Use of hand-held ultrasound to perform E-FAST by general surgery residents in a trauma reference center: First experience in the Colombian Caribbean region / Uso de ecografía portátil para realizar E-FAST por residentes de cirugía general en un centro de referencia en trauma: primera experiencia en la región del Caribe colombiano

Introduction. Extended focused assessment with sonography for trauma (E-FAST) can be performed with minimal training and achieve ideal results. It allows easy transport and use in austere environments such as the Colombian Caribbean, where many centers do not have 24-hour radiology services. The objective of this study was to determine the performance of the use of E-FAST in the evaluation of trauma by second-year general surgery residents in the emergency department. Methods. Retrospective observational study that evaluated the diagnostic performance of E-FAST with Butterfly IQ, in patients with thoracoabdominal trauma, who attended a referral center in the Colombian Caribbean between November 2021 and July 2022. Sensitivity, specificity, and positive and negative predictive values were evaluated, compared with intraoperative findings or conventional imaging. Results. A total of 46 patients were included, with a mean age of 31.2 ± 13.8 years, 87.4% (n=39) were male. The main mechanism of trauma was penetrating (n=32; 69.5%). It was found that 80.4% (n=37) of the patients had a positive E-FAST result, and of these, 97% (n=35) had a positive intraoperative finding. Sensitivity, specificity, positive predictive value and negative predictive value were 92.1%, 75%, 94.6%, and 66.6%, respectively. The positive likelihood ratio was 3.68, while the negative likelihood ratio was 0.10. Conclusion. General surgery residents have the competence to perform accurate E-FAST scans. The hand-held ultrasound device is an effective diagnostic tool for trauma and acute care surgery patients.

Introducción. La evaluación enfocada extendida con ecografía en trauma (E-FAST, extended focused assessment with sonography for trauma) puede realizarse con entrenamiento mínimo y lograr resultados ideales. Su fácil transporte permite usarla en entornos austeros, como el Caribe colombiano, donde muchos centros no disponen de servicio radiológico las 24 horas. El objetivo de este estudio fue determinar el rendimiento del uso de E-FAST por residentes de cirugía general de segundo año en la evaluación del paciente con trauma en urgencias. Métodos. Estudio observacional retrospectivo que evaluó el rendimiento diagnóstico de E-FAST con Butterfly IQ, en pacientes con trauma toracoabdominal que acudieron a un centro de referencia del Caribe colombiano, entre noviembre de 2021 y julio de 2022. Se evaluaron sensibilidad, especificidad, valores predictivos positivo y negativo, comparando la descripción de la ecografía con los hallazgos intraoperatorios o imagenología convencional. Resultados. Se incluyeron un total de 46 pacientes, con una media de edad de 31,2 ± 13,8 años, siendo el 87,4 % (n=39) hombres. El principal mecanismo de trauma fue penetrante (n=32; 69,5 %). Se encontró que el 80,4 % (n=37) de los pacientes tuvo resultado E-FAST positivo, y que, de estos, el 97 % (n=35) tuvo un hallazgo positivo intraoperatorio. Se calculó una sensibilidad de 92,1 %, especificidad de 75 %, valor predictivo positivo de 94,6 % y negativo de 66,6 %; la razón de verosimilitud positiva fue de 3,68 y la negativa de 0,10. Conclusión. Los residentes de cirugía general están capacitados para realizar exploraciones E-FAST precisas. El ecógrafo portátil es una herramienta de diagnóstico eficaz para pacientes traumatizados.

Exposición a pantallas de niñas, niños y adolescentes: recomendaciones, límites y controversias en el marco del distanciamiento social obligatorio: un estudio cualitativo / Child and Teenage Screen Exposure: Recommendations, Limits,and Controversies in the Context of Enforced Social Distancing: a Qualitative Study

Introducción: la utilización de pantallas durante la niñez y la preocupación por su potencial daño aumentaron en los últimos años. La recomendación de no superar dos horas diarias de uso resultó controvertida durante la pandemia por COVID-19. El objetivo principal de esta investigación fue explorar las opiniones y actitudes de los profesionales con respecto al uso de pantallas y comprender cómo se modificaron durante dicha pandemia. Materiales y métodos: estudio exploratorio con enfoque cualitativo y estrategia de teoría fundamentada, realizado entre 2020 y 2021.Participaron 23 profesionales (pediatras y generalistas) en cuatro grupos focales. Se realizaron lecturas del material desgrabado para interpretación del contenido. El análisis incluyó la generación de códigos que fueron agrupados en cinco ejes temáticos. Resultados: los ejes resultantes fueron: 1) temática de las pantallas en la consulta ambulatoria de niños sanos, 2) percepción sobre daños, 3) percepción sobre beneficios, 4) pantallas en épocas de ASPO (Aislamiento Social Preventivo y Obligatorio) y 5) pensamientos y acciones contradictorios sobre el uso de pantallas. Discusión: a la hora de recomendar sobre exposición a pantallas, en nuestros entrevistados predominó la intuición personal por sobre la evidencia científica disponible. Reconocieron que el contexto de ASPO visibilizó algunos beneficios asociados a la conectividad que brindan estos dispositivos. Conclusión: nuestros resultados muestran que la percepción sobre las pantallas se está volviendo cada vez más neutral en términos del balance entre sus riesgos y beneficios, conduciendo a que los profesionales sean más flexibles en sus recomendaciones al respecto. (AU)

