Análise de Perícias Psicológicas de Trânsito: Um Olhar sobre os Construtos Cognitivos / Analysis of Traffic Psychological Expertise: A Look at Cognitive Constructs / Análisis de la Experiencia Psicológica del Tráfico: Una Mirada a los Constructos Cognitivos

O objetivo da pesquisa foi analisar perícias psicológicas realizadas em cidades do Paraná do ano de 2019 no que tange aos aspectos cognitivos. Para tanto, foram consultados 1009 processos arquivados em clínicas credenciadas ao Departamento de Trânsito do Paraná (DETRAN-Pr). Os resultados, inerentes à caracterização das perícias, apontaram que os participantes com idade média de 27 anos, 44,4% possuindo ensino médio completo, 72,2% para a 1ª habilitação, 61% para a categoria A/B. Foram encontrados 12 tipos de instrumentos de Avaliação Psicológica padronizados. Os resultados apontam desempenho médio nos instrumentos e relação de dependência entre os principais construtos investigados. Considera-se que, além de habilidades cognitivas preservadas, a formação dos condutores desde o ensino básico é importante contribuinte para o trânsito seguro.(AU)

The objective of this research was to analyze psychological tests conducted in cities in the state of Paraná in the year 2019, focusing on cognitive aspects. For this purpose, we examined 1009 records from clinics accredited to the State Traffic Department of Paraná (DETRAN-Pr). The results, inherent to the characterization of the expertise, pointed out that the participants had an average age of 27 years, 44.4% had completed secondary education, 72.2% were first-time applicants, and 61% had the A/B category. Twelve types of standardized Psychological Assessment instruments were found. The results indicated that participants exhibited an average performance in these instruments, and there was a significant correlation between the main constructs investigated. These findings suggest that, in addition to maintaining cognitive skills, providing driver education starting from elementary school could significantly contribute to enhancing road safety.(AU)

El objetivo de la investigación fue analizar las pruebas psicológicas realizadas en ciudades de Paraná en el año 2019 sobre aspectos cognitivos. Para ello se consultaron 1009 expedientes archivados en clínicas acreditadas ante el Departamento de Tránsito de Paraná (DETRAN-Pr). Los resultados, inherentes a la caracterización de la especialización, apuntaron que los participantes tenían una edad media de 27 años, 44,4% tenían estudios secundarios completos, 72,2% para el 1º título, 61% para la categoría A/B. Se encontraron doce tipos de instrumentos de Evaluación Psicológica estandarizados. Los resultados muestran un desempeño promedio en los instrumentos y una relación de dependencia entre los principales constructos investigados. Se considera que, además de preservar las habilidades cognitivas, la formación de los conductores desde la escuela primaria en adelante es un importante contribuyente a la seguridad del tráfico.(AU)

Tax rules on wealth imbalance and the investigation of money laundering in Peru / Las reglas tributarias sobre desbalances patrimoniales y la investigación del lavado de activos: el caso peruano / Regras tributárias sobre desproporções patrimoniais e investigação de lavagem de dinheiro: o caso peruano

This study aims to evaluate the feasibility of using the tax methodology for determining unjustified increases in assets in money laundering cases heard in the courts. It also seeks to identify the errors made by the Tax Authority with the purpose of ascertaining whether these errors could hinder the successful application of the methodology in investigations of money laundering cases. In order to achieve these objectives, a mixed research methodology was conducted that included the analysis of rulings issued during the years 2020 and 2021 by the Peruvian Tax Court and sentences issued by the judiciary. This was complemented by semi-structured interviews with experts from the public sector, academia and accounting with relevant experience on the subject. The study found that there are some practical issues in the application of the methodology that can be overcome and that do not represent an insurmountable constraint. The study also found that the tax methodology allows for a more effective clarification of asset imbalances, and concludes that, once implementation errors have been overcome, the tax methodology can be feasibly employed to the benefit of money laundering investigations.

Esta investigación tiene como objetivos evaluar la factibilidad de utilizar la metodología tributaria de determinación de incrementos patrimoniales no justificados en la investigación de desbalances patrimoniales de casos de lavado de dinero ventilados en la vía jurisdiccional e identificar los errores que ha cometido la Administración Tributaria, a fin de establecer si estos representan problemas que pudieran dificultar la aplicación de la metodología a la investigación de casos de lavado de dinero. Con el propósito de lograr estos objetivos se condujo una investigación mixta que incluyó el análisis de las resoluciones emitidas durante los años 2020 y 2021 por el Tribunal Fiscal y sentencias emitidas por el poder judicial. Esto se complementó con entrevistas semiestructuradas a expertos del sector público, la academia y peritos contables con experiencia relevante sobre el tema. La investigación encontró que existen algunos empirismos aplicativos que pueden ser superados y que no representan ninguna restricción que no pueda ser gestionada. Se halló también que la metodología tributaria permite esclarecer de manera más efectiva los desbalances patrimoniales. La investigación concluye que, superados los errores de ejecución, es factible utilizar con ventaja la metodología tributaria en las investigaciones de lavado de dinero.

