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1.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1535436

ABSTRACT

Introducción: A consecuencia de la emergencia sanitaria por el virus SARS-CoV2, las actividades académicas migraron de forma repentina a un entorno de trabajo remoto; esto provocó que los hogares de todo el mundo se convirtieran en el asentamiento urgente de las estaciones de trabajo académico. La ergonomia como disciplina científica cobra relevancia al ser un aliado subsanador para mitigar los riesgos asociados con la aparición de lesiones musculoesqueléticas. De acuerdo con la memoria estadística del Instituto Mexicano de Seguridad Social, IMSS1, en el primer año de pandemia de COVID-19 se registraron 30 860 atenciones por lesiones en la región de manos y muñecas, 9696 en la zona de cabeza y cuello, 6251 dorsopatías y 1673 atenciones por astenopia a jóvenes de entre 18 a 29 años que desarrollaban actividades escolares. Objetivo: En este sentido, se aborda la presente investigación para conocer la composición de los espacios de trabajo académico en casa y analizar si existen factores o elementos que incidan en el riesgo de lesiones musculoesqueléticas en los estudiantes del nivel superior. Metodología: A través de un modelo de ecuaciones estructurales que cuenta con el constructo latente de las posibles lesiones (PL) en manos, espalda, piernas, cabeza, vista, oído, agotamiento físico y la respiración, las variables observables se atribuyen a los espacios utilizados para las actividades académicas en casa, muebles y equipos, Condiciones y Medio Ambiente (CyMAT). Resultados y discusión: Se encontró que un mal diseño de la estación de trabajo académico en casa, aunado a la utilización inadecuada de los muebles y equipos, aumenta la posibilidad de presentar síntomas asociados con las LMEs y, por tanto, daños en la salud del estudiante. Conclusión: La mediación de las estaciones de trabajo a través de la implementación de elementos ergonómicos mejora de forma sustancial la calidad de trabajo académico en casa, y hace evidente la importancia de la ergonomía como disciplina científica.


Introduction: As a result of the health emergency of the SARS-CoV2 virus, academic activities suddenly migrated to a remote work environment, causing homes around the world to become the urgent settlement of academic workstations. Ergonomics as a scientific discipline becomes relevant as it is a healing ally to mitigate the risks associated with the appearance of musculoskeletal injuries. According to the statistical report of the Mexican Institute of Social Security, IMSS1, in the first year of the COVID 19 pandemic, 30,860 care for injuries in the hands and wrists region, 9,696 in the head and neck area, 6,251 dorsopathies and 1,673 care for asthenopia were registered to young people between 18 and 29 years old who develop school activities. Objective: In this sense, this research is addressed to know the composition of academic workspaces at home and analyze if some factors or elements affect the risk of musculoskeletal injuries in students of the higher level. Methodology: Through a structural equations model that has the latent construct of possible injuries (PL) in the hands, back, legs, head, eyesight, hearing, physical exhaustion, and breathing; the observable variables are attributed to the spaces used for academic activities at home, furniture and equipment, conditions and environment (CyMAT) Results and discussion: It is explored that a bad design of the academic workstation at home coupled with the inappropriate use of furniture and equipment increases the possibility of presenting symptoms associated with SCI and therefore, damage to the student's health. Conclusion: The mediation of workstations through the implementation of ergonomic elements substantially improves the quality of academic work at home, making evident the importance of ergonomics as a scientific discipline

2.
Interacciones ; 9ene. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1448474

ABSTRACT

Introducción: La regulación de las emociones implica la modulación de las experiencias de las emociones para facilitar la consecución de los objetivos, por el contrario, las dificultades emocionales son un patrón de experiencias y/o expresiones emocionales que interfieren con el comportamiento dirigido a objetivos. Objetivos: Nuestro objetivo fue determinar la relación entre las dificultades en la regulación emocional con la postergación, la satisfacción con la vida y la resiliencia a la angustia. Método: La muestra consistió en 366 personas de la población general, con una media de edad de 33 años (DE=15) y un 62.1% de mujeres. Resultados: La postergación se relaciona positivamente con las seis estrategias de dificultades en la regulación de las emociones y el afecto negativo (AN), y negativamente con el afecto positivo (AP), la satisfacción con la vida y la resistencia a la angustia. La satisfacción con la vida y la resistencia a la angustia se relacionan negativamente con las estrategias de regulación identificadas y con el afecto negativo, y positivamente con el afecto positivo. La postergación, una vez controlado el AN y el AP se predice por la falta de claridad y la falta de objetivos. La satisfacción con la vida y la resistencia a la angustia son predichas por menos falta de estrategias. Conclusiones: Se concluye que de las variables sociodemográficas solo la edad es relevante en la postergación, dado que las personas menores de 21 años puntúan más elevado en este constructo. La postergación se relaciona positivamente con las seis dimensiones de las dificultades en la regulación de las emociones, en las que es predicha por la falta de objetivos y la falta de claridad, sin embargo, la satisfacción con la vida y la resistencia al malestar por menos falta de estrategias.


Background: Emotion regulation involves the modulation of emotional experiences to facilitate goal attainment. Conversely, emotional difficulties are a pattern of emotional experiences and expressions that interfere with goal-directed behavior. Objectives: Our aim was to determine the relationship between emotional regulation difficulties with procrastination, life satisfaction, and resilience to distress. Methods: The sample consisted of 366 individuals from the general population, with a mean age of 33 years (SD=15) and 62.1% female. Results: Procrastination was positively related to the six emotional distress regulation strategies and negative affect (NA), and negatively related to positive affect (PA). Life satisfaction and distress endurance are negatively related to the identified regulation strategies and NA, and positively related to PA. Procrastination, once NA and PA are controlled is predicted by lack of clarity and lack of goals. Satisfaction with life and resistance to distress are predicted by less lack of strategies. Conclusions: It is concluded that of the sociodemographic variables only age is relevant to procrastination, given that people younger than 21 years score higher on this construct. Procrastination is positively related to the six dimensions of difficulties in emotion regulation, where it is predicted by lack of goals and lack of clarity, however, satisfaction with life and resistance to discomfort by less lack of strategies.

