Elección de pareja: Implicaciones y complicaciones / Mate Choice: Implications and Complications

Resumen La soledad individualista humana impele a vivir en pareja y a alcanzar complementariedad hombre/mujer, afecto y reci procidad. El periodismo científico de este artículo parafrasea el contenido de su bibliografía al revisar la elección de pareja, su satisfacción y complicaciones e instrucción preventiva de circunstancias que ocasionan ruptura. La falla -desde la elección-, desconoce los mecanismos entre razón e instinto sexual. El problema del amor no es ser amado sino desarrollar tal capacidad, pues lo extingue la inadaptación y monotonía. Se describe el acto elector/elegido y sus razones simultáneas: conscientes (homogeneidad/heterogeneidad del encuentro; emulación del modelo animal; tipo, dinámica vincular y redes sociales; aspectos sociodemográficos; ubicación geográfica y accesibilidad; compartición sexual y expectativas inmediatas/ futuras), e inconscientes (problemática electora, interacción diádica y antecedentes parentales; mecanismos de defensa, intercambio de disociaciones; idealización; reciprocidad negativa, lucha de poder, identificación proyectiva, búsqueda de aprecio por el otro; narcisismo, falso sí mismo, mecanis mos de dilación/evasión de responsabilidad, inseguridad, intrusión y colusión). Una pareja saludable, entiende/atiende la creación y mantenimiento del "nosotros", elimina la lucha de poder y produce conciliación permanente. El acuerdo y comprensión tolerante son indispensables para una relación emocional satisfactoria, estable y duradera.

Abstract Human individualistic loneliness impels us to live as a couple and achieve complementarity between man and woman, af fection, and reciprocity. The science journalism of this article reviews the choice of partner, their satisfaction and complications, and preventive instruction of circumstances that cause rupture. The failure from the election ignores the mechanisms between reason and sexual instinct. The problem of love is not to be loved but to develop such a capacity, for it is extinguished by maladjustment and monotony. The voting/elected act and its simultaneous reasons are described: Conscious (homogeneity/heterogeneity of the encounter; emulation of the animal model; type, dynamic link and social networks; Sociodemographic aspects; sexual sharing and immediate/future expectations). Unconscious (electoral problems, dyadic interaction, and parental background; defense mechanisms, exchange of dissociations; idealization; negative reciprocity, power struggle, projective identification, search for appreciation for the other; narcissism, false self, mecha nisms of procrastination/evasion of responsibility, insecurity, intrusion, and collusion). A healthy couple, understands/at tends to the creation and maintenance of the "we", eliminates the power struggle and produces permanent conciliation. Tolerant agreement and understanding are indispensable for a satisfying, stable, and lasting emotional relationship.

Career paths and workforce diversity in hematology: A cross-sectional study of a 35-year alumni cohort from an academic residency program in Brazil

ABSTRACT Introduction: Although not mandatory, medical residency has become a sine qua non condition for practicing in most medical specialties in Brazil. Residency programs are hosted mainly by university accredited academic centers and hospitals in the national public healthcare system, under guidance and accreditation by a national commission. Despite the importance of these programs for the development of the hematology workforce, few studies have addressed their characteristics and impact on society. Methods: We performed a comprehensive cross-sectional survey of a 35-year alumni cohort from a hematology academic residency program in Brazil. Results: In total, 86/98 (87.8%) responded to the survey. The mean age at residency completion was 28.5 years, 60.5% of the alumni were women and sixty-four (74.4%) self-declared their skin color as white. Higher rates of parental education attainment and low rates of trainee financial dependence were observed and these patterns were stable over time. While the proportion of trainees from other states increased steadily, the number of hematologists practicing in other states remained stable. Approximately half of the alumni worked both in the private and public sectors, mainly in malignant hematology and in outpatient clinics. Twenty-five percent of the alumni reported prior leadership and teaching positions, mainly as directors of transfusion services. Conclusion: Our results provide data that can be potentially useful for policymakers and curricular development in the planning of strategies concerning the future workforce of hematologists.

A career in Forensic Odontology: it is not only about teeth / Odontologia Legal como carreira: não se trata apenas de dentes

Throughout the world, forensic odontology academic programmes have been designed and permeate discussions about international or local standard operational protocols, principles or guidelines requiring current technical and scientific knowledge. The heterogeneous groups of students who aim to pursue this career might have high educational and occupational aspirations that will be confronted with the labour markets. In this report, the authors briefly present aspects of the education and training that comprise the choice of a career in forensic odontology nowadays. In conclusion, the individual who opts for forensic odontology as a career must be prepared to find the confidence and resilience to practice professional skills in a unique and challenging field to comply with the society's expectation