O objetivo desta pesquisa é avaliar a viabilidade do uso da metodología tributária para determinar aumentos injustificados de patrimônio na investigação de desproporções patrimoniais em casos de lavagem de dinheiro julgados nos tribunais e identificar os erros cometidos pela Administração Tributária, a fim de estabelecer se estes representam problemas que poderiam dificultar a aplicação da metodologia na investigação de casos de lavagem de dinheiro. Para atingir esses objetivos, foi realizada uma pesquisa mista que incluiu a análise de decisões emitidas durante 2020 e 2021 pelo Tribunal Tributário e sentenças emitidas pelo judiciário. Isso foi complementado por entrevistas semiestruturadas com especialistas do setor público, acadêmicos e especialistas em contabilidade com experiência relevante no assunto. A pesquisa constatou que existem alguns empirismos de aplicação que podem ser superados e que não representam nenhuma restrição que não possa ser gerenciada. Também foi constatado que a metodología tributária permite um esclarecimento mais eficaz das desproporções patrimoniais. Na pesquisa, conclui-se que, uma vez superados os erros de implementação, é viável utilizar a metodologia tributária com vantagem nas investigações de lavagem de dinheiro.

The Legal Correspondence of Sexual Self-Defense Capability Assessment / 法医学杂志

OBJECTIVES@#To understand the legal application and case deposition of assessment opinions of sexual self-defense capability, and to explore the necessity of legal correspondence in the sexual defense capability assessment.@*METHODS@#According to the self-made questionnaire, the cases of sexual self-defense capability assessment completed by the Academy of Forensic Science from January 1, 2012 to December 31, 2018 were statistically analyzed through telephone interviews and referrals.@*RESULTS@#Among the 69 cases, 3 cases (4.3%) had complete sexual self-defense capability, 30 cases (43.5%) had weakened sexual self-defense capability, 32 cases (46.2%) had no sexual self-defense capability, and 4 cases (5.8%) were not suitable for assessment. Among the 30 cases with weakened sexual self-defense ability, 15 cases were filed and investigated by public security authorities for rape and 15 cases were not. The inconsistent rate of disposition was 1∶1. Among the 15 rape cases filed and investigated by the public security authorities, 10 cases were arrested and prosecuted by the procuratorate and sentenced to fixed-term imprisonment by the court, while the other 5 cases were not arrested and prosecuted by the procuratorate, with an inconsistent rate of disposition being 2∶1.@*CONCLUSIONS@#The legal application of the assessment opinion on the weakening of sexual self-defense capability is inconsistent, and the judicial disposition is confusing. It is imperative to unify and correspond the classification of sexual self-defense capability with the legal requirements.

Persuasión moral en el marco del posconflicto en Colombia: un estudio sobre la calidad de los argumentos y la experticia de la fuente / Moral persuasion in the post-conflict context in Colombia: a study on the quality of the arguments and the source expertise

Resumen En el presente estudio se analiza el impacto de la calidad de los argumentos y la experticia de la fuente en la persuasión moral, así como el cambio de un juicio moral en función de un mensaje persuasivo. La investigación sobre el efecto de la calidad de los argumentos y la experticia de la fuente en la persuasión moral es escasa, a pesar de que las teorías del intuicionismo social, del proceso dual y de las convicciones morales sugieren algunos apuntes al respecto. En este trabajo, para estudiar el impacto de estos dos factores en la persuasión moral, se llevó a cabo un estudio experimental con un diseño factorial 2 (experticia de la fuente) x 2 (calidad del argumento), con la participación de 433 personas. Específicamente, para evaluar el juicio moral y su eventual cambio, se construyó un dilema moral que contrapone los fundamentos morales de daño-cuidado y justicia-reciprocidad en el marco del posconflicto en Colombia. Los resultados muestran que si bien la mayoría de los participantes presentaron resistencia a la persuasión, tanto la calidad del argumento como la experticia de la fuente facilitan la persuasión, pero de forma independiente. Los resultados permiten varias reflexiones sobre las teorías del proceso dual de la persuasión y las teorías del juicio moral.

Abstract This study analyses the impact of argument quality and source expertise on moral persuasion, as well as the change of a moral judgment as a function of a persuasive message. Research on the effects of argument quality and source expertise on moral persuasion is scarce, although the theories of Social Intuitionism, Dual Process and Moral Convictions suggest some hints in this regard. To study the impact of these factors on moral persuasion, an experimental study was carried out with a 2 (source expertise) x 2 (argument quality) factorial design with 433 participants. A particularly sensitive moral dilemma was designed to contrast the moral foundations of Harm-Care and Justice-Reciprocity in the context of the post-conflict in Colombia to evaluate moral judgment and potential change of judgment. The results show that although most of the participants presented resistance to persuasion, both the quality of the argument and the expertise of the source facilitated persuasion, albeit independently. Results also suggest several reflections on both dual process theories of persuasion and theories of moral judgement.