3.
Interacciones ; 9: e278, ene. 2023.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1517795

ABSTRACT

Background: Emotion regulation involves the modulation of emotional experiences to facilitate goal attainment. Conversely, emotional difficulties are a pattern of emotional experiences and expressions that interfere with goal-directed behavior. Objectives: Our aim was to determine the relationship between emotional regulation difficulties with procrastination, life satisfaction, and resilience to distress. Methods: The sample consisted of 366 individuals from the general population, with a mean age of 33 years (SD=15) and 62.1% female. Results: Procrastination was positively related to the six emotional distress regulation strategies and negative affect (NA), and negatively related to positive affect (PA). Life satisfaction and distress endurance are negatively related to the identified regulation strategies and NA, and positively related to PA. Procrastination, once NA and PA are controlled is predicted by lack of clarity and lack of goals. Satisfaction with life and resistance to distress are predicted by less lack of strategies. Conclusions: It is concluded that of the sociodemographic variables only age is relevant to procrastination, given that people younger than 21 years score higher on this construct. Procrastination is positively related to the six dimensions of difficulties in emotion regulation, where it is predicted by lack of goals and lack of clarity, however, satisfaction with life and resistance to discomfort by less lack of strategies.


Introducción: La regulación de las emociones implica la modulación de las experiencias de las emociones para facilitar la consecución de los objetivos, por el contrario, las dificultades emocionales son un patrón de experiencias y/o expresiones emocionales que interfieren con el comportamiento dirigido a objetivos. Objetivos: Nuestro objetivo fue determinar la relación entre las dificultades en la regulación emocional con la postergación, la satisfacción con la vida y la resiliencia a la angustia. Método: La muestra consistió en 366 personas de la población general, con una media de edad de 33 años (DE=15) y un 62.1% de mujeres. Resultados: La postergación se relaciona positivamente con las seis estrategias de dificultades en la regulación de las emociones y el afecto negativo (AN), y negativamente con el afecto positivo (AP), la satisfacción con la vida y la resistencia a la angustia. La satisfacción con la vida y la resistencia a la angustia se relacionan negativamente con las estrategias de regulación identificadas y con el afecto negativo, y positivamente con el afecto positivo. La postergación, una vez controlado el AN y el AP se predice por la falta de claridad y la falta de objetivos. La satisfacción con la vida y la resistencia a la angustia son predichas por menos falta de estrategias. Conclusiones: Se concluye que de las variables sociodemográficas solo la edad es relevante en la postergación, dado que las personas menores de 21 años puntúan más elevado en este constructo. La postergación se relaciona positivamente con las seis dimensiones de las dificultades en la regulación de las emociones, en las que es predicha por la falta de objetivos y la falta de claridad, sin embargo, la satisfacción con la vida y la resistencia al malestar por menos falta de estrategias.

4.
Health Sciences Journal ; : 20-27, 2023.
Article in English | WPRIM | ID: wpr-984394

ABSTRACT

INTRODUCTION@#Due to COVID-19 pandemic, many have shifted into working at home which led to physical inactivity. This may cause musculoskeletal discomfort, chronic disease, muscle atrophy and spinal imbalance due to improper and prolonged sitting posture. Since mobile devices are relatively available for most of the office workers, there were still a lack of evidence-based mobile applications that can counteract the inactivity through exercises, which led to the researchers to create an application called SitMate that consists of evidence-based exercises which aimed to prevent musculoskeletal discomfort among a business process outsourcing company Workforce Management Personnel (BPO-WMP).@*METHODS@#Eleven participants (18-40 years old) full-time, work-from-home BPO-WMP were randomized into Treatment Group(TG)(n=6) and Control Group (CG)(n=5). The TG received one month intervention with the use of SitMate Application containing relaxation exercises, range of motion exercises and stretching exercises, and notifications for postural correction while the CG continued their usual working schedule.@*RESULTS@#There were no significant differences between two groups on all body parts that were measured using the Cornell Musculoskeletal Discomfort Questionnaire, and no significant differences in the intragroup pre-test and post-test scores on all body parts between TG and CG. For the intra-group post-test of the TG, there were noted improvements on the hip/buttock, right shoulder, upper back (median = 0) and right wrist (median = 1.5). There was also a noted increase in discomfort on the neck (median = 1.5) and lower back (median = 3). For the post-test of the CG, there were noted improvements on the right shoulder, right wrist (median = 0) and lower back (median = 1.5).@*CONCLUSION@#This study has shown that the SitMate application does not effectively reduce the prolonged sitting-related discomfort among the personnel after 1 month of intervention.


Subject(s)
Mobile Applications , Sedentary Behavior , Low Back Pain , Posture
5.
Chinese Journal of Experimental Ophthalmology ; (12): 499-502, 2023.
Article in Chinese | WPRIM | ID: wpr-990873

ABSTRACT

Dry eye is a multifactorial disease caused by changes in tear quality, volume and dynamics.Disturbance of tear film as the main character is accompanied by discomfort, visual disorder, and damage to the ocular surface and nerves.Cold thermoreceptors existing on the ocular surface are sensitive to alterations in corneal temperature and tear osmolality.They can give rise to the sensations of cold and pain, and regulate tear secretion, and are considered to be associated with the clinical manifestations of dry eye in some ways.This article reviewed the progress of corneal cold thermoreceptors in the regulation of corneal sensation and tear secretion, the related factors of corneal sensory regulation, and the clinical applications of TRPM8-related drugs, so as to provide ideas for the treatment of dry eye.

6.
Chinese Journal of Industrial Hygiene and Occupational Diseases ; (12): 429-434, 2023.
Article in Chinese | WPRIM | ID: wpr-986044

