Current management of patients with cutaneous melanoma with a positive sentinel lymph node / Tratamiento actual de pacientes con melanoma cutáneo y ganglio centinela positivo

Abstract Introduction : Immediate completion lymph node dissection (CLND) performed in patients with a positive sentinel lymph node biopsy (SLNB) cutaneous melanoma is not associated with improved melanoma specific survival versus active surveillance (AS) using nodal ul trasound. Clinical practice experience and outcomes of AS and adjuvant therapy is now starting to be published in literature. Methods : Retrospective analysis of patients with a positive-SLNB between June/2017-February/2022. Impact of management on any-site recurrence free survival (RFS), isolated nodal recurrence (INR), distant metasta sis-free survival (DMFS) and melanoma-specific survival (MSS) was evaluated. Results : From 126 SLNB, 31 (24.6%) were positive: 24 received AS and 7 CLND. Twenty-one (68%) received ad juvant therapy (AS, 67% and CLND, 71%). With a median follow-up of 18 months, 10 patients developed recur rent disease with an estimated 2-yr RFS of 73% (CI95%, 0.55-0.86) (30% in AS group vs. 43% in dissection group; P = 0.65). Four died of melanoma with an estimated 2-yr MSS of 82% (CI 95%, 0.63-0.92) and no differences between AS and CLND groups (P = 0.21). Estimated 2-yr DMFS of the whole cohort was 76% (CI 95%, 0.57-0.88) with no differences between groups (P = 0.33). Conclusion : Active surveillance strategy has been adopted for most positive-SLNB cutaneous melanoma patients. Adjuvant therapy without immediate CLND was delivered in nearly 70% of patients. Our results align with outcomes of randomized control trials and previous real-world data.

Resumen Introducción : La linfadenectomía inmediata (LI) re alizada en pacientes con biopsia de ganglio centinela (BGC) positivo por melanoma cutáneo no está asociada a mejoría en la supervivencia libre de enfermedad vs. vigilancia activa (VA). Resultados oncológicos y experi encia en la práctica clínica con dicha conducta asociados a tratamiento adyuvante comienzan a ser publicados en la literatura. Métodos : Análisis retrospectivo incluyendo paci entes con BGC-positiva por melanoma cutáneo entre junio/2017-febrero/2022. Se evaluó impacto del manejo en: supervivencia libre de recurrencia (SLR), recurren cia ganglionar aislada (RGA), supervivencia libre de metástasis a distancia (SLMD) y supervivencia libre de enfermedad (SLE). Resultados : De 126 pacientes, 31 (24.6%) fueron positi vos: en 24 se realizó VA y en 7 LI. Veintiún pacientes (68%) recibieron tratamiento adyuvante (VA, 67% y LI, 71%). Con una media de seguimiento de 18 meses, 10 pacientes presentaron recurrencia de la enfermedad con una SLR estimada a 2 años del 73% (CI95%, 0.55-0.86) (30% en VA vs. 43% en LI; P = 0.65). Cuatro murieron de melanoma con una SLE a 2 años del 82% (CI 95%, 0.63-0.92); sin diferencia entre ambos grupos (P = 0.21). La SLMD a 2 años de toda la cohorte fue de 76% (CI 95%, 0.57-0.88; P = 0.33). Conclusión : La vigilancia activa se ha adoptado como conducta para la mayoría de los pacientes con BGC-positivo. El tratamiento adyuvante sin linfadenectomía inmediata se realizó en cerca del 70% de nuestra serie. Los resultados de nuestra serie son similares a los re portados en la literatura.

Identidade(s) em movimento: ações coletivas e multiplicidade nas trajetórias juvenis / Identity(s) in movement: collective actions and multiplicity in youth / Identidad(es) en movimiento: acciones colectivas y multiplicidad en trayectorias jóvenes

Este texto trata de um ensaio teórico que busca discutir questões relativas ao conceito de identidade ou identidade(s), na perspectiva de alguns autores da Sociologia e da Psicologia Social Crítica, direcionando às ações coletivas e trajetórias juvenis. As elaborações sobre identidade têm como contribuição principal essencial a obra de Alberto Melucci (2006), compondo um esquadrinhamento teórico referencial no estudo realizado. Ao refletirmos sobre a identidade em movimento e a multiplicidade nas trajetórias juvenis percebemos por meio da literatura especializada e analisada que não podemos negar os contextos múltiplos que lançam mão os jovens para tomar as suas decisões e estratégias escolares e laborais. As trajetórias juvenis se apresentam oscilantes, não-lineares, caracterizadas por rupturas, uma série de transformações e rearranjos vividos, assim como a própria constituição das identidades(s). Os jovens vivem situações de experimentação em suas trajetórias pessoais e profissionais num movimento que se apresenta circulante, fluído e incerto.

This text is a theoretical essay that aims to discuss issues related to the concept of identity or identity( ies), from the perspective of some authors of Sociology and Critical Social Psychology, directing to collective actions and youth trajectories. The elaborations on identity have as their main essential contribution the work of Alberto Melucci (2006), composing a theoretical scrutiny of reference in the study carried out. When we reflect on identity in motion and the multiplicity of youth trajectories, we realize through the specialized and analyzed literature that we cannot deny the multiple contexts that young people use to make their school and work decisions and strategies. Youth trajectories are oscillating, non-linear, characterized by ruptures, a series of lived transformations and rearrangements, as well as the very constitution of identity(ies). Young people experience situations of experimentation in their personal and professional trajectories in a movement that is circulating, fluid and uncertain.