Introduction: screen use during childhood and potential harm concerns have increased in recent years. Advice not to allow more than two hours of screen use per day was contested during the COVID-19 pandemic. The primary purpose of this research was to probe the opinions and attitudes of professionals regarding the use of screens and to understand how these changed during the pandemic. Materials and methods: this exploratory study, with a qualitative approach and theory-based strategy, was made between 2020 and 2021, and involved the participation of 23 professionals (pediatricians and general practitioners) in four focus groups. The recorded material was analyzed for content interpretation. The analysis included generating codes that were grouped into five thematic areas. Results: the resulting axes were: 1) the issue of screens in the outpatient practice of healthy children; 2) perception of harm; 3) perception of benefits; 4) screens in times of Preventive and Compulsory Social Isolation (ASPO, for its acronym in Spanish); and 5) contradictory thoughts and actions on the use of screens. Discussion: when making recommendations regarding screen exposure, the interviewees' intuition predominated over available scientific evidence. They recognized that the ASPO context highlighted some of the benefits associated with the connectivity provided by these devices. Conclusion: our results show that awareness of screen displays is becoming increasingly neutral concerning the trade-off between their risks and benefits, prompting practitioners to become more flexible in their recommendations. (AU)

Dependence on the use of technologies and daytime sleepiness in adolescent students

INTRODUCTION: Over the past 50 years, there has been a decline in average sleep duration and quality, with adverse consequences for overall health. Growing evidence from countries around the world shows the negative impact of using internet access technologies on sleep due to the short wavelength enriched light emitted by these electronic devices. OBJECTIVE: To analyze the exposure to modern technologies/internet and its relationship with the state of daytime sleepiness in teenage high school students. METHODS: a survey was conducted in six public schools located in the northeast of Brazil. The sample consisted of 1,130 students (mean age 16.6 years ± 1.1). The data collection instrument used was an objective criterion. The characteristic analytical study and quantitative interpretation. Quantitative variables were expressed as mean and standard deviation. For association analyses, the chi-square test or Student's t-test was used. It was considered significant p<0.05. RESULTS: We found that 7% and 31.6% of the participants reported a state of sleepiness during and after classes, respectively. 59.3% report using the internet excessively, 39.9% have a feeling of dependence, 32.6% report sleep deprivation due to excessive internet use, and 26.7% are unsuccessful in trying to reduce the use of cell phones. CONCLUSION: The relationships between the variables in this study will allow us, the younger students use internet access equipment, the more they are exposed to the risk of sleep impairment.

Dependencia a los dispositivos móviles: revisión sistemática en Latinoamérica y Cuba durante la última década / Dependence on mobile devices: systematic review in Latin America and Cuba during the last decade

Introducción: la adicción a los dispositivos móviles se caracteriza por la dependencia patológica hacia estos, puede llegar a ocasionar ansiedad, estrés, baja competencia social y dificultades en la concentración. Resulta de suma importancia la revisión teórica de los principales resultados sobre el tema como punto de partida para la elaboración de estrategias de desarrollo. Objetivo: realizar una revisión sistemática de las principales investigaciones relacionadas con la adicción a los dispositivos móviles en Latinoamérica y particularmente, en Cuba. Métodos: se realizó una revisión sistemática para analizar los principales resultados en Latinoamérica y Cuba, se consideraron artículos originales publicados entre 2012 y 2022. Fueron utilizadas las pautas de revisiones sistemáticas PRISMA. Tras la identificación de los estudios en las bases de datos consultadas se realizó la lectura del título, resumen y contenido para determinar su relación con los objetivos del estudio. Desarrollo: se constató que existen pocos estudios en materia de adicciones a los dispositivos móviles en el contexto latinoamericano y cubano; las investigaciones muestran el impacto negativo sobre la salud mental de quienes padecen esta adicción, se destaca su influencia negativa en estudiantes universitarios, así como la validación de instrumentos que permitirán profundizar en esta temática. Conclusiones: se destaca la calidad de los estudios y la validez de los resultados científicos y se sugiere emplearlos como base para el desarrollo de proyectos de carácter terapéutico.

Background: addiction to mobile devices is characterized by pathological dependence on them, it can cause anxiety, stress, low social competence, and difficulties in concentration. The theoretical review of the main results on the subject is extremely important as a starting point for the elaboration of development strategies. Objective: to carry out a systematic review of the main investigations related to addiction to mobile devices in Latin America and particularly, in Cuba. Methods: a systematic review was carried out to echnol the main results in Latin America and Cuba, original articles published from 2012 to 2022 were considered. PRISMA systematic review guidelines were used. After identifying the studies in the consulted databases, the title, abstract and content were read to determine their relationship with the objectives of the study. Development: it was found that there are few studies on addictions to mobile devices in the Latin American and Cuban context; Research shows the negative impact on the mental health of those who suffer from this addiction, its negative influence on university students stands out, as well as the validation of instruments that will allow us to delve into this subject. Conclusions: the quality of the studies and the validity of the scientific results stand out and it is suggested to use them as a basis for the development of projects of a therapeutic nature.

