Autoestima e qualidade de vida em pacientes submetidos a cirurgia plástica / Self-esteem and quality of life in patients undergoing plastic surgery

Introdução: A autoestima é definida pelo valor que as pessoas dão a si mesmas. É um componente avaliativo do autoconhecimento. A cirurgia plástica tem sido uma alternativa para as pessoas melhorarem a visão de si mesmas, sentindo-se mais confiantes e satisfeitas com seus aspectos corporais. Dessa forma, com a elevação da autoestima nessas pessoas, a cirurgia é capaz de interferir de forma positiva não somente na autoavaliação corporal, mas também na dimensão psicossocial. Método: Foi realizado um estudo observacional descritivo e analítico longitudinal prospectivo no qual foi avaliado o impacto da cirurgia plástica na autoestima e nos relacionamentos pessoais e profissionais. Aplicamos um questionário sociodemográfico, a Escala de Autoestima de Rosenberg, além do Questionário de Qualidade de Vida da OMS abreviado (WHOQOL-bref) em pacientes no pré-operatório e que serão submetidos a cirurgia plástica com, pelo menos, 3 meses de pós-operatório, graduando, desta forma, a melhora ou não da autoestima e qualidade de vida. Resultados: Participaram da pesquisa 52 pacientes, sendo 48 mulheres (92,3%), apresentando idade média de 37±11 anos. Através da aplicação da Escala de Autoestima de Rosenberg, pudemos notar uma evolução da autoestima, em que os pacientes apresentaram uma média de 29,87±2,10 pontos no escore do período pré-operatório, passando para 34,92±1,84 pontos no período pós-operatório. (p<0,001). Já no WHOQOL-bref, foi obtida uma melhora da autoestima através dos escores dos 4 domínios. Conclusão: Através deste estudo, foi evidenciado um aumento da autoestima e qualidade de vida.

Introduction: Self-esteem is defined by the value people place on themselves. It is an evaluative component of self-knowledge. Plastic surgery has been an alternative for people to improve their vision of themselves, feeling more confident and satisfied with their body aspects. Therefore, by increasing self-esteem in these people, surgery is capable of positively interfering not only with body self-assessment but also in the psychosocial dimension. Method: A prospective longitudinal descriptive and analytical observational study was carried out in which the impact of plastic surgery on self-esteem and personal and professional relationships was assessed. We applied a sociodemographic questionnaire, the Rosenberg Self-Esteem Scale, in addition to the abbreviated WHO Quality of Life Questionnaire (WHOQOL-bref) in patients in the preoperative period and who will undergo plastic surgery at least 3 months after surgery. surgery, thus determining whether or not self-esteem and quality of life improve. Results: 52 patients participated in the research, 48 of whom were women (92.3%), with a mean age of 37±11 years. Through the application of the Rosenberg Self-Esteem Scale, we were able to notice an evolution in self-esteem, in which patients presented an average of 29.87±2.10 points in the preoperative period score, rising to 34.92±1.84 points in the postoperative period (p<0.001). In the WHOQOL-bref, an improvement in self-esteem was obtained through the scores of the 4 domains. Conclusion: Through this study, an increase in self-esteem and quality of life was evidenced.

Use of ChatGPT in Urology and its Relevance in Clinical Practice: Is it useful?

ABSTRACT Purpouse: One of the many artificial intelligence based tools that has gained popularity is the Chat-Generative Pre-Trained Transformer (ChatGPT). Due to its popularity, incorrect information provided by ChatGPT will have an impact on patient misinformation. Furthermore, it may cause misconduct as ChatGPT can mislead physicians on the decision-making pathway. Therefore, the aim of this study is to evaluate the accuracy and reproducibility of ChatGPT answers regarding urological diagnoses. Materials and Methods: ChatGPT 3.5 version was used. The questions asked for the program involved Primary Megaureter (pMU), Enuresis and Vesicoureteral Reflux (VUR). There were three queries for each topic. The queries were inserted twice, and both responses were recorded to examine the reproducibility of ChatGPT's answers. Afterwards, both answers were combined. Finally, those rwere evaluated qualitatively by a board of three specialists. A descriptive analysis was performed. Results and Conclusion: ChatGPT simulated general knowledge on the researched topics. Regarding Enuresis, the provided definition was partially correct, as the generic response allowed for misinterpretation. For VUR, the response was considered appropriate. For pMU it was partially correct, lacking essential aspects of its definition such as the diameter of the dilatation of the ureter. Unnecessary exams were suggested, for Enuresis and pMU. Regarding the treatment of the conditions mentioned, it specified treatments for Enuresis that are ineffective, such as bladder training. Therefore, ChatGPT responses present a combination of accurate information, but also incomplete, ambiguous and, occasionally, misleading details.

Kidney collecting system anatomy applied to endourology - a narrative review

ABSTRACT Objective: To evaluate the surgical anatomy of the kidney collecting system through a narrative review of the literature, highlighting its importance during diagnosis and its approach during surgical procedures for the treatment of renal stones. Material and Methods: We carried out a review about the anatomy of the kidney collecting system. We analyzed papers published in the past 40 years in the databases Pubmed, Embase and Scielo, and we included only papers in English and excluded case reports, editorials and opinions of specialists. Results: Renal collecting system could be divided in four groups: A1 - kidney midzone (KM), drained by minor calyx that are dependent on the superior or the inferior caliceal groups; A2 - KM drained by crossed calyx, one draining into the superior caliceal group and another draining into the inferior caliceal group; B1 - KM drained by a major caliceal group independent of both the superior and inferior groups; and B2 - KM drained by minor calyx entering directly into the renal pelvis. Some details and anatomic variations of the collecting system are related to clinical and radiological aspects, particularly perpendicular calyces, interpyelocalyx space, position of calyces in relation to renal border, classification of the renal collecting system, infundibular diameter and the angle between the lower infundibulum and renal pelvis. Conclusion: The knowledge of intra-renal collecting system divisions and variations as the angle between the renal pelvis and lower infundibula, position of the calices in relationship with renal edge and the diameter and position of the calyces are important for the planning of minimally invasive renal surgeries.

