Metaanálisis de generalización de la fiabilidad de los mitos de violación / Meta-analysis of reliability generalization of the rape myths

Resumen Los mitos de violación son actitudes y creencias generalmente falsas, amplias y persistentes, acerca de la violación, la víctima y el agresor, que son utilizadas para negar o justificar la agresión sexual hacia las mujeres. En las últimas dos décadas, los instrumentos más utilizados para medir este constructo corresponden a la escala de aceptación de mitos de violación de Illinois (IRMAS), que utiliza expresiones directas y explícitas mediante un lenguaje clásico, y la escala de aceptación de mitos modernos de agresión sexual (AMMSA) que usa un lenguaje sutil, indirecto y moderno. Se realizó un metaanálisis de generalización de la fiabilidad de 69 estudios empíricos que utilizaron alguna de las dos escalas de mitos de violación. El objetivo fue estimar la fiabilidad media de las puntuaciones combinadas de las escalas IRMAS y AMMSA para obtener un valor aproximado de su fiabilidad general y evaluar el posible efecto moderador de algunas variables de interés. El promedio de la fiabilidad por consistencia interna de las puntuaciones de las escalas para las 98 muestras estudiadas fue de .85, IC95 % [.84, .86]. Se observó una alta heterogeneidad (I. = 96 %), y el número de ítems es la única variable moderadora que explica significativamente la variabilidad de la fiabilidad observada. Estos resultados muestran que ambas escalas presentan índices de consistencia interna aceptables en sus diversas aplicaciones. Por lo tanto, las medidas de aceptación de mitos de violación cumplen con los criterios de fiabilidad adecuados para ser utilizadas en investigaciones empíricas en distintos contextos.

Abstract Rape myths are widespread and persistent attitudes, beliefs, and stereotypes, usually false, about rape, the victim, and the perpetrator. Their function is to deny and justify sexual assaults against women, affecting the victim's attributions of responsibility and the perpetrator's attributions of guilt in rape cases. These myths exert a bias in the processing of information, directing attention and perception toward stimuli that justify the victim's responsibility for sexual aggression. These beliefs can be grouped into several types of myths: Myths that hold the victim responsible by arguing that women should be careful and not expose themselves to avoid sexual aggression, myths that justify and reduce the responsibility of the aggressor by stating that the man could not contain his sexual desire and those myths that deny or normalize sexual aggression, which propose that rape occurs only in very specific contexts. In the last two decades, the instruments most commonly used to measure these beliefs are The Illinois Rape Myth Acceptance Scale (IRMAS), which uses direct and explicit expressions through classic language, and the Modern Sexual Assault Myth Acceptance Scale (AMMSA), where its expressions are modern, subtle and indirect. Considering the wide use of these instruments, it is justified to provide empirical evidence showing information on the psychometric properties of these scales. One of the procedures for synthesizing empirical results is meta-analyses (MA). This methodology can synthesize studies of specific variables and analyze the psychometric properties of the measurement instruments, providing relevant information on the quality of a given scale. Within this last type of RM are reliability generalizations (RG), those that study the reliability coefficients obtained in different applications of a scale, providing evidence on the properties of the measures used in measuring a construct. A meta-analysis of the RGs of 69 empirical studies that used any of the rape myth scales was performed. The objective was to estimate the mean reliability of the combined scores of the IRMAS and AMMSA scales to obtain an approximate value of their overall reliability and to assess the possible moderating effect of some variables of interest (e.g., research design, culture, sample type, etc.). The mean internal consistency reliability of the scale scores for the 98 samples studied was .85, 95 % C.I. [.84, .86] and the mean coefficient for each of the IRMAS and AMMSA scales was .84 and .85 respectively. All these values are above .80, a value established as satisfactory reliability of the instrument for general research. The Cronbach's alpha coefficients reported by the studies ranged from .71 to .98, with values considered moderate to excellent. These results show that both scales present acceptable internal consistency indices in various applications. There is high heterogeneity (I. = 96 %), with the number of items being the only moderating variable significantly explaining the observed reliability variability. This result was to be expected, given that the effect of test length on the estimation of reliability indices has a long tradition and is widely known in the psychometric literature.

Adaptación de Tareas para Detectar el Talento Matemático en Personas con Discapacidad Visual Basada en el Análisis de las Habilidades de Visualización y la Generalización / Adaptation of Tasks to Detect Mathematical Talent in People with Visual Impairment Based on the Analysis of Visualization and Generalization Skills

RESUMEN: En este trabajo se analizan las habilidades de visualización y la generalización en la resolución por una persona ciega de dos tareas propuestas para la identificación del talento matemático. A partir de este análisis, se establecen algunas pautas para adaptar las tareas y se contrastan con las habilidades requeridas en la prueba original, especialmente en las relativas a las características del talento asociadas a la generalización. Se evidencia que las personas con discapacidad visual requieren la manifestación de otras habilidades, como por ejemplo la memoria visual y la percepción de las relaciones espaciales que no son imprescindibles en el planteamiento original.

RESUMO: Neste trabalho, analisamos as capacidades de visualização e de generalização na resolução por uma pessoa cega de duas tarefas propostas para a identificação de talentos matemáticos. A partir dessa análise, foram estabelecidas algumas diretrizes para a adaptação das tarefas e contrastadas com as competências exigidas no teste original, especialmente as relacionadas às características do talento associadas à generalização. Verificamos que as pessoas com deficiência visual requerem a manifestação de outras capacidades, tais como a memória visual e a percepção de relações espaciais, que não são essenciais na abordagem original.

ABSTRACT: In this work, we analyze the visualization skills and generalization in the resolution by a blind person of two tasks proposed for the identification of mathematical talent. From this analysis, some guidelines were established to adapt the tasks and contrasted with the skills required in the original test, especially those related to the characteristics of talent associated with generalization. We verifed that people with visual impairment require the manifestation of other skills, such as visual memory and perception of spatial relationships, which are not essential in the original statement.