Este texto es un ensayo teórico que busca discutir cuestiones relacionadas con el concepto de identidad o identidad(es), desde la perspectiva de algunos autores de la Sociología y la Psicología Social Crítica, dirigiéndose a acciones colectivas y trayectorias juveniles. Las elaboraciones sobre identidad tienen como principal aporte esencial el trabajo de Alberto Melucci (2006), componiendo un escrutinio teórico de referencia en el estudio realizado. Cuando reflexionamos sobre la identidad en movimiento y la multiplicidad de trayectorias juveniles, percibimos a través de la literatura especializada y analizada que no podemos negar los múltiples contextos que utilizan los jóvenes para tomar sus decisiones y estrategias escolares y laborales. Las trayectorias juveniles son oscilantes, no lineales, caracterizadas por rupturas, una serie de transformaciones y reordenamientos vividos, así como la constitución misma de (s) identidad(es). Los jóvenes viven situaciones de experimentación en sus trayectorias personales y profesionales en un movimiento circulante, fluido e incierto.

Political Practices and Citizen Education with Gender Perspective. Analysis in Some Universities in Bucaramanga, Colombia / Prácticas políticas y formación ciudadana con perspectiva de género. análisis de algunas universidades de bucaramanga, colombia

RESUMEN El proyecto de investigación "Prácticas políticas y formación ciudadana con perspectiva de género. Análisis de las universidades de Bucaramanga", se propuso contribuir al mejoramiento de los planes de formación ciudadana de las Instituciones de Educación Superior (IES). Para eso, se examinaron los enfoques teóricos que fundamentan la formación ciudadana en los planes educativos-formativos de las IES y sus programas institucionales; se identificaron los mecanismos que estructuran las subjetividades y las identidades de género y que sustentan las prácticas sociales sobre la ciudadanía, de los(as) estudiantes de las Instituciones de Educación Superior de Bucaramanga; finalmente, se entregaron estrategias de formación ciudadana coherentes con las expectativas e intereses de la comunidad juvenil a las IES de Bucaramanga. En el trabajo de campo participaron seis Instituciones de Educación Superior de la ciudad y su área metropolitana, en donde se desarrollaron 13 entrevistas semiestructuradas a los directivos de las instituciones. De igual manera, se realizaron seis Grupos de Discusión con la participación de 163 estudiantes de ambos sexos. Los elementos encontrados demuestran que las Instituciones de Educación Superior en Bucaramanga y su área metropolitana deben implementar la propuesta dada en sus Proyectos Educativos Institucionales, en cuanto a la formación integral. Así mismo, la formación ciudadana debe conducir a la juventud a cuestionar todas las estructuras que median sus relaciones interpersonales. De igual manera, será el espacio para lograr comunicaciones efectivas, críticas y a reconocer las voces y criterios de los(as) otros(as); a interactuar con la diversidad y a poner en escena los valores de la tolerancia, el respeto y la solidaridad dentro de un pensamiento pluralista.

ABSTRACT The research project "Political practices and citizen education with gender perspective. Analysis in some universities in Bucaramanga, Colombia", had the purpose of improving citizen education plans in Higher Institutions. To accomplish the research objective, it as considered: to know the theoretical approaches that base the citizen education in educative/ formative plans of Higher institutions and their institutional programs; to identify the mechanisms that structures subjectivities and gender identities that support social practices on the citizenship of Higher Institution's' students in Bucaramanga, and finally, to contribute to Higher Institutions in Bucaramanga with coherent strategies of citizen education according to the expectations and interests of youth community. During the work field six Higher Institutions of Bucaramanga participated and were conducted 13 semi-structured interviews to institution's chiefs' officers. Moreover, they were conducted six focus groups with 163 students of both genders. The results show that Higher Institutions of Bucaramanga should focus on developing their institutional educative projects regarding integral education action plans. Those findings indicate a teaching-learning process guided by competences where Know and Be allows to build a personal identity and the conscience to have attitudinal control. Likewise, citizen education should lead youth to argue all the structures that mediate their relationships. Similarly, citizen education would be the room to achieve affective and critic communication, and to recognize the voices and criteria of others to interact with diversity and to stage the tolerance, respect and solidarity within a pluralistic thought. The methodology used to collect the information has been qualitative, through semi-structured in-depth interviews and workshops with different actors. analysis leads to identify some key elements that obscure the legislative and jurisprudential successes that de Colombian State has achieved in terms of reparation with a gender approach. The results indicate the need to go beyond gender as a differentiating category, to achieve greater effectiveness in the reparation proposed to the victims.

A integralidade do Cuidado no Ensino na Área da Saúde: uma Revisão Sistemática / Comprehensive Care in Health Teaching: A Systematic Review