ABSTRACT

Objective: To investigate the functional somatic discomfort status, and to analyze the effect of job stress, hostile attribution bias and ego depletion on functional somatic discomfort in clinical nurses. Methods: In May 2019, 10 cities in Henan Province and Fujian Province were randomly selected as sampling cities. Using the stratified cluster sampling method, nurses of clinical nursing posts in 22 third class hospitals and 23 second class hospitals were selected as the research objects. The general information, job stress, hostile attribution bias, ego depletion and functional somatic discomfort of clinical nurses were investigated by self-designed general information questionnaire, Perceived Stress Scale, Social Information Processing-attribution Bias Questionnaire, Self-regulatory Fatigue Scale, Patient Health Questionnaire-15. 1200 clinical nurses included, and a total of 1159 valid questionnaires were collected, the effective rate of questionnaire collection was 96.6%. The t test was used to compare the difference of the functional somatic discomfort scores of clinical nurses with different demographic characteristicst. The influence of job stress, hostile attribution bias and ego depletion on functional somatic discomfort of clinical nurses were analyzed with Bootstrap. Results: The functional somatic discomfort score of clinical nurses was (8.95±4.38), of which 859 (74.12%) had functional somatic discomfort symptom. The functional somatic discomfort score of clinical nurses aged 36-50 years old was higher than that of 19-35 years old, the functional somatic discomfort score of clinical nurses with service age ≥5 years was higher than that of <5 years, the functional somatic discomfort score of non-permanent clinical nurses was higher than that of permanent clinical nurses, the functional somatic discomfort score of clinical nurses in tertiary hospitals was higher than that of secondary hospitals, the functional somatic discomfort score of clinical nurses in surgical departments were higher than those in non-surgical departments, and the differences were statistically significant (P<0.05). Job stress affected functional somatic discomfort through the single mediating role of hostile attribution bias, the single mediating role of ego depletion, and the chain mediating role of hostile attribution bias and ego depletion (β=0.17, 95%CI: 0.10-0.20; β=0.16, 95%CI: 0.10-0.20; β=0.07, 95%CI: 0.03-0.10; P<0.05) . Conclusion: The functional somatic discomfort symptoms of clinical nurses are significant and varied among different age, working age, employment form, hospital grade and department groups. They are affected by work stress directly and through the separate mediating effect of hostile attribution bias and ego depletion, and the chain mediating effect of hostile attribution bias and ego depletion.


Subject(s)
Humans , Adult , Middle Aged , Child, Preschool , Young Adult , Hostility , Occupational Stress/epidemiology , Surveys and Questionnaires , Tertiary Care Centers , Nurses
7.
Psicol. soc. (Online) ; 35: e275160, 2023.
Article in Portuguese | LILACS, INDEXPSI | ID: biblio-1521411

ABSTRACT

Resumo Em que consiste a sociogenia apresentada por Frantz Fanon e quais as suas implicações para a compreensão dos modos de subjetivação em uma sociabilidade marcada pelo racismo e a desumanização? Este estudo estabelece um diálogo entre escritos de Sigmund Freud e Fanon para propor que a experiência colonial imprime um tipo particular de estranhamento, aqui nomeado como mal-estar colonial. O sofrimento sociopolítico resultante do racismo antinegro contemporâneo se expressa a partir de um duplo mal estar. Soma-se, ao mal-estar relativo ao desassossego dos indivíduos diante do preço a pagar pela pertença e segurança no laço social, a recusa do reconhecimento de sua pertença e do seu direito de usufruto do pacto social, travestido de pacto civilizatório. Este estudo, baseado na gênese social e política do sofrimento humano na sociabilidade colonial, considera que a perspectiva clínico-política implicada se alia à análise sociológica para atentar às dimensões singulares e universais do sujeito.


Resumen ¿En qué consiste la sociogenia presentada por Frantz Fanon y cuáles son sus implicaciones para comprender los modos de subjetivación en una sociabilidad marcada por el racismo y la deshumanización? Este estudio establece un diálogo entre los escritos de Sigmund Freud y Fanon para proponer que la experiencia colonial imprime un tipo particular de extrañamiento, aquí denominado malestar colonial. El sufrimiento sociopolítico resultante del racismo antinegro contemporáneo se expresa a través de un doble malestar. Al malestar relacionado con la inquietud de los individuos ante el precio a pagar por la pertenencia y la seguridad en el vínculo social se suma la negativa a reconocer su pertenencia y su derecho a disfrutar del pacto social, disfrazado de pacto civilizador. Este estudio, basado en la génesis social y política del sufrimiento humano en la sociabilidad colonial, considera que la perspectiva clínico-política involucrada se combina con el análisis sociológico para a las dimensiones singulares y universales del sujeto.


Abstract What does the sociogeny presented by Frantz Fanon consist of and what are its implications for understanding the modes of subjectivation in a sociability marked by racism and dehumanization? This study establishes a dialogue between the writings of Sigmund Freud and Fanon to propose that the colonial experience imprints a particular type of estrangement, here named as colonial malaise. The sociopolitical suffering resulting from contemporary anti-black racism is expressed through a double discomfort. Added to the discomfort related to the uneasiness of individuals regarding the price to pay for belonging and security in the social bond is the refusal to recognize their belonging and their right to enjoy the social pact, disguised as a civilizing pact. This study, based on the social and political genesis of human suffering in colonial sociability, considers that the clinical-political perspective involved is combined with sociological analysis to address both singular and universal dimensions of the subject.


Subject(s)
Psychoanalysis , Colonialism , Racism , Embarrassment
8.
Más Vita ; 4(1): 31-40, mar. 2022.
Article in Spanish | LILACS, LIVECS | ID: biblio-1372052

ABSTRACT

La voz es un elemento particular de los primeros años de vida en el sujeto debido a que es una de las formas de manifestar su necesidad, un deseo, u otro, por lo cual se adopta como una herramienta que se vincula a los procesos anímicos; puede ser una forma de ver síntomas o malestares que el paciente no quiere ni confesarse, ni confesar en una consulta. Objetivo: Comprender la manifestación del malestar a través de la voz del sujeto y la forma subjetiva del saber hacer con el conflicto, que apertura la importancia de la voz en el proceso psicoterapéutico. Materiales y métodos: Se enmarcó en un paradigma fenomenológico, es una investigación de campo con enfoque cualitativo mediante un estudio de caso. Resultados: A partir de este estudio se pudo determinar que el malestar incide en la voz del sujeto cuando no puede ser expresado con anterioridad, por tanto, la voz es una forma de expresión inconsciente que en ocasiones no es percibida por el sujeto que manifiesta un malestar. Conclusiones: El fenómeno de la voz está presente en los sujetos que formaron parte de esta investigación, pero cada uno de ellos lo formula de manera distinta, haciendo del malestar un saber hacer individual; por medio de la voz se manifiestan los silencios, el grito, el llanto y variadas formas orales que indican que hay asuntos pendientes, reflejando el conflicto que tiene el individuo con lo que está refiriendo, así deja huellas fonéticas en todo lo que nos relata(AU)


