Especificidades dos erros cometidos e do tempo despendido na actividade discriminação perceptiva de símbolos gráficos em alunos com dificuldades de aprendizagem / Specifics of errors and time spent in perceptual discrimination of graphic symbols in students with learning difficulties / Particularidades de los errores cometidos y el tiempo empleado en la actividad de la discriminación perceptiva de símbolos gráficos en estudiantes con dificultades de aprendizaje

A discriminação perceptiva de símbolos depende da organização perceptiva do sujeito da ação como sistema bio-psico-social complexo. Objectivo: estudo de especificidades da discriminação perceptiva de símbolos em alunos com dificuldades de aprendizagem. Amostra: 550 participantes ­ 275 com e 275 sem dificuldades de aprendizagem; idades 7 ­ 15 anos; escolaridade ­ 1º, 2º e 3º ciclo do ensino básico. Instrumentos metodológicos ­ entrevista clínico--psicológica, observação psicológica, Teste de Símbolos e Dígitos (SDMT). Resultados: Alunos com dificuldades de aprendizagem tendem a evidenciar mais emparelhamentos dígito-símbolo incorretos e menos corretos e a despenderem bastante mais tempo na execução da tarefa; portanto, executam menos emparelhamentos corretos por minuto, comparativamente a alunos sem dificuldades de aprendizagem. Conclusão: Nas dificuldades de aprendizagem, cometem-se mais erros e assinalam-se menos emparelhamentos correctos na tarefa de emparelhamento, quando há limites no tempo de execução; caso contrário, a disponibilidade de tempo compensa, reduzindo a quantidade de incorreções. Nas dificuldades de aprendizagem, é necessário mais tempo para executar a tarefa de emparelhamento, devido ao processamento de informação mais lento; tempo consumido na decodificação e identificação das correspondências dígito-símbolo e a discriminação perceptiva não se infirma com a rapidez necessária à simultaneidade e automatização do ato. (AU)

The perceptual discrimination of symbols depends on the perceptual organization of the individual as a complex bio-psychosocial system in action. Objective: To study the specifics of perceptual discrimination of symbols in students with learning difficulties. Sample: 550 participants - 275 with learning difficulties and 275 without; aged 7 to 15; educational levels ranging from the 1st to 3rd cycles of basic education. Methodological instruments included clinical-psychological interviews, psychological observations, and the Symbols Digit Modalities Test (SDMT). Results: Students with learning difficulties tend to display more incorrect and fewer correct digit-symbol pairings, and they invest considerably more time in task execution. Consequently, they achieve fewer correct pairings per minute compared to students without learning difficulties. Conclusion: Learning difficulties are associated with increased errors and fewer correct pairings in the task of pairing symbols when time constraints exist. Conversely, when ample time is available, it mitigates the quantity of inaccuracies. Learning difficulties necessitate more time for task completion due to slower information processing. The time spent on decoding, identifying digit-symbol correspondences, and perceptual discrimination does not align with the speed required for simultaneity and automation of the task. (AU)

La discriminación perceptiva de los símbolos depende de la organización perceptiva del sujeto de la acción como un complejo sistema bio-psico-social. Objetivo: estudiar las especificidades de la discriminación perceptiva de símbolos en estudiantes con dificultades de aprendizaje. Muestra: 550 parti-cipantes - 275 con y 275 sin dificultades de aprendizaje; edades de 7 a 15 años; escolaridad - 1º, 2º y 3º ciclo de educación básica. Instrumentos metodológicos: entrevista clínico-psicológica, observación psicológica, Test de Símbolos y Dígitos (SDMT). Resultados: Los estudiantes con dificultades de aprendizaje tienden a mostrar una mayor cantidad de emparejamientos dígito-símbolo incorrectos y menos correctos y dedican mucho más tiempo a la ejecución de la tarea; por lo tanto, realizan menos emparejamientos correctos por minuto, en comparación con los estudiantes sin dificultades de aprendizaje. Conclu-sión: En las dificultades de aprendizaje se cometen más errores y se notan menos emparejamientos correctos en la tarea de emparejamiento, cuando hay límites en el tiempo de ejecución; de lo contrario, la disponibilidad de tiempo es compensatoria, reduciendo el número de inexactitudes. En las dificultades de aprendizaje, se necesita más tiempo para realizar la tarea de empareja-miento, debido al procesamiento más lento de la información; el tiempo que se consume en decodificar e identificar las correspondencias dígito-símbolo y la discriminación perceptiva no ocurre tan rápidamente como es necesario para la simultaneidad y automatización del acto. (AU)

Velocidad de procesamiento en escolares chilenos con y sin Trastorno por Déficit de Atención con Hiperactividad (TDAH) / Processing Speed in Chilean Schoolchildren With and Without Attention Deficit Hyperactivity Disorder (ADHD) / Velocidade de processamento em estudantes chilenos com e sem Transtorno de Déficit de Atenção e Hiperatividade (TDAH)

