los resultados del ISBN para extraer las aportaciones de los últimos 10 años sobre el tema. Los resultados muestran una pluralidad de enfoques y perspectivas dependiendo del origen científico de cada investigador. Además, señalan la mayoría de mujeres en los niveles no universitarios y una satisfacción media-alta con la profesión, destacando en forma positiva el aspecto relacional, y en forma negativa, la valoración y el sueldo. Como mejora pudieran incluirse más referencias en inglés pero ello haría el artículo interminable.

The high relevance and influence of teachers in the younger generations makes the study of those teachers´ satisfaction really important, as it directly affects their professional performance and efficiency. This research work aims to revise the main studies about labor and professional satisfaction among teachers, starting with a conceptualization classified by authors and using a determined vision of the way data are obtained and of the measuring categories. The methodology followed has been the selection of three thematic databases and the ISBN´s results to extract the contributions on the subject published over the last ten years. The results show a plurality in the focuses and viewpoints depending on the scientific origin of every researcher. Besides, women are remarked as a majority in the educational levels below higher education and a satisfaction in levels between medium and high with the profession, highlighting, in a positive way, the relational aspect and, in a negative one, the valuation and the salaries. As an improvement, more references in English could have been included, but in that case the paper would have turned out being an endless work.

A especial relevância e incidência da profissão docente nas gerações jovens faz especialmente pertinente estudar sua satisfação, já que isto incide de forma direta no desempenho e eficácia de sua profissão. O objetivo deste trabalho é proceder a uma revisão dos principais estudos sobre satisfação laboral e profissional dos professores, partindo de uma conceptualização por autores e usando uma visão determinada da forma em que obtém os dados e as categorias de medida. A metodologia há consistido em selecionar três bases de dados temáticas e os resultados do ISBN para extrair as contribuições dos últimos 10 anos sobre o assunto. Os resultados mostram uma pluralidade de enfoques e perspectivas dependendo da origem científico de cada investigador. Ademais, assinalam a maioria de mulheres nos níveis não universitários e uma satisfação media-alta com a profissão, destacando em forma positiva o aspecto relacional, e em forma negativa, a valoração e o salário. Como melhora pudessem incluir-se mais referências em inglês mas isto faria o artigo interminável.

Cognitive Behavioral Therapy: state of the art, a review / Terapia cognitiva comportamental: estado da arte

Protocols in Cognitive-Behavioral Therapy applied for individual or group for the treatment of anxiety and mood disorders has been found to be effective. Case conceptualization is relevant and essential in Cognitive-Behavioral Therapy because it describes and explains patient presentations in ways that inform interventions. Yet the evidence base challenges the claimed benefits of case conceptualization. A systematic review of the literature has been conducted based on data from ISI Web of Knowledge and PubMed. Articles relating to Cognitive-Behavioral Therapy Protocols in both individual and group therapy procedures were selected. We reviewed 366 articles; we discarded 141, which were not in English, 86, which were reviews and 93 because of inadequate titles. After reading the abstracts a further 18 articles were excluded, leaving 28 to be fully evaluated. Finally, 19 were selected for the final review. These articles that describe Cognitive-Behavioral Therapy treatment for panic disorder, which were effective when patients were also treated by a psychiatrist. Depressive symptoms were only mildly reduced with cognitive therapy in patients seeking the acquisition of coping skills requiring deliberate efforts and reflective thought. Actually, changes in despair thoughts and behaviors require less rumination of negative interpretation of depressive patients. Finally, the Unified Protocol is an efficient procedure for group treatment in cases of generalized anxiety and mood disorders.

