Descripción del abuso sexual pediátrico a partir de hallazgos del examen físico / Description of pediatric sexual abuse based on physical exam findings

La comprensión de la frecuencia y el significado de diversos hallazgos médicos en niños sometidos a abuso sexual se modificaron con el tiempo. Antes de 1989, se pensaba que diversas variaciones en la apariencia de los tejidos genitales y anales se debían al abuso. Los estudios que describen en detalle la apariencia de los tejidos anales en niños seleccionados como no sometidos a abuso en 1989 y los hallazgos genitales en niñas no sometidas a abuso en 1990, mostraron que muchas de estas variaciones también se observaron en niños que no habían experimentado abuso. Las más comunes de estas variaciones se incluyeron en una lista de hallazgos anogenitales que también comprendían signos conocidos de lesiones agudas e infecciones de transmisión sexual, así como otros hallazgos físicos y de laboratorio cuya importancia con respecto al abuso se desconocía. Esta lista evolucionó a medida que se publicaban nuevos estudios y se procuraba llegar a un consenso entre los expertos en la evaluación del abuso sexual en niños en cuanto a la forma en que debían interpretarse los hallazgos de los exámenes médicos adicionales. La tabla de "interpretación de los resultados" evolucionó durante los 26 años siguientes, y la más reciente se publicó en 2018. Todavía hay hallazgos, en junio de 2020, respecto de los cuales no hay consenso entre los expertos en cuanto a cómo deben interpretarse en un niño evaluado por presunción de abuso sexual. Deberán revisarse los antecedentes de los cambios en la interpretación de los hallazgos genitales y perianales en niños con presunción de abuso sexual.

The understanding of the frequency and significance of various medical findings in sexually abused children has changed over time. Before 1989, several variations in the appearance of genital and anal tissues were thought to be due to abuse. Studies describing in detail the appearance of anal tissues in children selected for non-abuse in 1989, and genital findings in non-abused girls in 1990, showed that many of these variations were seen non-abused children as well. The most common of these variations were included in a listing of anogenital findings that also included known signs of acute injury and sexually transmitted infections, as well as other physical and laboratory findings for which the significance with respect to abuse was unknown. This listing evolved as new studies were published and efforts were made to reach consensus among experts in child sexual abuse evaluation as to how additional medical examination findings should be interpreted. The "Interpretation of Findings" table evolved over the next 26 years, with the most recent being published in 2018. There are still findings, as of June, 2020, for which no expert consensus exists as to how they should be interpreted in a child who is being evaluated for suspected sexual abuse. The history of the changes in the interpretation of genital and perianal findings in children with suspected sexual abuse will be reviewed.

El mejoramiento del desempeño profesional pedagógico de los docentes para la evaluación formativa / Upgrading of Professional Pedagogical Improvement of Professors for Formative Evaluation

Introducción: El impacto de la formación de los recursos humanos en salud, es uno de los indicadores que se miden en función de establecer los estándares de calidad a nivel nacional e internacional. La evaluación formativa constituye una herramienta elemental para los planes de mejora curricular. Objetivo: Identificar los fundamentos que sustentan el proceso de desempeño profesional pedagógico de los docentes en el área de la Evaluación Formativa. Métodos: Se realizó una investigación cualitativa de desarrollo en la Facultad de Ciencias Victoria de Girón durante el curso 2017-2018 y se utilizaron los métodos de nivel teórico: el Histórico lógico, el sistémico estructural funcional, la sistematización y la modelación y de nivel empírico, la revisión documental y el criterio de expertos. Resultados: Se propicia la transformación en los niveles de profesionalización de los docentes, referida al desarrollo que logra desde sus modos de actuación y se integran las acciones docente-educativas para una evaluación formativa propiciando la toma de decisiones y el desarrollo de los estudiantes. Conclusiones: Se identificaron los fundamentos que sustentan el proceso de mejoramiento del desempeño profesional pedagógico de los docentes en el área de la evaluación formativa. Este se apoya en la teoría de la educación avanzada y en la teoría de la evaluación para el vínculo de las funciones propias de la evaluación formativa(AU)

Introduction: The impact of training human resources on health is one of the indicators that are measured in terms of establishing quality standards at national and international level. Formative evaluation is an elementary tool for curricular improvement plans. Objective: To identify the foundations that support the process of pedagogical professional performance of professor in the area of formative evaluation. Methods: A qualitative development research was carried out in "Victoria de Girón" School of Sciences, during the academic year 2017-2018. The theoretical methods used were the logical-historical, the functional-structural-systemic, systematization, and modeling. The empirical methods used were documentary review and criteria of experts. Results: Transformation is fostered at the levels of professionalization of professors, concerning the development achieved from their ways of performance, while the teaching-educational actions are integrated for a formative evaluation, promoting decision-making and the development of students. Conclusions: The foundations that support the process of improvement of pedagogical professional performance of professors in the area of formative evaluation were identified. This is supported by the theory of advanced education and the theory of evaluation for the link of the functions inherent in formative evaluation(AU)