El TDAH es el trastorno del neurodesarrollo más diagnosticado en escolares. La evidencia indica que las funciones ejecutivas, como es el caso de la velocidad de procesamiento y la memoria de trabajo, están afectadas en estudiantes con TDAH, aunque no existe un acuerdo definitivo sobre su presencia sistemática en este trastorno. Esta investigación pretende determinar si la velocidad de procesamiento y la memoria de trabajo corresponden a variables cognitivas en el TDAH. Participaron 138 estudiantes de 10 a 17 años. Se determinó TDAH con la escala VADTRS; se evaluó velocidad de procesamiento con una tarea de rapidez grafomotora y memoria de trabajo con una tarea de dígitos. Se utilizó un diseño transversal, univariante e intersujeto para el análisis de los datos. El VADTRS detectó un grupo con TDAH (N = 97) y otro sin TDAH (N = 41). A ambos grupos se aplicaron tareas de velocidad de procesamiento y memoria de trabajo; los análisis permitieron detectar diferencias significativas en estas variables entre los grupos con y sin TDAH. El grupo con TDAH fue dividido según su presentación; no se detectaron diferencias significativas en velocidad de procesamiento; la memoria de trabajo mostró un rendimiento significativa- mente menor en las presentaciones de TDAH inatenta y combinada. La velocidad de procesamiento y la memoria de trabajo parecen distinguir entre sujetos con y sin TDAH, la velocidad de procesamiento no parece distinguir entre presentaciones y la memoria de trabajo aparece alterada en aquellas presentaciones en que el componente atencional es definitorio

ADHD is the most commonly diagnosed neurodevelopmental disorder in schoolchildren. Evidence indicates that executive functions, such as processing speed and working memory, are affected in students with ADHD, although there is no definitive agreement on their sys- tematic presence in this disorder. This research aims to determine whether processing speed and working memory correspond to cognitive variables in ADHD. A total of 138 students aged 10 to 17 years participated. ADHD was determined with the VADTRS scale; processing speed was assessed with a graphomotor speed task and working memory with a digit task. A cross-sectional, univariate, intersubject design was used for data analy- sis. The VADTRS detected one group with ADHD (N = 97) and one without ADHD (N = 41). Processing speed and working memory tasks were applied to both groups; analyses detected significant differences in these variables between the ADHD and non- ADHD groups. The ADHD group was divided according to presentation; no significant differences were detected in processing speed; working memory showed significantly lower performance in the inattentive and combined ADHD presentations. Processing speed and working memory appear to distinguish between subjects with and without ADHD, processing speed does not appear to distinguish between presentations, and working memory appears impaired in those presentations in which the attentional component is defining.

O TDAH é o distúrbio de desenvolvimento neurológico mais frequentemente diagnosticado em crianças em idade escolar. As provas indicam que as funções executivas, tais como a velocidade de processamento e a memória de trabalho, são afectadas nos estudantes com TDAH, embora não haja um acordo definitivo sobre a sua presença sistemática nesta doença. Esta investiga- ção visa determinar se a velocidade de processamento e a memória de trabalho correspondem a variáveis cognitivas na TDAH. Um total de 138 estudantes com idades compreendidas entre os 10 e os 17 anos participaram. A TDAH foi determinada com a escala VADTRS; a velocidade de processamento foi avaliada com uma tarefa de velocidade grafomotora e a memória de trabalho com uma tarefa de dígitos. Foi utilizado um desenho transversal, univariado e intersubjecto para análise de dados. O VADTRS detectou um grupo com ADHD (N = 97) e um grupo sem ADHD (N = 41). Ambos os grupos foram administrados com velocidade de processamento e tarefas de memória de trabalho; as análises detectaram diferenças significativas nestas variáveis entre os grupos com ADHD e sem ADHD. O grupo TDAH foi dividido de acordo com a apresentação; não foram detectadas diferenças significativas na velocidade de processamento; a memória de trabalho mostrou um desempenho significativamente inferior nas apresentações de TDAH desatenta e combinada. A velocidade de processamento e a memória de trabalho parecem distinguir entre assuntos com e sem TDAH; a velocidade de processamento não parece distinguir entre apresentações e memória de trabalho parece prejudicada nas apresentações em que a componente atencional está a definir

Repercussões sociais/culturais e psíquicas da linguagem escrita na aprendizagem do sujeito / Social/cultural and psychic repercussions of written language on the subject's learning

A linguagem escrita é uma ferramenta básica em nossa Cultura, pois ela permite resgatar e transmitir o patrimônio cultural através da História da Humanidade. Considera-se fundamental compreendê-la integralmente, levando em conta aspectos relacionados às quatro habilidades básicas: ler, escrever, falar e escutar, como fundamentado por Kenneth Goodman (1977) e Condemarin (1992). Aprender a ler e escrever é um "rito de passagem" que demanda experiências formais e informais, dentro e fora do contexto escolar. A produção da linguagem escrita abre espaço para a singularização, isto é, possibilita expressar e identificar-se aos valores e conceitos que contribuem para a formação individual e coletiva. Sendo considerada a "espinha dorsal da escolarização", muitas das queixas de Dificuldades de Aprendizagem podem ser relacionadas à sua fragilidade, tendo repercussões na constituição do sujeito aprendente. Este artigo tenta descrever a amplitude do que envolve a queixa escolar referente à produção de linguagem de maneira integral e integrada, apresentando enfoques teóricos que fundamentam a Psicopedagogia Dinâmica no que diz respeito ao desenvolvimento da linguagem.

Written language is a basic tool in our Culture, as it allows to rescue and transmit cultural heritage through the history of humanity. It is considered fundamental to fully understand it, considering aspects related to the four basic skills: reading, writing, speaking, and listening, as founded by Kenneth Goodman (1977) and Mabel Condemarin (1992). Learning to read and write is a "rite of passage" that requires formal and not formal experiences, both within and outside the school context. The production of written language opens space for singularization, that is, it makes it possible to express and identify oneself to the values and concepts that contribute to individual and collective formation. Being considered the "backbone of schooling", many of the complaints of Learning Difficulties can be reactivated to its fragility, having repercussions on the constitution of the learning subject. This article tries to describe the breadth of what involves the school complaint regarding the production of language in an integral and integrated way, presenting important theoretical approaches to broaden this reflection. presenting theoretical approaches that underlie Dynamic Psychopedagogy regarding language development.