Habilidades terapêuticas interpessoais: A retomada de Carl Rogers na prática da psicologia baseada em evidências / Interpersonal therapeutic expertise: The re-establishment of Carl Rogers in evidence-based practice in psychology / Habilidades terapéuticas interpersonales: La reanudación de Carl Rogers en la práctica de la psicología basada en la evidencia

A habilidade terapêutica interpessoal é um dos elementos centrais da expertise clínica para a prática psicoterápica baseada em evidências. Pesquisas recentes demonstram uma maior valorização dos fatores relacionais envolvidos no processo psicoterápico, como, por exemplo, o atual valor dado à compreensão empática como elemento facilitador da psicoterapia. Este trabalho tem por objetivo demonstrar a existência de uma convergência entre os pressupostos rogerianos e essas recentes evidências. Para tanto, propõe-se a análise dessa confluência a partir da retomada das condições necessárias para a psicoterapia postuladas por Carl Rogers, detalhadas em três elementos que envolvem a complexidade das habilidades terapêuticas interpessoais: a pessoa do terapeuta; a forma como o cliente percebe as atitudes do terapeuta; e a relação terapêutica em si. Por fim, aponta-se para o potencial da abordagem humanista e principalmente dos pressupostos rogerianos, que evidenciam uma proposta de alteridade e dialogicidade do processo psicoterapêutico, para compreensão e efetivação dos fatores relacionais na prática clínica, como passaram a endossar até mesmo as mais recentes evidências científicas de eficácia em psicoterapia, presentes nas últimas recomendações da APA, válidas, portanto, para toda a clínica psicológica, independentemente da abordagem teórica de escolha do terapeuta.

Interpersonal expertise is one of the central elements of clinical expertise for evidence-based practice in psychology. Recent research shows a greater appreciation of the relational factors involved in the psychotherapeutic process, such as, the value currently given to empathic understanding as a facilitator of psychotherapy. This work aims to demonstrate the existence of a convergence between the Rogerian assumptions and these recent evidences. To this end, it is proposed to analyze this confluence based on the resumption of the necessary conditions for psychotherapy postulated by Carl Rogers, as detailed in three elements that involve the complexity of interpersonal therapeutic skills: the person of the therapist; the way the client perceives the therapist's attitudes; and the therapeutic relationship per se. Finally, it points to the potential of the humanistic approach and mainly of Rogerian assumptions, which show a proposal of alterity and dialogicity for the psychotherapeutic process, for understanding and effecting relational factors in clinical practice, as newly endorsed even by the most recent scientific evidence of effectiveness in psychotherapy, present in the latest recommendations of the APA, valid, therefore, for the entire psychological clinic, regardless of the theoretical approach of choice of the therapist.

La capacidad terapéutica interpersonal es uno de los elementos de la experiencia clínica central para la práctica psicoterapéutica basada en la evidencia. Investigaciones recientes muestran una mayor apreciación de los factores relacionales involucrados en el proceso psicoterapéutico, como, por ejemplo, el valor actual que se le da al entendimiento empático como facilitador de la psicoterapia. Este trabajo tiene como objetivo demostrar la existencia de una convergencia entre los supuestos rogerianos y esta evidencia más reciente. Para este fin, se propone analizar esta confluencia con base en la reanudación de las condiciones necesarias para la psicoterapia postulada por Carl Rogers, detallada en tres elementos que involucran la complejidad de las habilidades terapéuticas interpersonales: la persona del terapeuta; la forma en que el cliente percibe las actitudes del terapeuta; y la relación terapéutica en sí misma. Finalmente, señala el potencial del enfoque humanista y principalmente de los supuestos rogerianos, que evidencian una propuesta de alteridad y dialogicidad para el proceso psicoterapéutico, para comprender y afectar los factores relacionales en la práctica clínica, ya que incluso comenzaron a respaldar más evidencia científica reciente de efectividad en psicoterapia, presente en las últimas recomendaciones de la APA, válidas, por lo tanto, para toda la clínica psicológica, independientemente del enfoque teórico de elección del terapeuta.

Psychological report in justice: an analysis of the quality of expert reports / O laudo psicológico na justiça: uma análise da qualidade dos laudos periciais / El informe psicológico en los tribunales: un análisis de la validade

Psychological reports must meet minimally technical and ethical requirements that are regulated by resolutions of the Federal Council of Psychology (CFP) and by legislation. This study aimed to assess whether psychological reports prepared by freelance psychologist experts for the processes of the Family and Childhood and Justice Courts of Rio Grande do Sul were in accordance with the resolutions, ethical aspects and the theoretical-technical requirements required by the CFP. It is a quantitative research, whose data were analyzed by descriptive statistics and descriptive frequency analysis with documentary analysis. Inconsistencies were identified in the preparation of the experts' psychological reports regarding the various requirements contained in the code of ethics and in the resolutions. It is considered that the misinformation of freelance psychologist experts with regard to CFP resolutions is one of the causes that contribute to the absence of items that are indispensable to the elaboration of quality psychological reports.

Os laudos psicológicos precisam atender minimamente a requisitos técnicos e éticos que são regulamentados por resoluções do Conselho Federal de Psicologia (CFP) e pela legislação. Este trabalho teve por objetivo avaliar se laudos psicológicos confeccionados pelos peritos nomeados pelos juízes para os processos das Varas de Família e da Infância e Juventude da Justiça do Rio Grande do Sul estavam de acordo com as resoluções, aspectos éticos e os requisitos teórico-técnicos exigidos pelo CFP. A qualidade dos laudos analisados foi medida a partir da observância ou não desse conjunto de normativos. Trata-se de uma pesquisa quantitativa, cujos dados foram analisados por estatística descritiva e análise de frequência descritiva com análise documental. Foram identificadas inconsistências na elaboração dos laudos psicológicos quanto aos diversos requisitos contidos no código de ética e nas resoluções. Considera-se que a desinformação de alguns peritos no que diz respeito às resoluções do CFP seja uma das causas que contribuem para a ausência de itens indispensáveis à elaboração de laudos psicológicos de qualidade.