Em todo o mundo, vários programas acadêmicos de Odontologia Legal têm sido criados e permeiam discussões sobre protocolos, princípios ou diretrizes operacionais, padrão internacional ou local, que exigem conhecimento técnico e científico atualizado. Os grupos heterogêneos de estudantes que pretendem seguir esta carreira poderão ter elevadas aspirações educativas e profissionais que serão confrontadas com os mercados de trabalho. Neste contexto, os autores apresentam brevemente aspectos da educação e formação que compõem a escolha de uma carreira em Odontologia Legal nos dias de hoje. Em conclusão, o indivíduo que opta pela Odontologia Legal como carreira deve estar preparado para encontrar confiança e resiliência para exercer habilidades profissionais em um campo único e desafiador para atender às expectativas da sociedade

Neuronal Response to Reward and Luminance in Macaque LIP During Saccadic Choice / 神经科学通报·英文版

Recent work in decision neuroscience suggests that visual saliency can interact with reward-based choice, and the lateral intraparietal cortex (LIP) is implicated in this process. In this study, we recorded from LIP neurons while monkeys performed a two alternative choice task in which the reward and luminance associated with each offer were varied independently. We discovered that the animal's choice was dictated by the reward amount while the luminance had a marginal effect. In the LIP, neuronal activity corresponded well with the animal's choice pattern, in that a majority of reward-modulated neurons encoded the reward amount in the neuron's preferred hemifield with a positive slope. In contrast, compared to their responses to low luminance, an approximately equal proportion of luminance-sensitive neurons responded to high luminance with increased or decreased activity, leading to a much weaker population-level response. Meanwhile, in the non-preferred hemifield, the strength of encoding for reward amount and luminance was positively correlated, suggesting the integration of these two factors in the LIP. Moreover, neurons encoding reward and luminance were homogeneously distributed along the anterior-posterior axis of the LIP. Overall, our study provides further evidence supporting the neural instantiation of a priority map in the LIP in reward-based decisions.

Brecha en matemáticas según sexo Caso: universitarios de Colombia / Lacuna entre os sexos em matemática. Caso: estudantes universitários colombianos / Gap in math by gender. Case: university students from Colombia

Resumen Se analiza la brecha por sexo en matemáticas (razonamiento cuantitativo) en universitarios de Colombia, con base en los resultados de las pruebas estatales de salida de la educación superior Saber Pro, 2018; incluyendo el factor regional. A partir de una modelación cuantílica y una descomposición Juhn-Murphy-Pierce; se identifica la existencia y persistencia de una brecha por sexo en el área evaluada, y diferencias entre las regiones Andina y Caribe. Se destaca: favorabilidad hacia los hombres; importancia de las características educativas e institucionales; importancia de las matemáticas de secundaria (explican cerca del 25% del diferencial); ampliación de la brecha en los cuartiles más altos; v) heterogeneidad regional de la brecha, ampliada por la interacción sexo-región.

Resumo A diferença de gênero em matemática (raciocínio quantitativo) entre estudantes universitários na Colômbia é analisada, com base nos resultados dos exames de saída do ensino superior estadual Saber Pro 2018, incluindo o fator regional. Com base na modelização de quantis e numa decomposição Juhn-Murphy-Pierce, identificamos a existência e persistência de uma diferença de gênero na área avaliada, bem como diferenças entre as regiões andinas e das Caraíbas. Destacam-se: favorabilidade em relação aos homens; importância das características educacionais e institucionais; importância da matemática secundária (explicando cerca de 25% do diferencial); alargamento da lacuna nos quartis mais altos; e heterogeneidade regional da lacuna, amplificada pela interação gênero-região.

Abstract The paper analyzes the gender gap in mathematics (quantitative reasoning) among Colombian university students, based on the results of the State higher education exit tests Saber Pro, 2018; including the regional factor. Based on a quantile modeling and a Juhn-Murphy-Pierce decomposition, the study identifies the existence and persistence of a gender gap in the evaluated area and differences between the Andean and Caribbean regions. The most remarkable points include: favouring men; importance of educational and institutional characteristics; importance of secondary mathematics (accounting for about 25% of the differential); widening of the gap in the highest quartiles; and regional heterogeneity of the gap, widened by gender-region interaction.