The voice is a particular element of the first years of life in the subject due to which is one of the ways to express their need, a desire, or another, for which it is adopted as a tool that is linked to psychic processes; it may be a way of seeing symptoms or discomforts that the patient does not want to confess or confess in a consultation. Objective:Understand the manifestation of discomfort through the voice of the subject and the subjective form of knowing how to deal with conflict, which opens up the importance of the voice in the psychotherapeutic process. Materials and methods:It was framed in a phenomenological paradigm, it is an investigation of field with a qualitative approach through a case study. Results:From this study it was possible to determine that discomfort affects the voice of the subject when it cannot be expressed with previously, therefore, the voice is a form of unconscious expression that sometimes is not perceived by the subject who manifests discomfort. Conclusions:The phenomenon of the voice is present in the subjects who were part of this investigation, but each one of them formulates it in a different way, making discomfort an individual know-how; through the voice silences, screaming, crying and various oral forms that indicate thatthere are issues pending, reflecting the conflict that the individual has with what he is referring to, thus leaving traces phonetics in everything he tells us(AU)


Subject(s)
Regression, Psychology , Behavior and Behavior Mechanisms , Physicians' Offices , Affect , Emotional Adjustment , Psychology, Clinical , Signs and Symptoms , Voice , Phonetics
9.
Psicol. reflex. crit ; 35: 20, 2022. tab, graf
Article in English | LILACS, INDEXPSI | ID: biblio-1406433

ABSTRACT

Awareness of perceptual and sensory changes that might occur in visual, auditory, proprioception, and other senses, in the early stages towards the First Episode Psychosis (FEP), and their subsequent sensorial evolution as the disturb progresses deeper into an acute episode, might be a key element for interrupting the process. In the present study, we investigated hearing discomfort/tolerance to 16 given sound streams. Sixteen people diagnosed with FEP, participated in the experiment. Sixteen frequency sweeps varying in modulation envelopes (sawtooth, sine), order (ascending, descending), duration (4s, 8s), and range (50­8000 Hz, 2­8 kHz) were presented randomly, but always in the same sequence, to FEP and healthy controls (HC). The level of discomfort was estimated by the participant by making a mark across a continuous line whose extremes read "nothing bad" (left) and "too bad" (right). Results showed that ascending sine pure frequency sweeps (p < 0.01) and descending sine pure frequencies sweeps (p < 0.01) caused the maximum discomfort in FEP. Other variables also showed differences between FEP and HC, and FEP were always more intolerant to such pure frequency sweeps than HC. We conclude that this might be useful for very early assessment of people at risk, people with FEP, and people with schizophrenia. (AU)


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Schizophrenic Psychology , Auditory Perception , Psychoacoustics , Psychotic Disorders
10.
Chinese Journal of Practical Nursing ; (36): 812-816, 2022.
Article in Chinese | WPRIM | ID: wpr-930702

ABSTRACT

Objective:To probe into the influence of adhesive tape and string fixation on postoperative catheter-associated urinary tract infection(CAUTI) and comfort degree of patients undergoing percutaneous nephrolithotomy.Methods:A total of 106 cases of male urinary tract calculi patients undergoing percutaneous nephrolithotomy in Urology Department of First Affiliated Hospital of Zhengzhou University from January 2018 to April 2019 were selected. They were divided into the experimental group (55 cases) and the control group (51 cases) by random digits tbale method. The control group received platform fixation method, the experimental group implemented adhesive tape and string fixation method for catheter fixation. The incidence of CAUTI were compared between two groups, the catheter exposed length changes and catheter-related discomfort changes was also compared.Results:The incidence of CAUTI were 3.9%(2/51) in the experimental group, significantly lower than 16.7%(8/48) in the control group, the difference was statistically significant ( χ2=4.42, P<0.05). After 3 days, 5 days and 7 days of indwelling catheter, the catheter exposed length were (17.76 ± 1.41), (17.12 ± 1.28), (16.49 ± 1.63) cm, significantly longer than those in the control group (16.04 ± 1.96), (15.81 ± 1.78), (15.29 ± 1.96) cm ( t=5.00, 4.17, 3.32, all P<0.05); the catheter-related discomfort symptom scores at above mentioned time were 0.82 ± 0.09, 0.53 ± 0.07, 0.49 ± 0.08, significantly lower than those in the control group (1.17 ± 0.23, 0.92 ± 0.09, 0.77 ± 0.11), the differences were statistically significant ( t=2.10, 2.88, 2.46, all P<0.05). Conclusions:Adhesive tape and string fixation method for catheter fixation can reduce the incidence of CAUTI of patients with urinary tract calculi, improve the catheter fixed state as well as reduce the patient′s catheter-related discomfort.

11.
Kampo Medicine ; : 207-213, 2022.
Article in Japanese | WPRIM | ID: wpr-986296

ABSTRACT

A 65-year-old man, with a history of surgery for esophagogastric junction cancer in X-3, was admitted to the Department of Internal Medicine in our hospital in March for anorexia that had developed since January X. The patient was diagnosed with adhesive small bowel obstruction, and underwent surgery to relieve the obstruction in early May. However, his symptoms did not improve, and he was referred to our department in mid-June. His drooling was considered to be due to “excessive saliva secretion.” He started taking a decoction of bushirichuto for epigastric discomfort and resistance and coldness of the hands and feet. On the 5th day, he started to feel more energetic, and on the 8th day, his saliva production decreased. Furthermore, on the 12th day, his sense of taste and appetite improved. As the oral intake increased, tube feeding could be reduced and rehabilitation progressed ; from an almost bedridden state, he was able to walk continuously for 150 m with a cane. On the 29th day, he was transferred to a chronic care hospital. His weight increased from 34.1 kg, when he was referred to our department, to 39.7 kg at the discharge time. Anorexia and drooling, which had otherwise continued for 5 months, were improved within a short period of time by using bushirichuto.