RESUMO O preparo de profissionais de saúde na perspectiva da integralidade e o interesse coletivo pela democratização da saúde motivam a transformação da realidade desarticulada e individualista do serviço. O cuidado inserido no conceito de integralidade permeia a teia de ações de saúde e efetiva a articulação do ensino-serviço e a conexão entre saberes e fazeres no alcance de competências para a integralidade. O objetivo deste estudo é verificar sobre o que versam as publicações entre 2010 e junho de 2016 quanto à integralidade do cuidado no ensino na área da saúde. Optou-se pela revisão sistemática, conduzida pelo Prisma-P. Realizaram-se buscas de artigos nas bases de dados Biblioteca Virtual em Saúde (BVS) e PubMed. Uma vez aplicados os critérios de inclusão e exclusão, resultaram 35 artigos, que foram avaliados por dois revisores à luz do Critical Appraisal Checklist for Interpretative and Critical Research (JBI Qari), totalizando 32 estudos incluídos nesta revisão. Da análise dos estudos emergiram quatro categorias: formação sob o eixo da integralidade, integralidade sob a perspectiva dos estudantes, integralidade sob a perspectiva dos docentes e ensino da integralidade do cuidado. Esta revisão sistemática possibilitou desenvolver um modelo conceitual de busca pela integralidade, o qual tem, de um lado, o ensino/formação por meio das instituições de ensino superior, e, do outro, os cenários de prática/serviços de saúde, onde se efetivam as ações de atenção à saúde. É essencial a articulação de propostas curriculares inovadoras com os princípios do Sistema Único de Saúde e políticas públicas de saúde, para dar sustentação à implementação de ações voltadas às necessidades da sociedade e, então, alcançar as competências dos profissionais de saúde com vistas à integralidade. Conforma-se o modelo em uma circularidade de ações que se justapõem e se entrecruzam, fortalecendo o processo de ensino--aprendizagem. Este modelo rompe com as ações isoladas, sem articulação do ensino e serviço, as quais tendem a enfraquecer as propostas e os resultados que se espera alcançar. Ações isoladas, muitas vezes, são implementadas com caráter de integralidade, porém atingem somente a superficialidade, sem entrelaçar ações que resultem em cuidado integral. Conclui-se que a integralidade se consolida pela edificação de práticas profissionais cotidianas eficazes, transversalidade nas práticas dos profissionais e como princípio educativo na formação.

ABSTRACT Transforming the disjointed and individualistic state-of-affairs of the Brazilian health service is promoted by the professional training geared toward comprehensive care and a collective interest for the democratization of health. The concept of integrality in relation to care permeates the web of health actions with effective coordination between teaching and service and links between knowledge and the actions within the scope of comprehensive care competences. The aim of this study is to review publications from 2010 to June 2016 in relation to comprehensive health care in teaching health sciences. The chosen method for the study was a systematic review conducted through Prisma-P. Article searches were carried out in the Biblioteca Virtual em Saúde (BVS) and PubMed databases. Once the inclusion and exclusion criteria had been applied, the resulting 35 articles were evaluated by two reviewers who used the Critical Appraisal Checklist for Interpretative and Critical Research (JBI Qari), corresponding to 32 studies included in this review. Analysis of the studies gave rise to four categories: training under the axis of comprehensive care comprehensive care from the students' perspective, comprehensive care from the teachers' perspective, and the teaching of comprehensive care. Based on this systematic review, a conceptual search model for integrality was developed, with teaching/training through higher education institutions on one side, and settings for health care practices/services on the other, that is, where health care actions take place. It is essential to develop innovative curricular proposals linked into the principles of the Brazilian Unified Health System and public health policies, to support actions geared to the needs of society, and subsequently help health professionals attain competencies associated to comprehensive care. The model is shaped as a circle of actions that are juxtaposed and intersecting, and strengthen the teaching-learning process. This model breaks away from isolated actions, in which teaching and service are disconnected and tend to weaken the proposals and the expected results. Isolated actions are often implemented in a holistic manner, but have only a superficial effect without interlinking actions that result in comprehensive care. It was concluded that comprehensive care must be consolidated through daily professional practices that are transversally overlap, and be promoted as an educational principle in training.

Construção de identidade(s) na velhice: os territórios enquanto marcos identitários / Construction of identity(ties) in old age: the territories as identitarian landmarks / Construcción de identidad(es) en la vejez: los territorios como puntos de referencia de identidad

RESUMO Este artigo tem por objetivo refletir sobre o contributo específico dos territórios - a casa, a rua, o entorno - enquanto referência fundamental na construção identitária de pessoas idosas. Nossa base reflexiva foi construída a partir de observações e descrições do território conhecido como "Alta", no casco histórico de Coimbra, Portugal; entrevistas semiestruturadas, com 12 de seus residentes; e com notas de campo, sistematizadas num diário de bordo da pesquisa, construído para o efeito. A construção identitária de grande parte das pessoas idosas encontra-se profundamente ancorada nos territórios onde vivem, principalmente quando estas pessoas residem há muito tempo em um mesmo espaço geográfico, no qual vivenciam uma parte muito substantiva do seu cotidiano. Esta centralidade é, ainda, reforçada quando apresentam mobilidades reduzidas ou condicionadas, quer pelas dificuldades de acessibilidade dos próprios territórios, quer por limitações pessoais, iniciadas e/ou acentuadas na velhice.

RESUMEN Este artículo tiene como objetivo reflexionar sobre la contribución específica de los territorios - la casa, la calle, el entorno - como un referente clave en la construcción de la identidad de las personas mayores. Nuestra reflexión fue construida sobre a base observaciones y descripciones del territorio conocido como "Alto" en el centro histórico de Coimbra, Portugal. Este material fue colectado mediante entrevistas semi-estructuradas con 12 de sus residentes, y notas de campo de quien investiga; los datos de la investigación fueron sistematizados en el formato libro de registro, construido para tal propósito. El análisis devela que la construcción de la identidad de gran parte de las personas mayores está profundamente anclada en los territorios en los que viven, sobre todo cuando estas personas viven mucho tiempo en la misma zona geográfica en la que experimentan una parte muy importante de su vida cotidiana. Este aspecto central se refuerza aún más en aquellos casos que han reducido o condicionado sus movilidades, ya sea por las dificultades de accesibilidad a los mismos, territorio o por las limitaciones personales, que comenzaron o se agudizaron en la vejez.