Crianças institucionalizadas: O impacto da privação psicossocial precoce na memória / Institutionalized children: The impact of early psychosocial deprivation on memory

Este trabalho tem por objetivo compreender como experiências emocionalmente traumáticas interferem na memória de crianças institucionalizadas (do nascimento aos 6 anos) em relação ao processo de aprendizagem. O afeto é importante para o desenvolvimento infantil. A falta de experiências afetivas na primeira infância, especificamente em crianças vítimas de abandono, maus-tratos, negligência e abuso, comuns nos casos de privação psicossocial, tem implicações como um estresse, e o impacto do estresse no início da vida pode afetar a memória, e sem memória não há aprendizagem. O método utilizado consiste em uma revisão de literatura. Os resultados obtidos apontaram uma baixa produção de pesquisas sobre a institucionalização precoce e sua relação com as dificuldades de aprendizagem na literatura brasileira e, apesar da intervenção psicopedagógica ser eficiente e de fácil acesso, atualmente são poucas unidades de acolhimento institucional que dispõem do(a) profissional de Psicopedagogia. A pesquisa problematiza o assunto a fim de que novos estudos sejam feitos para um maior entendimento sobre o impacto da privação psicossocial precoce de crianças na memória e na aprendizagem.

This work aims to understand how emotionally traumatic experiences interfere in the memory of institutionalized children (from birth to 6 years old) in relation to the learning process. Affection is important for child development. The lack of affective experiences in early childhood, specifically in children who are victims of abandonment, mistreatment, neglect and abuse, common in cases of psychosocial deprivation, have implications such as stress, and the impact of stress in early life can affect memory, and without memory there is no learning. The method used consists of a literature review. The results obtained showed a low production of research on early institutionalization and its relationship with learning difficulties in Brazilian literature, and despite the psychopedagogical intervention being efficient and easily accessible, there are currently few institutional reception units that have the Psychopedagogy professional. The research problematizes the subject so that new studies can be carried out for a better understanding of the impact of early psychosocial deprivation of children on memory and learning.

Percepción de la ansiedad y de las dificultades de aprendizaje según los criterios de la familia y de los profesores de niños con Trastorno por Déficit de Atención e Hiperactividad / Perception of anxiety and learning difficulties according to the criteria of the family and eachers of children with Attention Deficit Hyperactivity Disorder

Resumen Tanto el Trastorno por Déficit de Atención e Hiperactividad (TDAH) como la ansiedad son dos de los trastornos que más se evidencian en la población infanto-juvenil existiendo una correlación entre ambos tal y como se recoge en numerosos estudios. La combinación de ambos trastornos afecta a los procesos de enseñanza-aprendizaje del niño provocando dificultades de aprendizaje (DA) en el mismo. Los objetivos del presente trabajo se basaron en valorar los criterios que evidencian padres y profesores en niños con TDAH para caracterizar el grado de adecuación de la percepción y evaluar si esta se ajusta a la realidad o es insuficiente, si existen diferencias en dicha percepción entre padres y docentes; analizar la conciencia que tienen sobre las posibles DA que puedan presentar, para así aportar orientaciones adecuadas que permitan una favorable inter vención y evolución. La muestra se compone de 137 sujetos con edades comprendidas entre 9 y 15 años con un Coeficiente Intelectual Total (CIT) de entre 80 y 120. Los instrumentos que se utilizaron fueron: la escala de inteligencia de Wechsler para niños-V (WISC-V), el Cuestionario de Ansiedad Estado-Rasgo en Niños(STAI-C), el Sistema de Evaluación de Niños y Adolescentes(SENA) y el Inventario de Problemas en la Escuela (IPE). Como resultado se observa que la ansiedad percibida por estos niños no está relacionada con la que aprecian padres y profesores, sin embargo, estos últimos sí que coinciden en su apreciación.

Abstract Both Attention Deficit Hyperactivity Disorder (ADHD) and anxiety are two of the disorders that are most evident in the infant-juvenile population and there is a correlation between the two, as shown in numerous studies. The combination of both disorders affects the child's teaching-learning processes, causing learning difficulties (LD). The aims of the present study were based on assessing the criteria evidenced by parents and teachers in children with ADHD to characterize the degree of adequacy of perception and to evaluate whether this is in line with real ity or insufficient, whether there are differences in this perception between parents and teachers, and to analyze their awareness of the possible AD they may present, in order to provide appropriate guidelines for favourable intervention and evolution. The sample consisted of 137 subjects aged between 9 and 15 years with a Total IQ (TIQ) between 80 and 120. The instruments used were: the Wechsler Intelligence Scale for Children-V (WISC-V), the State-Trait Anxiety Questionnaire for Children (STAI-C), the Child and Adolescent Assessment System (SENA) and the Inventory of Problems at School (IPE). As a result, it is observed that the anxiety perceived by these children is not related to the anxiety perceived by parents and teachers, although the latter do coincide in their assessment.