12.
China Pharmacy ; (12): 735-739, 2022.
Article in Chinese | WPRIM | ID: wpr-923011

ABSTRACT

OBJECTIVE To investigate the efficacy and safety of Shenxiang suhe pill in the adjuvant treatment of triple vessel lesion of coronary artery. METHODS From February 2019 to February 2021,146 patients with unstable angina pectoris and triple vessel lesion of coronary artery (chest discomfort of hanning xinmai type )admitted to Harrison International Peace Hospital were divided into observation group and control group according to random number table ,with 73 cases in each group. Control group was given Isosorbide dinitrate tablets+Aspirin enteric-coated tablets+Clopidogrel bisulfate tablets+Atorvastatin calcium tablets+ Bisoprolol fumarate tablets for western medicine treatment. Observation group was additionally given Shenxiang suhe pill 0.7 g/time orally after meal ,twice a day ,on the basis of control group. After 2 courses of treatment (3 weeks as a course of treatment ,with an interval of 1 week for each course of treatment ),curative effect and symptoms of angina pectoris [frequency and duration of angina pectoris ,walking distance of 6-min walking test (6MWT)],TCM syndrome score ,cardiac markers [neutrophil to lymphocyte ratio (NLR)and the contents of endothelin-1(ET-1),nitric oxide (NO),soluble suppression of tumorigenicity 2 (sST2),angiotensin Ⅱ(Ang-Ⅱ)] and quality of life [Seattle angina questionnaire (SAQ),36-item short form health survey (SF-36)] before and after treatment were compared between the two groups. Adverse drug reactions (ADR)during treatment and major adverse cardiovascular events (MACE)during follow-up were recorded. RESULTS The total response rate of the observation group was 86.30%,significantly higher than 71.23% of the control group (P<0.05). Before treatment ,there was no statistical difference in the above indexes between 2 groups(P>0.05). After treatment ,the frequency and duration of angina pectoris ,TCM syndrome score ,NLR and the contents of sST 2,ET-1 and Ang- Ⅱ in the two groups decreased or shortened significantly ,while the walking distance of 6MWT,NO content ,scores of each dimension in SAQ and SF- 36 increased significantly ;and the above indexes in observation group were significantly better than those in control group (P<0.05). There was no significant difference in the inciden ce of ADR between the two groups (P>0.05); however,the incidence of MACE in observation group was significantly lower than that in control group (P<0.05). CONCLUSIONS In the treatment of adjuvant treatment of triple vessel lesion of coronary artery ,Shenxiang suhe pill can improve the symptoms of angina pectoris and vascular endothelial function ,reduce the incidence of MACE ,improve the quality of life ,and has good safety.

13.
J. Phys. Educ. ; 32: e3228, 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1356401

ABSTRACT

ABSTRACT The present study aimed at showing the cross-cultural adaptation and validation of the Spanish health questionnaire so-called Cuestionario de Salud Docente (CSD) for the Brazilian context with regard to the following variables: welfare (satisfaction and self-efficacy), and discomfort (musculoskeletal disorders, cognitive disorders, exhaustion and vocal cord disorders). Different steps were taken in order to ensure the quality of the translation and adaptation of the CSD concerning semantic, idiomatic, experiential and conceptual equivalence between the original items and the translated ones. The final sample of the pilot study consisted of 697 teachers, 168 men and 529 women, aged between 18 and 52 years who worked in 3 Early Childhood Education Centers, 9 Elementary Schools from the 1st to 5th grade, 04 Elementary Schools from the 6th to 9th grade, and 4 High Schools. Cohen's Kappa coefficient was used for assessing the temporal stability of the scores, and Cronbach's alpha test for the internal consistency of the dimensions and overall evaluation of the instrument, which showed a significant correlation. As a measuring instrument, the questionnaire is considered reliable to evaluate teacher's health, in addition to containing guidelines for further studies on welfare and discomfort variables of Brazilian teachers.


RESUMO O presente estudo apresenta a adaptação e validação transcultural do Questionário Saúde Docente (QSD) para o contexto brasileiro nas variáveis de bem-estar (satisfação e autoeficácia) e mal-estar (disfunções musculoesqueléticas, disfunções cognitivas, esgotamento e disfunções da voz). Foram realizadas distintas etapas para assegurar a qualidade da tradução e da adaptação do QSD no que se refere à equivalência semântica, idiomática, experiencial e conceitual entre os itens originais e traduzidos. A amostra final do estudo piloto foi constituída por 697 professores, sendo 168 do sexo masculino e 529 do feminino, com idades entre 18 e 52 anos, atuantes em 03 centros de Educação Infantil, 09 escolas do nível Ensino Fundamental de 1º ao 5º ano e 04 dos níveis Ensino Fundamental de 6º ao 9º ano e Ensino Médio. Para a análise da estabilidade temporal dos escores foi empregado o teste de Kappa e para a consistência interna das dimensões e da avaliação global do instrumento o teste de alfa de Cronbach, os quais apresentaram correlações satisfatórias. Como instrumento de medida, o questionário é considerado confiável para avaliar a saúde docente, além disso contém diretrizes para futuros estudos das variáveis associadas ao bem-estar e mal-estar de professores brasileiros.

14.
Chinese Journal of Behavioral Medicine and Brain Science ; (12): 806-810, 2021.
Article in Chinese | WPRIM | ID: wpr-909525

ABSTRACT

Objective:To explore the relationship between cardiac discomfort symptoms, fear of disease progress and post-traumatic stress disorder (PTSD) in patients with acute myocardial infarction(AMI) after discharge, and to clarify main intervention direction of PTSD in patients with AMI.Methods:Patients with AMI who were discharged from Tangshan Gongren Hospital between 1 month and 1 year were selected from November 2019 to November 2020.The cardiac discomfort symptoms scale, fear of progress questionnaire(FoP-Q-SF) and post-traumatic stress disorder self-rating scale(PTSD-SS) were used to investigate cardiac discomfort symptoms, fear of disease progress level and post-traumatic stress disorder status.Spearman rank correlation analysis was used to analyze the relationship between cardiac discomfort symptoms, fear of disease progress and post-traumatic stress disorder by SPSS 24.0 software. The mediating effect of fear of disease progress was analyzed by AMOS 24.0 software.Results:The PTSD score was (32.78±12.38) of patients with AMI discharged from hospital for 1 month to 1 year and the incidence of PTSD was 12.3%.Spearman correlation test showed cardiac discomfort symptoms and fear of disease progress were positively correlated with PTSD( r=0.530, 0.723, both P<0.01) and cardiac discomfort symptoms was positively correlated with fear of disease progress( r=0.518, P<0.01). Mediating effect test showed that fear of disease progress was a complete mediator between cardiac discomfort symptoms and PTSD. Conclusion:Cardiac discomfort symptoms can affect PTSD through a complete mediator of fear of disease progress.