Impacto de la retroalimentación y la evaluación formativa en la enseñanza-aprendizaje de Biociencias / The impact of feedback and formative evaluation on Biosciences teaching-learning

Introducción: En nuestros días, la identificación y sistematización de la evaluación del aprendizaje en las universidades está encaminada a garantizar la pertinencia, eficacia y eficiencia de las mismas, co25nformando un marco de referencia para la reflexión y toma de decisiones encaminadas a la mejora de los procesos enseñanza-aprendizaje. En este sentido, es fundamental la información acerca de las percepciones, las actitudes, las experiencias y las expectativas en relación con la implementación de la evaluación formativa como una herramienta que permite generar diversas estrategias para los planes de mejora curricular. Objetivo: Obtener información acerca de las percepciones, las actitudes, las experiencias y las expectativas en relación con la evaluación formativa y el impacto de la retroalimentación a estudiantes de Medicina de primer semestre de la Universidad de La Sabana que cursan Biociencias. Métodos: Se realizó un estudio cualitativo mediante el empleo de la técnica de los grupos focales. Se preparó un guion en torno las inquietudes obtenidas a partir de la retroalimentación y se formularon varias preguntas que fueron grabadas en audio. Se evidenciaron cuatro categorías emergentes de exploración. Resultados: Las argumentaciones de los participantes se realizaron a partir de las memorias obtenidas en el audio del grupo focal; desde el guion inicial, surgen subcategorías en las que se ordenaron los hallazgos. Se evidenciaron 4 categorías que abarcan la comprensión del estudiante respecto de la función formativa de la evaluación, el empoderamiento de los estudiantes frente al proceso de evaluación formativa, el manejo de conflictos derivados de la evaluación y algunas sugerencias para mejorar los procesos de evaluación desde la perspectiva del estudiante. Conclusiones: Para que estas evaluaciones tengan la resonancia que se espera de ellas, deben estar inmersas en el pensamiento pedagógico contemporáneo, los objetivos de los cursos y los resultados esperados del aprendizaje, donde se halle una total congruencia entre los mismos(AU)

Introduction: Nowadays, identification and systematization of the evaluation of learning in universities is aimed at guaranteeing its pertinence, effectiveness and efficiency, creating a reference framework for reflection and decision-making aimed at the improvement of the teaching-learning processes. In this respect, information about perceptions, attitudes, experiences and expectations about the implementation of formative evaluation as a tool that allows generating different strategies for curricular improvement plans is fundamental. Objective: To obtain information about the perceptions, attitudes, experiences and expectations about formative evaluation and the feedback impact on first-semester medical students of University of La Sabana in the Biosciences course. Methods: A qualitative study was carried out using the technique of focus groups. A script was prepared about the concerns obtained from feedback and several questions were formulated that were recorded in audio. Four emerging categories of exploration were evidenced. Results: The arguments of the participants were produced from the memories obtained in the audio of the focus group. From the initial script, subcategories appear in which the findings were ordered. There were four categories that include the student's understanding of the formative function of the evaluation, the students' empowerment in the formative evaluation process, managing of conflicts derived from evaluation, and some suggestions to improve the evaluation processes from the student's perspective. Conclusions: In order for these evaluations to have the impact expected from them, they must be immersed in the contemporary pedagogical thought, the objectives of the courses and the expected results of the learning process, where there is a total congruence among them(AU)

Esterilidad masculina por trauma testicular contuso cerrado a propósito de dos casos / Male sterility by blunt testicular trauma closed a report of two cases

El traumatismo testicular contuso es una lesión poco frecuente que se presenta sobre todo en hombres jóvenes, que ocurre debido al impacto violento de los testículos contra el arco púbico. Tales traumas contusos pueden ocasionar diferentes lesiones a nivel del tejido testicular y de las estructuras anexas que se asocian a esterilidad masculina a través de trastornos de la espermatogénesis, mecanismos autoinmunes o por lesión de los conductos postesticulares. Se estudiaron dos casos de trauma testicular contuso en los cuales se diagnosticó esterilidad como parte del estado secuelar.

The blunt testicular trauma is an uncommon lesion that occurs mainly in young men, which occurs due to the violent impact of the testes against the pubic arch. Such blunt trauma injury may cause different levels of testicular tissue and adnexal structures that are associated with male sterility through spermatogenesis disorders, autoimmune mechanisms or by injury the postesticulares ducts. Two cases of blunt testicular trauma in which infertility was diagnosed were evaluated as part of sequelar been studied.