La transferencia de los resultados de la investigación en el sector de la Salud Pública de Holguín, Cuba / Transfer of research results in the public health sector of the province of Holguín, Cuba

La transferencia de los resultados de la investigación favorece la efectividad de los procesos sustantivos universitarios y la calidad de los sistemas y servicios de salud, teniendo en cuenta la producción científica de los profesionales del sector y las prioridades de la investigación establecidas. Con el objetivo de describir la transferencia de los resultados de la investigación en el sector de la salud pública de la provincia de Holguín se realizó un estudio descriptivo-retrospectivo durante el período del 2016 al 2020. Se emplearon métodos de nivel teórico (análisis-síntesis, inductivo-deductivo e histórico-lógico) y métodos empíricos (la observación participante, la encuesta y la revisión documental). La estadística descriptiva facilitó el análisis, el procesamiento y la presentación de las variables seleccionadas a través de tablas de frecuencia simple. La Universidad de Ciencias Médicas fue la principal entidad generadora de resultados investigativos transferibles. El programa de formación de recursos humanos y el de atención materno-infantil aportaron la mayor cantidad de tareas generalizables en correspondencia con las prioridades nacionales. Los mecanismos de transferencia más utilizados fueron los talleres de transferencia y las consultorías especializadas. Los resultados investigativos objeto de transferencia responden a los programas priorizados del sector de la salud y provienen de sus instituciones académicas, asistenciales y de servicios. Los canales de transferencia garantizaron la aplicabilidad y el cumplimiento del plan de generalización. Se incrementaron en el último quinquenio los niveles de transferencia de los resultados investigativos en el sistema de salud holguinero(AU)

Transfer of research results fosters the effectiveness of crucial university processes as well as the quality of health systems and services, bearing in mind the scientific production of professionals from the sector and the research priorities established. A retrospective descriptive study was conducted with the purpose of describing the transfer of research results in the public health sector of the province of Holguín in the period 2016-2020. Use was made of theoretical methods (analysis-synthesis, inductive-deductive and historical-logical) and empirical methods (participatory observation, survey and document review). Descriptive statistics facilitated the analysis, processing and presentation of the variables selected in the form of simple frequency tables. The University of Medical Sciences was the main institution generating transferable research results. The human resources training program and the mother and child care program contributed the largest number of generalizable tasks included among national priorities. The most common transfer mechanisms were transfer workshops and specialized consultancy. Transferred research results correspond to priority programs from the health sector and originate in academic, health care and service institutions. Transfer channels ensured the applicability and fulfillment of the generalization plan. An increase in the transfer of research results is observed in the health system of Holguín in the last five years(AU)

Estabelecendo recombinação generalizada de relações substantivo-verbo por meio de treino em matriz para crianças com Transtorno do Espectro Autista / Establishing recombinative generalization of noun-verb relations through matrix training for children with Autism Spectrum Disorder

O treino em matriz é um procedimento de ensino que implica na organização dos componentes do repertório a ser ensinado em dois eixos. Ele tem sido utilizado para favorecer a recombinação generalizada de repertórios verbais. No entanto, ainda que pessoas com Transtorno do Espectro Autista (TEA) apresentem geralmente dificuldades na linguagem, verifica-se que poucos estudos investigaram os efeitos do treino em matriz para o estabelecimento de repertórios verbais nessa população. O presente estudo avaliou, a partir de um delineamento de linha de base múltipla entre participantes, o efeito do treino em matriz na indução de recombinação generalizada de relações substantivo-verbo, em português, para duas crianças com TEA. As relações substantivo-verbo de nove figuras foram organizadas em uma matriz 3x3, sendo ensinadas diretamente três relações e testadas as outras seis. Outras nove relações substantivo-verbo foram organizadas em uma segunda matriz 3x3, sendo todas apenas testadas. O procedimento foi eficaz no estabelecimento das relações substantivo-verbo para um dos participantes e ocasionou aumento na emissão de respostas corretas das relações para o outro. Discutem-se a ampliação da validade externa do efeito do treino em matriz para crianças com TEA, questões relativas ao estabelecimento de controle de estímulos e quadros autoclíticos nesse procedimento de ensino.

Matrix training is a teaching procedure that involves the organizing the components of the repertoire to be taught in two axes. It has been used to promote the generalized recombination of verbal repertoires. However, even though people with Autism Spectrum Disorder (ASD) usually present language difficulties, few studies have investigated the effects of matrix training on the establishment of verbal repertoires in this population. The present study evaluated, from a multiple participant multiple baseline design, the effect of matrix training on the induction of generalized recombination of noun-verb relations, in Portuguese, for two children with ASD. The noun-verb relations of nine figures were organized in a 3x3 matrix, with three relations being directly taught and the other six tested. Another nine noun-verb relations were organized in a second 3x3 matrix, all of which were just tested. The procedure was effective in establishing noun-verb relations for one of the participants and produced an increase in the issuance of correct responses of the relations for the other. The expansion of the external validity of the effect of matrix training for children with ASD, issues related to the establishment of stimulus control and autoclitic frames in this teaching procedure are discussed.

Biomechanical Modeling of Tissues at Relaxation Stage Based on Neural Network / 医用生物力学

Objective Taking pig kidney as an example, through a series of comparative and analogical experiments, the influencing factors of compressive stress at relaxation stage of biological tissues were analyzed, and a more accurate and widely applicable biomechanical model at relaxation stage was established. Methods The compressive stress relaxation experiments of pig kidney under different conditions were carried out by using the self-built mechanical experiment platform. The collected data were analyzed and mapped, and various factors affecting the relaxation force changes were summarized. Based on the conclusion, the neural network learning algorithm was used to model the force change process at relaxation stage of pig kidney. Results The pre-extrusion pressure and relaxation time were the main influencing factors for compressive stress changes of biological tissues at relaxation stage. The average error of test sample validation experiment was 6.4 mN, and the average prediction error of generalization sample validation experiment was 34.9 mN, so the modeling effect was good. Conclusions Neural network modeling algorithm has the advantages of strong generalization ability and good fault tolerance, which contributes to providing more realistic force tactile feedback prediction for virtual surgery system. It is also a new idea for mechanical modeling of nonlinear biological tissues.