Psychological resources and student burnout among pre-university students / Recursos psicológicos e burnout estudantil em pré-vestibulandos / Recursos psicológicos y agotamiento estudiantil en estudiantes preuniversitarios

The expectations imposed on students to achieve good academic performance have continually increased. This study's objective was to explore how career adaptability, psychological capital, and mental health indicators predict student burnout. A total of 1,398 students intending to enter higher education in 2020 participated; most were women from the Southeast. The results indicate that perception of control and resilience protects students from exhaustion, while stress and depression favor its emergence. In addition, the concern, anxiety, optimism, and resilience constructs prevent disengagement, while depression facilitates disengagement to be experienced in daily life. These findings reinforce the relationship between personal resources and well-being in the academic environment. (AU)

A expectativa de bom desempenho acadêmico cresce gradualmente e desenvolver habilidades para lidar com os desafios do período do vestibular se faz cada vez mais importante. O objetivo deste artigo foi explorar como recursos de adaptabilidade de carreira, capital psicológico e indicadores de saúde mental predizem o Burnout de estudantes. Participaram deste estudo 1398 estudantes que visavam ingressar no ensino superior no ano de 2020, sendo maioria mulher e que pertencia à região sudeste. Os resultados indicaram que a percepção de controle e resiliência favorecem ao estudante a não vivenciar a exaustão, bem como o estresse e depressão favorecem o seu surgimento. Construtos de preocupação, ansiedade, otimismo e resiliência evitam o desengajamento e a depressão colabora para que este esteja presente no dia a dia. A partir disso, os achados desta pesquisa enfatizam a relação existente entre recursos pessoais e bem-estar no ambiente dos estudos. (AU)

La expectativa de un buen desempeño académico crece gradualmente y el desarrollo de habilidades para enfrentar desafíos del período vestibular es importante. El objetivo del artículo fue explorar cómo recursos de adaptabilidad a la carrera, Capital Psicológico y indicadores de salud mental predicen Burnout de estudiantes. Participaron 1398 estudiantes con objetivo de ingresar a la educación superior en 2020, la mayoría eran mujeres y pertenecían a región sureste. Resultados indicaron que percepción de control y resiliencia favorecen que el alumno no experimente agotamiento, así como el estrés y la depresión favorecen su aparición. Las construcciones de preocupación, ansiedad, optimismo y resiliencia previenen la desconexión y la depresión ayuda a asegurar que esté presente en la vida cotidiana. A partir de esto, los hallazgos de esta investigación enfatizan la relación entre los recursos personales y el bienestar en el ambiente de estudio. (AU)

Influence of solvent choice and operating conditions on Chlorzoxazone crystal shape and size

Abstract Solubility of pharmaceutical drugs in organic solvents is one of the important parameters to understand the equilibrium concentration of solute-solvent, which helps optimize and design crystallization conditions to obtain the desired product crystals. In the present study, Chlorzoxazone (CHZ) is used as a model pharmaceutical compound to investigate the equilibrium solubility, the influence of solvent and the operating conditions on the shape, and the size distribution. The solubility of CHZ is determined in organic solvents like Isopropanol, Ethanol, and 2-Ethoxyethylacetate, Ethylacetate and Ethyllactate using shake flask method from -5ºC to 60ºC. The solubility of CHZ in these solvents shows an increasing trend as the temperature increases in the following order: ethyllactate + water (0.5+0.5) < ethylacetate < isopropanol < ethanol < 2-ethoxyethylacetate < ethyllactate + water (0.75+0.25). The solvents, isopropanol, ethanol, and ethyl lactate, produce needle-shaped crystals, while 2-ethoxyethylacetate and ethyl acetate tend to produce plate shaped crystals. CHZ crystals obtained from 2-ethoxyethylacetate tend to have plate shaped crystals with a lower aspect ratio and are selected for batch cooling crystallization experiments performed at different cooling rates, and agitation. It is found that the agitation at 300 rpm and the cooling rate 0.2ºC/min produce more uniform crystal size distribution

Oficina para elaboração de testes de múltipla escolha de ciências básicas aplicadas: relato de experiência / Workshop on item writing to assess basic sciences in health professional education: an experience report

Resumo: Introdução: A avaliação do estudante é componente essencial de todo programa educacional. O aprendizado das ciências básicas é fundamental para dar sentido ao que se aprende na fase clínica da formação de um profissional em saúde. Entretanto, a maioria dos treinamentos de elaboradores de testes de múltipla escolha (TME) é voltada à formulação de questões clínicas e não inclui abordagem específica para questões das ciências básicas. Relato de experiência: Foi realizada uma oficina para a capacitação docente na elaboração de TME de aplicação dos conhecimentos de ciências básicas, visando à elaboração de uma prova a ser aplicada no final do ciclo básico de seis cursos da saúde. O material instrucional foi elaborado pelos autores, que ofereceram uma oficina no formato on-line. Um diferencial dessa capacitação foi a aplicação de modelos de elaboração de enunciados com contextos definidos, utilizando momentos de preparo assíncronos e encontro síncrono. Após a oficina, aplicaram-se questionários sobre a satisfação e aprendizagem dos participantes. A maioria avaliou a oficina como boa ou muito boa e referiu aumento da percepção de capacidade para elaborar TME, e, ao final, somente 7% se sentiram pouco preparados para elaborar um TME seguindo as boas práticas. Houve melhora na qualidade dos TME elaborados, tendo como referencial os índices de dificuldade e discriminação. Discussão: Existem evidências do valor do desenvolvimento do corpo docente na melhoria da qualidade das questões produzidas. O formato de oficina proposto foi bem avaliado pelos participantes e contribuiu para a qualidade das questões de provas aplicadas ao final do ciclo básico. Conclusão: Estratégias como a descrita qualificam as avaliações dentro da escola e contribuem para a organização de provas externas.