Linfangioma Quístico del Páncreas. Un Tumor poco Frecuente

El linfangioma quístico del páncreas (LQP), es un tumor extremadamente raro y representa solo el 1% de los linfangiomas abdominales. El objetivo de este manuscrito fue reportar un caso de LQP intervenido quirúrgicamente; y revisar la evidencia existente respecto de sus características morfológicas, terapéuticas y pronósticas. Mujer de 67 años, con LQP operada en Clínica RedSalud Mayor Temuco en septiembre de 2023. Se verificó un tumor sólido-quístico de 16 cm de diámetro mayor, adherido al páncreas a nivel del cuerpo de la glándula, de 867 gramos de peso, con líquido amarillento en su interior; la que fue extirpada completamente. Después del estudio histológico, se realizaron tinciones inmunohistoquímicas complementarias para CD31, D2-40 y calretina. La paciente tuvo un curso postoperatorio sin incidentes, siendo dado de alta al tercer día postoperatorio. En el control alejado, se encontraba en buenas condiciones generales. El LQP es un tumor muy poco frecuente. Las características clínicas e imágenes de este tipo de lesiones son inespecíficas. Debe considerarse en el diagnóstico diferencial de las lesiones quísticas pancreáticas. La resección quirúrgica completa con márgenes libres es el tratamiento de elección; y el pronóstico del LQP es favorable si se reseca por completo.

SUMMARY: Pancreas cystic lymphangioma (PCL) are extremely rare, accounting for only 1% of abdominal lymphangiomas. The aim of this study was to report a rare case of PCL, who underwent surgery; and review the existing evidence regarding its morphological, therapeutic and prognostic characteristics. 67-year-woman patient with PCL who underwent surgery at Clínica RedSalud Mayor Temuco in September 2023. In this case, a solid-cystic tumor with a major diameter of 16 cm was identified, adhering to the pancreas at the level of the body of the gland, weighing 867 grams and containing yellowish fluid in its interior. The tumor was completely excised. Subsequent to histological examination, additional immunohistochemical staining was performed for CD31, D2-40, and calretinin. The patient experienced an uneventful postoperative course and was discharged on the third postoperative day. During the follow-up, the patient remains in good general condition. LQP is a very rare tumor. Clinical features and images of this type of lesions are nonspecific. It should be considered in the differential diagnosis of pancreatic cystic lesions. Complete surgical resection with free margins is the treatment of choice; and the prognosis of LQP is favorable if it is completely resected.

Fundamentos do processo de trabalho em terapia ocupacional: uma abordagem analítica a partir do diálogo entre Terapia Ocupacional Social e Saúde Coletiva Latino-Americana / Labor process foundations of occupational therapy: an analytical approach based on the dialogue between Social Occupational Therapy and Latin American Collective Health / Fundamentos del proceso de trabajo de la terapia ocupacional: una aproximación analítica basada en el dialogo entre Terapia Social Ocupacional y Salud Colectiva Latinoamericana

Resumo Introdução Este artigo apresenta uma abordagem analítica da prática da terapia ocupacional baseada no materialismo histórico dialético, compreendendo que a prática profissional da terapia ocupacional é considerada trabalho no sistema capitalista, podendo ser analisada à luz da Teoria do Processo de Trabalho. Objetivo Propor uma abordagem analítica com o intuito de apoiar o desenvolvimento de práticas de terapia ocupacional emancipatórias, baseadas no diálogo entre a Terapia Ocupacional Social e a Saúde Coletiva Latino-Americana. Método Com base na pesquisa-ação emancipatória, foram realizadas dez oficinas com dez terapeutas ocupacionais visando à produção coletiva de conhecimento. Resultados A atividade humana foi identificada como objeto do processo de trabalho da terapia ocupacional, definida pela categoria trabalho em sua dimensão ontológica. A participação radical foi proposta como o produto intencionado deste processo, sendo entendida como a participação na luta por transformar elementos da determinação social das condições coletivas de trabalho e vida. Os sujeitos desse processo são os terapeutas ocupacionais e os indivíduos, grupos e/ou comunidades acompanhados, todos entendidos como seres sociais em parceria para a transformação social. São identificadas quatro ferramentas teórico-metodológicas: análise emancipatória de atividades humanas, proposição emancipatória de atividades humanas, operacionalização da participação radical e intervenções sobre o tecido social. Conclusão A terapia ocupacional como prática social oferece uma contribuição específica para o desenvolvimento de uma práxis revolucionária coletiva que, voltada para a realização de uma utopia concreta, poderá gerar os meios para produzir uma nova sociedade.

Abstract Introduction This paper presents an analytical approach to occupational therapy practice grounded in historical dialectical materialism. It understands occupational therapy professional practice as work within a capitalist system, and thus subject to analysis through the labor process theory. Objective To propose an analytical approach to occupational therapy practice aimed at supporting the development of an emancipatory practice framework based on the dialogue between Social Occupational Therapy and Latin American Collective Health. Method Utilizing emancipatory action research methodologies, this study conducted 10 workshops with 10 occupational therapists aimed at collective knowledge production. Results Human activity is identified as the object of occupational therapy working process, defined by the category work in its ontological dimension. Radical participation is set as the intended product of this process, which entails engaging in efforts to transform the social determination of collective living conditions. The individuals in this process include occupational therapists and the followed-up individuals, groups, and/or communities, all viewed as social beings collaborating toward social transformation. Four theoretical-methodological tools are identified: emancipatory analysis of human activities, emancipatory proposition of human activities, operationalization of radical participation, and interventions in the social fabric. Conclusion Occupational therapy, as a form of social practice, offers a specific contribution to the development of a collective revolutionary praxis. This praxis, aimed at realizing a concrete utopia, seeks to generate the means to create a new society.