Los informes psicológicos deben cumplir mínimamente con los requisitos técnicos y éticos que están regulados por las resoluciones del Consejo Federal de Psicología (CFP) y por la legislación. El objetivo de este trabajo fue evaluar si los informes psicológicos elaborados por expertos psicólogos independientes para los procesos de los Tribunales de Familia e Infancia y Justicia de Rio Grande do Sul se ajustaban a las resoluciones, aspectos éticos y requisitos teórico-técnicos exigidos por el CFP. Es una investigación cuantitativa, cuyos datos fueron analizados por estadística descriptiva y análisis de frecuencia y documental. Se identificaron inconsistencias en la preparación de los informes psicológicos de los expertos con respecto a los diversos requisitos contenidos en el código de ética y en las resoluciones. La información errónea de los expertos psicólogos independientes con respecto a las resoluciones contribuyen a la ausencia de elementos que son indispensables para la elaboración de informes psicológicos de calidad.

Programa de maestría para profesionales vinculados al análisis clínico / Master program for professionals linked to clinical analysis

RESUMEN El objetivo de la investigación de la cual deriva el presente texto estuvo encaminado a elaborar una propuesta de programa de maestría para los profesionales de la salud vinculados al análisis clínico, desde las tecnologías del diagnóstico en laboratorio. Se realizó un estudio descriptivo transversal en el Centro de Inmunología y Productos Biológicos de la Universidad de Ciencias Médicas de Camagüey, en el período comprendido de enero a marzo de 2019. De los métodos empíricos fueron empleados la técnica de discusión grupal y la encuesta aplicada a egresados y jefes de los servicios asistenciales. Se concluye que se elabora una propuesta de programa de maestría para los profesionales de la salud vinculados al análisis clínico como respuesta a la necesidad e interés por elevar los niveles de competencia y desempeño profesional e investigativo de estos desde las tecnologías del diagnóstico en laboratorio.

ABSTRACT The objective of the research was to develop a proposal for a master's program for health professionals linked to clinical analysis from laboratory diagnostic technologies. A descriptive cross-sectional study was carried out at the Center for Immunology and Biological Products of the University of Medical Sciences of Camagüey, in the period from January to March 2019. From the empirical methods, the group discussion technique was used, and the survey applied to graduates and heads of healthcare services. It is concluded that a master's program proposal is prepared for health professionals linked to clinical analysis in response to the need and interest in raising the levels of competence and professional and investigative performance of these from the technologies of laboratory diagnosis.

A compreensão emocional infantil: uma revisão da literatura / Children’s emotional understanding: a literature review / La comprensión emocional infantil: una revisión de la literatura

A compreensão emocional é uma habilidade de grande relevância para o desenvolvimento emocional infantil, estando relacionada ao ajustamento social e à competência acadêmica. O objetivo deste estudo foi examinar características da produção acadêmica nessa temática, entre 2007 e 2017, de modo a identificar lacunas e fomentar avanços em novas pesquisas nesse campo. Para alcançar esse objetivo, foram realizadas buscas em duas bases de dados, tendo sido selecionados, após a aplicação dos critérios de inclusão e exclusão, 32 artigos. Algumas categorias foram concebidas para analisar os estudos. Verificou-se uma maior concentração de estudos em países europeus e norte-americanos, e em crianças de 0 a 5 anos. Conclui-se que há necessidade de estudos brasileiros sobre o tema e que explorem a diversidade de contextos socioculturais do país.

Emotional understanding is a very important skill for the child’s emotional development, and is related to social adjustment and academic adroitness. The aim of this study was to examine the characteristics of scholar research on this theme in the last ten years, in order to foster advance in new inquires on this domain. For this purpose, searches were conducted in two databases and, after using the exclusion criteria, 32 articles were selected. A few categories were designed to analyze the studies. A higher concentration of studies was found among European and North American countries, and in children from 0 to 5 years old. It is concluded that there is a need for Brazilian studies on the subject to explore the cultural diversity of the country.

La comprensión emocional es una habilidad de gran importancia para el desarrollo emocional infantil y está relacionada con el ajustamiento social y con la competencia académica. El objetivo del presente estudio fue examinar características de la producción académica en esa temática, entre 2007 y 2017, a fin de identificar brechas y fomentar avances en nuevas investigaciones en ese campo. Para lograr ese objetivo, se realizaron búsquedas en dos bases de datos y fueron seleccionados 32 artículos con base en los criterios de exclusión e inclusión. Algunas categorías fueron creadas para analizar los estudios. Hubo una mayor concentración de los estudios en los países europeos y norteamericanos y en niños de 0 a 5 años de edad. Se concluye que hay la necesidad de estudios brasileños acerca del tema y que exploren la diversidad de los contextos sociales del país.