Tracing origin and development of "Fenglong (ST 40) for phlegm": examination and verification / 中国针灸

From the perspective of academic history, the background and evolution of "Fenglong (ST 40) for phlegm" were systematically summarized. As a result, it was found that in the early period, Fenglong (ST 40) was used for "tangible phlegm" of respiratory tract, but in the later generations, due to the comprehensive effects of various factors, the phlegm treated by Fenglong (ST 40) was generalized. In modern clinical practice of acupuncture and moxibustion, Fenglong (ST 40) is widely used for phlegm-related diseases. In addition, the knowledge content represented by "Fenglong (ST 40) for phlegm" showed evolution and change in academic heritage of previous dynasties. It is necessary for modern acupuncture researchers to systematically sort out, test and discriminate the habitual knowledge in combination with the background of traditional Chinese medicine, so as to promote the contemporary inheritance and application of traditional acupuncture theory and knowledge.

Optimized preparation method of leukocytes-rich platelet-rich plasma by varying conditions during centrifugation / 中国修复重建外科杂志

Objective: To identify a more popularized preparation protocol of leukocytes-rich platelet-rich plasma (L-PRP) for higher tolerance rate. Methods: The peripheral blood samples of 76 volunteers (45.0 mL/case) were mixed with 5 mL sodium citrate injection for blood transfusion, and L-PRP was prepared by twice centrifugations. All blood samples were divided into three groups according to the parameters of twice centrifugation: experimental group A (12 cases, 400× g, 10 minutes for the first time and 1 100× g, 10 minutes for the second time), experimental group B (27 cases, 800× g, 10 minutes for the first time and 1 100× g, 10 minutes for the second time), and control group (37 cases, 1 360× g, 10 minutes for the first time and 1 360× g, 10 minutes for the second time). The platelet recovery rate and platelet and leukocyte enrichment coefficient of L-PRP in each group were calculated and compared. Results: After removal of abnormal blood samples (platelet recovery rate was more than 100% or white thrombus), the remaining 55 cases were included in the statistical analysis, including 10 cases in experimental group A, 21 cases in experimental group B, and 24 cases in control group. The platelet enrichment coefficient and platelet recovery rate of experimental group B were significantly higher than those of experimental group A and control group ( P0.05). There was no significant difference in leukocyte enrichment coefficient between experimental groups A, B, and control group ( P>0.05). Conclusion: The preparation quality of PRP is affected by various factors, including centrifugal force, centrifugal time, temperature, and operation process, etc. Twice centrifugation (800× g, 10 minutes for the first time and 1 100× g, 10 minutes for the second time) is an ideal and feasible centrifugation scheme, which can obtain satisfactory platelet recovery rate and enrichment coefficient with thicker buffy coat, which can reduce the fine operation requirements for operators, improve the fault tolerance rate and generalization.

Generalization of Conscious Fear Is Positively Correlated with Anxiety, but Not with Depression

Generalization of learned fear has been considered to be critical for our survival. Patients with anxiety problems show overgeneralization of learned fear, as reflected by defensive physiological responses to harmless stimuli. Together with these physiological responses, conscious feeling of fear is a seminal part of emotional process that is directly related to the suffering of anxiety patients. However, the effect of anxiety on the generalization of conscious feeling remains unclear. We thus focused on the question whether the generalization of conscious feeling of fear depends on individual anxiety level in nonpatient participants. To address this question, we developed a fear generalization paradigm using natural scene images. We found that subjective feeling of fear was generalized to similar stimuli with the conditioned stimuli (CS), and that this generalization of conscious fear was positively correlated with the level of individual anxiety. Anxiety and depression frequently co-occur, but the individual depression level was not correlated with the fear generalization. These suggest that individual anxiety level mainly affects the generalization of conscious fear.

Altered expression of AMPAR and NMDAR subunits in hippocampal CA1 area with contextual fear memory generalization in mice / 中华行为医学与脑科学杂志

Objective To investigate the alteration of subunit expression of AMPAR and NMDAR in hippocampal CA1 area of mice with contextual fear memory generalization.Methods 35 male C57BL/6 mice,aged 8 weeks,were involved in the experiment.Seven mice were randomly selected as the naive group, which didn't receive the behavioral training.28 mice experienced the context fear conditioning and contextual shift task were divided into generalization group and non generalization group according to the result.Then Western blot was used to measure the expression of AMPAR and NMDAR subunits in CA1 in the naive group,non generalization group and generalization group.Results (1)Seven mice(discrimination ratio:0.52±0.08)showed contextual generalization when undergoing the same stress level,while the other 21 mice (discrimination ratio:0.75±0.07)didn't(P<0.01),however,these two group showed similar freezing(%) in the memory acquisition process.(2)The subunit composition of AMPA receptors had no significant differ-ence in CA1 area among the Naive group,non generalization group and generalization group(P>0.05).(3) NR1 subunit was similar in the three groups(P>0.05).NR2A expression was significantly increased in the non generalization group(1.11±0.20)and generalization group(1.09±0.20)compared with that in the na-ive group(0.95±0.17)(both P<0.05).The expression of NR2B was significantly increased in generalization group(1.05±0.17)compared with that in the naive group(0.83±0.19)and non generalization group(0.80± 0.14)(both P<0.05).The ratio of NR2A/NR2B was significantly increased in non generalization group (1.23±0.25)compared with that in the naive group(0.89±0.31)and generalization group(0.86±0.17) (both P<0.05).Conclusion (1)Only part of the individuals show contextual fear memory generalization after the same stress,and this contextual generalization progress is not related to the acquisition of context fear memory.(2)There is no significant change in expression of AMPAR subunits in CA1 of mice with the contextual generalization.The rise of NR2B and the decline of ratio of NR2A/NR2B are the main changes, suggesting that consequently the alternation of synaptic plasticity maybe one of the mechanisms of contextual fear memory generalization.