The influence of whole-body vibration, media, and artificial lighting on eye-movement during reading / A influência da vibração de corpo inteiro, da mídia e da iluminação artificial no movimento dos olhos durante tarefas de leitura

ABSTRACT Objective: To evaluate if participants, subjected to whole-body vibration, two different types of media (paper versus tablet) and two lighting environments (fluorescent versus LED), present a difference in eye-movement parameters during reading tasks. Methods: Fourteen adults silently read two different texts in each one of the eight randomized testing conditions (whole-body vibration versus media versus lighting), resulting in 16 different texts read per individual. Whole-body vibration was applied in the vertical direction, 5Hz and 0.8 m/s2 root-mean-square amplitude, a condition similar to those experienced by forklift truck drivers. Participants were in a sitting position with a backrest. An eye-tracker evaluated the eye-movements during the reading task. Results: Whole-body vibration significantly reduced the number of ocular fixations, and cross-correlation; and increased the reading efficiency, fixation duration, directional attack, and binocular anomalies. Neither the type of media nor the lighting environment interfered significantly with the eye-movements, both in situations with and without vibration. Conclusion: The results indicate that whole-body vibration interfered in the eye-movements during the reading task. This may impose a difficulty to process the visual information and to synchronously coordinate the binocular movements under vibration environments.

RESUMO Objetivo: Avaliar se participantes submetidos à vibração de corpo inteiro, a dois tipos diferentes de mídia (papel versus tablet) e a dois ambientes de iluminação (fluorescente versus LED) apresentam diferença nos parâmetros de movimento dos olhos durante tarefas de leitura. Métodos: Quatorze adultos leram silenciosamente dois textos diferentes em cada uma das oito condições de teste (vibração de corpo inteiro versus mídia versus iluminação), de forma aleatória, resultando em 16 textos diferentes lidos por indivíduo. A vibração de corpo inteiro foi aplicada no sentido vertical, com amplitude de 5Hz e 0,8m/s² da raiz do valor quadrático médio, em condição semelhante às vivenciadas pelos motoristas de empilhadeiras. Os participantes permaneceram em postura sentada com encosto. Um rastreador ocular avaliou os movimentos oculares durante a leitura. Resultados: A vibração de corpo inteiro reduziu significativamente o número de fixações oculares e a correlação cruzada entre os olhos e aumentou a eficiência de leitura, duração da fixação, ataque direcional e anomalias binoculares. Nem o tipo de mídia nem as condições de ambientes de iluminação interferiram significativamente nos movimentos oculares, tanto em situações com ou sem vibração. Conclusão: Os resultados indicam que a Vibração de Corpo Inteiro pode interferir nos movimentos oculares durante a leitura. Isso pode impor uma dificuldade no processamento da informação visual e na coordenação síncrona dos movimentos binoculares em ambientes de vibração.

Eficacia de la terapia de estimulación cognitiva asistida por tecnología en pacientes con demencia / Efficacy of technology-assisted cognitive stimulation therapy in patients with dementia

De la mano del envejecimiento poblacional, la demencia o trastorno neurocognitivo mayor afecta a una cantidad cada vez mayor de personas, lo que implica un alto costo para los servicios de salud. Las guías de práctica clínica recomiendan ofrecer terapias de estimulación cognitiva a las personas afectadas y cada vez es más común el empleo de herramientas tecnológicas que permiten su aplicación a gran escala a pesar de la incertidumbre acerca de su beneficio.En este artículo revisamos la evidencia más actualizada sobre la eficacia de las herramientas computarizadas para el entrenamiento cognitivo de pacientes con demencia. Encontramos algunos estudios que sugieren que podría haber una posible mejora cognitiva en los pacientes con demencia y en la calidad de vida de sus cuidadores. Sin embargo, la mayoría de los estudios no fueron de buena calidad metodológica, fueron realizados con un número limitado de pacientes, en periodos poco prolongados, y los desenlaces fueron evaluados a través de múltiples pruebas de difícil interpretación. (AU)

With the increasing population aging, dementia or major neurocognitive disorder affects a growing number of people,incurring a substantial burden on healthcare services. Clinical practice guidelines recommend providing cognitive stimulation therapies to affected individuals, and the use of technological tools for implementing therapies on a large scale is increasingly common despite the uncertainty about their benefits.In this article, we reviewed the most up-to-date evidence on the effectiveness of computerized tools for cognitive training in patients with dementia. We found some studies that suggest that there could be a possible cognitive improvement in patients with dementia and in the quality of life of their caregivers. However, most studies were not of good methodological quality, were carried out with a limited number of patients, in short periods of time, and the outcomes were evaluated through multiple tests that were difficult to interpret. (AU)

Uso y abuso de dispositivos móviles y su rol en el desarrollo de trastornos del sueño en adolescentes / Use and abuse of mobile devices and their role in the development of sleep disorders in adolescents

Las tecnologías de información y comunicación suponen un avance para la sociedad. Hoy en día, los dispositivos móviles proveen servicios convenientes para la cotidianidad, facilitando la comunicación, el ocio y las relaciones interpersonales, sin embargo, se describe que su uso excesivo influye en la aparición de síntomas como ansiedad, comportamientos adictivos y alteraciones del sueño. De todos los usuarios de estas tecnologías, los adolescentes son un grupo especialmente afectado, debido al fácil acceso a estas desde edades muy tempranas y la consecuente integración a su vida diaria. Por lo que se pretende determinar el papel del uso de dispositivos móviles en el desarrollo de trastornos del sueño en adolescentes. Pese a sus efectos deletéreos, se ha observado que el uso de estas tecnologías puede ocasionar sensación de bienestar y apoyo social en algunos usuarios, particularmente cuando promueve la interacción con sus pares. El uso excesivo de las tecnologías, en especial horas antes de dormir, se relaciona con un patrón de sueño anómalo, se ha identificado que los trastornos del sueño más prevalentes en los usuarios son el insomnio y la somnolencia diurna excesiva