Developmental pathway routes to achieve expert performance in portuguese track and field athletes

Abstract Aim: The aim of this study was to characterize the developmental pathway undertaken by Portuguese expert track and field athletes considering the quantity and type of structured and unstructured activities. Methods: The sample was composed of 24 experts and 35 non-expert athletes who completed a questionnaire designed to gather information about their previous experiences in sports. Results: Results reveal key factors which distinguished expert from non-expert athletes' developmental pathway were related to a greater commitment within track and field in relation to years (U = 251.000, p < 0.01) and hours (U = 212.500, p < .01), as well as with the number of years spent in unstructured activities (U = 284.500, p < .05). Furthermore, a significant association (χ2 = 27.131, p < 0.01) was found between the number of unstructured activities practiced and an expert performance attainment. Conclusions: These findings revealed that more successfully track and field athletes had an early diversified pathway with greater involvement in structured and unstructured activities. Overall, the study provides an insight into the developmental pathway of Portuguese track and field athletes.

Evaluación de imputabilidad penal en crímenes sexuales / Assessment of criminal imputability in sexual crimes

Resumen El artículo tiene como objetivo definir el crimen sexual y estudiar la relación entre los crímenes sexuales y los trastornos mentales. También se describen aspectos del peritaje psiquiátrico de las personas que han cometido delitos sexuales. La evaluación de la imputabilidad penal es extremadamente importante para ajustar, en cada caso, la aplicación de medidas de seguridad y las sanciones penales y correccionales apropiadas.

This article aims to define sexual crime, to study the relationship between sexual crimes and mental disorders. Aspects of psychiatric expertise of individuals Who have committed sex crimes are also described. The assessment of criminal imputability is extremely important in order to adjust, in each case, the application of security measures and appropriate criminal and correctional sanctions.

Novo olhar ao board interlocking: evidências a partir das redes sociais corporativas / Nueva mirada al board interlocking: evidencias a partir de las redes sociales corporativas / A new look at board interlocking: evidence from corporate social networks

Resumo Este estudo teve por objetivo avaliar as estruturas de interligações pelos membros do conselho de administração (CA) com expertise política e financeira de empresas listadas na B3. A amostra foi composta por 2.474 observações no período de 2010 a 2015. Por meio da Teoria da Agência, sugere-se que o board interlocking (BI) pela expertise financeira pode auxiliar o monitoramento corporativo e servir como mitigador dos conflitos da agência. Por outro lado, o BI pela expertise política pode maximizar o comportamento oportunista. Na visão da Teoria da Dependência de Recursos, o BI pela expertise financeira pode auxiliar as empresas na captação de recursos financeiros, enquanto o BI pela expertise política pode maximizar os resultados mediante contratos mais lucrativos e vantagens oferecidas pelos políticos. Conclui-se que a sistematização do BI pelos diferentes tipos de expertise pode ser utilizada em futuras pesquisas para explicar as estratégias, as decisões e os fenômenos corporativos, bem como para avaliar as causas e os efeitos de tais estruturas na gestão das organizações.

Resumen El estudio tiene como objetivo evaluar las estructuras de interconexiones entre los miembros del Consejo de Administración (CA) con experiencia política y financiera de empresas que cotizan en la B3. La muestra se compuso de 2.474 observaciones en el período 2010-2015. Por medio de la Teoría de la Agencia, se sugiere que el board interlocking (BI) por la experiencia financiera puede auxiliar al monitoreo corporativo y servir como mitigador de los conflictos de la agencia. Por otro lado, el BI por la experiencia política puede maximizar el comportamiento oportunista. En la visión de la Teoría de la Dependencia de Recursos, el BI por la experiencia financiera puede auxiliar a las empresas en la captación de recursos financieros, mientras que el BI por la experiencia política puede maximizar los resultados mediante contratos más lucrativos y ventajas ofrecidas por los políticos. Se concluye que la sistematización del BI por las diferentes experiencias puede ser utilizada en las investigaciones futuras para explicar las estrategias, decisiones y fenómenos corporativos, así como para evaluar las causas y los efectos de tales estructuras en la gestión de las organizaciones.

Absract The study aims to evaluate the interconnection structures by members of the Board of Directors with political and financial expertise of companies listed in the Brazilian stock market B3. The sample consisted of 2,474 observations in the period from 2010 to 2015. It is suggested by the Agency Theory that board interlocking (BI) for financial expertise can help in corporate monitoring and mitigates the agency's conflicts. On the other hand, BI by political expertise can maximize opportunistic behavior. In the view of Resource Dependency Theory, BI for financial expertise can assist companies in attracting financial resources, while BI for policy expertise can maximize results through more lucrative contracts and advantages offered by policymakers. It is concluded that the systematization of BI by different expertise can be used in future research to explain corporate strategies, decisions, and phenomena, as well as to evaluate the causes and effects of such structures in the management of organizations.

Perception of university students about doctors and quality of health care provision at clinics: a multi-national study in India, Pakistan, Spain and United States of America