ABSTRACT This article aims to reflect on the specific contribution of the territories - the house, the street, the surroundings - as a key reference in the identity construction of the elderly. Our reflective base was built from observations and descriptions of the territory known as "Alta", situated in the historical core of Coimbra, Portugal, and semi-structured interviews with 12 of its residents as well as from field notes, systematized in a research logbook, built for this purpose. The identity construction of much of the elderly is deeply anchored in the territories where they live, especially when these people have been living for a long time in the same geographic area in which they have experienced a substantial part of their daily lives. This centrality is further reinforced when they have reduced or conditioned mobility, either by the accessibility difficulties of the territories themselves, or by personal limitations, initiated and /or intensified in old age.

Caracterización de prácticas de capacidad de innovación en organizaciones: Revisión literaria y diagnóstico en unidades de servicios

El artículo responde a las preguntas: ¿Cuáles son las prácticas que aplican las organizaciones de servicios para facilitar la construcción y desarrollo de su capacidad de innovación? y ¿Las unidades financieras de IES públicas en Colombia, aplican tales prácticas? El problema se fundamenta en estudios sobre desfinanciación de la Educación Superior (ES) y la necesidad de innovar en las fuentes de ingresos. Las IES demandan la capacidad para responder a la dinámica del entorno, requerimientos de calidad, cobertura, tecnología etc. Por medio de una revisión sistemática de la literatura, este estudio caracteriza prácticas identificadas en artículos científicos que mejoraron la capacidad de innovación en organizaciones de servicios; y realiza un diagnóstico del porcentaje de IES que las aplican. Se hace evidente en el estudio, que el nivel de autonomía de las IES influye en la aplicación de las prácticas.

The article answers the questions: What are the practices applied by service organizations to facilitate the construction and development of their innovation capacity? Do financial units and public higher education institutions in Colombia, apply the practices? The problem is based on studies of de-funding of Higher Education (HE) and the need to innovate in revenue. The HEI demand the ability to respond to the dynamics of the environment, quality requirements, coverage, technology etc. Through a systematic review of the literature This study characterizes practices identified in scientific articles that enhanced the capacity of innovation in service organizations and performs a diagnosis of the percentage of HEI that apply It is evident from the study that the level of autonomy of HEIs influences the practices implementation.

O artigo responde as perguntas: Quais são as práticas aplicadas pelas organizações de serviço para facilitar a construção e desenvolvimento de sua capacidade de inovação? As unidades financeiras e instituições de ensino público superior na Colômbia, aplicar tais práticas? O problema é baseada em estudos de de-financiamento do Ensino Superior (ES) ea necessidade de inovar em fontes de renda. A IES exigir a capacidade de responder À dinâmica do ambiente, requisitos de qualidade, a cobertura, tecnologia etc. Através de uma revisão sistemática da literatura, este estudo caracteriza práticas identificadas em artigos científicos que aumenta a capacidade de inovação nas organizações de serviços; e efectua um diagnóstico de a percentagem de AIS que se aplicam. É evidente a partir do estudo que o nível de autonomia das instituições de ensino superior influencia a implementação de práticas.

As primeiras respostas à epidemia de aids no Brasil: influências dos conceitos de gênero, masculinidade e dos movimentos sociais / First responses to the aids epidemic in Brazil: influences of the concepts of gender, masculinity and the social movements

Este ensaio caracteriza-se por ser uma reflexão teórica sobre as concepções de gênero e masculinidade e, como estas influenciaram a formulação de uma identidade de grupo e de movimentos que marcaram as primeiras respostas do Estado brasileiro à epidemia de aids. Sendo assim, o artigo apresenta, além das teorias de gênero e masculinidade, um panorama sobre a formulação das ‘redes de solidariedade’ e de grupos e organizações não governamentais, focados na luta pelos direitos das pessoas vivendo com HIV/aids e no apoio à aqueles que viviam com a doença, a expansão da homofobia, por parte daqueles que utilizaram o HIV como bode expiatório de fobias e preconceitos e, a formulação de Políticas Públicas em reação às inquietações de representantes da comunidade homossexual. Conclui-se que o fato de as primeiras pessoas identificadas como portadoras do HIV serem homens gays marcou profundamente as respostas dadas à epidemia...

This essay represents a theoretical reflection on the concepts of gender andmasculinity, and how they helped shape an identity for the groups and movementsthat constituted the first responses by the Brazilian State to the AIDSepidemic. Therefore, in addition to the gender and masculinity theories, thisarticle presents an overview of the development of ‘solidarity networks’ andof groups and non-governmental organizations that are focused on: fightingfor the rights of HIV/AIDS carriers; on supporting those who live with thedisease; on the homophobia engendered by those using HIV as a scapegoatfor phobias and prejudice; and on making public policies as a response to the concerns of gay community representatives. In conclusion, the fact that the first HIV carriers were identified as gay men influenced profoundly not only theresponse to the epidemic, but the direction taken by the LGBT movement, and led to an undeniable stigmatization of individuals affected by the syndrome.On the other hand, AIDS was responsible for bringing ‘sexual deviance’ to the surface, as well as other dissenting forms of heterosexuality and hegemonicmasculinity, making them everyday realities...