Information and communication technologies represent an advance for society. Nowadays, mobile devices provide convenient services for everyday life, facilitating communication, leisure and interpersonal relationships, however, it is described that their excessive use influences the appearance of symptoms such as anxiety, addictive behaviors and sleep disturbances. Of all the users of these technologies, adolescents are a particularly affected group, due to the easy access to them from a very early age and the consequent integration into their daily lives. Therefore, it is intended to determine the role of the use of mobile devices in the development of sleep disorders in adolescents. Despite their deleterious effects, it has been observed that the use of these technologies can cause a feeling of well-being and social support in some users, particularly when it promotes interaction with their peers. The excessive use of technologies, especially hours before bed, is related to an abnormal sleep pattern, it has been identified that the most prevalent sleep disorders in users are insomnia and excessive daytime sleepiness

Digital asthenopia: blue-blocking lenses and + 0,40D additional power in the near zone, for eye strain, accommodation and convergence functions / Astenopia digital: avaliação de lentes com filtro de luz azul e poder adicional de +0,40D na zona de perto, para fadiga visual e nas funções de convergência e acomodação

ABSTRACT Purpose Evaluate blue-violet light filter and additional power of +0.40 D in the near zone ophthalmic lenses, on convergence, accommodative functions, and symptoms of digital asthenopia (DA). Methods Randomized study in cross-over design conducted on 49 volunteers (age, 29 ± 5.5 years; male: female, 18:31). Each subject wore test (+0.40 D in the near zone) and control lenses (regular single vision) for 4 weeks in randomized order. Both lenses had a selective blue-violet light filter. A baseline measurement was taken with the subjects' current updated glasses. Accommodation amplitude (AA) and near point of convergence (NPC) were measured binocularly with the RAF ruler. DA was evaluated by a questionnaire. Results No significant difference (p=.52) was found for AA comparing baseline (11.50±1.88 D), test (11.61± 1.62 D), and control SV lenses (11.88±1.50 D). No significant difference was found for NPC (p=.94), between baseline (6.50 ± 2.89cm), test (6.71± 3.49) and control SV lenses (6.82± 3.50 cm). No significant difference was found comparing test and control SV lenses in symptoms of DA (p=0.20). Conclusions The +0.40 D lenses have no negative impact on convergence or loss of accommodation power. The +0.40 D and control SV lenses had a similar impact on attenuating symptoms of DA.

RESUMO Objetivo Avaliar os efeitos do uso de lentes oftálmicas com filtro seletivo de luz azul-violeta, sem e com poder adicional de + 0,4D na zona de perto nas funções de acomodação e convergência e para sintomas de astenopia digital (AD). Métodos Ensaio clínico controlado, randomizado e mascarado, com 49 voluntários (idade, 29 ± 5,5 anos; masculino: feminino, 18: 31). Cada participante usou lentes de teste (+0,40 D na zona de perto) e controle (visão simples), por 4 semanas de forma randomizada. Ambas as lentes tinham filtro seletivo de luz azul-violeta. A medição inicial (baseline) foi feita com os óculos atualizados de cada participante. A amplitude de acomodação (AA) e o ponto de convergência próximo (PPC) foram medidos binocularmente com a régua RAF. A AD foi avaliada por um questionário. Resultados Não houve diferença estatisticamente significante (p=0,52) para as medidas de AA comparando as lentes baseline (11,50±1,88 D), teste (11,61±1,62 D) e controle VS (11,88±1,50 D). Nenhuma diferença significativa foi encontrada para a medida do PPC (p=0,94), entre as lentes baseline (6,50 ± 2,89cm), teste (6,71±3,49) e controle VS (6,82±3,50 cm). Nenhuma diferença significativa foi encontrada comparando lentes teste de VS e controle nos sintomas de AD (p=0,20). Conclusões As lentes com +0,40 D não têm impacto negativo na convergência ou na perda de acomodação. As lentes +0,40 D e controle VS, tiveram impacto semelhante na redução dos sintomas de AD.

Development and usability of a photograph-based smartphone app for ocular surface tumor screening / Desenvolvimento e usabilidade de um aplicativo para smartphones baseado em fotografias para rastreio de tumores de superfície ocular

ABSTRACT Objective: To develop and examine the usability of a mobile application aimed at improving knowledge about ocular surface tumors among medical students, general practitioners and ophthalmologists. Methods: A cross-sectional quantitative study was carried out by a multidisciplinary team and developed in three stages: administration of a specific questionnaire to medical students, assessing the demand for the application, creation and development of the application in collaboration with the Technological Innovation Laboratory of Centro Universitário Christus and usability assessment. General practitioners and ophthalmologists were selected to answer the System Usability Scale questionnaire. Data were exported into the Statistical Package for the Social Sciences, version 20.0 Windows, for quantitative analysis. Results: The OncoEye application was developed for the iOS and the Android platforms and included four main menus: Glossary, Patients, Referrals and Queries. Most students (89.9%) considered the development of the application important for wider access to information about the topic. Most students (39.9%) were able to recognize ocular lesions and 26.1% could distinguish between benign and malignant conditions. System Usability Scale questionnaire responses revealed good usability, with an average score of 92.65. Users (100%) described the application as user-friendly and well- integrated. Conclusion: An innovative application for ocular surface tumors was created and developed. The application achieved good levels of acceptance and was described as user-friendly by users.