Background: Patient satisfaction is considered as an indicator of the healthcare quality. Information on patient satisfaction based on medical expertise of the physician, interpersonal skills, physician-patient interaction time, perception and needs of the patient allow policymakers to identify areas for improvement. Primary care services and healthcare structure differ between the countries. The present study was done to determine and analyze the determinants associated with patient satisfaction in India, Pakistan, Spain and USA.Methods: This descriptive study was performed in January to August 2019 among students from Mumbai University, India, Dow University of Health Sciences, Karachi, Pakistan, University CEU Cardenal Herrera, Valencia, Spain, Texas State University, Texas, USA. On the basis of the eligibility criterion (those who gave a written informed consent and were registered students of respective university) 890 (India: 369, Pakistan: 128, Spain: 195, USA: 99) students were selected for the present study.Results: India had almost similar male (49%) to female (51%) ratio of participants. For other 3 countries (PK, ES, US), female participant percentage was nearly 20% or even more as compared to male participants. Overall participant’s satisfaction score about medial expertise of the doctor were highest in India (71%) and were lowest in Spain (43%). Overall satisfaction score about time spent with doctor were highest for India (64%) and were lowest for Spain (41%). Overall satisfaction score about communication with doctor were highest for US (60%) and were lowest for PK (53%). Overall satisfaction score for medical care given by the doctor was lowest in PK (43%) and was highest in US (64%). Overall satisfaction about doctor, highest number of US (83%) and lowest number of PK (32%) participants were satisfied about medical interaction with doctors.Conclusions: These multi-country findings can provide information for health policy making in India, Pakistan, Spain and USA. Although the average satisfaction per country, except Pakistan is more than 60%, the results suggest that there is ample room for improvement.

Anabolizantes na graduação em educação física: um dilema ético-sanitário entre estudantes que praticam fisiculturismo / Anabolics steroids in a physical education undergraduate program: an ethical-sanitary dilemma among bodybuilder students

RESUMO Este artigo trata do dilema enfrentado por estudantes-fisiculturistas de Educação Física que se dedicam a aprender, por conta própria, sobre o uso de anabolizantes para fins não terapêuticos em um curso de graduação vinculado à área da saúde. A noção de dilema ético-sanitário é desenvolvida a partir da articulação entre os conceitos de expertise, de Nikolas Rose, e o de risco em saúde, de Deborah Lupton. Entrevistas episódicas com seis alunos da graduação dos cursos de licenciatura e bacharelado em Educação Física de uma universidade brasileira foi a opção metodológica adotada. Como resultado, identificamos dois perfis de estudantes praticantes de fisiculturismo: um composto pelos que ingressaram no curso com o objetivo de aprender a usar anabolizantes; e outro que julgava já saber sobre e tinha por objetivo buscar uma certificação profissional universitária. Concluímos que o dilema ético-sanitário observado em ambos os perfis deveria ser tratado em aula nos cursos de graduação em Educação Física, pois o "silêncio curricular" sobre o processo de hipertrofia muscular pela via medicamentosa, associado à atmosfera de clandestinidade, pode favorecer a circulação de mais desinformação e ainda mais riscos ao público alvo deste estudo.

ABSTRACT This article deals with the dilemma faced by physical education student-bodybuilders who are dedicated to learning on their own about the uses of anabolic steroids for non-therapeutic purposes. The concept of the ethical-sanitary dilemma is developed from the articulation between Nikolas Rose's concept of expertise and Deborah Lupton's concept of risk. Episodic interviews with six undergraduate students of Physical Education from a Brazilian university were applied in this study as the principal method. As a result, we identified two profiles of student-bodybuilders: one composed of those who joined the program in order to learn how to use anabolic steroids, and another one composed of those who presumed to know about the uses and whose purpose was to earn an undergraduate diploma. We conclude that the ethical-sanitary dilemma observed in both profiles should be addressed in the Physical Education undergraduate courses since the "curricular silence" on the process of muscular hypertrophy via steroid anabolics, associated with the clandestine atmosphere, may add more misinformation and even more risks to the target audience of this study.

O que a pesquisa sobre raciocínio clínico tem a dizer a preceptores e professores de áreas clínicas? / What does research on clinical reasoning have to say to clinical teachers?

O raciocínio clínico é um fator determinante da performance do médico, crucial para chegar a um diagnóstico correto e possibilitar decisões terapêuticas adequadas. Ajudar seus estudantes a desenvolver o raciocínio clínico é um desafio diário de muitos professores e, para selecionar estratégias de ensino adequadas, pode ser útil conhecer um pouco dos resultados da pesquisa sobre raciocínio clínico que vem se desenvolvendo já há algumas décadas. Este artigo traz uma síntese de achados desta pesquisa que ajudam a compreender os processos cognitivos envolvidos no raciocínio clínico, a trajetória que leva o estudante de uma condição de "iniciante" `a de "expert" e abordagens instrucionais que têm se mostrado úteis para facilitar esta trajetória. O foco do artigo é o processo diagnóstico, porque é ele que tem sido o objeto central de pesquisa. Esta pesquisa indica que não há estratégias de raciocínio específicas, próprias do médico expert, que possam ser ensinadas ao estudante. É a existência de uma larga base de conhecimentos organizados na memória em scripts de doenças de diversos formatos que explica o melhor desempenho do expert. Quanto mais numerosos, mais ricos e melhor organizados são os scripts que um médico tem na memória, mais apto ele está para fazer diagnósticos acurados. Estes scripts são formados gradualmente ao longo dos anos de formação e para desenvolvê-los o estudante deve ser exposto a uma grande diversidade de problemas clínicos, com os quais ele deve interagir de forma ativa. Abordagens instrucionais que requerem que o estudante reflita de forma sistemática sobre os problemas, analisando diferenças e similaridades entre eles, explicando mecanismos subjacentes, comparando e contrastando diagnósticos alternativos têm se mostrado úteis para ajudar a refinar scripts de doenças e são ferramentas valiosas para os professores interessados no desenvolvimento do raciocínio clínico de seus estudantes.