15.
Kampo Medicine ; : 22-26, 2021.
Article in Japanese | WPRIM | ID: wpr-924611

ABSTRACT

Persistent or intractable hiccups worsen the activity of daily life and the quality of life of patients, but are sometimes difficult to treat. There are no recommended therapies in Western medicine for hiccups, and Kampo medicine can often be used. However, there have been no case reports on keishininjinto for hiccups. We experienced two cases of hiccups successfully treated with keishininjinto. Case 1 was a 68-year-old man who continued intractable hiccups for 3 years. Case 2 was an 81-year-old man who developed persistent hiccups during mechanical ventilation. Both cases had spontaneous sweat, tendency of diarrhea, epigastric discomfort and resistance, and cold of epigastrium, so we diagnosed them as keishininjinto-sho. It took 6 months to improve hiccups after administration of keishininjinto in case 1 and 1 week in case 2. Keishininjinto can be effective for hiccups with interior and cold pattern.

16.
Dental press j. orthod. (Impr.) ; 26(1): e2119155, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1154069

ABSTRACT

ABSTRACT Introduction: Shorter miniscrew implants (MSIs) are needed to make orthodontics more effective and efficient. Objective: To evaluate the stability, insertion torque, removal torque and pain associated with 3 mm long MSIs placed in humans by a novice clinician. Methods: 82 MSIs were placed in the buccal maxillae of 26 adults. Pairs of adjacent implants were immediately loaded with 100g. Subjects were recalled after 1, 3, 5, and 8 weeks to verify stability and complete questionnaires pertaining to MSI-related pain and discomfort. Results: The overall failure rate was 32.9%. The anterior and posterior MSIs failed 35.7% and 30.0% of the time, respectively. Excluding the 10 MSIs (12.2%) that were traumatically dislodged, the failure rates in the anterior and posterior sites were 30.1% and 15.2%, respectively; the overall primary failure rate was 23.6%. Failures were significantly (p= 0.010) greater (46.3% vs 19.5%) among the first 41 MSIs than the last 41 MSIs that were placed. Excluding the traumatically lost MSIs, the failures occurred on or before day 42. Subjects experienced very low pain (2.2% of maximum) and discomfort (5.5% of maximum) during the first week only. Conclusions: Shorter 3 mm MSIs placed by a novice operator are highly likely to fail. However, failure rates can be substantially decreased over time with the placement of more MSIs. Pain and discomfort experienced after placing 3 mm MSIs is minimal and temporary.


RESUMO Introdução: Mini-implantes (MIs) mais curtos são necessários para uma Ortodontia mais eficiente e efetiva. Objetivo: Avaliar a estabilidade, torque de inserção e de remoção e dor associada a MIs de 3mm instalados em humanos por um ortodontista principiante. Métodos: 82 MIs foram instalados na região vestibular da arcada superior de 26 adultos. Pares de mini-implantes adjacente receberam carga imediata de 100g. Após 1, 3, 5 e 8 semanas, os pacientes foram reavaliados para verificar a estabilidade e preencher um questionário sobre a dor e o desconforto relacionados aos MIs. Resultados: A taxa geral de falhas foi de 32,9%, sendo de 35,7% para os MIs anteriores e 30% para os MIs posteriores. Excluindo os 10 MIs que foram perdidos por trauma (12,2%), a taxa de falha nas regiões anterior e posterior foram de 30,1% e 15,2%, respectivamente e ocorreram no 420 dia ou antes. A taxa geral de falha primária foi de 23,6%. A taxa de falha foi significativamente maior (p=0,010) nos primeiros 41 MIs do que nos 41 últimos (46,3% vs. 19,5%). As experiências relacionadas à dor foram baixas (2,2% máximo), assim como ao desconforto (5,5% máximo) durante a primeira semana. Conclusão: MIs de 3mm instalados por um novato são mais propensos a falhas. Porém, as taxas de falha podem diminuir substancialmente com a instalação de mais MIs com o decorrer do tempo. A dor e o desconforto após a instalação desses dispositivos são mínimos e temporários.


Subject(s)
Humans , Adult , Bone Screws , Dental Implants , Orthodontic Anchorage Procedures , Dental Implants/adverse effects , Feasibility Studies , Dental Prosthesis, Implant-Supported , Torque , Dental Implantation, Endosseous , Maxilla/surgery
17.
Arch. Clin. Psychiatry (Impr.) ; 47(6): 180-186, Nov.Dec. 2020. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1248758

ABSTRACT

ABSTRACT Background: Depression and maladaptive schemas were found to worsen the pain experience in individuals with chronic pain. Objectives: The aim of the present study was to evaluate the relationship between depressive symptoms, early maladaptive schemas, distress and discomfort tolerance in female patients with migraine. Methods: Seventy eight female migraine patients(37 depressed and 41 non-depressed subjects according to BDI scores) and 55 healthy controls were evaluated with Numeric Pain Rating Scale(NPRS),Beck Depression Inventory(BDI),Young Schema Questionnaire-Short Form-3(YSQ-SF-3),Discomfort Intolerance Scale(DIS) and Distress Tolerance Scale(DTS). Results: Distress and discomfort tolerance were lower in both migraine groups than control subjects. EMSs were higher in depressed migraine patients than in non-depressed migraine group and non-clinical controls. A positive correlation between BDI and YSQ-SF-3 scores(p<0.001), a negative correlation between BDI and DIS(p<0.01), and also a negative correlation between BDI and DTS(p<0.001) were found among migraine patients. Hierarchical regression analysis revealed that 20% of the depressive symptoms were explained with DIS scores, while explanatoriness raised up to 46% by addition of YSQ-SF-3 scores to the model. Discussion: Cognitive interventions for modifying EMSs and improving distress and discomfort tolerance might be added to the treatment strategies in female migraine patients.

18.
Aquichan ; 20(3): e2033, July-Sept. 2020. tab, graf
Article in English | BDENF, LILACS, COLNAL | ID: biblio-1130968

ABSTRACT

ABSTRACT Objectives: The purpose of this study is to identify the relationship between wound severity, discomfort, and psychological problems in patients with a diabetic foot ulcer in Indonesia. Methods: A cross-sectional study is conducted in three general hospitals and one clinic in Indonesia. The Bates-Jensen wound assessment tool (BWAT), the discomfort evaluation of wound instrument (DEWI), and the depression, anxiety, and stress scale (DASS) are used to measure the variables of interest. Path analysis is performed to evaluate the association between wound severity, discomfort, and psychological problems. Results: Of 140 patients with diabetic foot ulcers who joined this study, the majority experienced immobilization (74.3 %), pain (69.3 %), and sleep disturbance (63.6 %). The means were as follows: discomfort (2.35 ± 0.33), depression (1.34 ± 0.41), stress (1.49 ± 0.48), anxiety (1.43 ± 0.40), and wound severity (31.35 ± 9.96). Discomfort partially mediated the relationship between wound severity and psychological problems, which indirect effect was 0.11. Conclusion: High prevalence of discomfort, both physical and psychological, was found in patients with a diabetic foot ulcer. Discomfort mediates the relationship between wound severity and psychological problems. Integrating comfort into wound care management may help to reduce the psychological burden.