RESUMO Objetivo: Desenvolver e avaliar a usabilidade de um aplicativo para dispositivos móveis que aprimore o conhecimento de estudantes de medicina e de médicos sobre tumores da superfície ocular. Métodos: Foi realizado estudo transversal e quantitativo por uma equipe multiprofissional, consistindo em três etapas: realização de um questionário específico com estudantes de medicina, avaliando a necessidade de elaboração do aplicativo; criação e desenvolvimento do aplicativo pelo Laboratório de Inovação Tecnológica do Centro Universitário Christus e avaliação de usabilidade. Médicos generalistas e oftalmologistas foram selecionados para responder ao questionário System Usability Scale. Os dados foram exportados para o programa Statistical Package for the Social Sciences, versão 20.0, para Windows para análise quantitativa. Resultados: O aplicativo OncoEye foi desenvolvido com quatro menus principais: Glossário, Pacientes, Encaminhamento e Perguntas. Dentre os estudantes, 89,9% consideraram o desenvolvimento do aplicativo importante para orientação sobre o tema, 39,9% souberam reconhecer lesão ocular, e 26,1% puderam diferenciar lesão ocular maligna ou benigna. As respostas dos usuários à ferramenta System Usability Scale demonstraram boa usabilidade, com pontuação média de 92,65 (87,74 a 97,55). Todos os usuários consideraram o aplicativo de fácil manuseio e bem integrado. Conclusão: Um aplicativo inovador para tumores da superfície ocular foi criado e desenvolvido, apresentando boa aceitação e fácil manuseio pelos usuários.

Sistema de gestión TO-BE: garantizar el derecho a la salud de pacientes con ITS en Perú / TO-BE management system: guaranteeing the right to health of patients with STIs in Peru

Se realizó una investigación de campo para conocer la gestión de los procesos de solicitud y admisión de citas médicas, considerando la estigmatización y discriminación de las personas ITS, con el fin de garantizar el derecho a la salud de estos pacientes en Perú. Se ejecutó la sistematización de la información sobre los procesos y mecanismos de exigibilidad, bajo los lineamientos y manuales de los cuatro procesos estratégicos del MINSA contemplados para el otorgamiento de citas médicas, siguiendo los lineamientos de Gob.Pe, Adicionalmente, mediante verificación de los procesos se construyeron la matriz entidad-relación de la gestión por procesos del SSP, y el flujograma del proceso de solicitud y otorgamiento de citas AS-ISS. Se consideraron aspectos tecnológicos-médicos-legales con la participación de 201 pacientes independientemente del motivo o patología a consultar, identificando incidentes en la eficiencia del proceso misional. Por último, se implementó el flujograma de procesos de reserva de citas médicas a través de la aplicación ejecutable para smartphones, tabletas y otros dispositivos móviles (APP) TO-BE la cual conlleva a 10 pasos desde el registro de usuario hasta la emisión de comprobante de otorgamiento de cita médica. Se analizaron las preferencias de los usuarios sobre las causas superables en el proceso misional, mediante una encuesta estructura a 170 usuarios de SSP(AU)

A field investigation was carried out to learn about the management of the processes of request and admission of medical appointments, considering the stigmatization and discrimination of STI people, in order to guarantee the right to health of these patients in Peru. The systematization of the information on the processes and mechanisms of enforceability was carried out, under the guidelines and manuals of the four strategic processes of the MINSA contemplated for the granting of medical appointments, following the guidelines of Gov. Pe, Additionally, through verification of the processes The entity-relationship matrix of the management by processes of the SSP, and the flowchart of the process of request and granting of appointments AS-ISS were constructed. Technological-medical-legal aspects were considered with the participation of 201 patients regardless of the reason or pathology to be consulted, identifying incidents in the efficiency of the missionary process. Finally, the flowchart of medical appointment reservation processes was implemented through the executable application for smartphones, tablets and other mobile devices (APP) TO-BE, which entails 10 steps from user registration to issuance of voucher of granting a medical appointment. Users' preferences regarding causes that can be overcome in the missionary process were analyzed through a structured survey of 170 SSP users(AU)

Análise dos sintomas osteomioarticulares pelo uso de tecnologias portáteis em docentes de uma instituição privada / Analysis of musculoskeletal symptoms by the use of portable technologies in teachers of a private institution

As tecnologias portáteis cada vez mais estão sendo utilizadas e tornaram-se necessárias para o dia a dia da população de maneira geral, entretanto, o uso em excesso, más posturas durante o uso, padrão inadequado ergonômico, potencializado pelo sedentarismo, estresse, expõem seus usuários a riscos de desenvolver processos agudos e crônicos de dor e possíveis lesões osteomioarticulares. Objetivo: Analisar a prevalência dos sintomas osteomioarticulares pelo uso de tecnologias portáteis em docentes de uma instituição privada. Materiais e métodos: Trata-se de um estudo descritivo e observacional transversal, de caráter quantitativo, composta por uma amostra de 68 docentes do centro de ciências biológicas e da saúde na Universidade da Amazônia. As variáveis encontradas foram mensuradas e tabuladas visando eliminar erros utilizando o software microsoft excel, assim como, foram feitas análises descritas dos dados através do software bioestat. Resultados: Como resultados, foi constatado que docentes de uma instituição privada apresentam em grande maioria sintomas osteomioarticulares pelo uso de tecnologias portáteis, principalmente para a região cervical (49% dos participantes), seguido da região lombar (46% dos participantes) obtendo valores significantes para esses e demais achados(p<0,05). Conclusão: Os resultados deste estudo apresentam importância sobre vários segmentos, principalmente para os docentes, pois fornece fundamentais informações e descrições acerca do uso de tecnologias portáteis e possíveis repercussões no sistema osteomioarticular. (AU)