Clinical reasoning is a crucial determinant of physicians' performance. It is key to arrive at a correct diagnosis, which substantially increases the chance of appropriate therapeutic decisions. Clinical teachers face the daily challenge of helping their students to develop clinical reasoning. To select appropriate teaching strategies, it may be useful to become acquainted with the results of the research on clinical reasoning that has been conducted over the last decades. This article synthesizes the findings of this research that help in particular to understand the cognitive processes involved in clinical reasoning, the trajectory that leads the student from novice to expert, and instructional approaches that have been shown to be useful to facilitating this trajectory. The focus of the article is the diagnostic process, because it is about it that most research has been conducted. This research indicates that there is not a particular reasoning strategy that is specific to expert physicians and could be taught to students. It is the availability of a large knowledge base organized in memory in illness scripts of different formats that explains the expert's better performance. The more, the richer, and the more well-structured are the illness scripts a physician has stored in memory, the more he/she would be able to make accurate diagnoses. These scripts are formed gradually over the years of education. To help develop them, students should be exposed to a wide variety of clinical problems, with which they must interact actively. Instructional approaches that require students to systematically reflect on problems, analyzing differences and similarities between them, explaining underlying mechanisms, comparing and contrasting alternative diagnoses, have proved useful to help refine disease scripts. These approaches are valuable tools for teachers concerned with the development of their students clinical reasoning.

Uma etnografia virtual em um grupo sobre o transtorno bipolar: sociabilidades e saberes produzidos no meio on-line / Virtual ethnography in a group about bipolar disorder: sociabilities and knowledge produced in the online environment / Una etnografía virtual en un grupo sobre el trastorno bipolar: sociabilidades y saberes producidos en el medio on-line

Publicado pela primeira vez no Manual Diagnóstico e Estatístico de Transtornos Mentais (DSM) III, o transtorno bipolar trouxe uma nova maneira de entender e vivenciar as oscilações emocionais, fortemente imbuída dos referenciais da psicofarmacologia, neurociências e novas conceituações sobre as variações afetivas. Com o objetivo de investigar os sentidos, as sociabilidades e os modos de ser constituídos a partir desse diagnóstico, foi feita uma etnografia no grupo brasileiro do Facebook mais numeroso sobre a bipolaridade, que identificou o seguinte: a rede facilita a produção de uma expertise experiencial; a ideia de que "apenas quem sofre entende" fortalece a identificação mútua; em contraposição à antiga psicose maníaco-depressiva, o transtorno bipolar adquire certa positividade, tornando-se fonte de humor; a química medicamentosa é o principal recurso usado para gerir a vida afetiva, tornando os pacientes parcialmente independentes do médico ao manejarem esses recursos entre si; e o transtorno bipolar é dissociado do Eu.(AU)

Published for the first time in DSM IIII, bipolar disorder has brought a new way of understanding and experiencing emotional oscillations, strongly impregnated with the frameworks of psychopharmacology, neurosciences, and with new conceptualizations of affective variations. Aiming to investigate the meanings, sociabilities and ways of being constituted from this diagnosis, an ethnography was performed in the most numerous Brazilian Facebook group about bipolar disorder, which identified the following aspects: the network facilitates the production of an experiential expertise; the idea that "only those who suffer from it can understand it" strengthens mutual identification; in opposition to manic depression, as it was formerly called, bipolar disorder acquires a certain positivity, becoming a source of humor; drug therapy is the main resource used to manage affective life, making patients partially independent from the physician when they handle these resources among themselves; bipolar disorder is dissociated from the "self".(AU)

Publicado por primera vez en el DSM III, el trastorno bipolar proporcionó una nueva manera de entender y experimentar las oscilaciones emocionales, fuertemente basada en los referenciales de la psicofarmacología, neurociencias y nuevas conceptuaciones sobre las variaciones afectivas. Con el objetivo de investigar los sentidos, sociabilidades y modos de ser constituidos a partir de este diagnóstico, se realizó una etnografía en el grupo brasileño del Facebook más numeroso sobre la bipolaridad que identificó lo siguiente: la red facilita la producción de una expertise con base en la experiencia; la idea de que "solamente quien lo sufre entiende" fortalece la identificación mutua; en contraposición a la antigua psicosis maníaco-depresiva, el trastorno bipolar adquiere cierta positividad, convirtiéndose en fuente de humor; la química medicamentosa es el principal recurso utilizado para administrar la vida afectiva, haciendo que los pacientes sean parcialmente independientes del médico al manejar estos recursos entre sí; el trastorno bipolar se disocia del "yo".(AU)

Bibliometric Analysis of Research Hotspots Related to Marine Oil Spill Accidents in the Environmental Field Based on Web of Science / 法医学杂志

Objective To conduct bibliometric analysis of the relevant literature in the environmental field published from 1982 to 2018 collected by the Web of Science citation database and further explore the frontier research dynamics and hotspots in the environmental field. Methods The word "oil spill*" was used as the subject term for retrieval. A knowledge map of hotspots in oil spill research was built through software VOSviewer and the clustering relations between them were explored. The frequency and relevance of the keywords in the corresponding literature were obtained by the matrix of keywords built through the Thomson Data Analyzer （TDA） software. Results The four main research hotspots of marine oil spill pollution were oil spill numerical simulation and model prediction, oil spill exposure toxicity and risk assessment, oil spill component and source analysis and oil spill pollution characteristics and treatment. Conclusion The study analyzes the main content of the four research hotspots and the current research progress and provides scientific basis for further understanding of the mechanism of marine oil spill occurrence, migration and transformation, implementation of oil spill treatment and repair as well as more accurate assessment of eco-environment damage.