RESUMEN Objetivos: el presente estudio tiene como objetivo identificar la relación entre la gravedad de la herida, la molestia y los problemas psicológicos en pacientes con úlcera del pie diabético en Indonesia. Métodos: se realizó un estudio transversal en tres hospitales generales y una clínica de Indonesia. La herramienta de evaluación de heridas Bates-Jensen (BWAT, por sus siglas en inglés), el instrumento de evaluación de molestia de la herida (DEWI, por sus siglas en inglés) y la escala de depresión, ansiedad y estrés (DASS, por sus siglas en inglés) se utilizaron para medir las variables de interés. Se realizó un análisis de ruta para evaluar la asociación entre la gravedad de la herida, la molestia y los problemas psicológicos. Resultados: de 140 pacientes con úlcera del pie diabético que participaron en este estudio, la mayoría experimentó inmovilización (74,3 %), dolor (69,3 %) y trastornos del sueño (63,6 %). Las medias fueron las siguientes: molestia (2,35 ± 0,33), depresión (1,34 ± 0,41), estrés (1,49 ± 0,48), ansiedad (1,43 ± 0,40) y gravedad de la herida (31,35 ± 9,96). La molestia medió en parte la relación entre la gravedad de la herida y los problemas psicológicos, cuyo efecto indirecto fue de 0,11. Conclusión: se encontró una alta prevalencia de molestias, tanto físicas como psicológicas, en pacientes con úlcera del pie diabético. Además, la molestia media la relación entre la gravedad de la herida y los problemas psicológicos. La integración de la comodidad en el manejo del cuidado de las heridas puede ayudar a reducir la carga psicológica.


RESUMO Objetivos: o objetivo deste estudo é identificar a relação entre a gravidade da ferida, o desconforto e os problemas psicológicos en pacientes com úlcera do pé diabético na Indonésia. Métodos: foi realizado um estudo transversal em três hospitais gerais e uma clínica da Indonésia. A ferramenta da avaliação de feridas Bates-Jensen (BWAT, por sua sigla em inglês), o instrumento de avaliação do desconforto da ferida (DEWI, por sua sigla em inglês) e a escala de depressão, ansiedade e estresse (DASS, por sua sigla em inglês) foram utilizados para medir as variáveis de interesse. Uma análise de rota foi realizada para avaliar a associação entre a gravidade da ferida, o desconforto e os problemas psicológicos. Resultados: de 140 pacientes com úlcera diabética do pé que participaram deste estudo, a maioria experimentou imobilização (74,3 %), dor (69,3 %) e transtornos do sono (63,6 %). As médias foram: desconforto (2,35 ± 0,33), depressão (1,34 ± 0,41), estresse (1,49 ± 0,48), ansiedade (1,43 ± 0,40) e gravidade da ferida (31,35 ± 9,96). O desconforto foi o mediador em parte da relação entre a gravidade da ferida e os problemas psicológicos, cujo efeito indireto foi de 0,11. Conclusões: verificou-se alta prevalência de desconforto, tanto físico quanto psicológico, em pacientes com úlcera diabética do pé. Além disso, o desconforto intermedeia a relação entre a gravidade da ferida e os problemas psicológicos. A integração do conforto na gestão do cuidado das feridas pode ajudar a reduzir a carga psicológica.


Subject(s)
Humans , Male , Female , Diabetic Foot , Wounds and Injuries/psychology , Mental Health , Indonesia
19.
Acta colomb. psicol ; 23(1): 18-27, Jan.-June 2020. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1098002

ABSTRACT

Abstract The aim of this study was to analyze the explanatory level of the variables advertising influence, verbal messages, social models and social situations as regards body dissatisfaction, weight worry, and bodily discomfort. The study was conducted in a convenience sample of 206 Mexican women with an average age of 22.12 years (SD = 4.21). Structural equation modeling was used to analyze the direct and indirect effects of the independent variables on the dependent ones in three hypothetical models proposed. In the case of the model proposed for body dissatisfaction, it was found that the set of vari ables had 79% of variance explained and showed adequate goodness-of-fit indices (χ2/gl = .877; GFI = .982; CFI = .978; AGFI = .980; SRMR = .068; RMSEA = .079). The model for weight worry had 62% of variance explained and an acceptable goodness of fit (χ2/gl = 1.556; GFI = .981; CFI = .975; AGFI = .978; SRMR = .068; RMSEA = .080). Finally, the model for bodily discomfort had 72% of variance explained and showed adequate goodness of fit (χ2/gl = .173; GFI = .976; CFI = .969; AGFI = .972; SRMR = .062; RMSEA = .072). It is concluded that social influences have a significant impact on body image. Verbal messages had the strongest impact on the variables studied.


Resumen El objetivo del presente estudio fue analizar el grado explicativo de las variables "influencia de la publicidad", "mensajes verbales", "modelos sociales" y "situaciones sociales" frente a la insatisfacción corporal, la preocupación por el peso y el malestar corporal en una muestra seleccionada por conveniencia de 206 mujeres mexicanas con promedio de edad de 22.12 años (DT = 4.21). Específicamente, se utilizó un modelamiento de ecuaciones estructurales para identificar los efectos directos e indirectos de las variables independientes sobre las dependientes en tres modelos hipotéticos propuestos, y como resultados se encontró que el conjunto de variables tuvo un valor explicativo de 79 % para el modelo planteado para la insatisfacción corporal, con buenos indicadores de bondad de ajuste (χ2/gl = .877; GFI = .982; CFI = .978; AGFI = .980; SRMR = .068; RMSEA = .079); de 62 % para el modelo de preocupación por el peso, con una adecuada bondad de ajuste (χ2/gl = 1.556; GFI = .981; CFI = .975; AGFI = .978; SRMR = .068; RMSEA = .080); y de 72 % para el modelo de malestar corporal, con buenos valores de bondad de ajuste (χ2/gl = .173; GFI = .976; CFI = .969; AGFI = .972; SRMR = .062; RMSEA = .072). Se concluye que las influencias sociales tienen un impacto significativo en la imagen corporal y que los mensajes verbales presentan un mayor impacto en las variables estudiadas.