Generalização de mandos aprendidos pelo PECS (Picture Exchange Communication System) em crianças com transtorno do espectro autista / Generalization of mands learned by PECS (Picture Exchange Communication System) in children with autism / Generalización de mandos aprendidos por PECS (Picture Exchange Communication System) en los niños autistas

O ensino de comportamento verbal com o uso de comunicação alternativa é um instrumento para melhorar a interação social de crianças com Transtorno do Espectro Autista (TEA). O objetivo do estudo foi ensinar mandos com o Picture Exchange Communication System (PECS) e avaliar a sua generalização entre ambientes. Os mandos treinados consistem na troca de cartões com estímulos visuais pelos próprios itens. Participaram do estudo quatro crianças diagnosticadas com TEA, com idade entre 6 e 12 anos. Após treino do PECS, professora e mães receberam instruções e registraram a emissão de mandos (teste de generalização) nos ambientes escolar e domiciliar. Os resultados mostraram que para três crianças o ensino de mandos foi bem sucedido e que ocorreu a generalização para outros itens nos dois contextos avaliados. É discutida a necessidade de maior controle de variáveis que interfiram no treino para a aquisição de mandos, além de planejamento da generalização pelas crianças para ambientes, pessoas e itens diferentes.

Verbal training with the use of alternative communication is a tool for improving the social interaction of children with Autism Spectrum Disorder (TEA). The aim of this study was to promote generalization of trained mands through the Picture Exchange Communication System (PECS). Trained mands comprise the exchange of pictures with visual stimuli by the items themselves. There were 4 autists aged between 6 and 12 years old, who took part in the study. After the PECS training, the teacher and the mothers were instructed to take notes of the mands performed in school and home settings. Results have shown that 3 children met the learning criterion for PECS and that there was a generalization for other settings. The need for greater control of the variables that interfere with mand acquisitions and the children planning for generalization of environment, people and different items have been discussed.

Entrenamiento verbal con el uso de la comunicación alternativa es una herramienta para mejorar la interacción social de los niños con trastorno del espectro autista (TEA). El objetivo era enseñar a los comandos con el Sistema Picture Exchange Communication (PECS) y evaluar su generalización. Mandos entrenados consisten en el intercambio de cartas con los estímulos visuales por elementos propios. Los participantes del estudio fueron cuatro niños diagnosticados con TEA, de 6 a 12 años. Después del entrenamiento del PECS, profesor y madres fueron instruidos y grabó las exigencias de emisiones (prueba de generalización) en el entorno escolar y el hogar. Los resultados mostraron que a tres hijos demandas del entrenamiento fue un éxito y lo que pasó generalización a otros artículos en los dos contextos evaluados. Se discutió la necesidad de mayores variables de control que interfieren con lo entrenamiento para adquirir comandos y la generalización de la planificación para los niños a los ambientes, personas y diferentes elementos.

Generalización del Sistema de información para la gestión de ciencia, tecnología e innovación (SINFORCIT) / Generalization of the Information System for Science Management, Technology and Innovation (SINFORCIT)

Introducción: esta investigación es una evaluación de impacto de una aplicación web, realizada en la Facultad de Ciencias Médicas General Calixto García en el año 2014 y generalizado en el año 2015 - 2016. Objetivo: evaluar los efectos de la generalización de la aplicación web SINFORCIT en el mejoramiento de la gestión de los procesos de los Departamentos de Ciencia, Tecnología e Innovación (CTI), de las facultades de Ciencias Médicas. Método: investigación cualitativa, no experimental, de corte transversal, de evaluación de los efectos de la generalización del producto SINFORCIT. La investigación fue estructurada en cinco etapas que evaluó variables cuantitaivas y cualitativas a partir de la cuarta etapa en que se generalizó el producto. Se realizó un monitoreo semestral a los usuarios, previo convenio para el uso del producto mediante encuestas semestrales. Este sistema de información se encuentra disponible en un host en Infomed desde marzo del 2016. Resultados: se obtuvo un efecto social importante por ser de fácil accesibilidad y operativo, ofrecer mayor eficiencia y optimización del tiempo en la gestión de los procesos de CIT y con un impacto económico para 100 por ciento de la plantilla docente en un período de 11 meses estimado en 88 CUC por concepto de ahorro en mensajería electrónica y de 524 378,80 pesos (cup), de ahorro por concepto de salarios/horas para las gestiones presenciales habituales. Conclusiones: la generalización mejoró la gestión de los procesos con eficiencia, optimización del tiempo y ahorro de recursos financieros(AU)

Introduction: the impact of a web application is assessed in this paper. It was carried out at General Calixto Garcia Faculty of Medical Sciences in 2014 and it was generalized in 2015- 2016. Objective: evaluate the effects of the generalization of SINFORCIT web application in the improvement of the process management of the Departments of Science, Technology and Innovation (CTI) of the Faculties of Medical Sciences. Method: a non-experimental, qualitative, cross-sectional, evaluation of the effects of generalization of the product SINFORCIT was conducted. The research was structured in five stages that evaluated quantitative and qualitative variables from the fourth stage in which the product was generalized. A semi-annual monitoring was done to the users, after agreeing the use of this product, through semiannual surveys. This information system has been available on a host at Infomed since March 2016. Results: an important social effect was obtained by being easily accessible and operative, offering greater efficiency and optimization of the time in the management of ITC processes and with an economic impact on 100 percent of the teaching staff in an 11-month period estimated in savings 88 CUC in electronic messaging and 524 378.80 pesos (cup) in saving by salaries / hours for habitual face-to-face meetings. Conclusions: the generalization improved the management of the processes with efficiency, optimization of the time and saving of financial resources(AU)