Resumen Introducción Este artículo presenta una aproximación analítica a la práctica de la terapia ocupacional basada en el materialismo histórico dialéctico. Entiende la práctica profesional de terapia ocupacional como trabajo bajo el capitalismo y, como tal, puede ser analizada bajo la teoría del proceso de trabajo. Objetivo Proponer un enfoque analítico de la práctica de la terapia ocupacional con la intención de apoyar el desarrollo posterior de un marco para la práctica de la terapia ocupacional emancipadora basada en el dialogo entre la Terapia Ocupacional Social y la Salud Colectiva Latinoamericana. Método A partir de una investigación acción emancipadora, se realizaron 10 talleres con diez terapeutas ocupacionales con el objetivo de la producción colectiva de conocimiento. Resultados La actividad humana es identificada como objeto del proceso de trabajo de la terapia ocupacional, definida por la categoría trabajo en su dimensión ontológica. La participación radical se establece como el producto previsto del proceso, es decir, la participación en la lucha por los elementos transformadores de la determinación social de las condiciones de vida colectivas. Los sujetos del proceso de trabajo son los terapeutas ocupacionales y los individuos, grupos y/o comunidades acompañados, todos entendidos como seres sociales en colaboración para la transformación social. Se identifican cuatro herramientas teórico-metodológicas: análisis emancipatorio de las actividades humanas, propuesta emancipadora de las actividades humanas, operacionalización de la participación radical e intervenciones en el tejido social. Conclusión La terapia ocupacional como práctica social ofrece una contribución específica al desarrollo de una praxis revolucionaria colectiva que, dirigida a realizar una utopía concreta, puede generar los medios para producir una nueva sociedad.

Assessment of sexual and body esteem in postpartum women with or without perineal laceration: a cross-sectional study with cultural translation and validation of the Vaginal Changes Sexual and Body Esteem Scale

Objective: We aimed to translate and determine cultural validity of the Vaginal Changes Sexual and Body Esteem Scale (VSBE) for Brazilian Portuguese language in postpartum women who underwent vaginal delivery with or without perineal laceration and cesarean section. Methods: A cross-sectional study conducted virtually, with online data collection through a survey with 234 postpartum women of 975 that were invited. Clinical, sociodemographic, and psychometric variables from the VSBE questionnaire were analyzed (content validity index, internal consistency, test-retest reliability, construct/structural and discriminant validity). Multivariate analysis was performed to explore associated factors with the presence of perineal laceration. Results: One-hundred fifty-eight women experienced vaginal delivery, of which 24.79% had an intact perineum, 33.33% had perineal laceration, and 9.4% underwent episiotomy; and 76 participants had cesarean sections. Women with perineal laceration were older, presented dyspareunia and previous surgeries than women without perineal laceration (p<0.05). For VSBE, a high internal consistency (Cronbach's α > 0.7) was observed, but it did not correlate with Body Attractiveness Questionnaire and Female Sexual Function Index; however, it correlated with the presence of women sutured for perineal laceration. Moreover, VSBE presented good structural validity with two loading factors after exploratory factor analysis. VSBE also demonstrated discriminant validity between the presence or absence of perineal laceration. The presence of urinary incontinence (UI) (OR=2.716[1.015-4.667];p=0.046) and a higher VSBE total score (OR=1.056[1.037-1.075];p<0.001) were the only factors associated with perineal laceration. Conclusion: Vaginal Changes Sexual and Body Esteem Scale demonstrated appropriate translation and good internal consistency, discriminant/construct validity and reliability. Vaginal Changes Sexual and Body Esteem Scale total score and presence of UI were associated with women that underwent perineal laceration.

Thinking on ideological and political education in Medical Parasitology teaching / 中国血吸虫病防治杂志

With the deepening reform of ideological and political education, Medical Parasitology teaching needs to update the teaching concept, change the teaching ideas, as well as keep trying to combine ideological and political education with the curriculum content closely. In addition to teaching students’ basic knowledge and practical skills, teachers are needed to cultivate their moral literacy and political awareness through course teaching, so as to provide the basis for students’ subsequent adaptations to social environments and jobs. Currently, the study of ideological and political education in Medical Parasitology teaching is still in the exploratory stage. Therefore, colleges and universities need to carry out effective construction of ideological and political education in Medical Parasitology teaching, in order to achieve good teaching outcomes and provide insights into ideological and political education in teaching.

Ethical Considerations and Countermeasure Analysis of Public Mental Disorders Stigma in China / 中国医学伦理学

Discrimination against patients with mental disorders and the resulting stigma will not only affect patients’ medical treatment, but also bring about community isolation and lack of resources. Mental health problems have become a major public health problem and a prominent social problem. From the perspective of bioethics, the existence of public mental disorders stigma violates the principles of justice and respect. This paper quantitatively described the status quo of public mental disorders stigma in China, and explored its influencing factors through factor analysis and binary logistic regression analysis. The public stigma of mental disorders score was (54.64±11.048). Factor analysis extracted 4 common factors, namely isolation, pain, contact, and empathy, with a cumulative explained variance of 68.948%. The results showed that age and contact history were the main factors affecting the public stigma of mental disorders. It is recommended to reduce discrimination by enhancing understanding and improving empathy. Specifically, it is to implement the personal liability for discrimination through ethical regulation and legal construction, and strengthen the concept of a community of shared future for mankind by creating a tolerant social atmosphere, so as to achieve an appropriate balance between public safety and individual rights and interests.