Abstract: Introduction: Student assessment is an essential component of all educational programs. Basic science learning is essential for making clinical knowledge meaningful to healthcare students. However, most item writer training is focused on the formulation of clinical questions and does not include a specific approach to basic science questions. Experience Report: Workshops on item writing for knowledge application on basic sciences were carried out with the aim of planning a test to be applied at the end of the basic cycle of six health courses. The instructional material was prepared by the authors, who offered online workshops. A differential of this training was the application of models of item lead-in elaboration with defined contexts, using moments of asynchronous preparation and synchronous encounter. After each workshop, surveys were applied to assess participants' satisfaction and learning. Most participants rated the workshop as good or very good and reported an increase in their perceived ability to prepare single best answer multiple-choice questions. At the end, only 7% reported they were not prepared to write an item following good practices. There was an improvement in the quality of the items prepared, using the difficulty and discrimination indexes as a reference. Discussion: There is evidence of the value of faculty development in improving the quality of the questions produced. The proposed workshop format was well evaluated by the participants and contributed to the quality of tests applied to students at the end of the basic science cycle. Conclusion: Strategies such this qualify assessments within the school and contribute to the organization of external exams.

Jeitinho Brasileiro: desenvolvimento de uma medida ipsativa baseada em historietas / Brazilian jeitinho: developing an ipsative measure based on daily stories / Jeitinho brasileño: desarrollo de una evaluación ipsativa basada en historias diarias

Este estudo teve por objetivo desenvolver um instrumento para identificação de padrões comportamentais, baseado em situações reais do cotidiano relacionadas ao Jeitinho Brasileiro, que mapeia a tomada de decisão em diferentes contextos sociais. Foram desenvolvidos dois estudos que exploraram o fenômeno. No estudo 1, descreve-se a construção de uma escala de medida ipsativa, de escolha forçada, composta por 11 historietas de situações cotidianas e desfechos que exigem tomadas de decisão. No estudo 2, testa-se o instrumento desenvolvido em uma amostra de 480 participantes. A análise confirmatória de escalonamento multidimensional evidenciou um modelo bidimensional de duas dimensões polarizadas: (1) orientação positivo-negativo (assertivo/malandro) e (2) disposição passivo-ativo (negligente/criativo). A operacionalização de uma medida ipsativa demonstrou uma opção funcional alternativamente à escala tipo Likert, possibilitando a mensuração psicológica para comparação inter-individual. O estudo, portanto, fornece uma ferramenta empírica complementar em uma perspectiva específica para os comportamentos cotidianos sob a ótica do Jeitinho Brasileiro

This study aimed to develop an instrument to identify behavioural patterns based on real everyday situations related to the Brazilian Jeitinho, which maps decisionmaking in different social contexts. Two studies were developed to explore the phenomenon. In study 1, the construction of an ipsative measurement scale (forced-choice) is described, composed of 11 daily stories about real situations and outcomes that require decisionmaking. In study 2, the instrument developed was tested in a sample of 480 participants. Confirmatory multidimensional scaling was carried and showed a two-dimensional model with 2 polarized dimensions: (1) positive-negative orientation (assertive/malandro or rascal) (malandro is like slippery and naughty people) and (2) passive-active disposition (negligent/creative). The operationalization of an ipsative measure demonstrated a functional option as an alternative to the Likert-type scale, enabling psychological measurement for inter-individual comparison. The study, therefore, provides a complementary empirical tool in a specific perspective for everyday behaviours from the perspective of the Brazilian Jeitinho

Este estudio tuvo como objetivo desarrollar un instrumento para identificar patrones de comportamiento, basado en situaciones cotidianas relacionadas con el "jeitinho" brasileño, que mapee la toma de decisiones en diferentes contextos sociales. Se desarrollaron dos estudios que exploraron el fenómeno. El estudio 1 describe la construcción de una escala de evaluación ipsativa (elección forzada), compuesta de 11 histórias de situaciones cotidianas y desenlaces que requieren la toma de decisiones. El estudio 2 prueba el instrumento desarrollado en una muestra de 480 participantes. El escalamiento multidimensional mostró un modelo bidimensional con 2 dimensiones polarizadas: (1) orientación positiva-negativa (asertivo/bribón) y (2) disposición pasivoactiva (negligente/creativa). La operacionalización de una medida ipsativa demostró una opción funcional alternativamente a la escala tipo Likert, permitiendo la medición psicológica para la comparación interindividual. El estudio, por lo tanto, proporciona una herramienta empírica complementaria en una perspectiva específica para los comportamientos cotidianos desde la perspectiva del "jeitinho" brasileño