Protocolos de Terapia Cognitivo-Comportamental quando aplicados em grupo ou individualmente para tratamento de transtornos de ansiedade e de humor têm eficácia. A conceituação de caso é relevante e essencial na Terapia Cognitivo-Comportamental. Ela tem como função a descrição e explicação da história de vida de cada paciente, favorecendo assim como um guia informativo quanto às escolhas do terapeuta sobre as respectivas intervenções clínicas. Desta forma, o terapeuta ao conceituar o caso tem facilidade em alcançar as metas propostas na terapia com base em evidências. Uma revisão sistemática da literatura foi realizada com base em dados do ISI Web of Knowledge e PubMed. Foram selecionados artigos relativos à Terapia Cognitivo-Comportamental em protocolos terapêuticos individuais e de grupo. Encontramos 366 artigos; descartamos 141 artigos que não estavam em Inglês, 86 que eram revisões e 93 por apresentarem títulos inadequados. Após consulta aos resumos outros 18 artigos foram excluídos, deixando 28 para avaliação do texto integral. Finalmente, 19 foram selecionados para a inclusão. Todos estes artigos relatam tratamento por meio da Terapia Cognitivo-Comportamental. O protocolo para o transtorno do pânico mostra eficácia quando associado ao uso de medicamentos psiquiátricos. Os sintomas depressivos são levemente reduzidos pela Terapia Cognitiva por meio de aquisição das novas habilidades de enfrentamento que exigem esforços na atitude e na reflexão de pensamentos dos pacientes. Na verdade, os pacientes depressivos ruminam menos seus pensamentos quando os interpretam de forma negativa do que nos momentos em que estão completamente sem esperança. Finalmente, o Protocolo Unificado é um procedimento eficiente para o tratamento em grupo ou individual nos transtornos de ansiedade generalizada e de humor.

La conceptualización de un caso de trastorno de ansiedad generalizada (TAG) propuesta por terapeutas psicoanalíticos: análisis mediante los criterios del diagnóstico psicodinámico operacionalizado 2 (OPD-2): resultados preliminares / A generalized anxiety disorder (GAD) s case conceptualization proposed by psychoanalytic therapists: analysis through operacionalized psychodynamic diagnostic 2 (OPD-2) s criteria: preliminary Results

La siguiente investigación clasificó la conceptualización de un caso de TAG, realizada por terapeutas psicoanalíticos, utilizando los criterios del Diagnóstico Psicodinámico Operacionalizado 2 (OPD-2). Se re-analizó información proveniente de la tesis doctoral en curso del primer autor, donde 30 psicoterapeutas (15 psicoanalíticos y 15 cognitivos), en una entrevista individual, propusieron inferencias pronósticas y una conceptualización del caso para un paciente TAG. El objetivo del presente estudio fue la utilización de los criterios OPD-2 para un análisis secundario de las 15 entrevistas ya conducidas con los participantes psicoanalíticos. Se describen la justificación, los procedimientos y preguntas centrales de esta investigación. Se presenta el OPD-2 como instrumento de análisis. Según resultados preliminares, los ejes OPD-2 III y IV predominaron en la identificación del problema principal del paciente, los ejes IV y V en su diagnóstico tentativo, y el eje II en las expectativas inferidas del paciente respecto del tratamiento. Se discuten implicancias de esta investigación para la práctica clínica psicoanalítica.

The present study classified a GAD´s case conceptualization made by psychoanalytic therapists using Operationalized Psychodynamic Diagnostic 2 (OPD-2) criteria. Information from the first author´s ongoing dissertation research was re-analyzed. In that study, 30 psychotherapists (15 psychoanalytic and 15 cognitive) proposed prognostic inferences and a case conceptualization for a GAD patient. The aim of the present study was to use OPD-2´s criteria for a secondary analysis of the 15 interviews already conducted with the psychoanalytic participants. The present study`s rationale, procedures and central research questions are described. OPD-2 is presented as a data analysis` instrument. According to preliminary results, OPD-2´s axis III and IV were predominant in the patient´s main problem identification, axis IV and V were used to describe patient´s preliminary diagnosis, and axis II was observed in the patient´s inferred treatment expectations. Implications for psychoanalytic clinical practice are discussed.

Los jóvenes y las jóvenes en el Estado de México: sociodemografía y empleo 2010 / Youngsters from the State of Mexico: socialdemographics and employment 2010 / Os jovens, homens e mulheres no Estado do México: características sociodemográficas e emprego 2010

El presente estudio aborda el tema de los jóvenes mexiquenses de 14 a 29 años de edad que se encuentran en condición de inactividad en el ámbito de lo laboral y educativo, que se integran al recientemente creado concepto de NiNi; el de los jóvenes que ni estudian ni trabajan, la investigación se desarrolló desde una óptica de análisis teórico Socio Antropológico, que permitió observar los componentes mismos del fenómeno, así como, bajo qué especificidades se desarrolla dicho fenómeno. Así, el objetivo del presente artículo, consiste en ofrecer una disertación en torno al actual concepto de NiNi, a partir de información referida, proponiendo como elemento final una conceptualización mucho más acorde a la realidad de la población inmersa en el fenómeno.