Games as a measure of reading and writing generalization after computerized teaching of reading skills

Abstract Behavior Analysis is usually accused of not being able to account for the generalization of verbal behavior that is present in linguistically competent individuals. However, several behavior analytic studies investigate this theme, and gamification has been seen as a useful way to study generalization. The purpose of this study was to evaluate reading and writing generalization in games, after these behaviors were taught through the program Learning to Read in Small Steps. Participants were four children between 7 and 12 years old who had reading and writing deficits. The experimental design was a pre-posttest design that encompassed five phases. Performance in probes suggests generalization of reading and writing skills to new activities (games) and responses. This study represents a small step in a systematic understanding of how games can be used to assess behavior change. (AU)

Limitaciones más frecuentes en los ensayos clínicos con asignación aleatoria (eca) en el área de medicina interna / Most frecuent limitations on randomized clinical trials / Freqüentes limitações nos ensaios clínicos com distribuição aleatória (eca) na área de medicina interna

Introducción: Los ensayos clínicos controlados son el mejor diseño epidemiológico para evaluar la eficacia y seguridad de nuevas intervenciones y medicamentos. A pesar de ser estudios con asignación aleatoria, los ensayos clínicos presentan limitaciones que pueden disminuir la validez clínica de estos y la aplicabilidad en ciertos grupos de poblaciones. El objetivo del estudio es describir las limitaciones que reportan los autores de los ECA en la publicación de las 4 revistas médicas generales de alto factor de impacto. Metodología: Estudio de carácter observacional, descriptivo. Se escogió una muestra por conveniencia de 30 estudios en total pertenecientes al área de medicina interna y se describieron las limitaciones que expresaban los autores en la discusión del artículo. Todos los artículos pertenecientes a revistas médicas de alto factor de impacto publicados en los últimos 3 años. Resultados: Un total de 30 artículos de ensayos clínicos aleatorizados fueron incluidos en la revisión. Se identificaron en total 11 categorías de limitaciones diferentes; en orden de frecuencia son: atribuible a la intervención (16,3%), validez externa por población (13,1%), duración del seguimiento (13,1%), co-intervenciones (11,4%), suspensión de la intervención o retiro de los participantes durante el estudio (11,4%), medición del desenlace (9,8%), ausencia de limitaciones (9,8%), tamaño de la muestra (6,5%), identificación de los efectos adversos serios (4,9%), ausencia de grupo placebo (1,63%), y por ultimo limitación atribuible a la metodología del ensayo (1,63%). Conclusiones: En la serie de ECA revisados; la limitación más frecuente parte de la intervención, seguida de las que afectan la aplicabilidad clínica.

Introduction: Actually the best way to review efficacy and safety or Randomized Clinical Trials (RCT) of any therapeutic intervention. Despite randomization (reported as most important way to ensure external validity), RCT have limitations, these could carry weight on its clinical applicability. Authors of this search described limitations reported originally by each RCT authors of 4 important journals. Methods: An observational and descriptive study with a total of 30 internal medicine trials as sample. All the trials published in the last 3 years in the most important journals. 11 categories of limitations were identifed and statistically analyzed with relative and absolute frequency. Outcomes: A total of 30 RCT were included in the revision. Were identified 11 categories of different limitations , in order of frequency: attributable to the intervention (16,3%), external validity by population (13,1%) , duration of follow-up (13,1%), co-intervention (11,4%), suspension of the intervention or withdraw of the participants during the study (11,4%),outcomes measurement (9,8%),trials without limitations (9,8%),sample size (6,5%), serious adverse events (4,9%), trials without placebo (1,63%), and limitation about trials methods (1,63%). Conclusion: In a total of 30 RCT, the most frequent limitation is attributable to the intervention followed by external validity.

Introdução: Os ensaios clínicos controlados são o melhor desenho epidemiológico para avaliar a eficácia e segurança de novas intervenções e medicamentos. Apesar de ser estudos randomizados, os ensaios clínicos têm limitações que podem reduzir a validade clínica e aplicabilidade destes em certos grupos populacionais. O objetivo do estudo é descrever as limitações relatadas pelos autores de ensaios clínicos randomizados na publicação das 4 revistas médicas gerais de elevado fator de impacto. Metodologia: Estudo descritivo e observacional. Uma amostra por conveniência for escolhida entre 30 estudos, todos eles pertencentes à área da medicina interna e foram descritas as limitações que os autores mencionaram na discussão do artigo. Todos os artigo são de revistas medicas de elevado fator de impacto publicadas nos últimos 3 anos. Resultados: Um total de 30 artigos de ensaios clínicos aleatórios foi incluído na revisão. Um total de 11 categorias diferentes de limitações foi identificado; em ordem de frequência elas são: atribuível à intervenção (16,3%), validade externa pela população (13,1%), duração do seguimento (13,1%), cointervenções (11,4%), suspensão da intervenção ou saída dos participantes durante o estudo (11,4%), medição do resultado (9,8%), ausência de limitações (9,8%), tamanho da amostra (6,5%), identificação dos efeitos adversos graves (4,9%), ausência do grupo placebo (1,63%) e, finalmente, a limitação atribuível à metodologia do ensaio (1,63%). Conclusão: Na serie de ECA revisados, a limitação mais frequente parte da intervenção, seguida por aqueles que afetam a aplicabilidade clínica.