Portable technologies are increasingly being used and have become necessary for the daily life of the population in general, however, overuse, bad postures during use, inadequate ergonomic pattern, enhanced by sedentary lifestyle, stress, expose their users at risk of developing acute and chronic pain processes and possible musculoskeletal injuries. Objective: To analyze the prevalence of musculoskeletal symptoms through the use of portable technologies in teachers of a private institution. Materials and methods: It is a descriptive and observational cross-sectional study, of quantitative character, composed of a sample of 68 professors from the center of biological sciences and health at the University of the Amazon. The variables found were measured and tabulated in order to eliminate errors using the microsoft excel software, as well as described analyzes of the data using the bioestat software. Results: As a result, it was found that professors at a private institution mostly present musculoskeletal symptoms due to the use of portable technologies, mainly for the cervical region (49% of the participants), followed by the lumbar region (46% of the participants) obtaining significant values for these and other findings (p <0.05). Conclusion: The results of this study are important in several segments, mainly for teachers, as it provides fundamental information and descriptions about the use of portable technologies and possible repercussions on the osteomioarticular system. (AU)

Public repudiation acts on YouTube: Amplification and mobilizing effects / Actos de repudio público en youtube: amplificación y efectos movilizantes

RESUMEN Los medios sociales han favorecido la producción y consumo de contenidos sobre asuntos de interés ciudadano como aquellos de reclamo social a las autoridades. Dentro de estos aparece una tipología de videos difundidos en YouTube y otras redes en los que personalidades políticas son increpadas en el espacio público por transeúntes casuales. Estos encuentros espontáneos, registrados en dispositivos móviles y trasladados al entorno Web, sirven, potencialmente, como una forma alternativa de protesta social y, en consecuencia, podrían incitar a la movilización y a la participación ciudadana. Este artículo examina este fenómeno desde el análisis de las propiedades de amplificación y los efectos a nivel de movilización social de una selección de actos de repudio a personalidades políticas de Colombia y Venezuela. A través de una metodología mixta se examinaron cuatro casos en los que se observaron las variables de difusión y viralidad, participación, influencia, continuidad, unidad y movilización, en concordancia con la literatura sobre movimientos sociales en la Web. Los resultados permiten concluir que, a pesar del auge y las cualidades atribuidas a las plataformas sociales, estos contenidos no logran efectos concretos en las audiencias que se traduzcan en acciones más allá de la participación en línea.

ABSTRACT Social media have favored the production and consumption of content on matters of citizen interest, such as those of social claim to authorities. Within these, there is a typology of videos broadcasted on YouTube and other social media networks, in which political personalities are rebuked in public space by casual pedestrians. These spontaneous encounters, recorded on mobile devices and posted on the World Wide Web, potentially serve as an alternative form of social protest and, consequently, could incite citizen mobilization and participation. This article examines this phenomenon from the analysis of the amplification properties and the social mobilization effects of a selection of repudiation acts against political personalities from Colombia and Venezuela. Based on the literature on social movements on the Web, and through the application of a mixed methodology, this study examines the variables of diffusion and virality, participation, influence, continuity, unity and mobilization in four distinctive cases. The results allow us to conclude that, despite the rise and qualities attributed to social platforms, these contents do not reach concrete effects on audiences that are translated into actions beyond online participation.

Behavior in children and adolescents associated to screen time in Porto Velho, Brazilian Western Amazon / Comportamento de crianças e adolescentes em relação ao tempo de tela em Porto Velho, Amazônia Ocidental Brasileira

INTRODUCTION: In studies directed to children and adolescents, the sedentary behavior has been usually represented by exposure to screen, which comprise the total or separate measured time exposed to television, videogame, tablets, mobile devices, and computer. OBJECTIVE: To analyze the prevalence and factors associated with screen time in children and adolescents. METHODS: A cross-sectional school-based study was carried out with 1,471 students from Elementary School, aged between 7 to 18 years (51.3% male), enrolled at public schools (55.6%) in Porto Velho, Rondônia (RO) state, Brazil. Excess screen time was defined as watching television, using the computer, and playing video games for more than two hours per day. Poisson regression was used to obtain crude and adjusted prevalence ratios and their respective 95% CI. RESULTS: Overall prevalence of screen time exposure over two hours per day was 65.9%. After adjustments, risk of screen time exposure was higher in males, PR = 1.51 (95% CI: 1.08 - 1.92), under or equal to 14 years old, PR = 1.69 (95% CI: 1.48 - 1.92), in the 5th grade, PR = 1.41 (95% CI: 1.02 - 1.89), in the 6th grade, PR = 1.44 (95% CI: 1.06 - 1.97) and in the 7th grade, PR = 1.52 (95% CI: 1.09 - 2.13), attending two weekly PE classes or fewer, PR = 1.25 (95% CI: 1.07 - 1.53) ), consuming more than 3 daily meals, PR = 2.69 (95% CI: 2.14 - 3.37) and overweight, PR = 1.51 (95% CI: 1.13 - 2.03). CONCLUSION: The findings showed that the exposure equal to or more than two hours of daily screen time was high. The students more exposed to this outcome had the next characteristics: male sex, age less than or equal to 14 years, from the fifth, sixth, and seventh grade of elementary education, practice physical education classes less than or equal to two hours per week, consume more than three meals daily and have excess body fat (G%).