Analysis of Barriers to Public and Private Cardiac Rehabilitation Programs in Patients with Low and High Adherence

ABSTRACT Introduction: Participants in cardiac rehabilitation programs have low adherence to their sessions, which makes extremely important to recognize the barriers that cause non-adherence, identifying whether the type of service and level of adherence influence these barriers. Methods: This is a cross-sectional observational study, in which 220 individuals (66.80±11.59 years) of both genders who are members of public and private exercise-based cardiac rehabilitation programs participated. The volunteers were divided according to the level of adherence, considering patients with low adherence (PLA) those with < 70% of attendance and high adherence (PHA) those with > 70%. Then, initial evaluation, Cardiac Rehabilitation Barriers Scale, analysis of socioeconomic level, Hospital Anxiety and Depression Scale, and Mini-Mental State Examination were applied. Results: Higher total barriers were found in PLA in the public service compared to PHA in the private service (P=0.023). In the subscale "perceived need", PHA in the public service showed higher values than PLA and PHA in the private service (P≤0.001). The "access" barrier was higher for PHA in the public service when compared to PHA in the private service (P=0.024). PHA in the public service exhibited a higher barrier regarding questions about distance, transportation problems, cost, and time constraints. Conclusion: The public program presents higher barriers in the questions and categories compared to the private program, mainly the PHA. Furthermore, there are differences in the profile of the participants regarding socioeconomic and anxiety levels, treatment time, ethnicity, and city where they live.

Experiencias interactivas y conversacionales de familias visitantes en "Darwin, la exposición,explorando las especies", en el Museo Trompo Mágico, México / Interactive and conversational experiences of visiting families in "Darwin, the exhibition, exploring species," at the Museo Trompo Mágico, Mexico

Resumen Analizamos el contenido conversacional y las interacciones de diez familias, con el fin de comprender cómo es la experiencia de aprendizaje en una exposición científica. Como herramienta de análisis se utilizó un protocolo que combina aspectos teóricos y empíricos de la interactividad. Los resultados evidencian que las familias participaron activamente en la exhibición, observando y conversando sobre los animales, haciendo preguntas, buscando respuestas y elaborando explicaciones basadas en el pensamiento científico. Los adultos actuaron como facilitadores del aprendizaje y para ello se apoyaron en paneles informativos fomentando la conexión con experiencias previas. Los niños muestran curiosidad, emociones y comportamientos que evidencian sus experiencias de aprendizaje e interés por temas científicos.

Abstract We analyzed the conversational content and interactions of ten families, with the aim of understanding the learning experience of families in a scientific exhibition. As instrument of analysis, it was used a protocol combining theoretical and empirical aspects of interactivity. The results show that the families actively participated in the exhibition, observing and talking about the animals, asking questions, looking for answers and elaborating explanations based on scientific thinking. The adults acted as facilitators of learning and for this they were supported by information panels promoting the connection with previous experiences. Children show curiosity, emotions and behaviors that evidence their learning experiences and interest in scientific topics.

Care-recipient perspectives on the responsiveness of Orthopedic surgical services in a tertiary center in Nigeria

Responsiveness optimisesthe system-based approach to meeting legitimate demands by healthcare recipients. This study assessed the responsiveness of orthopaedic services at the University of Port Harcourt Teaching Hospital (UPTH) from the perspectives of the care recipients. Methods:Descriptive cross-sectional study among 442 consecutively recruited recipients of orthopaedic services at UPTH from March to June 2020. Close-ended questionnaire with responsiveness conceptualised by five constructs: dignity, autonomy, confidentiality, quality of basic amenities and choice of care provider, each measured along 4-point response scale. The internal consistency reliability of the responsiveness scale was determined by the Cronbach's alpha coefficient. Descriptive (frequency, percentages, bar charts) and inferential (ordinal logistic regression) statistics were conducted and p-values ≤ 0.05 were considered statistically significant. Results: Response rate was 97.3% and the Cronbach's alpha coefficient for the responsiveness scale was 0.83. Participants' mean age was 38.5±14.8years with more being males (55.8%), privately employed (34.9%) and completed secondary education (82.5%). Proportion of respondents who gave excellent ratings across responsiveness domains were dignity (32.8%), autonomy (34.2%), confidentiality (26.3%), amenities (25.8%) and no excellent rating for choice of provider. Marital, employment and visit status were the most consistent factors associated with feedback on autonomy, choice of providers, confidentiality domains.Conclusion: More orthopaedic patients were pleased with the level of autonomy and dignity than choice of providers and quality of basic amenities. There is the need for enhanced responsiveness of orthopedic services to meeting the unique needs of patients and achieving improved quality of care and patient outcomes