Self-perceived oral health: a study with patients wearing removable dentures

Aim: This study aimed to investigate the relationship between self-perceived oral health and the prosthetic status of individuals who seek care in prosthodontics clinics. Methods: Self-perceived oral health was analyzed through the Geriatric Oral Health Assessment Index (GOHAI). Abutment tooth mobility was assessed, and denture status was determined by clinical assessment of stability, retention, occlusal balance, vertical dimension, and integrity of dentures. The frequency of individuals in each variable was determined for the low and very low GOHAI conditions. Chi-square, Pearson, and stepwise logistic regression tests were used for the statistical analyses (α = 0.05). Results: Ninety wearers of removable dentures with a mean age of 55.1±9.1 years were evaluated. None of the variables was related to GOHAI values (p > 0.05). The regression analysis showed that age predicts (p = 0.006) the variation of GOHAI conditions (OR = 0.924, CI = 0.873- 0.978), showing only 7.6% protective effect against very low GOHAI. Unsatisfactory stability showed the opposite effect (p = 0.034) and the individuals with this characteristic are more likely (OR = 3.055) to have very low GOHAI scores (CI = 1.085- 8.602). Conclusions: The self-perceived oral health of wearers of removable dentures worsens with age and unsatisfactory stability of dentures

Autoestima de trabalhadores terceirizados do setor de conservação de higiene e limpeza de hospitais privados / Self-esteem of outsourced workers in the hygiene conservation and cleaning of private hospitals / Autoestima de trabajadores subcontratados en el sector de higiene y limpieza de hospitales privados

Objetivo: analisar aspectos positivos e negativos relacionados à autoestima de trabalhadores terceirizados de serviços de higiene e limpeza hospitalar. Método: estudo exploratório, de abordagem qualitativa, realizado em duas instituições hospitalares privadas. Os participantes foram trabalhadores terceirizados dos serviços de higiene e limpeza. Para a coleta de dados, utilizou-se um questionáriosociodemográfico e um roteiro de entrevista semiestruturada. Realizada análise temática indutiva. Resultados: a amostra constitui-se de 15 trabalhadores, do sexo feminino, que expressaram aspectos positivos e negativos que afetam sua autoestima, que estão relacionados à organização e ambiente de trabalho, às relações interpessoais e benefícios trabalhistas. Conclusão: aspectos positivos e negativos estão presentes entre esses trabalhadores e os gestores hospitalares devem refletir sobre o serviço de higiene e limpeza, estabelecendo estratégias educativas e coletivas para os trabalhadores relacionadas às práticas de trabalho realizadas neste contexto(AU)

Objective: to analyze positive and negative aspects related to the self-esteem of outsourced workers in hospital hygiene and cleaning services. Method: exploratory study, with a qualitative approach, carried out in two private hospital institutions. Participants were outsourced workers from hygiene and cleaning services. For data collection, a sociodemographic questionnaire and a semi-structured interview script were used. Inductive thematic analysis was performed. Results: the sample consisted of 15 female workers, who expressed positive and negative aspects that affect their self-esteem, which are related to the organization and work environment, interpersonal relationships and work benefits. Conclusion: positive and negative aspects are present among these workers and hospital managers should reflect on the hygiene and cleaning service, establishing educational and collective strategies for workers related to work practices carried out in this context(AU)

Objetivo: analizar aspectos positivos y negativos relacionados con la autoestima de trabajadores subcontratados en los servicios de higiene y limpieza hospitalaria. Método: estudio exploratorio, con enfoque cualitativo, realizado en dos hospitales privadas. Los participantes eran trabajadores subcontratados de los servicios de higiene y limpieza. Para la recolección de datos, se utilizó un cuestionario sociodemográfico y un guion de entrevista semiestructurada. Se realizó un análisis temático inductivo. Resultados: la muestra estuvo conformada por 15 trabajadoras, quienes expresaron aspectos positivos y negativos que inciden en su autoestima, los cuales están relacionados con la organización y clima laboral, las relaciones interpersonales y las prestaciones laborales. Conclusión: los aspectos positivos y negativos están presentes entre estos trabajadores y los administradores de hospitales deben reflexionar sobre el servicio de higiene y limpieza, estableciendo estrategias educativas y colectivas para los trabajadores, relacionadas con las prácticas de trabajo realizadas en este contexto(AU)

Orientação sexual e sintomas depressivos: papel mediador da autoestima e satisfação com a vida / Sexual orientation and depressive symptoms: mediating role of self-esteem and life satisfaction / Orientación sexual y síntomas depresivos: papel mediador de la autoestima y la satisfacción con la vida

Objetivo: verificar se autoestima e satisfação com a vida exercem efeitos mediadores na relação entre orientações sexuais minoritárias e sintomatologia depressiva em amostra de pós-graduandos stricto sensu. Método: estudo analítico, transversal, conduzido com 321 pós-graduandos stricto sensu entre março/abril de 2021. Utilizou-se o Patient Health Questionnaire-9 para avaliação de sintomas depressivos, Escala de Autoestima de Rosemberg e Escala de Satisfação com a Vida. Análises de mediação simples foram conduzidas por meio da macro PROCESS. Resultados: pós-graduandos de orientações sexuais minoritárias apresentaram maior severidade de sintomas depressivos e menores indicadores de autoestima e satisfação com a vida do que seus pares heterossexuais. Autoestima e satisfação com a vida mediaram parcialmente a relação entre orientação sexual e severidade de sintomas depressivos em uma proporção de, respectivamente, 48,26% e 37,54%. Conclusão: autoestima e satisfação com a vida apresentaram-se como importantes mediadores da relação entre orientações sexuais minoritárias e sintomas depressivos entre pós-graduandos(AU)

Objective: to verify whether self-esteem and satisfaction with life exert mediating effects on the relationship between minority sexual orientations and depressive symptoms in a sample of graduate students. Method: analytical, cross-sectional study conducted with 321 Brazilian graduate students between March/April 2021. The Patient Health Questionnaire-9 was used to assess depressive symptoms, was used too, Rosemberg´s Self-Esteem Scale and the Life Satisfaction Scale. Simple mediation analyzes were conducted using the PROCESS macro. Results: graduate students with minority sexual orientations had more severe depressive symptoms and lower indicators of self-esteem and life satisfaction than their heterosexual peers. Self-esteem and satisfaction with life partially mediated the relationship between sexual orientation and severity of depressive symptoms in a proportion of, respectively, 48.26% and 37.54%. Conclusion: self-esteem and life satisfaction were important mediators of the relationship between minority sexual orientations and depressive symptoms among graduate students(AU)