INTRODUÇÃO: Em estudos direcionados a crianças e adolescentes, o comportamento sedentário tem sido usualmente representado pela exposição aos comportamentos de tela, que compreendem as medidas (unificadas ou distintas) do tempo de televisão, videogame, tablets, aparelhos celulares e computador. OBJETIVO: Investigar a prevalência e os fatores associados ao tempo de tela em crianças e adolescentes. MÉTODO: Estudo transversal de base escolar, com 1471 escolares de 9 a 18 anos, sendo 51,3% do sexo masculino pertencentes às escolas públicas (55,6%) do ensino fundamental de Porto Velho, Rondônia. O tempo excessivo de tela foi definido como assistir televisão, usar o computador e jogar videogames por mais de duas horas diárias. Análise utilizada foi regressão de Poisson para obtenção das razões de prevalências brutas e ajustadas e seus respectivos IC95%. RESULTADOS: A prevalência geral de exposição de tempo de tela maior que duas horas diárias foi de 65,9%. Após ajustes, o risco à exposição de tempo de tela foi maior no sexo masculino RP = 1,51 (IC95%: 1,08 - 1,92), idade menor ou igual a 14 anos RP = 1,69 (IC95%: 1,48 - 1,92), graus de ensino 5ª ano RP=1,41 (IC95%: 1,02 - 1,89), 6ª ano RP=1,44 (IC95%: 1,06 - 1,97) e 7ª ano RP = 1,52 (IC95%: 1,09 - 2,13), frequentar as aulas de educação física menos ou igual a duas aulas semanais RP = 1,25 (IC95%:1,07 - 1,53), consumir refeições diárias mais de três por dia RP = 2,69 (IC95%:2,14 - 3,37) e ter excesso de gordura RP = 1,51 (IC95%: 1,13 - 2,03. CONCLUSÃO: Os resultados mostraram que a exposição igual ou superior a duas horas de tela diária era alta. Os estudantes mais expostos a este desfecho tiveram as seguintes características: sexo masculino, idade menor ou igual a 14 anos, de quinta, sexta e sétima série do ensino fundamental, praticar aulas de educação física menor ou igual a duas horas semanais, consumir mais de três refeições diárias e estar com excesso de gordura corporal (G%).

Effects of the excessive use of electronic screens on vision and emotional state / Efeitos do uso excessivo de telas eletrônicas na visão e no estado emocional

ABSTRACT Objective To investigate relations between electronic screen use and eye health in a representative sample of the Brazilian population. Methods Data were collected online and analyzed at a private Brazilian hospital (Provisão Hospital, Maringá, Brazil). Male and female individuals aged 12 to 35 years participated in the study. A population-based cross-sectional survey based on a questionnaire developed using the Google Forms interface was carried out. The questionnaire was answered anonymously in order to ensure the confidentiality of data and the privacy of participants. Data were collected between October 13, 2020, and January 30, 2021. Results A total of 200 questionnaires were completed. Most responders were young people aged 18 to 27 years. Daily electronic device use time reported by responders ranged from more than 5 hours (150; 75.5%) to 3 to 5 hours/day (28; 14%) or 2 to 3 hours/day (16; 8%). Only a small proportion of responders (2.5%) used these devices less than 1 hour per day. Most participants had myopia (164; 84%) and/or astigmatism (151; 75.5%), whereas keratoconus was less prevalent (34; 17%). However, 92 participants were unable to say whether they had these diseases or not. Most participants reported eye symptoms after screen use (red eyes, fatigue, dry and gritty eyes and blurred vision). Mental issues such as smartphone dependence and difficulties to communicate while using electronic devices were also addressed. Most responders reported dependence and communication problems. Conclusions Most young people in this sample had sings of eye disease, including keratoconus. Smartphone dependence and addition was also observed. Findings presented may inform future studies and help health authorities to properly guide public health strategies aimed at eye disease prevention.

RESUMO Objetivo Investigar o uso de telas na saúde ocular em uma amostra populacional brasileira. Métodos Os dados foram adquiridos on-line, e as análises foram realizadas em uma clínica privada na Região Sul do Brasil. Os participantes foram indivíduos de 12 a 35 anos, de ambos os sexos. Foi realizada pesquisa transversal de base populacional por meio de questionário elaborado na plataforma Google Forms. O questionário foi respondido de forma anônima, mantendo o sigilo dos dados coletados e a privacidade dos participantes. A coleta de dados teve início em 13 de outubro de 2020 e término em 30 de janeiro de 2021. Resultados Foram respondidos 200 questionários. A maioria foi de jovens entre 18 e 27 anos. O tempo de uso de dispositivos eletrônicos durante o dia foi de mais de 5 horas para 150 (75,5%) entrevistados, 28 (14%) gastavam de 3 a 5 horas por dia, 16 (8%) de 2 a 3 horas por dia e uma pequena parte dos entrevistados (2,5%) usava menos de 1 hora por dia. A maioria dos participantes tinha miopia (164; 84%) e/ou astigmatismo (151; 75,5%). Ceratocone foi menos prevalente (34; 17%), entretanto 92 pessoas não sabiam a resposta. A maioria dos participantes teve problemas nos olhos após o uso da tela, como olhos vermelhos, cansados e secos, além de visão turva. Questões mentais, como dependência de smartphones e dificuldade de comunicação durante o uso do dispositivo, também foram abordadas. A maioria dos entrevistados demonstrou dependência e problemas de comunicação. Conclusões A maior parte dos jovens apresentou quadro de doenças oculares, incluindo ceratocone. Dependência e adição de smartphone também foram observados. Esses resultados apoiam a identificação de fatores associados à patologia ocular, servindo de base para estudos futuros, e podem auxiliar às autoridades de saúde no direcionamento adequado das atividades de prevenção e controle em saúde pública.