Impacto de la covid-19 en estudiantes de preparatoria en comunidades rurales, México

(analítico) El proceso educativo se trasladó de las escuelas a los hogares mexicanos como consecuencia de la covid-19. El objetivo planteado fue analizar el impacto económico, familiar y académico de la covid-19 en discentes de comunidades rurales que asisten a la preparatoria. La metodología fue cuantitativa. La muestra fueron 222 estudiantes de la Universidad Autónoma de Sinaloa, en México, que respondieron un cuestionario en línea. Los datos se analizaron por estadística descriptiva y análisis de correlación. En los resultados se destacan tres impactos: económicos, por falta de ingresos para comprar tecnología; familiares, por la falta de apoyo de padres y madres; y académicos, porque hay poca capacitación en el uso de TIC. En conclusión, la covid-19 causó dificultades y puso de manifiesto una brecha digital, inequidad social y rezago educativo.

(analytical) The educational process shifted from schools to the home for Mexicans as a result of COVID-19. The objective was to analyze the economic, family and academic impact of COVID-19 among students from rural communities attending high school in Sinaloa. The methodology used for the study was the quantitative. The statistical sample size was 222 students from the Universidad Autónoma de Sinaloa, in México, who respond to an online questionnaire. The data was analyzed using descriptive statistics and correlational analysis. The results showed three types of problems: economic issues due to lack of income to buy the technological items required for online learning; family problems, specifically the lack of support provided by parents to help children with distance education; and academic difficulties, because there was little training provided to students on the use of technology. The authors concluded that COVID-19 caused difficulties and highlighted the existence of a digital divide, social inequality and educational lag.

(analítico) O processo educacional mudou as escolas para lares mexicanos como resultado da covid-19. O objetivo era analisar o impacto econômico, familiar e acadêmico do Covid-19 em algumas comunidades rurais que eles estudam ensino preparatório. A metodologia era quantitativa. A amostra era de 222 alunos da Universidade Autônoma de Sinaloa, no México, eles responderam a um questionário online. Os dados foram analisados por meio de estatística descritiva e análise de correlação. Os resultados mostram três problemas: econômicos devido à falta de renda para comprar tecnologia; parentes por falta de apoio dos pais e filhos, e Acadêmicos porque há pouco treinamento no uso das TIC. Em conclusão, da covid-19 causou dificuldades e revelou uma lacuna digital, desigualdade social e atraso educacional.

Saúde e queixa escolar: registros de conserv(ação) na conduta de psicólogos / Salud y queja escolar: registros de conserv(acción) en la conducta de los psicólogos / Health and school complaint: records of conserv(action) in the conduct of psychologists

RESUMO. Este artigo expõe a temática da conduta de profissionais da psicologia no campo da saúde, diante das demandas escolares. Resulta de uma pesquisa de Mestrado, cujo objetivo principal foi, com base na Psicologia Histórico-Cultural, identificar de que forma as práticas contemporâneas da psicologia na saúde explicitam a concepção dos profissionais ante os encaminhamentos e a função da escola para a constituição da subjetividade. Para tanto, foram analisados prontuários de crianças e adolescentes entre quatro e dezessete anos, encaminhados por queixa escolar a dois serviços públicos de saúde em um município de pequeno porte do interior paulista, durante o biênio 2014-2015, e efetivadas entrevistas com as/os psicólogas/os responsáveis nos diferentes serviços. Os resultados indicaram que a atividade da/o psicóloga/o, ao receber a demanda escolar, encontra-se pouco alterada em relação às condutas que vêm sendo adotadas no país, desde os anos de 1990. As práticas aderidas consistem, em grande maioria, no atendimento clínico individual ou grupal, que não envolve o ambiente escolar. Também se mantém o perfil das crianças encaminhadas e, no contexto da ciência psicológica aplicada à saúde, um distanciamento quanto ao conhecimento das implicações da educação escolar para a aprendizagem e o desenvolvimento humano, tanto quanto a importância do acesso aos bens culturais humanos, o que pode ser decisivo para as circunstâncias e para a qualidade do processo de humanização.

RESUMEN. Este artículo expone el tema de la conducta de los profesionales de la psicología en el campo de la salud, delante de las demandas escolares. Es el resultado de una investigación de maestría, cuyo objetivo principal era, basado en la psicología histórico-cultural, identificar cómo las prácticas contemporáneas de psicologia, en la salud, hacen explícito la concepción de los profesionales delante de las derivaciones y el papel de la escuela para el constitución de subjetividad. Con este fin, se analizaron los registros de salud de niños y adolescentes entre cuatro y diecisiete años, reenviados por queja escolar a dos servicios de salud pública en una pequeña ciudad del interior de São Paulo, durante el bienio 2014-2015, y efectivadas entrevistas con los psicólogos responsables em los diferentes servicios. Los resultados indicaron que la actividad del psicólogo, al recibir la demanda escolar, cambia poco en relación a las conductas que se han adoptado en el país, desde la década de los noventa. Las prácticas adheridas consisten, en su gran mayoría, en el cuidado clínico individual o grupal, que no involucra el ambiente escolar. El perfil de los niños referidos también se mantiene y, en el contexto de la ciencia psicológica aplicada a la salud, una distancia en cuanto al conocimiento de las implicaciones de la educación escolar para el aprendizaje y el desarrollo humano, así como la importancia del acceso a los bienes culturales humanos, que puede ser decisivo para las circunstancias y la calidad del proceso de humanización.