Development characteristics of empathy and its relationship with aggression in adolescents / 中国心理卫生杂志

Objective:To explore the development characteristics of empathy in adolescents and the relations with aggression.Methods:With multistage stratified random sampling method,15 738 middle school students were selected from 5 provinces across China.The Buss-Warren Aggression Questionnaire Revised in China (BWAQ-RC) and Interactional Reactivity Index (IRI-C)was used to measure adolescents'aggression and empathy.Results:Girls had higher level of empathy than boys (P <0.001).Age and gender were interacted in predicting empathetic con-cern (P <0.001).Perspective taking was significant negative predictor of indirect aggression,physical aggression, hostile and angry (P <0.001),while empathetic concern was significant positive predictor of indirect aggression, verbal aggression,hostile and angry (P <0.001).Empathy was divided into 4 class used the K-Means clustering a-nalysis,namely,low empathy class,high perspective taking class,high empathetic concern class,high perspective taking and empathetic concern class.In contrast to other classes,individuals in low empathy class were more likely to involve in physical aggression (P <0.05),and individuals in high level of perspective taking and empathetic con-cern class were related with less physical aggression and elevated verbal aggression (P <0.05).Individuals in high empathetic concern class exhibited more indirect aggression,hostile and anger than other subgroups (P <0.05). Conclusion:The unbalance development of the two components of empathy may be closely correlated with different conduction of aggressive behaviors.

A cross-sectional study of 4 mental disorders in Chifeng City of Inner Mongolia Autonomous Region / 中国心理卫生杂志

Objective:To describe the epidemiological characteristics of mental disorders in community resi-dents aged 18 years and over in the Chifeng City of Inner Mongolia Autonomous Region.Methods:Six thousand three hundred and seventy six individuals aged 18 years and over were sampled using stratified Probability-Propor-tional-to-Size Sampling in Chifeng City in 2010.All respondents were investigated by face-to-face interview.The Composite International Diagnostic Interview-3.0 Computer Assisted Personal Interview (CIDI-3.0-CAPI)was used to make diagnoses based on the definition and criteria of the Diagnostic and Statistical Manual of Mental Dis-orders,Fourth Edition (DMS-IV).Results:A total of 4528 subjects completed the CIDI-3.0-CAPI.Regarding anxi-ety disorder,mood disorder,substance use disorder,and impulse control disorder,the 30-day adjusted prevalence rates (95%CI)were 2.5%(2.08% -2.99%,0.9%(0.67% -1.23%),0.5%(0.34% -0.76%),and 0.6%(0.41% -0.86%)respectively,and the 12 -month prevalence rates were 4.5% (3.93% -5.15%),2.4%(2.0% -2.90%),1.1% (0.84% -1.45%),and 1.0% (0.74% -1.32%)respectively.The lifetime adjusted prevalence rates were 6.6% (5.92% -7.36%),6.5% (5.81% -7.24%),2.7% (2.26% -3.21%),and 1.4%(1.23% -1.95%)respectively.Conclusion:According to morbidity,anxiety disorders,mood disorder,substance use disorders and impulse control disorders are common in Chifeng City of Inner Mongolia Autonomous Region se-quencely,being a prominent public health problem.

A Study on Reliability and Validity of the Impact of Event Scale-Revised-North Korea (IES-R-NK) / 신경정신의학

OBJECTIVES: This study was conducted to translate the Impact of Event Scale-Revised (IES-R) into North Korean language and confirm its reliability and validity. METHODS: A total of 207 North Korean defectors recruited from the Call Center for North Korean Defectors participated in this study. Psychiatrists and psychiatric residents interviewed the participants individually and made psychiatric diagnosis. Subsequently, they completed the Brief Psychological State Inventory for North Korean Refugees (BPSI-NKR), the Center for Epidemiologic Studies Depression Scale-North Korea (CES-D-NK), and the Alcohol Use Disorders Identification Test-North Korea (AUDIT-NK) as well as the Impact of Event Scale-Revised-North Korea (IES-R-NK). Of the original participants, 143 subjects participated in test-retest reliability study after one week. RESULTS: The internal consistency using Cronbach's alpha was superior in both male and female from North Korea. In addition, the temporal stability was also satisfactory. A good convergent validity was clearly shown by significant correlations with BPSI-PTSD and CES-D-NK, respectively. On the other hand, IES-R-NK had no or weak correlations with AUDIT-NK and BPSI-NKR-alcohol, demonstrating its satisfactory discriminant validity. CONCLUSION: IES-R-NK might be considered as a short and valid screening tool for identification of PTSD symptoms in North Korean defectors.

Prevalence rates of depression and anxiety in HIV-infected men who have sex with men / 中国心理卫生杂志

Objective:To know about the prevalence rates of depression and anxiety and its related factors a-mong human immunodeficiency virus (HIV)-infected men who have sex with men (MSM)in China.Methods:Under the help of MSM group,totally 600 HIV-infected MSM were recruited by snowballing sample among HIV-positive MSM,and 541 effective electronic questionnaire were received.Participants completed self-made question-naire of HIV-positive MSM healthy condition which included social demographic and health behavior et al.The Center for Epidemiologic Studies Depression Scale(CES-D)and Self-Rating Anxiety Scale (SAS)were used to survey the condition of depression (CES-D score ≥16)and anxiety (SAS score ≥50)respectively.Results:The percentage of having depression and anxiety symptoms was 44.7% (242 /541)and 25.1% (136 /541)respective-ly.Multiple unconditioned logistic regression analysis showed that the risk of having depressive symptoms included considered suicide in the past year (OR =3.31,95%CI:1.73 -5.34),nondisclosure their HIV infection to male primary sexual partners (OR =0.47,95%CI:0.30 -0.73),discrimination experience (OR =1.19,95%CI:1.11 -1.29).Compared with monthly income of 1500 yuan or less,participants who earned >5000 yuan monthly were less likely to have depressive symptoms (OR =0.34,95%CI:0.17 -0.71).Factors associated with anxiety symp-toms included considered suicide in the past year (OR =2.43,95%CI:1.40 -4.21),accepted antiviral therapy (OR=1.74,95%CI:1.06 ~2.84),discrimination experience (OR =1.12,95%CI:1.05 ~1.20).Participants earned >5000 yuan monthly (OR =0.44,95%CI:0.20 ~0.94)could decrease the risk of having anxiety symptom compared with whose monthly income of 1500 yuan or less.Conclusion:The prevalence rate of depression and anxiety symp-tom among HIV-infected MSM is high and need more attention.It may be helpful to call for the strategy of promo-ting mental health on decreasing social discrimination,communicating with sexual partners,and improving their eco-nomic status.