Objetivo: verificar si la autoestima y la satisfacción con la vida ejercen efectos mediadores en la relación entre las orientaciones sexuales minoritarias y la sintomatología depresiva en una muestra de estudiantes de posgrado stricto sensu. Método: estudio transversal analítico realizado junto a 321 estudiantes de posgrado stricto sensu entre marzo y abril de 2021. Para evaluar los síntomas depresivos, se utilizó el Patient Health Questionnaire-9, la Escala de Autoestima de Rosemberg y la Escala de Satisfacción con la Vida. Los análisis de mediación simple se realizaron utilizando la macro PROCESS. Resultados: los estudiantes de posgrado con orientaciones sexuales minoritarias presentaron síntomas depresivos más severos y menores indicadores de autoestima y satisfacción con la vida que sus pares heterosexuales. La autoestima y la satisfacción con la vida mediaron parcialmente la relación entre la orientación sexual y la severidad de los síntomas depresivos en una proporción de, respectivamente, 48,26% y 37,54%. Conclusión: la autoestima y la satisfacción con la vida fueron importantes mediadores de la relación entre la orientación sexual minoritaria y los síntomas depresivos entre estudiantes de posgrado(AU)

Atividade física, sintomatologia depressiva e autopercepção do envelhecimento em idosas ativas de Porto Alegre-RS / Physical activity, depressive symptoms and self-perception of aging in active elderly women in Porto Alegre-RS

Objetivo: analisar a relação entre a atividade física, a sintomatologia depressiva e a autopercepção do envelhecimento em idosas socialmente ativas do município de Porto Alegre/RS. Método: os instrumentos utilizados foram o questionário geral, a Escala Geriátrica de Depressão (GDS), o Questionário de Autopercepção do Envelhecimento (APQ); Questionário Internacional de Atividade Física (IPAQ). A pesquisa foi composta por amostra 167 idosas, realizada entre 2016 a 2017. Resultados: na autopercepção de envelhecimento, as subescalas controle positivo e consequência positiva apresentaram as maiores médias na amostra total. Na GDS, 22,2% das idosas apresentaram sintomatologia depressiva, não tendo relação com a faixa etária. No nível de atividade física, as tarefas domésticas e que as mantém ativa. Conclusões: houve associação significativa inversa da prática de atividade física, com os escores de consequência negativa e controle negativo. Também da prática de atividade física no domínio do lazer com os escores de consequência negativa e sintomas depressivos.(AU)

Objective: to analyse the relationship between physical activity, depressive symptoms, and self-perception of aging in socially active elderly women in the city of Porto Alegre/RS. Method: the instruments used were the general questionnaire, the Geriatric Depression Scale (GDS), the Aging Self-Perception Questionnaire (APQ); International Physical Activity Questionnaire (IPAQ). The research consisted of a sample of 167 elderly women, carried out between 2016 and 2017. Results: in self-perception of aging, the positive control and positive consequence subscales presented the highest means in the total sample. In the GDS, 22.2% of elderly women presented depressive symptoms, unrelated to age group. In terms of physical activity, household chores keep them active. Conclusions: there was a significant inverse association between physical activity and negative consequence and negative control scores. Also, the practice of physical activity in the leisure domain with negative consequence scores and depressive symptoms.(AU)

Objetivo: analizar la relación entre la actividad física, los síntomas depresivos y la autopercepción del envejecimiento en mujeres mayores socialmente activas de la ciudad de Porto Alegre / RS. Método: los instrumentos utilizados fueron el cuestionario general, la Escala de Depresión Geriátrica (GDS), el Cuestionario de Autopercepción del Envejecimiento (APQ); Cuestionario Internacional de Actividad Física (IPAQ). La investigación estuvo compuesta por una muestra de 167 mujeres mayores, realizada entre 2016 y 2017. Resultados: en la autopercepción del envejecimiento, las subescalas de control positivo y consecuencia positiva presentaron las medias más altas en la muestra total. En el GDS, el 22,2% de las ancianas presentaron síntomas depresivos, no relacionados con el grupo de edad. En cuanto a la actividad física, las tareas del hogar los mantienen activos. Conclusiones: hubo una asociación inversa significativa entre la actividad física y las puntuaciones de consecuencias negativas y de control negativo. También la práctica de actividad física en el ámbito del ocio con puntuaciones de consecuencias negativas y síntomas depresivos.(AU)

O que é autoestima para os analistas do comportamento? Uma revisão sistemática / What is self-esteem for behavioral analysts? A systematic review

A autoestima é um termo muito utilizado pelas pessoas no senso comum, mas ainda são necessários mais estudos para entendê-lo sob o ponto de vista comportamental. O objetivo deste estudo foi realizar uma revisão de textos da Análise do Comportamento a respeito de autoestima. Foi realizada uma busca em três fontes diferentes: periódicos exclusivos de Análise do Comportamento; as coleções de livros Sobre Comportamento e Cognição e Comportamento em Foco; e na Scielo. No total, 16 textos preencheram os critérios, que eram a) ter a palavra "autoestima" no título b) ser um texto da Análise do Comportamento. Foram discutidas as definições de autoestima utilizadas, os participantes dos estudos, os estímulos usados em testes de medida implícita e os principais resultados. Nenhum dos textos analisados utilizou intervenções voltadas ao aumento da autoestima. Apesar de serem textos da abordagem comportamental, muitos dos estudos utilizam apenas definições e instrumentos não comportamentais. As principais conclusões da revisão foram: 1) ainda existem poucos estudos sobre autoestima na Análise do Comportamento; 2) ainda não existe uma definição comportamental bem construída, especialmente na literatura internacional.