ABSTRACT. This article exposes the theme of the conduct of psychology professionals in the field of health, in view of school demands. It results from a Master's research, mainly aimed to, based on Historical-Cultural Psychology, identify how contemporary Psychology practices in health may explain the professionals' understanding about the referrals and the role of the school in building subjectivity. To this end, medical records of children and adolescents of four to seventeen years old were analyzed. Participants had been referred due to school complaint to two public healthcare services in a small municipality in São Paulo, in the biennium 2014-2015, and participated in interviews with the responsible psychologists in the services. The results indicated that the psychologist's activity when receiving the school demand has changed a little in relation to the conducts being adopted in the country since the 1990s. The practices adopted mainly consist in individual or group clinical care, disregarding the school environment. The profile of the children referred is also maintained and, in the context of psychological science applied to health, there is a distancing regarding the knowledge of the implications of school education on human learning and development, as well as the importance of accessing human cultural assets. This could be decisive for the circumstances and the quality of the humanization process.

Analysis of related factors of emotional and behavioral abnormalities in children with overactivity of bladder / 现代泌尿外科杂志

【Objective】 To analyze the related factors of emotional and behavioral abnormalities in children with overactive bladder (OAB). 【Methods】 OAB children (aged 6 to 16 years) in a survey of 5 032 children from a county in Henan Province during Sep.2022 and Dec.2022 were identified and surveyed with Overactive Bladder Symptom Score (OABSS), Strength and Difficulties Questionnaire (SDQ) and Pediatric Sleep Questionnaire (PSQ). According to the SDQ score, they were divided into abnormal group (SDQ≥20) and normal group. 【Results】 There were 35.7%(137/385) cases in the abnormal group and 64.3% (248/385) in the normal group. Gender, education level of caregivers, body mass index (BMI), age, constipation, enuresis and severity of OAB were significantly associated with emotional and behavioral abnormalities (P<0.05). Children in the abnormal group showed significant differences in emotional symptoms, conduct problems, hyperactivity symptoms, peer interaction and sleep (P<0.001). Multivariate regression analysis revealed significant differences in gender, educational level of caregi-vers, BMI, age, constipation, enuresis, severity of OAB and PSQI between the two groups (P<0.05). 【Conclusion】 The prevalence of emotional and behavioral abnormalities is high in children with OAB, which is related to female gender, high BMI, puberty, constipation, enuresis and severity of OAB.

Relationship between emotional exhaustion and work stress, thought suppression, difficulties in emotion regulation in clinical nurses / 中国职业医学

Objective To explore the current status of emotional exhaustion among clinical nurses and its relationship with work stress, thought suppression, difficulties in emotion regulation. Methods A totally of 1 159 clinical nurses from 10 cities in Henan Province and Fujian Province were enrolled as the research subjects using grabbing random balls method. And their status of work stress, thought suppression, difficulties in emotion regulation and emotional exhaustion were investigated by Depression-Anxiety-Stress Scale, White Bear Suppression Inventory, Brief Version of the Difficulties in Emotion Regulation Scale and Emotional Exhaustion Scale. Results The scores for work stress, thought suppression, difficulties in emotion regulation, emotional exhaustion were (23.5±3.8), (47.4±6.5), (54.1±7.2), (11.7±4.2), respectively. Among them, 40.0% of nurses experienced emotional exhaustion. Bootstrap analysis results showed that work stress positively affected emotional exhaustion among clinical nurses [standardized partial regression coefficient (β)=0.42, 95% confidence intervals (CI)： 0.36-0.44］. Work stress affected emotional exhaustion through thought suppression (β=0.16, 95%CI： 0.14-0.20), difficulties in emotion regulation (β=0.16, 95%CI： 0.14-0.19), and the chain mediating role of thought suppression and difficulties in emotion regulation (β=0.07, 95%CI： 0.04-0.09). Conclusion Emotional exhaustion symptoms are prevalent among clinical nurses. Work stress directly and indirectly influences thought suppression, difficulties in emotion regulation and emotional exhaustion of nurses.

Path analysis of mediating effect of perceived stress affecting impact of event in rehabilitation patients with traumatic injury / 中国康复理论与实践

ObjectiveTo explore the effect of perceived stress on the impact of event in rehabilitation patients with traumatic injury, and the mediating role of difficulties in emotion regulation, rumination and sleep. MethodsFrom March, 2022 to March, 2023, using the convenient sampling method, a questionnaire survey was conducted on 192 rehabilitation patients with traumatic injury from Southwest Hospital, Xinqiao Hospital and Daping Hospital. Assessment tools included Perceived Stress Scale, Difficulties in Emotion Regulation Scale, Brief Ruminative Response Scale, Self-Rating Scale of Sleep, and Impact of Event Scale-revised. ResultsPerceived stress, difficulties in emotion regulation, rumination, sleep and the impact of event were correlated with each other in rehabilitation patients with traumatic injury (r = 0.447~0.684, P < 0.01). Perceived stress significant positively predicted the impact of event (β = 0.49, P < 0.001), as well as difficulties in emotion (β = 0.70, P < 0.001), rumination (β = 0.21, P < 0.05) and sleep (β = 0.29, P < 0.001). The direct effect of perceived stress on the impact of event was not significant, but it affected the impact of event through seven mediation paths, among which the independent mediation effect size of difficulties in emotion regulation, rumination and sleep accounted for 24.41%, 11.91% and 24.82%, respectively; the chain mediation effect size of difficulties in emotion regulation and rumination accounted for 13.88%, the chain mediation effect size of difficulties in emotion regulation and sleep accounted for 18.08%, the chain mediation effect size of rumination and sleep accounted for 3.17%, and the chain mediation effect size of difficulties in emotion regulation, meditation and sleep accounted for 3.70%. ConclusionPerceived stress affected the impact of event in rehabilitation patients with traumatic injury through the independent mediation and chain mediation of difficulties in emotion regulation, rumination and sleep.