Acceptance and effectiveness of the Healthier Choice Logo (HCL) among food industries in Malaysia

@#Introduction: The Healthier Choice Logo (HCL) was introduced in 2017 by the Ministry of Health Malaysia. This paper analysed acceptance of HCL, effectiveness of HCL in encouraging healthier product reformulation, and factors affecting reformulation among food industries. Methods: An online self-administered questionnaire consisting of four sections utilising multiple choice and 5-point Likert scale questions was distributed to food industries in Malaysia. Sample size calculation yielded 100 respondents. Results: Food industries had a higher acceptance of the processes and requirements involved in HCL implementation. HCL was highly effective in encouraging product reformulation among food industries in Malaysia. Meeting consumer demand, improving brand image, public health, more awareness around nutrition labelling, logo and national nutrition target, more technical knowledge and budget were found to motivate healthier product reformulation. However, product suitability, consumer acceptability, difficulties maintaining taste and shelf life, and limited budget were the challenges faced in product reformulation. There was no correlation between HCL acceptance and factors encouraging or inhibiting reformulation. Conclusion: These findings are expected to help relevant authorities or stakeholders make changes, if necessary, towards processes and requirements involved in HCL application to ensure wider HCL implementation. Future research should identify the relationship between HCL implementation and public health improvement among the Malaysian population.

Preference of nursing staff on providing " Internet + nursing service" for elderly patients / 中华医院管理杂志

Objective:To find the preferences of nursing staff when they provide " Internet + nursing service" for elderly patients.Methods:By means of the discrete choice experiment, a questionnaire was designed to investigate the preferences of nursing staff when they provide " Internet + nursing services" for elderly patients. In-service nursing staff from 8 medical and health institutions in Ningbo city and Wenzhou city were selected by random sampling, for an online questionnaire survey conducted from May to June 2022. The preferences of nursing staff on their service income, service content, service distance, service continuity and residence status of elderly patients when providing " Internet + nursing service" were analyzed by mixed logit regression.Results:A total of 420 valid questionnaires were collected. Compared to 50 yuan/order, nursing staff preferred to a price of 150 yuan/order ( β= 1.22, P<0.001) nursing services; Compared to specialized nursing services, nursing staff preferred to the routine care ( β= 0.86, P<0.001) and health promotion ( β= 0.86, P<0.05) service; Compared to<5 km, nursing staff were unwilling to provide nursing services for elderly patients at distances of 5-10 km and 11-15 km ( β=-0.66, P<0.05; β=-0.95, P<0.001) ; Compared to 1-2 visits per month, nursing staff preferred not to provide continuing care services ( β=-0.70, P<0.05); Compared to homestay with the patient family, nursing staff preferred to provide nursing services for elderly patients residing in nursing homes ( β= 1.21, P<0.001) . Conclusions:Considering the preference of nursing staff tend to provide " Internet + nursing service" for the elderly patients with services featuring appropriate price, non-specialist care, close distance, low continuity (moderate intensity used as the reference) and security assurance for practice.

A Cross-Sectional Study on Determinants of Career Choice Preferences amongUndergraduate Medical Students at One of the Medical Colleges of Gujarat, India

Introduction :Choosing a medical specialty is a life-defining decision for medical students. As medical students progress through medical course, it is observed that their interests in specialties change due to one reason or another. 1.To assess career choices for post-graduation among under graduateObjectives: medical students. 2. To determine the factors influencing the carrier choices of study participants. Method: A cross sectional study was conducted among 594 MBBS students of one of the Government Medical Colleges of Gujarat during December 2019 to March 2020. All undergraduate medical students except student from 1 year MBBS was enrolled in the study by purposive sampling. A self-administered pretested,st semi-structured questionnaire was utilized to collect socio-demographic variables, their choice of post- graduation subject and reasons for the same. Descriptive statistics such as mean, standard deviation (mean ± SD) and percentage were calculated. Chi square test was applied for statistical analysis. Out of 594Results: participants studied, 375 (63.1%) were males and 219 (36.9%) females. Most preferred specialties were medicine 138(24.7%) and general surgery 60(10.7%)among all students. Obstetrics and Gynaecology 34(75.6%) and Community Medicine 2(59.0%) were preferred by females while General Surgery 51 (85.0%) and Orthopaedics 20 (87.0%) were more preferred by males as a career. This difference proved to be statistically significant(p < 0.05). The distribution by years with different specialties shows statistically significant differences with Medicine, Dermatology, Paediatrics, ENT, Ophthalmology and Others. Personal interest was most valued influencing factor among 184 (31.0%) followed by job opportunities 111 (18.7%) and the least popular factor was financial reasons 17 (2.9%). The majority of the studentsConclusion: planned to specialize in clinical fields such as edicine and urgery. Most common factors influenced theirM S choices were personal interests and career opportunities in the preferred fields. Financial reasons or the influence of the role model were least important factor as far as carrier choice of medical undergraduates was concerned.