Progresso terapêutico de sujeitos submetidos a terapia fonológica pelo modelo de oposições múltiplas: comparação do progresso terapêutico / Therapeutic progress on subjects submitted to phonological therapy using the multiple oppositions approach

Este trabalho tem como objetivo analisar e comparar o progresso terapêutico apresentado por crianças submetidas ao Modelo de Oposições Múltiplas estimuladas na terapia com os mesmos sons-alvo. Participaram deste relato de caso duas crianças com desvio fonológico, sendo um menino (S1) e uma menina (S2), com idades de 4:2 e 4:11, respectivamente. Os dados da fala foram coletados por meio da avaliação fonológica. Para o tratamento, foi utilizado o Modelo de Oposições Múltiplas durante 25 sessões com os mesmos sons-alvo, todos pertencentes a classe das fricativas. As substituições e omissões no inventário fonológico de cada criança foram analisadas, assim como a ocorrência de processos fonológicos pré e pós-terapia. Observou-se que o sujeito que apresentava mais substituições (S1) foi o que apresentou maiores aquisições de fonemas no inventário fonológico. O S1 foi o que apresentou maior ocorrência de processos em sua fala, tanto pré quanto pós-terapia, o que dificultava a inteligibilidade de fala para o ouvinte. Os processos que envolveram a classe das líquidas foram os que apresentaram um maior percentual de ocorrência, mesmo após a terapia. O Modelo de Oposições Múltiplas possibilitou um adequado progresso no tratamento dessas crianças com desvio fonológico, proporcionando uma expansão no inventário fonológico e uma diminuição de ocorrência de processos fonológicos apesar de haver diferenças quanto a evolução apresentada por cada uma.

This work aims to analyze and compare the therapeutic progress shown in children submitted to the Multiple Oppositions Approach, stimulated in therapy with the same target sounds. Two children with phonological disorder participated in this case report, being a boy (S1) and a girl (S2), aged 4:2 and 4:11, respectively. The speech data were collected through phonological evaluation. As treatment, we used the Multiple Oppositions Approach during 25 sessions with the same target sounds, all belonging to fricatives classes. The substitutions and omissions of each child's phonological inventory were analyzed, as well as the occurrence of pre and post-therapy phonological processes. It was observed that the subject with more substitutions (S1) was the one with phonemes major acquisitions in the phonological inventory. S1 showed the highest occurrence of cases in his speech, both pre and post-therapy, which made the speech intelligible to the listener. The processes involving the class of liquids showed a higher percentage of occurrences, even after therapy. The Multiple Oppositions Approach showed an adequate progress of the treatment of these children with phonological disorder, providing a phonological inventory expansion and a reduction of phonological processes occurrence, although with differences regarding the evolution presented by each one.

Generalização estrutural obtida por crianças com desvio fonológico submetidas a diferentes abordagens terapêuticas / Structural generalization by children with speech-sound disorders under different therapeutic approaches

OBJETIVO: verificar qual grupo (com ou sem estimulação das habilidades práxicas orofaciais) apresentou melhores generalizações estruturais, considerando os seguintes tipos: a itens não utilizados no tratamento; para outra posição na palavra; dentro de uma classe de sons; e para outra classe de sons. MÉTODOS: a amostra foi composta por seis sujeitos (três meninas e três meninos), com idades entre 5:4 e 7:0 no início da terapia. Os sujeitos foram divididos em três grupos, recebendo terapia fonológica por meio do modelo de Pares Mínimos oposições Máximas/ Empty Set, sendo os do grupo estudo tratados com estimulação de habilidades práxicas de face e língua (GFoLFa), e com exercícios de habilidades práxicas de língua (GFoL), e o grupo controle submetido apenas à terapia fonológica (GFo). Todos foram avaliados pré e pós-terapia quanto ao sistema fonológico (Yavas, Hernandorena e Lamprecht, 1991); ao Teste de Praxias Orofaciais (Berzoatti, Tavano e Fabbro, 2007); e ao Teste de Praxias Articulatórias e Bucofaciais (Hage, 2000). RESULTADO: o GFoLFa obteve evoluções maiores generalizações para os quatro tipos analisados (dentro de uma classe de sons, para outras posições na palavra, para outra classe de sons e a itens não utilizados no tratamento). O GFoL apresentou importante número de generalizações dentro de uma classe de sons; e GFo apresentou generalização para outra classe de sons. CONCLUSÃO: os grupos que receberam intervenção práxica obtiveram maiores generalizações, porém sugerem-se novos estudos aplicando este modelo, para que possam ser confirmados esses resultados, com outras amostras. .

PURPOSE: to verify which group (with or without stimulation of orofacial praxis skills) presented better structural generalizations by considering the following types: generalization to items not used in the treatment, to another position in the word, within a class of sounds, and to another class of sounds. METHODS: the sample consisted of six subjects (three girls and three boys), whose ages ranged between 5:4 and 7:0 at the beginning of therapy. The subjects were divided into three groups, and they all received phonological therapy through the model of Minimal Pairs-Maximum Oppositions/Empty Set. They were organized as follows: study group, treated with stimulation of facial and tongue praxis skills (GFoLFa), and with exercises of tongue praxis skills (GFoL), and control group, treated with phonological therapy (GFo) only. They were all assessed before and after therapy as to the phonological system (Yavas,Hernandorena and Lamprecht, 1991); also with the Orofacial Praxis Test (Berzoatti, Tavano and Fabbro, 2007), and the Bucofacial Articulatory Praxis test (Hage, 2000). RESULT: the GFoLFa group achieved greater progress as regards generalizations to the four types analyzed (within a class of sounds, to other positions in the word, to another class of sounds and to items not used in the treatment). The GFoL group presented a substantial number of generalizations within a class of sounds; and GFO showed generalization to another class of sounds. CONCLUSION: the groups that received praxis treatment produced greater generalizations; however, we suggest new studies applying this model, so that these results can be confirmed with other samples. .