Self-esteem is a term that is widely used in common sense, but more studies are still needed to understand it from a behavioral point of view. The objective of this study was to carry out a review of Behavior Analysis papers regarding self-esteem. A search was conducted in three different sources: Behavior Analysis journals; the book collections Sobre Comportamento e Cognição and Comportamento em Foco; and on Scielo. In total, 16 texts met the criteria, which were a) having the word "self-esteem" in the title and b) being a Behavior Analysis text. We discuss the definitions of self-esteem used, the participants in the studies, the stimuli used in the implicit measurement tests and the main results. None of the analyzed texts used interventions aimed to increase self-esteem. Even though they are texts of the behavioral approach, many of the studies only use non-behavioral definitions and instruments. The main conclusions of the review were: 1) there are still few studies on self-esteem in Behavior Analysis; 2) there is still no well-constructed behavioral definition, especially in international literature.

Los hábitos de vida saludables en relación al autoconcepto físico en taekwondokas ecuatorianos en tiempos de la pandemia "COVID 19"

La práctica de taekwondo, en el confinamiento de la pandemia del COVID 19, guarda relación con los hábitos de vida saludables y autoconcepto físico. En tal sentido, se determinó como el objetivo de esta investigación identificar las relaciones que puedan producirse entre las respuestas al CAF (Cuestionario de autoconcepto físico) y hábitos de vida saludables de los practicantes de taekwondo a nivel nacional. Se implementó un diseño ex post facto de carácter retrospectivo y correlacional, donde las variables independientes no son susceptibles de manipulación, se utilizó un muestreo no probabilístico discrecional, cuya muestra la componen 423 deportistas de taekwondo entre 12 y 58 años. Los participantes cumplimentaron el Cuestionario de autoconcepto físico (CAF) y el Cuestionario de hábitos de vida saludables. Los resultados, comprueban la importancia de los entrenamientos en confinamiento de taekwondo como aporte de una vida saludable, en relación con su propia percepción del autoconcepto físico de los participantes. Se concluyó que la práctica del taekwondo en época de pandemia aportó significativamente en el cuidado y desarrollo de los hábitos de vida saludables.

A prática do Taekwondo, no confinamento da pandemia da COVID-19, está relacionada a hábitos de vida saudáveis e ao autoconceito físico. Nesse sentido, o objetivo desta pesquisa foi identificar as relações que podem ocorrer entre as respostas ao CAF (Questionário de Autoconceito Físico) e os hábitos de vida saudável dos praticantes de Taekwondo em nível nacional. Foi implementado um projeto retrospectivo e correlacional ex post facto, em que as variáveis independentes não são suscetíveis de manipulação. Foi utilizada uma amostragem não probabilística discreta, com uma amostra de 423 atletas de taekwondo entre 12 e 58 anos de idade. Os participantes preencheram o Questionário de Autoconceito Físico (CAF) e o Questionário de Hábitos de Estilo de Vida Saudável. Os resultados comprovam a importância do treinamento de confinamento do taekwondo como contribuição para um estilo de vida saudável, em relação à percepção dos próprios participantes sobre seu autoconceito físico. Concluiu-se que a prática do taekwondo em tempos de pandemia contribuiu significativamente para o cuidado e o desenvolvimento de hábitos de vida saudáveis.

The practice of Taekwondo, in the confinement of the COVID19 pandemic, is related to healthy lifestyle habits and physical self-concept. In this sense, the objective of this research was determined to identify the relationships that may occur between the responses to the CAF (Physical Self-Concept Questionnaire) and healthy lifestyle habits of Taekwondo practitioners nationwide. An ex post facto design of a retrospective and correlational nature was implemented, where the independent variables are not susceptible to manipulation, a discretionary non-probabilistic sampling was used, which sample is made up of 423 taekwondo athletes between 12 and 58 years old. The participants completed the Physical Self-Concept Questionnaire (CAF) and the Healthy Life Habits questionnaire. The results prove the importance of Taekwondo confinement training as a contribution to a healthy life, in relation to their own perception of the participants' physical self-concept. It was concluded that the practice of taekwondo during the pandemic contributed significantly to the care and development of healthy lifestyle habits.

Head-to-head comparisons of enhanced CT, 68Ga-PSMA-11 PET/CT and 18F-FDG PET/CT in identifying adverse pathology of clear-cell renal cell carcinoma: a prospective study

ABSTRACT Objectives: Accurate preoperative prediction of adverse pathology is crucial for treatment planning of renal cell carcinoma (RCC). Previous studies have emphasized the potential of prostate-specific membrane antigen positron emission tomography / computed tomography (PSMA PET/CT) in differentiating between benign and malignant localized renal tumors. However, there is a scarcity of case reports elucidating the identification of aggressive pathological features using PET/CT. Our study was designed to prospectively compare the diagnostic value of enhanced CT, 68Ga-PSMA-11 and 18F-fluorodeoxyglucose (18F-FDG) PET/CT in clear-cell renal cell carcinoma (ccRCC) with necrosis or sarcomatoid or rhabdoid differentiation. Materials and Methods: A prospective case series of patients with a newly diagnosed renal mass who underwent enhanced CT, 68Ga-PSMA-11 and 18F-FDG PET/CT within 30 days prior to nephrectomy was included. Complete preoperative and postoperative clinicopathological data were recorded. Patients who received neoadjuvant targeted therapy, declined enhanced CT or PET/CT scanning, refused surgical treatment or had non-ccRCC pathological indications were excluded. Radiological parameters were compared within subgroups of pathological characteristics. Bonferroni corrections were used to adjust for multiple testing and statistical significance was set at a p-value less than 0.017. Results: Seventy-two patients were available for the final analysis. Enhanced CT demonstrated poor performance in identifying necrosis, sarcomatoid or rhabdoid differentiation and adverse pathology (all P > 0.05). The maximum standardized uptake value (SUVmax) of 68Ga-PSMA-11 PET/CT was more effective than 18F-FDG PET/CT in identifying tumor necrosis and adverse pathology, with an area under the curve (AUC) of 0.85 (cutoff value=25.26, p<0.001; Delong test z=2.709, p=0.007) for tumor necrosis and AUC of 0.90 (cutoff value=25.26, p<0.001; Delong test z=3.433, p<0.001) for adverse pathology. However, no significant statistical difference was found between 68Ga-PSMA-11 and 18F-FDG PET/CT in predicting sarcomatoid or rhabdoid feature (AUC of 0.91 vs.0.75, Delong test z=1.998, p=0.046). Subgroup analyses based on age, sex, tumor location, maximal diameter, stage and WHO/ISUP grade demonstrated that 68Ga-PSMA-11 PET/CT SUVmax had a significant predictive value for adverse pathology. Enhanced CT value and SUVmax demonstrated strong reliability [intraclass correlation coefficient (ICC) > 0.80], indicating a robust correlation. Conclusions: 68Ga-PSMA-11 PET/CT demonstrates distinct advantages in identifying aggressive pathological features of primary ccRCC when compared to enhanced CT and 18F-FDG PET/CT. Further research and assessment are warranted to fully establish the clinical utility of 68Ga-PSMA-11 PET/CT in ccRCC.