Processos de escolha e inserção profissional de psicólogos organizacionais e do trabalho / Processes of choice and professional insertion of organizational and work psychologists / Procesos de elección e inserción profesional de psicólogos organizacionales y del trabajo

Quem escolhe um curso superior e busca entrar no mercado de trabalho o faz a partir das condições do contexto em que está inserido. A partir da perspectiva da Psicologia Sócio-histórica, o objetivo deste artigo foi identificar os processos de escolha e inserção profissional de psicólogos atuantes no campo da Psicologia Organizacional e do Trabalho (POT). Participaram do estudo quatorze psicólogos, que responderam a um questionário e a uma entrevista semiestruturada. Foi aplicada a análise de conteúdo e identificadas as categorias analíticas: escolha pela graduação em Psicologia, escolha pela atuação em POT e processo de inserção profissional. Evidenciou-se que as escolhas pelo curso e pelo campo POT bem como a inserção no trabalho se desenvolveram como processos entrelaçados e interdependentes entre si.

Those who choose a higher education course and seek to enter the work market do so based the conditions of the context in which they are inserted. From the perspective of Socio-Historical Psychology, the aim of this article was to identify the processes of choice and professional insertion of psychologists working in the field of Organizational and Work Psychology (OWP). Fourteen psychologists participated in the study, who answered a questionnaire and a semi-structured interview. Content analysis was applied and the analytical categories identi fied: choice for graduation in Psychology, choice for work in POT and professional insertion process. It was evident that the choices for the course and the POT field, as well as the insertion in the work, developed as inter twined and interdependent processes.

Quien elige un curso de educación superior y busca ingresar en el mercado de trabajo lo hace en función de las condiciones del contexto em el que se insertan. Desde la perspectiva de la Psicología Sociohistórica, el objetivo de este artículo fue identificar los procesos de elección e inserción profesional de los psicólogos que trabajan en el campo de la Psicología Organizacional y del Trabajo (POT). En el estudio participaron catorce psicólogos, quienes respondieron un cuestionario y una entrevista semiestructurada. Se aplicó análisis de contenido y se identificaron las categorías analíticas: elección de graduación en Psicología, elección de actuación en POT y proceso de inserción profesional. Se evidenció que las opciones para el curso y el campo POT, así como la inserción laboral, se desarrollaron como procesos entrelazados e interdependientes.

Experimentos de elección discreta. Diseño, análisis e implementación en salud / Discrete choice experiments. Design, analysis and implementation in health

Resumen: Los experimentos de elección discreta (DCE, su sigla en inglés), son una metodología usada para evaluar preferencias de desenlaces o intervenciones relacionadas con salud. A diferencia de otras técnicas de medición que utilizan métodos simples de elección o herramientas estadísticas básicas que fallan al evaluar los beneficios específicos de una intervención, proceso de entrega, beneficio, satisfacción y preferencia de los usuarios en términos de tiempo, calidad o atributo específico, los DCE combinan, en la generación de atributos y modelamiento matemático, complejas tareas de diseño y ejecución, que mejoran la calidad y optimizan la cantidad necesaria de información mediante el uso eficiente de recursos y resultados de excelente calidad. Este documento presenta la historia, el desarrollo y la fundamentación teórica de los DCE y muestra las críticas, las potenciales limitaciones y las precauciones.

Abstract: Discrete choice experiments (DCE) are a methodology for evaluate patient preferences for health-related outcomes or interventions. Other preference measurement techniques that use simple methods of choice or basic statistical tools that fail to evaluate the specific benefits of an intervention, delivery process, benefit, satisfaction and patients' preferences in terms of time, quality or specific attribute. The DCE combine in the generation of attributes and mathematical modeling, complex task of designing and execution, to improve the quality and optimize the necessary amount of information, achieving an efficient use of resources with excellent quality results. This document presents globally a brief of the history, development and theoretical foundation of the DCE and then presents in a critical way the potential limitations, precautions in their use and implementation that allow to establish the possible scenarios of use and development.