This study approaches the topic concerning youngsters from the State of Mexico, with ages ranging from 14 to 29 years who are inactive both in the work and educational fields, who have been integrated to the recent NiNi concept; youngsters who do not study or work. The research is conducted from a Socio-Anthropological theoretical analysis perspective, which allows to observe the components of the phenomenon themselves, as well as under what specificities it develops. Accordingly, its objective consists of offering a dissertation around the current NiNi concept, from referred information, thus proposing, as the final element, a final conceptualization much more in accord with the reality of the population immersed in this phenomenon.

O presente estudo aborda o tema de jovens mexiquenses de 14 e 29 anos de idade que se encontram em condição de inatividade no ámbito do laboral e do educativo que se integram ao recentemente criado conceito de NiNi; os jovens que nem estuam e nem trabalham, a pesquisa de uma ótica de análise téorica sócio-antropológica, que permite observar os componentes mesmos do fenômeno bem como as especificidades que se desenvolvem. Assim, o objetivo do presente artigo, consite em oferecer uma dissertação sobre o atual conceito de NiNi, a partir da informação referida, propondo como elemento final uma conceitualização que esteja muitomais de acordo com a realidade da população imersa no fenómeno.

O corpo como pulso / El cuerpo como pulso / The body as a pulse

O corpo é foco de muitos estudos e intervenções. Alguns paradigmas o concebem apenas em seu aspecto sensório-motor, enquanto outros transitam prioritariamente por uma dimensão psicológica. Procurando contribuir para a formulação de outras perspectivas no campo, apresentam-se aspectos da concepção de corpo de Stanley Keleman em ressonância com os estudos de Regina Favre. A partir de cenas clínicas em grupos de seminários, podemos pensar o corpo como pulso, multimídia, multifacetado, que se (des) constrói permanentemente nos encontros. Articulando experiências clínicas da autora como terapeuta ocupacional e docente da graduação e em grupos de estudos, essas concepções servem como guia para uma clínica pensada, construída e balizada pelo corpo mediante utilização de abordagens corporais para a promoção de encontros plasmados por afetos e acontecimentos, na tentativa de criar corpos que possam sustentar as intensidades vividas e permitam a observação de si, a aproximação com o outro e a produção de singularidades.

The body is the focus of many studies and interventions. Some paradigms conceptualize the body only in relation to its motor-sensory characteristics, while others prioritize its psychological dimensions. With the aim of contributing towards formulating other perspectives within this field, some aspects of Stanley Keleman and Regina Favre's conceptualization of the body are presented here. Starting from clinical situations during seminar groups, we can take the body to be a multifaceted multimedia pulse that is continually [de]constructed through encounters. Together with the author's clinical experiences as an occupational therapist and teacher or undergraduates, these conceptualizations serve as a guide to clinical practice that is thought out, constructed and balanced by the body, using body approaches to promote encounters molded by affections and events, in an attempt to create bodies capable of sustaining the lived intensity of experiences, and which enable self-observation, closeness to other people and production of singularities.

El cuerpo es foco de muchos estudios e intervenciones. Algunos paradigmas lo conciben sólo en su aspecto sensorio-motor mientras otros transitan prioritariamente por una dimensión psicológica. Tratando de contribuir para la formulación de otras perspectivas en tal campo, se presentan aspectos de concepto del cuerpo, de Stanley Keleman en resonancia con los estudios de Regina Favre. A partir de escenas clínicas en grupos de seminarios, podemos pensar el cuerpo como pulso, de muchas facetas, que se (des) construye permanentemente en los encuentros. Articulando experiencias clínicas de la autora como terapeuta ocupacional y docente de la graduación y en grupos de estudios, estas conceptuaciones sirven como guía para una clínica pensada, construida y orientada por el cuerpo mediante el uso de planteamientos corporales para la promoción de encuentros plasmados por afectos y acontecimientos, en la tentativa de crear cuerpos que puedan sustentar las intensidades vividas y permitan la observación de sí mismo, la aproximación con el otro y la producción de singularidades.