Heterogeneity of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation based on latent profile analysis / 器官移植

Objective To explore heterogeneous subtypes of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation and the characteristics differences of different types of children after liver transplantation. Methods Seven hundred and forty-one children who underwent living-related liver transplantation were enrolled. The self-designed general information questionnaire, Chinese version of 5-Item World Health Organization Well-Being Index (WHO-5) and the parent-report version of the Strengths and Difficulties Questionnaire (SDQ) were filled out by their guardians. The scores of five dimensions of SDQ were used as the manifest variables of the model. The classification model of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation was constructed by latent profile analysis. The latent categories of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation were analyzed. The influencing factors of latent categories were analyzed by univariate analysis and logistic regression model. Results There were three latent categories of psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation, including peer communication problem group (n=302), psychological and behavioral adaptation group (n=145) and psychological and behavioral adjustment difficulty group (n=294). The first two groups were merged into the psychological and behavioral health group (n=447), which had significant differences in the five dimensions and the total score of difficulties of SDQ compared with the psychological and behavioral adjustment difficulty group (n=294) (all P<0.001). Logistic regression analysis showed that age≤5 years old, primary disease of non-cholestatic liver disease, stem family were the risk factors for psychological and behavioral adjustment difficulties in pediatric recipients after liver transplantation. Female gender, high education levels of parents and high WHO-5 score of guardians were the protective factors for psychological and behavioral adjustment difficulties in pediatric recipients after liver transplantation (all P<0.05). Conclusions The psychological and behavioral adaptation characteristics of pediatric recipients after liver transplantation are heterogeneous. Medical staff should pay extensive attention to different characteristics of pediatric recipients after liver transplantation with different psychological and behavioral adaptation categories and adopt targeted screening and intervention strategies, aiming to improve psychological and behavioral adaptation outcomes of pediatric recipients after liver transplantation.

Face and Content Validity of a Handwriting Program for Children With Handwriting Difficulties

@#Introduction: Occupational therapists have been developing various handwriting intervention that has fundamental occupational goals with known validity to guide professional practice in the treatment of children with handwriting difficulties. This study aimed to explore the development and content validation of a developed handwriting intervention programme for children with handwriting difficulties. Methods: This study employed a combination of qualitative and quantitative methodology based on the sequential exploratory design in two main stages. The first stage is the focus group discussion and followed by a validation procedure using face and content validity scored by the expert reviewers. A total of thirteen experts participated in this study. Results: The findings were analyzed thematically according to physical appearance, language used, and content in the developed programme. The face and content validity report a convincing value, ranging from 0.99 to 1.00 of S-CVI values on four aspects, relevancy, clarity, simplicity, and ambiguity in the developed programme. Conclusion: This study provided preliminary approval for the development and validation of a handwriting intervention programme for children with handwriting difficulties to support the demand in the Malaysian school curriculum.

Difficulties and strategies of total mesorectal excision for middle and low rectal cancer after neoadjuvant therapy / 中华消化外科杂志

Patients with local advanced rectal cancer (LARC) can benefit from neoadju-vant chemoradiotherapy (nCRT) of reducing local recurrence rate and improving survival rate. However, tissue edema after nCRT may lead to unclear tissue spaces, making it challenging for lymph node dissection and nervous system protection. The difficulty in locating inferior margin of tumor after clinical complete remission or closing to clinical complete remission, as well as the increasing risk of anastomotic leakage after nCRT, pose difficulties and new challenges of total mesorectal excision for middle and low rectal cancer. Based on literatures and clinical experiences, the authors summarize the difficulties and strategies of total mesorectal excision after nCRT, in order to provide reference for colleagues.

Dificuldades financeiras, aspectos alimentares e de saúde em estudantes universitários, durante a pandemia de Covid-19 / Financial difficulties, dietary and health aspects in university students during the Covid-19 pandemic

Introdução: As dificuldades financeiras advindas da pandemia, em virtude de mudanças econômicas do país, além de refletirem no estado de segurança alimentar e nutricional e no estado de saúde dos indivíduos, acarretaram o aumento da evasão dos cursos superiores. Objetivo: Verificar a associação entre as dificuldades financeiras, durante a pandemia de Covid-19, com os aspectos alimentares e de saúde dos graduandos da Universidade Federal de Juiz de Fora (UFJF). Método: Estudo transversal com graduandos da UFJF. Os dados foram coletados entre setembro de 2020 e março de 2021, através de questionário on-line. Utilizou-se Teste Qui-quadrado (p<0,05) para avaliar os fatores associados às dificuldades financeiras durante a pandemia. Verificou-se a razão de chances (Odds Ratio - OR) das associações encontradas. Resultados: Avaliaram-se 584 graduandos, dentre os quais se constatou que 31,7% passaram por dificuldades financeiras durante a pandemia. Notou-se que a presença de dificuldades financeiras no período pandêmico se associou positivamente à presença de Insegurança Alimentar e Nutricional (INSAN), à autopercepção negativa de saúde, à má qualidade do sono e às alterações de depressão, ansiedade e estresse. Além disso, os indivíduos caracterizados com dificuldades financeiras tinham maiores chances de apresentarem INSAN, percepção negativa de saúde, má qualidade do sono, bem como alterações nos níveis de depressão, ansiedade e estresse, quando comparados à sua contraparte. Conclusão: Conclui-se que as dificuldades financeiras durante o período pandêmico são associadas à presença de INSAN e aspectos de saúde alterados. Assim, ressalta-se a necessidade de criação de estratégias que visem à assistência financeira e psicológica dos graduandos.