Effect of low volume background instrumental flute music on visual reaction time: a cross sectional interventional study

Background: Music is believed to affect the cognitive function. However, there is conflicting evidence about the effect of background music on the same. Few studies have been done on the effect of instrumental music on cognition. Aim and Objective: The aim of our study was to study the effect of low-volume instrumental music on visual reaction time (RT). Materials and Methods: Visual RT (simple reaction time [SRT] and choice reaction time [CRT]) using Deary–Liewald software was recorded in 48 medical students aged 18–21 years, without, and then with low-volume background instrumental flute music. Results were compared with regard to change in mean values of SRT, CRT, and mean central processing time. Data were analyzed statistically using unpaired t-test and statistical significance (P < 0.05) was sought. Results: We did not find any statistically significant change in visual RT after subjecting the students to low-volume background instrumental music. Conclusion: Background instrumental does not significantly affect visual RT but this should be further analyzed.

Item analysis of multiple-choice questions in anatomy for first year MBBS

Background: Multiple choice questions (MCQs) are preferred tools of assessment because of objectivity, ease of scoring and how each MCQ functions as an item can be understood by Item analysis. Aims and Objectives: The aim of the study was (i) to carry out item analysis of MCQs used in formative assessment to know the validity and (ii) to carry out a post validation item analysis of MCQ’s of 1st MBBS students in anatomy to use results for further actions. Materials and Methods: 45 MCQs were administered to 112 students of 1st M.B.B.S. as a formative assessment. Difficulty index and Discrimination index were calculated. Results: Mean difficulty index was 56.67 ± 22.09, and mean discrimination index was 0.35 ± 0.23. Distribution of easy, moderate, and difficult MCQ was 20, 67, and 13%, respectively. About 20% of MCQs were poor, 20% with acceptable discriminating index, 27% had good, and 33% MCQ were of excellent discrimination index. No item was negatively discriminating and all distractor were functional. Very easy and very difficult items had poor discriminating index. Conclusion: Most of items had moderate difficulty and good to excellent discrimination. Too easy and too difficult items showcased poor discrimination, no negatively discriminating item and absence of non-functional distractor suggest good quality framing of the MCQs.

Fatores que influenciam a via de parto no Brasil / Factor influencing the mode of delivery in Brazil

Introdução: A prevalência de cesarianas cresceu no Brasil. Gestação e parto são influenciados por aspectos culturais e econômicos da sociedade em que a gestante está inserida. Objetivo: Analisar fatores que influenciam a escolha da via de parto pela gestante. Métodos: Trata-se de revisão narrativa da literatura incluindo artigos publicados entre 2009 e 2020. Foram feitas buscas nas bases de dados Pubmed, LILACS e SciELO, com descritores "Bioética", "Cesárea", "Comportamento de escolha", "Decisão", "Direitos da mulher", "Gravidez", "Parto", "Parto normal", "Sistema único de saúde". Resultados: Foram encontradas taxas de cesariana no setor privado maiores do que no público. Menor idade materna e escolaridade, raça negra, residência em meio rural e nas regiões Norte e Nordeste foram associados a menor prevalência de cesariana. Obesidade materna, cesariana prévia, intercorrências na gravidez, apresentação fetal não cefálica, macrossomia estiveram mais relacionados a cesariana. Dor, previsibilidade, relação da mãe com o recém-nascido, alta hospitalar, vida sexual e retorno às atividades foram relacionados a escolha do parto vaginal. Discussão: A disparidade de cesarianas no setor público e privado sugere o impacto de aspectos financeiros na escolha. Variáveis socioeconômicas são importantes nessa decisão. Conclusões: A escolha da via de parto é influenciada por vários fatores. [au]

Introduction: The prevalence of caesarean sections has grown in Brazil. Pregnancy and childbirth are influenced by cultural and economic aspects of the society in which the pregnant woman is inserted. Objective: To analyze factors that influence the choice of the mode of delivery by the pregnant woman. Methods:This is a narrative literature review including articles published between 2009 and 2020. Searches were made in Pubmed, LILACS and SciELO databases, with descriptors "Bioethics", "Caesarean section", "Choice behavior", "Decision", "Women's rights", "Pregnancy", "Childbirth", "Normal delivery" and "The Unified Brazilian Health Care System". Results: Caesarean section rates were found to be higher in the private sector than in the public sector. Lower maternal age and education, black race, residence in rural areas and in the North and Northeast regions were associated with lower prevalence of caesarean section. Maternal obesity, previous caesarean section, complications in pregnancy, non-cephalic fetal presentation and macrosomia were more related to caesarean section. Pain, predictability, mother's relationship with the newborn, hospital discharge, sexual life and return to activities were related to the choice of vaginal delivery. Discussion: The disparity of caesarean sections in the public and private sectors suggests the impact of financial aspects on the choice. Socioeconomic variables are important in this decision. Conclusions: The choice of mode of delivery is influenced by several factors. [au]