Single Port Robotic Pyeloplasty: early single-center experience

ABSTRACT Purpose: Ureteropelvic junction obstruction (UPJO) is a prevalent cause of hydronephrosis, especially in young patients. The treatment paradigm for this condition has shifted from open to minimally invasive pyeloplasty. In the present study we describe our initial single centre experience with single port (SP) robot-assisted pyeloplasty (RAP) via periumbilical incision. Material and methods: With the patient in a 60-degree left flank position, the SP system is docked with the Access port (Intuitive Surgical, Sunnyvale, CA, US) placed in a periumbilical 3 cm incision. Robotic instruments are deployed as follows: camera at 12 o'clock, bipolar grasper at 9 o'clock, scissors at 3 o'clock and Cadiere at 6 o'clock. After isolation and identification of the ureter and the ureteropelvic junction (UPJ), the ureter is transected at this level and then spatulated. Anastomosis is carried out by two hemicontinuous running sutures, over a JJ stent. Results: Between 2021 and 2023, a total of 8 SP RAP have been performed at our institution, with a median (interquartile range, IQR) of 23 years (20.5-36.5). Intraoperative outcomes showed a median (IQR) OT of 210.5 minutes (190-240.5) and a median (IQR) estimated blood loss (EBL) of 50 mL (22.5-50). No postoperative complications were encountered, with a median (IQR) length of stay (LOS) of 31 hours (28.5-34). Conclusion: In the present study we evaluated the feasibility and safety of SP RAP. The observed outcomes and potential benefits, combined with the adaptability of the SP platform, hold promising implications for the application of SP system in pyeloplasty treatment.

PROPUESTA REFLEXIVA CONCEPTUAL SOBRE LA TRASCENDENCIA ESPIRITUAL Y SUS IMPLICACIONES PARA ENFERMERÍA / REFLECTIVE CONCEPTUAL PROPOSAL ON SPIRITUAL TRANSCENDENCE AND ITS IMPLICATIONS FOR NURSING

OBJETIVO: Elaborar una propuesta reflexiva conceptual sobre la trascendencia espiritual y sus implicaciones para enfermería. CONTENIDO: En el presente artículo se realizó una reflexión teórica sobre el fenómeno de la trascendencia espiritual y la construcción interpretativa del concepto destacando revisión de sus atributos que permiten su comprensión. Se incluyen los principales atributos conceptuales y se reflexiona sobre la trascendencia espiritual en enfermería, entendida como una capacidad motivada de manera intrínseca en la persona frente a situaciones vitales, esta capacidad le permite conectar con la situación y buscar sobrepasarla a partir de su sentido de espiritualidad. CONCLUSIONES: La trascendencia espiritual involucra el camino que puede llevar a la persona a una comprensión de situaciones contemplativas y de dificultad y a la vez a contemplar la vida y la existencia de una forma armónica y esta capacidad puede ser promovida en el cuidado de la enfermera.

OBJECTIVE: To elaborate a conceptual reflective proposal on spiritual transcendence and its implications for nursing. CONTENT: In this article, a theoretical reflection on the phenomenon of spiritual transcendence and the interpretative construction of the concept was carried out, highlighting a review of its attributes that further contributed to its understanding. The main conceptual attributes of spiritual transcendence are included and its implications for nursing reflected upon. Spiritual transcendence is understood as an intrinsically motivated capacity in the person in the face of life situations, a capacity that allows him/her to connect with the situation and seek to overcome it based on his/her sense of spirituality. CONCLUSIONS: Spiritual transcendence provides a path that can lead the person to an understanding of difficult situations, while allowing time to contemplate life and existence in a harmonious way. This is a capacity that can be promoted in nursing care.

Vivencias sexuales y autoestima en mujeres mexicanas con histerectomía / Sexual experiences and self-esteem in Mexican women with hysterectomy

RESUMEN La histerectomía es la segunda cirugía más frecuente dentro de la ginecología a nivel mundial. En México se calcula que una de cada tres mujeres, antes de los 60 años, se someterá a dicho procedimiento. Las mujeres con histerectomía atraviesan por una serie de cambios que pueden afectarlas en distintos aspectos de su vida, repercutiendo en lo psicológico, social y anatómico. El objetivo de la presente investigación fue interpretar las vivencias sexuales y autoestima de mujeres mexicanas con histerectomía. Se utilizó una metodología cualitativa fenomenológica-hermenéutica, en la que participaron 11 mujeres con histerectomía abdominal. Los resultados se agruparon en 2 categorías principales: sexualidad y autoestima, y sus respectivas subcategorías. En la primera, se reporta una disminución de la lubricación y en consecuencia afectaciones en el deseo, satisfacción y orgasmo. En la segunda, se documentaron alteraciones que se presentaban con cambios de percepción y pensamientos, así como en sus capacidades, sentimientos y actitud. El proceso que transitaron las mujeres, tras la histerectomía, influyó en los componentes de su sexualidad y autoestima. El tiempo de afrontamiento y su resultado favorable estuvo asociado con lograr anteponer la autoestima a la afectación vivida en su sexualidad.