Benefício de Prestação Continuada e perícia médica previdenciária: limitações do processo / Continued benefit and social security medical evaluation: limitations of the process

Com o objetivo de analisar os resultados do processo de avaliação da pessoa com deficiência (PcD) requerente do Benefício de Prestação Continuada (BPC) - após a implantação do modelo de avaliação baseado na Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) - foi desenvolvido um estudo documental envolvendo a análise estatística descritiva de 1.404 requerimentos de BPC para PcD, no período de maio de 2006 a abril de 2012. Os resultados evidenciaram a permanência da estrutura de exclusão, com a avaliação adotada, mantendo-se a restritividade de acesso da PcD ao BPC.

Aimed at analyzing the results of the process of evaluation of the disabled people who ask for the Continued Benefit - after the implementation of the model of evaluation based on the International Classification of Functioning, Disability and Health - it was developed a documentary study in which 1,404 application forms for the Continued Benefit for disabled people from May, 2006 to April, 2012 were submitted to a statistical descriptive analysis. The results showed that the exclusion structure has been kept with the adopted evaluation, as well as the restrictiveness to the Continued Benefit for disabled people.

Child sexual abuse and pediatricians / 소아과

Child sexual abuse is not a rarely encountered problem. Child sexual abuse is a pediatric disease entity with lifelong impact. Child sexual abuse, different from sexual assault, is not always accompanied by violent force and usually repeated over a period of time. Child sexual abuse should be approached by multidisciplinary team experts. Every pediatrician should know the child protection network in his district and be competent in the child sexual abuse medical evaluation and treatment as a primary doctor. In order to accomplish that goal, the Korean Pediatric Society should change the pediatric residency training curriculum and foster child sexual abuse experts. Pediatricians have responsibilities to do their active role in response to children at risk.

Child sexual abuse and pediatricians / 소아과

Child sexual abuse is not a rarely encountered problem. Child sexual abuse is a pediatric disease entity with lifelong impact. Child sexual abuse, different from sexual assault, is not always accompanied by violent force and usually repeated over a period of time. Child sexual abuse should be approached by multidisciplinary team experts. Every pediatrician should know the child protection network in his district and be competent in the child sexual abuse medical evaluation and treatment as a primary doctor. In order to accomplish that goal, the Korean Pediatric Society should change the pediatric residency training curriculum and foster child sexual abuse experts. Pediatricians have responsibilities to do their active role in response to children at risk.

The Application of Vestibular Functional Test in the Diagnosis and Evaluation of Flight Illusion in Pilots / 听力学及言语疾病杂志

0.05). ②Among 30 pilots with abnormal vestibular functions,19 were permanently grounded and 11 were permitted to return their flying station. 36 pilots returned to fly in 45 cases with normal vestibular functions. The permanently grounded rate had significant differences between the two groups with normal and abnormal vestibular functions. (P

Diagnosis,treatment and medical evaluation of anatomical abnormalities in nasal cavity in aircrew / 解放军医学杂志

Objective To sum up the experiences of diagnosis,treatment and medical evaluation of the anatomical abnormalities in nasal cavity(AANC,including deviation of nasal septum and turbinate hypertrophy) in aircrew.Methods Case data of 91 pilots with CANC were analyzed.The classification and typing of AANC and secondary barotraumas associated with typing of AANC were studied.Results There were 50 cases of class I AANC(with symptoms or signs on ground),41 cases of class II(no symptoms or signs on ground but with symptoms of secondary barotraumas in flight,including IIa 10 cases:with symptoms of secondary barosinusitis,IIb 26 cases:with symptoms of secondary barotrauma of ear,IIc 5 cases:with symptoms of secondary barosinusitis and barotrauma of ear after flying).For the typing of AANC,there were 41 cases of nasal septum deviation,29 cases of inferior turbinate hypertrophy,8 cases of middle turbinate hypertrophy,and 13 cases of nasal septum deviation and turbinate hypertrophy.85 cases were still in a qualified position to continue their flying job,1 pilot was transferred from fighter to transport pilot,2 pilots were temporarily grounded,and 3 were permanently grounded.Conclusions AANC is very common in aircrew.AANC in aircrew is classified and typed according to the effect of gas pressure adjustment functions of ear and nasal sinus.The classification and typing are of important implication in clinical aviation medicine.Medical workers must unify the qualification criteria in selection for air candidates,and also in diagnosis,treatment,medical evaluation of disease in aircrew.This is an important measure to improve the health quality and ensure combat effectiveness for the air force.