Biological Toxicity Effects of Soil Pollution Caused by Galvanized Wastewater Based on Vibrio Qinghaiensis sp.-Q67 / 法医学杂志

Objective To establish a rapid diagnosis method for the biological toxicity of soil, accurately and rapidly evaluate the toxicity of contaminated sites and identify the dominant pollutants. Methods Take the soil pollution of a galvanized factory as an example, while the metal concentration level was analyzed and detected, a rapid biological toxicity detection method based on the acute toxicity test of luminescent bacteria （Vibrio qinghaiensis sp.-Q67） was established, and the dominant pollutants were identified by stepwise multiple regression. Results The pollutants came from wastewater and metal plating fragments directly discharged from the manufacturing line of the factory. The concentration of those pollutants was correlated with the acute toxicity of Vibrio qinghaiensis sp.-Q67. The dominant pollutants in the study were zinc （Zn）, aluminum （Al） and copper （Cu）. Conclusion The luminescent bacteria toxicity test method based on Vibrio qinghaiensis sp.-Q67 can conveniently and rapidly assess the degree of toxic damage of polluted soil and identify the dominant pollutants and can be applied to the acute toxicity evaluation of polluted soil.

Formation and Development of Environmental Forensics System in China / 法医学杂志

With the growing attention on ecological environment problems and gradual realization of ecological environment value, environmental damage has jumped from administrative penalty to a new stage, judicial penalty, and environmental damage appraisal has provided a legal weapon to safeguard ecological security. As a new forensic category of China with high comprehensiveness and technical difficulty, environmental damage appraisal involves diversified and complex subjects, fields and appraisal objects, and is still in an early stage in terms of theory and practice. This study aims to provide an important reference for the improvement of the Chinese environmental damage appraisal system of environmental damage by summarizing advanced international experience in areas such as laws and regulations, working mechanism and technical system, and putting forward targeted countermeasures and suggestions based on the problems existing in the development and practice of environmental damage appraisal in China.

Application of expertise-based pragmatic randomized controlled trial in acupuncture-moxibustion clinical research / 中国针灸

According to clinical practice, the characteristics and issues of pragmatic randomized controlled trial(PRCT) and expertise-based randomized controlled trial (EBRCT) in acupuncture-moxibustion clinical research were summarized. The characteristics of expertise-based pragmatic randomized controlled trial (EB-PRCT), which is the combination of above two, and its application in acupuncture-moxibustion clinical trial were explored. PRCT emphasizes the clinical practice, the positive control of standard therapy and the the blind performance on data collection and statistics. PRCT has the advantage of flexible grouping, nevertheless, it also has shortcomings such as higher cost and lack of typical subjects. EBRCT emphasizes the participation of professional acupuncturists, so that the therapeutic effect is ensured, the compliance of subjects and the bias of manipulation are improved. Thus, the replacement scheme of acupuncturists is essential in EBRCT. Having the complementary advantages, EB-PRCT provides a superior research method for acupuncture-moxibustion clinical trial, and leads to convincing results.

Study of morbidity pattern and outcome of patients admitted in paediatric intensive care unit in a tertiary care rural teaching hospital

Background: The care of the critically ill children remains one of the most demanding and challenging aspects in the field of paediatrics. The main purpose of Paediatric Intensive care unit is to prevent mortality by intensively monitoring and treating critically ill children who are considered at high risk of mortality. In the developing countries, there is a scarce data on paediatric critical care. Evaluation of the outcome of medical interventions can assess the efficacy of treatment. This helps in better decision making, improving the quality of care and modifying the future of management if required. This study will also help to study the causes of morbidity and mortality among paediatric age group in our hospital. Aims and Objectives of the study is to evaluate the morbidity pattern and outcome of admissions in the PICU of a rural teaching hospital, and to take measures to prevent morbidity and mortality by improving critical care facilities.Methods: This was a retrospective study, the cases admitted in paediatric ICU in our teaching hospital in last two and a half considering the estimated sample size. Data will be collected from PICU and Medical record Department. Details will be studied with the help of medical record and will be analysed and interpreted according to the medical record details.Results: During a period of 30 months of the study, total of 417 patients were admitted in our PICU. Of the total cases studied, Maximum i.e. 180(43.2%) had age below 1 year. The minimum ' maximum range of age was between 1 day to 18 years. About 228(54.7%) cases were males and 189(45.3%) were females. The most common diagnosis was LRTI which was observed in 61(14.7%) of cases. The most common system involved was respiratory system which was observed in 101(21.8%) cases. Of total cases studied, 357(85.6%) were discharged, 36(8.6%) had DAMA (discharge against medical advice) and 24(5.8%) expired.Conclusions: Mortality was low in our PICU. We conclude based on the present study that in our rural set up PICU, with better treatment protocols, skilled expertise/ Paediatric Intensivist we have chances to facilitate the care of critically ill patients giving desirable outcome.