ABSTRACT Hysterectomy is the second surgery with more frequency inside gynecology at a worldwide level. In Mexico it is calculated that one of every three women before 60 years old will be subjected to that procedure. Women with hysterectomy undergo a series of changes that could affect them in different aspects of their lives, impacting in the psychological, social, and anatomical. The objective of this investigation was to interpret the sexual experiences and self-esteem of Mexican women with hysterectomy. A qualitative phenomenological-hermeneutic methodology was used where 11 women with abdominal hysterectomy participated. Results were grouped in 2 main categories: sexuality and self-esteem, and their respective subcategories. In the first category, a decrease on lubrication, which consequently had negative effects on desire, satisfaction, and orgasm was reported. In the second, some alterations characterized by changes on the participants' perception and thoughts were documented, as well as on their capacities, feelings, and attitudes. The process that women went through after the hysterectomy, influenced the components of their sexuality and self-esteem. The coping time and its favorable result were associated with putting self-esteem above the negative impact in their sexual life.

Teoria Sistêmica, subsistema do Direito e o novo paradigma da Saúde Única / Systemic Theory, Law subsystem and the new One Health paradigm / La Teoría Sistémica, el sistema del Derecho y el nuevo paradigma One Health

Objetivo: discutir o novo paradigma da Saúde Única à luz da Teoria Sistêmica de Niklas Luhmann e a atuação do subsistema do Direito em face das interconexões da abordagem. Metodologia: tratou-se de um ensaio crítico inédito, com utilização da teoria luhmaniana e os novos conceitos da saúde única. Resultados: a teoria dos sistemas sociais de Luhmann possibilita o subsistema do Direito, em sua autopoiese, além de compreender e passar a operar com as novas abordagens integradas de saúde humana, saúde animal e meio ambiente. Conclusão: o subsistema do Direito está apto a incorporar em sua comunicação interna o novo paradigma, reconhecendo a futura legislação da saúde única.

Objective: to discuss the new One Health paradigm in the light of Niklas Luhmann's Systemic Theory and the performance of the Law subsystem in view of the interconnections of the approach. Methodology: this was an unprecedented critical essay, using Luhmanian theory and the new concepts of single health. Results: Luhmann's theory of social systems enables the subsystem of Law, in its autopoiesis, to understand and begin to operate with the new integrated approaches to human health, animal health and the environment. Conclusion: the Law subsystem can incorporate the new paradigm into its internal communication, recognizing the future single health legislation.

Objetivo: discutir el nuevo paradigma One Health a la luz de la Teoría Sistémica de Niklas Luhmann y el desempeño del subsistema del Derecho frente a las interconexiones del abordaje. Metodología: se trató de un ensayo crítico inédito, utilizando la teoría luhmaniana y los nuevos conceptos de salud única. Resultados: la teoría de los sistemas sociales de Luhmann permite al subsistema Derecho, en su autopoiesis, comprender y pasar a operar con los nuevos enfoques integrados de la salud humana, la salud animal y el medio ambiente. Conclusión: el subsistema del Derecho logra incorporar el nuevo paradigma en su comunicación interna, reconociendo la futura legislación de la salud única.

Necesidad de tratamiento ortodóntico y su relación con el rendimiento académico, la autoestima y el bullying: revisión de la literatura / Need for orthodontic treatment and its relationship with academic performance, self-esteem and bullying: a review of the literature / Necessidade de tratamento ortodôntico e sua relação com o desempenho acadêmico, a autoestima e o bullying: uma revisão da literatura

RESUMEN La finalidad del presente estudio fue llevar a cabo un análisis de la literatura sobre la autopercepción de la necesidad de tratamiento ortodóntico relacionado al rendimiento académico, la autoestima y el bullying. Se realizó una búsqueda electrónica de artículos originales (estudios transversales) que cumplan con los criterios de inclusión y exclusión, elaborados desde el 2018 hasta el 2022, de las siguientes bases de datos: PubMed, Web of Science, Scopus, SciELO y ScienceDirect, en idiomas inglés, español y portugués. Finalmente, se seleccionaron 17 artículos que cumplían los criterios de exclusión y el diseño del estudio.

ABSTRACT The purpose of the present study was to conduct a literature review on the self-perception of the need for orthodontic treatment related to academic performance, self-esteem, and bullying. An electronic search was conducted for original articles (cross-sectional studies), meeting the inclusion and exclusion criteria, produced from 2018 to 2022, from the following databases: PubMed, Web of Science, Scopus, SciELO, and ScienceDirect, in English, Spanish, and Portuguese languages. Finally, 17 articles were selected that met the exclusion criteria and the study design.

RESUMO O objetivo deste estudo foi conduzir uma revisão da literatura sobre a autopercepção da necessidade de tratamento ortodôntico, considerando sua relação com o desempenho acadêmico, a autoestima e o bullying. Para atingir esse objetivo, uma busca eletrônica de artigos originais (estudos transversais) foi conduzida, com inclusão de trabalhos produzidos entre 2018 e 2022. Essa busca foi realizada em diversas bases de dados, incluindo PubMed, Web of Science, Scopus, SciELO e ScienceDirect. Foram considerados artigos em inglês, espanhol e português, seguindo critérios de inclusão e exclusão. No decorrer desse processo, foram selecionados 17 artigos que atendiam aos critérios pré-estabelecidos de exclusão e ao desenho do estudo.