Treatment Model in Children with Speech Disorders and Its Therapeutic Efficiency

Introduction: Speech articulation disorders affect the intelligibility of speech. Studies on therapeutic models show the effectiveness of the communication treatment. Objective: To analyze the progress achieved by treatment with the ABAB—Withdrawal and Multiple Probes Model in children with different degrees of phonological disorders. Methods: The diagnosis of speech articulation disorder was determined by speech and hearing evaluation and complementary tests. The subjects of this research were eight children, with the average age of 5:5. The children were distributed into four groups according to the degrees of the phonological disorders, based on the percentage of correct consonants, as follows: severe, moderate to severe, mild to moderate, and mild. The phonological treatment applied was the ABAB—Withdrawal and Multiple Probes Model. The development of the therapy by generalization was observed through the comparison between the two analyses: contrastive and distinctive features at the moment of evaluation and reevaluation. Results: The following types of generalization were found: to the items not used in the treatment (other words), to another position in the word, within a sound class, to other classes of sounds, and to another syllable structure. Conclusion: The different types of generalization studied showed the expansion of production and proper use of therapy-trained targets in other contexts or untrained environments. Therefore, the analysis of the generalizations proved to be an important criterion to measure the therapeutic efficacy...

Generalización e inferencia: un acercamiento a su compresión desde tres enfoques / Generalization and inference: an understanding based on three approaches

Se trata de una reflexión que busca poner en discusión los diferentes significados que pueden adquirir los conceptos de generalización e inferencia, de acuerdo con el enfoque o perspectiva desde el cual se pretendan utilizar. Para este propósito, en primer lugar, se pone en consideración la importancia y el uso que se ha dado a estos conceptos en el campo de la epidemiología clásica-moderna, especialmente para definir asuntos de validez interna y externa y para la formulación de hipótesis. Seguidamente, se presentan las principales argumentaciones que al respecto defiende Clifford Geertz desde su perspectiva epistemológica de la etnografía interpretativista y de acuerdo con su concepción teórica de la cultura. Posteriormente, se presentan las ideas que sustenta Juan Samaja desde su enfoque epistemológico y metodológico para la investigación en salud, abogando principalmente por el razonamiento abductivo, y no sólo el inductivo y el deductivo que han sido privilegiados en los estudios lógicos. Por último se presenta una discusión y unas conclusiones destacando que en estas tres perspectivas la salud pública tiene una oportunidad para enriquecer sus procesos de generación de nuevo conocimiento y para comprender de mejor manera las condiciones de salud y de bienestar colectivo.

This paper is a reflection which seeks to stimulate discussion and debate concerning the different meanings that the concepts of generalization and inference can take on, based on the approach or perspective that is being employed. For this purpose the importance and usage which has been accorded to these concepts within the field of classic-modern epidemiology is taken into consideration, especially in order to define internal and external validity issues and to formulate hypotheses. Next the main arguments are presented and are defended by Clifford Geertz from his epistemological perspective of interpretive ethnography and based on his theoretical conception of culture. Subsequently the ideas maintained by Juan Samaja are presented from his epistemological and methodological approach for research into health, advocating primarily for abductive reasoning, and not simply inductive and deductive, which have until now been privileged in logic studies. Finally a discussion and conclusions are presented, highlighting that from these three perspectives public health has the opportunity to expand its new knowledge generation processes and to better understand the conditions for good collective health and wellbeing.

A generalização a partir do tratamento com fricativas: ambientes favoráveis versus ambientes pouco favoráveis e neutros / The generalization through the treatment with fricatives: favorable environments versus unfavorable and neutral environments

O objetivo deste estudo foi analisar e comparar a ocorrência e os tipos de generalização observados a partir do tratamento das fricativas /z/, /ʃ/ e /ʒ/ em dois grupos de crianças, um utilizando palavras com contextos fonológicos favoráveis e outro os contextos pouco favoráveis e neutros. Seis crianças com desvio fonológico e idades entre 4:7 e 7:8 participaram do estudo com a autorização dos responsáveis. Realizaram-se avaliações fonoaudiológicas e complementares para o diagnóstico do desvio fonológico. Os sujeitos foram pareados de acordo com a gravidade do desvio, sexo, faixa etária e aspectos do sistema fonológico em relação aos fonemas alterados. Metade das crianças foi tratada com palavras em que os fonemas /z/, /ʃ/ e /ʒ/ encontravam-se em ambientes fonológicos favoráveis e a outra metade com ambientes pouco favoráveis e neutros. Foram realizadas oito sessões e, após estas, nova avaliação de fala foi realizada para verificar os tipos de generalização obtidos. Os percentuais de generalizações foram comparados entre os grupos por meio do teste estatístico de Mann-Whitney (p<0.05). Ao término da terapia, observou-se aumento dos percentuais de generalização para todos os sujeitos. Na comparação entre os grupos não foi verificada diferença estatística para as generalizações analisadas. Entretanto, houve vantagem do grupo favorável em relação às generalizações “para outra posição na palavra” e “dentro de uma classe de sons”. Os resultados obtidos podem estar relacionados ao pequeno número de sujeitos ou a outros fatores mencionados no artigo.