Introduction: The financial difficulties caused by the pandemic due to economic changes in the country, in addition to affecting food and nutrition security and the state of health of individuals, resulted in greater evasion from higher education courses. Objective: To check the association between financial difficulties during the COVID-19 pandemic with the dietary and health aspects of undergraduate students from Universidade Federal de Juiz de Fora (Federal University of Juiz de Fora ­ UFJF). Methods: Transversal study with UFJF undergraduate students. The data were collected between September 2020 and March 2021, via an online survey. The chi-square test (p<0.05) was used to evaluate the factors associated with financial difficulties during the pandemic. We also checked the odds ratio (OR) for the associations found. Results: We assessed 584 undergraduate students, 31.7% of which were found to have gone through financial difficulties during the pandemic. We observed that the presence of financial difficulties in that period was positively associated with Food and Nutrition Insecurity (INSAN, Portuguese acronym), negative self-perception of health, bad sleep quality, and changes in depression, anxiety, and stress levels. Moreover, individuals characterized as having financial difficulties had a higher chance of having INSAN, negative perception of health, bad sleep quality, as well as changes in the levels of depression, anxiety, and stress, when compared to their counterparts. Conclusion: We concluded that financial difficulties during the pandemic period are associated with INSAN and affected health aspects. Therefore, we highlight that there is a need for the development of strategies which aim to provide financial and psychological assistance to undergraduate students.

The teaching of fights in school physical education: a state of knowledge of brazilian studies / O ensino das lutas na educação física escolar: um estado do conhecimento de estudos brasileiros

ABSTRACT This article aims to analyze the Brazilian academic publications on fights and Physical Education. We used content analysis through a state of knowledge, with 38 articles as corpus. As results we built four empirical analytical categories: 1) Space and sociocultural aspects: they point the lack of infrastructure and the scarcity of materials as restrictive factors for the approach of the fight contents in schools; 2) Technologies/media: that serve as auxiliary tools for the inclusion of fights in school Physical Education; 3) Physical Education curriculum: addresses issues related to content, culture, documents and teachers; and 4) Pedagogical practice: which involves more specific issues observed in the studies, such as methodologies involving the application of the content to classes, experiences, dimensions of the content, activities and implications about the themes discussed in the content, such as the association with violence, gender discrimination and sexuality. We conclude that the studies show that the approach of fights as content in schools is still incipient, being the insecurity of the teacher a preponderant factor so that fights are not inserted. Thus, studies indicate the need to create materials and methodologies that help teachers, thus enabling the use of content already consolidated in the literature.

RESUMO Este artigo tem como objetivo analisar as publicações acadêmicas brasileiras sobre lutas e Educação Física. Utilizou-se a análise de conteúdo por meio de revisão narrativa, com 38 artigos como corpus. Como resultado construímos quatro categorias analíticas empíricas: 1) Espaço e aspectos socioculturais: apontam a falta de infraestrutura e a escassez de materiais como fatores restritivos para a abordagem dos conteúdos de luta nas escolas; 2) Tecnologias/mídias: que servem como ferramentas de auxílio para a inclusão das lutas na Educação Física escolar; 3) Currículo de Educação Física: aborda questões relacionadas a conteúdo, cultura, documentos e professores e 4) Prática pedagógica: que envolve questões mais específicas observadas nos estudos, como metodologias que envolvem a aplicação do conteúdo às aulas, vivências, dimensões do conteúdo, atividades e implicações sobre os temas discutidos no conteúdo, como a associação com a violência, a discriminação de gênero e a sexualidade. Concluímos que os estudos mostram que a abordagem das lutas como conteúdo nas escolas ainda é incipiente, sendo a insegurança do professor fator preponderante para que as lutas não sejam inseridas. Dessa forma, estudos indicam a necessidade de criar materiais e metodologias que auxiliem os professores, possibilitando assim a utilização de conteúdos já consolidados na literatura.

Causas do desmame precoce em lactentes: uma revisão integrativa / Causes of early weaning in infants: an integrative review

Objetivo: O objetivo do presente trabalho é descrever, por meio de revisão da literatura, as causas do desmame precoce em lactentes no Brasil. Métodos: Foram incluídos na revisão artigos publicados entre o período de 2016 e 2020. As informações foram coletadas nas bases de dados BVMS, Google Acadêmico, NCBI PubMed e Portal de Periódicos Capes e nos sites da Sociedade Brasileira de Pediatria, da OMS, da Unicef e da Opas, usando-se os termos indexadores: desmame precoce, dificuldade no aleitamento materno e prevalência do aleitamento materno. Resultados: Os artigos coletados para a pesquisa demonstraram que as maiores dificuldades encontradas pelas mães foram ocasionadas por: uso de mamadeira e chupeta, problemas nas mamas, falta de informação, parto cirúrgico e falta do contato pele a pele. Conclusão: Para reduzir o desmame precoce, é necessário que as mães recebam orientação e incentivo desde a gestação. Também é importante haver divulgação sobre as possíveis dificuldades e intercorrências que podem surgir durante o aleitamento materno, bem como orientações sobre a gestação e os procedimentos a serem adotados quando ocorrerem problemas nas mamas, como mastite e fissuras, que estão associadas com a pega incorreta. O apoio precisa ser multiprofissional. Deixa-se como sugestão a Iniciativa Hospital Amigo da Criança como possível estratégia para combater o desmame precoce.(AU)