20.
Rev. Bras. Med. Fam. Comunidade (Online) ; 15(42): 2571, 20200210. ilus, tab
Article in Portuguese | LILACS | ID: biblio-1282604

ABSTRACT

Introdução: No contexto do Sistema Único de Saúde, o conceito da prevenção quaternária adentra timidamente os níveis de atenção à saúde, no entanto, sofre expansão significativa no âmbito da atenção primária à saúde. Objetivo: Identificar por meio da sistematização de evidências científicas, as contribuições técnicas e socioculturais da prevenção quaternária no âmbito da atenção primária à saúde no Brasil. Métodos: Trata-se de uma revisão integrativa de estudos presentes nas bases de dados científicas da Scientific Electronic Library Online, Biblioteca Virtual em Saúde, biblioteca virtual da Comissão de Aperfeiçoamento de Pessoal do Nível Superior e MEDLINE via PubMed com a utilização dos descritores "prevenção quaternária" e "atenção primária à saúde", em inglês e português. Resultados: O corpus de análise foi composto por 22 artigos, sendo que a produção científica sobre o tema se deu de forma mais intensa a partir do ano de 2015 e, em sua maioria, possuíam como abordagem metodológica ensaios teóricos. Dentre as contribuições técnicas destacaram-se a introdução do ensino da prevenção quaternária de modo continuado aos graduandos e profissionais; a construção de protocolos e documentos de amparo profissional; a utilização de modelos explicativos dinâmicos na socialização do quadro clínico; a conduta profissional com os usuários e as contribuições socioculturais envolvendo mudanças na percepção profissional e comunitária sobre o fenômeno saúde-doença, assim como o incentivo a práticas de desmedicalização sociocultural em relação à dor, incapacidade, desconforto, envelhecimento, nascimento e morte. Conclusão: Apesar do reconhecimento das potencialidades da prevenção quaternária, faz-se necessário fortalecer estratégias que possibilitem o desenvolvimento de políticas públicas para fomentar e gerenciar alianças estratégicas com tomadores de decisão, profissionais de saúde e cidadãos, para fomentar a redução de diagnósticos e tratamentos excessivos, contribuindo com a qualidade do cuidado.


Introduction: In the context of the Unified Health System, the concept of quaternary prevention shyly enters the levels of health care, however, undergoes significant expansion in the scope of primary health care. Objective: To identify, through the systematization of scientific evidence, the technical and socio-cultural contributions of quaternary prevention within the scope of primary health care in Brazil. Methods: This is an integrative review of studies present in the scientific databases of the Scientific Electronic Library Online, Regional Portal of the Virtual Health Library of the Latin American and Caribbean Center on Health Sciences Information of the Pan American Health Organization, virtual library of the Higher Education Personnel Improvement Commission, and MEDLINE through PubMed using the descriptors "quaternary prevention" and "primary health care", in English and Portuguese. Results: The corpus of analysis consisted of 22 articles, and the scientific production on the topic took place more intensively from the year 2015 and, for the most part, had theoretical essays as methodological approach. Among the technical contributions, we highlight the introduction of teaching on quaternary prevention in a continuous way to undergraduates and professionals; the construction of protocols and documents of professional support; the use of dynamic explanatory models in the socialization of the clinical picture and professional conduct with users and socio-cultural contributions involve changes in the professional and community perception about the phenomenon of illness and health conception, as well as the incentive to practices of socio-cultural demedicalization in relation to pain, disability, discomfort, aging, birth, and death. Conclusion: Despite the recognition of the potential of quaternary prevention, it is necessary to strengthen strategies that enable the development of public policies to foster and manage strategic alliances with decision makers, health professionals and citizens, to promote the reduction of excessive diagnoses and treatments, contributing to the quality of care.


Introducción: En el contexto del Sistema Único de Salud, el concepto de prevención cuaternaria entra tímidamente en los niveles de atención de salud, sin embargo, experimenta una expansión significativa en el alcance de la Atención Primaria de Salud. Objetivo: Identificar, a través de la sistematización de evidencia científica, las contribuciones técnicas y socioculturales de la prevención cuaternaria en el ámbito de la Atención Primaria de Salud en Brasil. Métodos: Esta es una revisión integradora de estudios presentes en las bases de datos científicas de la Biblioteca Electrónica Científica en línea, Portal Regional de la Biblioteca Virtual en Salud del Centro Latinoamericano y del Caribe de Información en Ciencias de la Salud de la Organización Panamericana de la Salud, biblioteca virtual de la Comisión de Mejoramiento del Personal de Educación Superior y MEDLINE a través de PubMed utilizando los descriptores de prevención cuaternaria y atención primaria de salud, en inglés y portugués. Resultados: El corpus de análisis estuvo conformado por 22 artículos, siendo la producción científica sobre el tema más intensiva desde 2015 y, en su mayor parte, tuvo ensayos teóricos como abordaje metodológico. Entre los aportes técnicos, destacamos la implantación de la docencia en prevención cuaternaria de forma continua a estudiantes de pregrado y profesionales; construcción de protocolos y documentos de apoyo profesional, uso de modelos explicativos dinámicos en la socialización del cuadro clínico y conducta profesional con los usuarios y los aportes socioculturales implican cambios en la percepción profesional y comunitaria sobre el fenómeno de la enfermedad y la concepción de la salud, así como el incentivo a prácticas de desmedicalización sociocultural en relación al dolor, discapacidad, malestar, envejecimiento, nacimiento y muerte. Conclusión: A pesar del reconocimiento del potencial de la prevención cuaternaria, es necesario fortalecer estrategias que permitan el desarrollo de políticas públicas para fomentar y gestionar alianzas estratégicas con los tomadores de decisiones, profesionales de la salud y ciudadanos, para promover la reducción de diagnósticos y tratamientos excesivos, contribuyendo a la calidad de la atención.


Subject(s)
Primary Health Care , Unified Health System , Family Practice , Medical Overuse , Quaternary Prevention
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