The aim of this study was to analyze and compare the occurrence and the types of generalization observed through the treatment of the fricatives /z/, /ʃ/ and /ʒ/ in two groups of children, one using words with favorable phonological contexts and another with unfavorable and neutral contexts. Six children with phonological disorder between 4:7 and 7:8 year-old participated in the study, with their parents’ authorization. There were speech-language and complementary evaluations to diagnose the phonological disorder. The subjects were matched according to the severity of the phonological disorder, sex, age and aspects of the phonological system in relation to the altered phonemes. Half the children were treated with words in which the phonemes /z/, /ʃ/ and /ʒ/ were in favorable phonological environments and the other half with unfavorable and neutral environments. There were eight sessions and, after them, a new speech evaluation was performed in order to verify the types of generalization that were obtained. The generalization percentages were compared between the groups by statistical test Mann-Whitney (p<0.05). At the end of therapy, it was observed an increasing in generalization percentage for all the subjects. In the comparison between the groups, no statistical difference was found to the analyzed generalizations. However, there was an advantage to for the favorable group regarding to the generalizations “to another position in the word” and “inside a sound class”. The obtained results can be related to the small number of subjects or to other factors mentioned in the article.

A influência das habilidades em consciência fonológica na terapia para os desvios fonológicos / The influence of phonological awareness abilities in therapy for phonological disorder

Este trabalho teve como objetivo analisar as habilidades em consciência fonológica e o progresso (inventário fonético e fonológico e as generalizações) na terapia fonológica. O grupo pesquisado foi constituído por cinco crianças com desvio fonológico, com idades entre 5:0 e 6:11, submetidas à terapia fonológica. Foram analisados os resultados obtidos na avaliação da consciência fonológica pré-tratamento, a fim de verificar o desempenho das crianças quanto ao seu conhecimento fonológico. Realizou-se a avaliação fonológica pré e pós-tratamento, em que foi possível obter os inventários fonéticos e fonológicos dos sujeitos. Após, foram analisadas as generalizações obtidas com a terapia fonológica (itens lexicais não utilizados no tratamento, outras posições na palavra, dentro de uma classe de sons, outra classe de sons). Os resultados evidenciaram que não existe relação entre o desempenho em tarefas de consciência fonológica e os progressos na terapia. Tais resultados corroboram os achados da literatura, confirmando que crianças com desvio fonológico podem ser capazes de responder adequadamente a tarefas metalinguísticas como a consciência fonológica, sem que essa condição as auxilie a corrigir os desvios de sua fala. Sugere-se que este assunto seja mais bem investigado com um número maior de sujeitos, bem como com a avaliação da consciência fonológica pré e pós-terapia, no intuito de se obter dados generalizáveis os quais serão importantes para o entendimento dos casos de desvio fonológico.

This study aimed to analyze the phonological awareness skills and progress (phonetic and phonological inventory and generalizations) in phonological therapy. The research group consisted of five children presenting speech disorders, aged 5:0 and 6:11, subjected to phonological therapy. The results of the phonological awareness assessment were analyzed before the treatment in order to verify the performance of children and their phonological knowledge. The evaluation was performed before and after the treatment. It was possible to obtain the phonetic and phonological inventories of the subjects and, after that, the generalizations obtained with phonological therapy were analyzed (considering lexical items that were not used during treatment, other positions in word, within one sound class or another class of sounds). The results showed that there is no relation between the performance in phonological awareness tasks and the evolution of the phonological therapy. On the other hand, the results agree with the research findings from the literature, reinforcing the idea that, children with phonological disorder can be able to react properly to metalinguistic tasks such as phonological awareness without being able to correct their speech problems. Finally, it can be conclude that this research subject should be investigated deeper and another analysis should be carried out involving a higher number of subjects, including the phonological awareness evaluation before and after therapy. By doing this, it will be possible to obtain other important data to improve the treatment of phonological disorder.

Mudanças fonológicas obtidas no tratamento pelo modelo de oposições múltiplas / Phonological changes obtained in the treatment based on the multiple opposition approach

OBJETIVO: analisar as mudanças fonológicas decorrentes da aplicação do Modelo de Oposições Múltiplas no que se refere ao Percentual de Consoantes Corretas-Revisado (PCC-R), no número de fonemas adquiridos no inventário fonológico e nos tipos de generalização. MÉTODO: o grupo pesquisado foi constituído por cinco sujeitos com desvio fonológico. Foram realizadas avaliações fonoaudiológicas e complementares. Os dados da fala foram coletados e analisados por meio da avaliação fonológica pré e pós-tratamento. Os sujeitos foram submetidos à terapia pelo Modelo de Oposições Múltiplas. RESULTADOS: constatou-se que houve diferença estatisticamente significante no que tange ao PCC-R, ao número de fonemas adquiridos, à generalização a itens lexicais não utilizados no tratamento, para outra posição da palavra e para outras classes de sons. Não houve diferença estatística para a generalização dentro de uma classe de sons, porém, observou-se um aumento do percentual no pós-tratamento. CONCLUSÃO: o Modelo de Oposições Múltiplas foi efetivo para o tratamento desses sujeitos falantes do Português Brasileiro, pois proporcionou mudanças no PCC-R, no número de fonemas adquiridos e algumas generalizações (a itens lexicais não utilizados no tratamento, para outra posição na palavra, dentro de uma classe de sons, para outras classes de sons).

PURPOSE: to analize the phonological changes resulting from the application of the Multiple Opposition Approach concerning the Percentage of Consonants Correct - Revised (PCC-R), on the number of phonemes that were acquired in the phonological inventory and on the types of generalization. METHOD: the researched group included five subjects with phonological disorders. It was carried out phonological and complementary assessments. The speech data were transcribed and analyzed through the phonological assessment pre and post-treatment. The subjects underwent the treatment based on the Multiple Opposition Approach. RESULTS: an increase in PCC-R, number of acquired phonemes and presence of different types of generalization in the final assessment, which was statistical difference, except the results of the generalization within sound class were not statistical difference in the pos-treatment. CONCLUSION: the Multiple Oppositions Approach was effective for the treatment of Brazilian Portuguese speakers because the model provided changes in the PCC-R, number of acquired phonemes and some generalizations (to lexical items non used during treatment, to another position of the word, inside a sound class and to other sound class).