Identification of isoquinoline alkaloids from Berberis microphylla by HPLC ESI-MS/MS / Identificación de alcaloides isoquinolínicos en Berberis microphylla G. Forst mediante CLAE IES-MS/MS

Berberis microphylla (G. Forst) is a native plant growing in Patagonia. In recent years Patagonia Berberis are becoming important due to their interesting biological properties related to their alkaloids content. The aim of this study was determine the distribution and proportion of isoquinoline alkaloids in leaves, stems and roots of B. microphylla collected in two different climatic zones from Chilean Patagonia. Using by HPLC ESI-MS/MS isocorydine, jatrorrhizine, palmatine, reticuline, scoulerine, tetrahydroberberine and thalifendine were detected for the first time in this specie, and the presence of allocryptopine, berberine, calafatine and protopine, previously isolated in B. microphylla was corroborated. The alkaloids profile showed differences of compounds in samples collected in two climatic zones, where more compounds were detected in plants from Lago Deseado than Cerro Sombrero. Furthermore, a greater number of alkaloids were found in stem and root extracts and berberine and thalifendine were detected in higher proportion in these structures.

Berberis microphylla (G. Forst) es un arbusto nativo que crece en la Patagonia. Actualmente, esta planta ha sido foco de estudio dada las propiedades biológicas que presenta, atribuidas principalmente al contenido de alcaloides. El objetivo de este estudio fue determinar la distribución y proporción de alcaloides isoquinolínicos en hojas, tallos y raíces de B. microphylla colectadas en dos zonas climáticas de la Patagonia chilena. Mediante CLAE IES-MS/MS se informa por primera vez la presencia de isocoridina jatrorrizina, palmatina, reticulina, escoulerina, tetrahidroberberina y talifendina en esta especie y se confirma la presencia de allocriptopina, berberina, calafatina y protopina, identificados previamente en B. microphylla. El perfil de alcaloides mostró diferencias en la presencia de compuestos en las muestras colectas en las dos zonas climáticas, observándose un mayor número de compuestos en plantas provenientes de Lago Deseado. Además, un mayor número de compuestos se identificó en extractos de tallos y raíces donde berberina y talifendina fueron detectados en mayor proporción.

PTSD and Related Factors among Dispatched Firefighters to Rescue Sites after the Great Japanese Earthquake (Running head: Dispatched Firefighters' PTSD) / 대한산업의학회지

OBJECTIVES: This study aims to investigate the risk of posttraumatic stress disorder (PTSD) and its related factors among firefighters dispatched to the rescue sites after the Great Japanese Earthquake in 2011. METHODS: Among 104 male firefighters dispatched to rescue sites after the Great Japanese Earthquake, 73 firefighters were assessed. The 73 firefighters completed questionnaires, which include general characteristics, an impact of event scale-revised Korean version (IES-R-K), a coping checklist, a scale of perceived social support, and a post-traumatic stress diagnostic scale (PDS). The data was analyzed to find factors related to PTSD risk. RESULTS: The mean value of age and work tenure in this study were 38.6 years (SD=5.7) and 11.6 years (SD=6.0), respectively. The number and rate of the PTSD high-risk group in dispatched firefighters in this study was 7 cases and 9.6% using IES-R-K, with an over 25-point cutoff score. The mean rank of tenure, 53.5 in the PTSD high-risk group (n=7), was significantly higher than that of 32.2 in the PTSD low-risk group (n=66). The mean rank of assessable support, 20.2 in the PTSD high-risk group was significantly lower than that of 38.7 in the PTSD low-risk group. In logistic analysis of model 1 including PDS in independent variables, were associated with being a PTSD high-risk group as in the following: higher PDS score (OR 2.18, 95% CI: 1.07~4.46), longer tenure (OR 3.42, 95% CI: 1.01~11.89), more using coping method (OR 1.35, 95% CI: 1.00~1.81), and lower perceptions of social support (OR 0.84, 95% CI: 0.72~0.97). In logistic analysis of model 2 without PDS in independent variables, more using coping method (OR 1.14, 95% CI: 1.01~1.28) and lower perceptions of social support (OR 0.95, 95% CI: 0.91~0.98) were associated with being a PTSD high-risk group. CONCLUSION: The PTSD high-risk group in dispatched firefighters indicated that their odds ratios were increased when they used more coping methods under specific stress conditions and had lower perceptions of social support. Therefore, for those, who might be dispatched to overseas, the psychological support approach should be considered to produce effective coping methods against traumatic events and to be aware of abundant resources for social support regarding the problem.