Objective: The aim of this study is to describe, through a literature review, the causes of early weaning in infants in Brazil. Methods: Articles published between the period 2016 to 2020 were included in the review. The information collected was from the Virtual Health Library database of the Ministry of Health, Google Scholar, NCBI PubMed, Portal de Periódicos Capes and on the website of the Brazilian Society of Pediatrics, on the website of WHO and on the website of Unicef and on the PAHO website using the indexing terms: early weaning, difficulty in breastfeeding and prevalence of breastfeeding. Results: The articles collected for the research show me the greatest difficulties encountered by mothers were bottle use, pacifier, breast problems, lack of information, surgical delivery, and lack of skin-to-skin contact. Conclusion: To reduce early weaning, mothers need to receive guidance and encouragement from pregnancy. Disclosure about the possible difficulties and complications that may arise during the breastfeeding. Guidance since pregnancy what procedures to take, when breast problems occur such as mastitis, fissures, which are associated with incorrect handle. Support needs to be multiprofessional. The Iniciativa Hospital Amigo da Criança is suggested as a possible strategy to combat early weaning.(AU)

Covid-19 One Year on: Exposure to Infection, Covid-related Functional Difficulties and Concerns Among Medical Students From a Malaysian Medical School

@#Introduction: The COVID-19 pandemic has forced revolutionary changes in the delivery of medical education and imposed much stress on medical students and academicians. This study aimed at evaluating the level of exposure to COVID-19, COVID-related functional difficulties and concerns experienced by medical students, approximately one year after COVID-19 became significant health and socio-economic issues in Malaysia. Methods: A cross-sectional study using self-administered online questionnaire, was conducted among the undergraduate medical students of a private university in Malaysia. Results: A total of 243 medical students participated. They reported low level of exposure to COVID-19 infection. Majority of them demonstrate moderate level of difficulties in learning (median score of 3, highest score = 4) and high levels of COVID-related concerns (median scores of 4 to 5, highest score = 5). Lowest household income category was a significant predictor of high level of functional difficulties (OR = 3.878, 95%CI: 1.651, 9.110); whilst female gender was a significant predictor of high level of COVID-related concerns (OR = 7.400, 95%CI: 1.920, 28.514). Conclusion: One year following the onset of COVID-19 pandemic in Malaysia, medical students still reported significant functional difficulties in learning and demonstrated high levels of COVID-related concern. Collaborative efforts to mitigate the problems need to be intensified with emphasis on the delivery of online medical education and special attention to female and lower socio-economic group students to prevent detrimental consequences to medical students and medical education. Multi-center and longitudinal studies are recommended.

Family Members’ Behaviors toward Terminally Ill Cancer Patients with Communication Difficulties and the Related Support Provided by Medical Professionals

Objective: To clarify family members’ behaviors toward terminally ill cancer patients with communication difficulties and the related support provided by medical professionals. Method: Participants included 15 medical professionals engaged in palliative care (physicians, nurses, and psychologists) and 5 bereaved family members who had cared for terminally ill cancer patients at a hospital. Semi-structured interviews were conducted on the following: (1) family members’ behaviors toward the patient and (2) related support provided by medical professionals to family members. The interviews were qualitatively analyzed using category analysis. Results: We identified three categories of family members’ behaviors toward the patient such as behaviors that continue to communicate with the patient as usual, behaviors that assist patients to feel secure and relaxed, We also identified nine categories of the related support provided by medical professionals such as advising family members on how to behave with the patient and providing encouraging feedback to family members on their behaviors toward the patient. Discussion: Our results suggest that medical professionals encouraged family members to continue their behaviors to patients confidently. Support to family members included suggesting behaviors to make it easier for them to put into practice, encouraging the patient and family interaction, and giving feedback on the family member’s behaviors.

1. Rethinking the Angle of Approaching Learners in Difficulties / 医学教育

Supporting learners in difficulties is difficult. It is the responsibility of hospitals, universities and other medical education institutions to respond effectively. Traditionally, there has been a bias against focusing on the learner and a tendency to be persuaded by teachers’ beliefs. However, the factors that can lead to learners having difficulties in education include not only the learners but also the educators and the environment. There are also pedagogical, psychological, and cultural approaches to analyzing each factor. In the future, we would like to suggest that a single supporter have more than one perspective. However, because of the context in which supporters are placed, there is a limit to the number of perspectives that can be taken. Therefore, it is hoped that medical education institutions will be able to provide a support system in which multiple supporters, from multiple positions and with multiple perspectives, can ensure a broad perspective.

Takotsubo cardiomyopathy in a bedridden patient with dementia and communication difficulties due to Alzheimer’s disease / Journal of Rural Medicine

Takotsubo cardiomyopathy is a transient wall motion abnormality of the left ventricular apex, accompanied by emotional or physical stress. Although Takotsubo cardiomyopathy is generally considered a benign disease, severe clinical complications may occur, and early detection of the disease is important. In this report, we present the case of an 86-year-old bedridden woman with a history of bronchial asthma who was transferred to our hospital because of wheezing. She was diagnosed with Alzheimer’s disease and had communication difficulties. After an asthma attack and improvement, Takotsubo cardiomyopathy was identified via electrocardiography. She was unable to complain of any symptoms but showed serial electrocardiographic changes, elevated myocardial markers, and transient left ventricular apical ballooning. The prevalence of dementia increases dramatically with age. This case indicates that Takotsubo cardiomyopathy may occur even in patients with severe dementia, who are bedridden and show communication difficulties in a clinical setting.