Nosocomial nasal myiasis in an intensive care unit

A 73-year-old Chinese man was admitted to the Accident and Emergency Premorbid Ward of a local hospital in Malaysia. The patient complained of shortness of breath with cough and was in a semi-conscious state. He was later admitted to an intensive care unit (ICU) of the hospital. Six days after admission 5-6 maggots were recoverd from the nasal cavity. The maggots were identifi ed as the third-instar larvae of Lucilia cuprina Wiedmann (Diptera: Calliphoridae) based on the morphological characteristics. This patient was classifi ed as having nosocomial myiasis. The presence of the third instar larvae indicated that the infestation was not more than three to four days. An adult sarcophagid identifi ed as Parasarcophaga rufi cornis (Fabricius) caught in the ICU where the patient was warded provided further evidence of the potential for the nosocomial infestation.

Posttraumatic Stress Symptoms and Related Factors in Firefighters of a Firestation / 대한산업의학회지

OBJECTIVES: To investigate the factors related with posttraumatic symptoms and to estimate the prevalence of posttraumatic disorder of urban male firefighters. METHODS: From a study sample comprising 260 male firefighters from one fire station, the responses from 146 who had experienced one or more traumatic events, responded to the 'Impact of Event Scale-Revised Korean version' (IES-R-K) and didn't show any evidence of depression were analyzed. We surveyed the firefighters using a self-administered questionnaire including general characteristics, job-related characteristics, IES-R-K, and a 'Firefighters and paramedics' incident stressor'. RESULTS: The mean value of IES-R-K in this study was 11.3 and it was higher in the married firefighters than in the unmarried firefighters (p=0.005) and in the 24-hr shift workers than in the ordinary day shift workers (p=0.032). The frequency of posttraumatic stress disorder (PTSD) of the firefighters in this study using IES-R-K was 13.7%, with a cutoff point of 24/25. The overall number of experiences of 25 traumatic events was larger in emergency medical personnel and rescue workers than in other work functions (p=0.000). CONCLUSIONS: The prevalence of PTSD symptoms in firefighters was estimated to 13.7% using IES-RK and was higher than the prevalence of PTSD in the general population. A program to manage the mental health and provide early detection for mental illness for firefighters is needed.

Beneficio del agonista gaba B (Baclofen) sobre los hallazgos clínicos y endoscópicos en pacientes con esofagitis por enfermedad de reflujo gastroesofágico

Este trabajo se realizó con la finalidad de comprobar el beneficio del agonista GABA B (Baclofen) sobre los hallazgos clínicos y endoscópicos en pacientes con esofagitis por enfermedad de reflujo gastroesofágicos. En atención a ésto, se establecieron los siguientes objetivos específicos: 1. Evaluar el efecto del agonista GABA-B sobre la sintomatología de los pacientes con esofagitis por reflujo gastroesofágico utilizando la escala del dolor del 0 al 10. 2. Evaluar los hallazgos endoscópicos de la esofagitis por reflujo gastroesofágico en pacientes que reciben 40mg de Baclofen diario, a través de las escala de Los Ángeles. 3. Evaluar la tolerancia de la droga (BACLOFEN). 4. Evaluar si el efecto es distinto con respecto a al edad, sexo, tiempo de la evolución de la enfermedad. El trabajo partió de una revisión detallada de la fisiología, fisiopatología de las relajaciones transitorias del esfínter esofágico inferior y del mecanismo de acción del medicamento Baclofen (GABA-B). El estudio corresponde a una investigación longitudinal, prospectiva y experimental. La población estuvo comprendida por 16 pacientes que acudieron a la consulta de gastroenterología de la C.H.E.T presentando síntomas de ERGE, pero se trabajo con una muestra total de 10 pacientes que cumplieron con los criterios establecidos para la inclusión en el estudio y que completaron el mes de tratamiento. Se realizó historia clínica, estudio endoscópico pre y post tratamiento, laboratorio pre y post tratamiento y finalmente se determino la concentración de hormona de crecimiento. Los resultados fueron representados en cuadro y gráficos y se procedió a la interpretación de los resultados, donde se comprueba el beneficio del Baclofen en la ERGE y finalmente se presentan las conclusiones y recomendaciones.

This study was made with the purpose of verifying the benefit of agonist GABA B (Baclofen) on the clinical and endoscopic findings in patients with esophagitis due to gastroesophageal reflux disease (GERD). In attention to this, specific objectives were established. 1-To evaluate the effect of agonist GABA-B on the symptoms of patients with GERD, we used the pain scale from 0 to 10. 2- To evaluate the endoscopic findings of GERD esophagitis in patients receiving 40mg daily of Baclofen, using Los Angeles classification. 3- To evaluate the tolerance of the drug (BACLOFEN). 4- To evaluate if the effect is different with respect to age, sex, time of evolution of the disease. The study started with a detailed revision of the physiology, physiopathology of the transitory relaxations of the inferior esophageal sphincter and the mechanism of action of Baclofen (GABA-B). The study corresponds to a longitudinal, prospective and experimental investigation. The population included were 16 patients who attended the gastroenterology unit of the C.H.E.T presenting GERD symptoms, but we only included 10 patients who fulfilled the criteria established for inclusion in the study and completed the month of treatment. A medical history, pre and post treatment endoscopic studies and laboratory were performed, and finally we determined the growth hormone concentration. The results were represented in graphics and charts and then they were interpreted. The benefits of Baclofen in GERD were demonstrated and final conclusions and recommendations were presented.

A leitura em segunda língua: práticas de linguagem constitutivas da(s) subjetividade(s) de um grupo de surdos adultos / Reading in a second language: language practices that constitute the subjectivity(ies) of a group of adult deaf

Este trabalho discute aspectos constitutivos da(s) subjetividade(s) de um grupo de surdos adultos, a partir do desenvolvimento de oficinas bilíngües de leitura. A partir de interações discursivas em Língua Brasileira de Sinais (LIBRAS), tal espaço possibilitou uma transformação dos lugares sociais assumidos pelos sujeitos, ao permitir o estabelecimento de diálogos entre histórias de vida e entre as diversas relações sociais construídas em e pelo grupo. Considerando que a subjetividade é sempre relativa, determinada pelos diversos olhares dos outros e construída em lugares e em tempos sócio-ideológicos distintos; um evento plural, marcado discursivamente, no qual o eu se completa dialogicamente na(s) relação(ões) com o(s) outro(s), as discussões realizadas neste estudo apontam para a necessidade de um repensar dos espaços educacionais como lócus de interações discursivas e, portanto, de transformação e de constituição dos sujeitos.

Based on the realization of bilingual reading workshops, this work discusses some aspects that constitute the subjectivity(ies) of a group of adult deaf. Grounded on discursive interactions in Brazilian sign language (LIBRAS), such space allowed a transformation of the social places assumed by the subjects because it permitted the establishment of dialogs between life stories and the different social relationships constructed within and by the group. Assuming that subjectivity is always relative, determined by the various looks of the others and constructed in distinct social-ideological places and times, and that it constitutes a plural event discursively marked, in which the self completes itself dialogically in its relationship(s) to the others, the discussions presented in this study highlight the need to rethink the educational spaces as loci of discursive interactions and thus of transformation and constitution of the subjects.

A Study on Reliability and Validity of the Korean Version of Impact of Event Scale-Revised / 신경정신의학

OBJECTIVES: The present study was conducted to explore the reliability and validity of the "Impact of Event Scale-Revised Korean version" (IES-R-K). METHODS: The subjects were college students who visited a college counseling center and patients who were admitted to a general hospital and two orthopedic local clinics. Those subjects who experienced catastrophic traumatic events were tested for CAPS, BDI, STAI-I, II, and MMPI-PTSD scale. RESULTS: The range of correlations between item-total were .45-.89. The coefficients of internal consistency were .69-.83, of them were the Split-half reliability was .71 and the test-retest reliability was .89, all within expected ranges. Inter-correlations of IES-R-K, CAPS, BDI, STAI-I, II, and MMPI-PTSD scale were high. CAPS showed the highest correlation coefficient. Factor analysis indicated 4 factors in IES-R;avoidance, hyperarousal, intrusion, and sleep problem & numbness. IES-R-K can be a useful self-rating diagnostic instrument for PTSD symptoms to be a clinical concern by using 24/25 cutoff in total score. The partial PTSD cutoff score is 17/18. CONCLUSION: The IES-R-K was confirmed in it's reliability and validity. IES-R-K could be applied for screening of PTSD.

Surgical treatment of congenital blepharophimosis syndrome and long-term follow-up / 中华医学美学美容杂志

ObjectiveTo summarize long-term effects of different op eration methods to cure congenital blepharophimosis syndrome in the past twenty years. MethodsIn the past twenty years, according to the clini cal features of 74 cases of congenital blepharophimosis syndrome,we adopted one -stage or two-stage technique to do the medial and lateral canthoplasty and/or to correct blepharoptosis. 24 patients accepted post-operative follow-up as l ong as 9 years. ResultsGenerally, Mustrarde technique was adop ted to correct inverse epicanthus for 54 cases, but for 20 patients with mild ep icanthus we adopted other methods. When enlarging the medial canthus, we selecti vely shortened the medial canthal ligament for 36 patients. When transverse tens ion on the upper eyelids was not increased, 33 cases selected one-stage techniq ue to correct this syndrome and obtained the same effects as two-stage techniqu e did for the other 41 cases. Other combined deformations of the patients should be treated in adolescence according to the patients' requirements. ConclusionBy adopting one-stage or two-stage technique to perform the medial and lateral canthoplasty and/or to correct blepharophimosis for con genital blepharophimosis syndrome can reach the satisfactory results if a correc t indication is selected.

The role of the posterior elements of the spine in the classification of th oraco-lumbar burst fractures and spinal cord injuries / 中华骨科杂志

Objective To observe the role of the posterior e lements of the spine in the spinal cord injuries and to provide the basic evidence for proper evaluation of the se verity of spinal cord injuries and th e possibilities of functional recove ry.Methods Experimental study:The experiment al model of spinal burst fracture was established in the thoraco-lumbar column section which subjected high velocity vertical loadi ng in static pattern.The pressure changes in the vertebral canal and the severity of posterior elements of the spin e were observed,and then their relationship was studied.Clinical Study:The data were obtained from 127consecutive cases of thoraco-lumbar burst fracture associated with paraplegia.The relationship between t he severity of spinal cord injury,functional recovery and the posterior elements injuries was studied retrosp ec-tively.Results The experimental study showed that g reat pressure changes appeared in th e vertebral spec-imens without posterior elements in juries.On the contrary,the peak value of pressure was low in cases with posterior elements injuries.Clini cal results:Of 38cases(69.09%)with spinal cord injuries in 55patie nts without posterior elements injurie s,functional recovery was found in 24cases(63.16%).In another group,of 52cases(72.22%)with spinal cord injuries in 72patie nts with posterior elements injurie s,functional recovery was found in 20cases(38.46%).The statistic difference between t he two groups indicated that the severity of spinal cord injuries in t he patients without posterior eleme nts injuries was more severe than that with posterior elements injuries.Conclusion The spinal posterior elements play a n important role in spinal cord injuries.The severity of posterior elements injuries can be used as a sca le in the evaluation of the severity o f spinal cord injuries,functional re covery and improvement of Denis classification.[