Uso de dispositivos móviles por parte de lactantes y preescolares: una revisión sistemática / Use of mobile devices by infants and preschoolers: a systematic review

Este estudio tiene como objetivo el examinar la frecuencia con la que los niños de 1 a 5 años hacen uso de los nuevos dispositivos móviles y su relación con la salud. Se realizó una revisión sistemática, retrospectiva, en Pubmed y Scielo; de un total de 145 artículos recolectados se incluyeron 43, cuyos criterios de inclusión y exclusión fueron: publicación de 2008 a 2021, sin predilección por alguna metodología en específico, variables de estudio (salud física, psicológica y social), no estudios en animales, trabajos repetidos y sin relevancia para el estudio, la calidad de la evidencia fue analizada con relación al valor de p y el índice de confianza 95% para cada variable en cuestión. El uso de Dispositivos móviles >2hrs/día se asocia a riesgo de desarrollo de alteraciones a la salud de los niños de 1 a 5 años, se necesita una vigilancia proactiva de los tutores(AU)

This study aims to examine the frequency with which children between the ages of 1 and 5 make use of new mobile devices and their relationship to health. A retrospective systematic review was carried out in Pubmed and Scielo; Of a total of 145 articles collected, 43 were included, whose inclusion and exclusion criteria were: publication from 2008 to 2021, without predilection for any specific methodology, study variables (physical, psychological and social health), no studies in animals, Repeated works without relevance to the study, the quality of the evidence was analyzed in relation to the value of p and the 95% confidence index for each variable in question. The use of mobile devices> 2hrs/day is associated with the risk of development of alterations to the health of children aged 1 to 5 years, a proactive vigilance of the tutors is needed(AU)

Clinical efficacy of controlled-release morphine tablets combined with celecoxib in pain management and the effects on WNK1 expression

OBJECTIVES: This study was designed to evaluate the clinical efficacy of controlled-release morphine tablets combined with celecoxib in relieving osteocarcinoma-related pain and the effects of the combination on WNK1 expression. METHODS: A total of 110 patients with osteocarcinoma-related pain were selected and divided into two groups based on the treatment administered, including the control group (treated with controlled-release morphine tablets alone) and the study group (treated with a combination of controlled-release morphine tablets and celecoxib). We compared the treatment efficacy, pain level (visual analog scale (VAS)), time of onset of breakthrough pain (BTP), dose of morphine, incidence of adverse events, quality of life (QOL) score, and With-no-lysine 1 (WNK1) expression in the peripheral blood (PB) as determined with qRT-PCR before and after treatment, of the two groups. RESULTS: The total effective rate of the study group was higher than that of the control group, while the VAS score, time of onset of BTP, dose of morphine, incidence of adverse events, QOL score, and relative WNK1 expression in the PB were lower than those of the control group (p<0.05). CONCLUSION: Combination treatment with controlled-release morphine tablets and celecoxib can be extensively used in the clinical setting because it effectively improves the symptoms, QOL score, and adverse effects in patients with osteocarcinoma-related pain.

Ferramentas tecnológicas de interação em tablets no atendimento fonoaudiológico de crianças com transtorno dos sons da fala / Interactional technology tools in tablets phonological intervention in children with speech disorders / Herramientas tecnológicas de interacción en tabletas en la atención fonoaudiológica de niños con transtorno del habla

INTRODUÇÃO: Cada vez mais, proliferam-se ferramentas tecnológicas de comunicação. Nesse contexto, o tema desta pesquisa é a utilização dessas tecnologias nas intervenções fonoaudiológicas com crianças com transtorno dos sons da fala. OBJETIVO: Descrever a utilização de ferramentas tecnológicas de interação em tablets no atendimento fonoaudiológico de crianças com transtorno dos sons da fala. MÉTODO: Pesquisa descritiva com quatro crianças de ambos os sexos, na faixa etária de 5,3 a 5,11 anos. Foram realizadas avaliação e reavaliação individual dos sujeitos selecionados por meio das provas de fonologia do teste de linguagem infantil - ABFW. Os indivíduos foram atendidos semanalmente, com duração de 30 minutos. O tablet foi utilizado como dispositivo auxiliar. Foram coletados depoimentos livres (da professora e da coordenadora) sobre a evolução dos casos. Os dados foram analisados quantitativa e qualitativamente a partir de categorias definidas a posteriori. RESULTADOS: O tablet foi usado em 92,68% das sessões, e em média por 64,55% do tempo total das sessões. Prevaleceram os jogos interativos terapeuta/paciente (43,57%), seguidos por aplicativos de jogos individuais (33,12%) e uso da câmera em (23,29%). Analisando o conjunto dos casos estudados, verificou-se a seguinte tendência: o tablet funcionou como recurso motivador para o processo terapêutico, embora em diferentes graus e de maneira não decisiva para evolução dos casos. CONCLUSÃO: Nos sujeitos aqui estudados a utilização de ferramentas tecnológicas de interação favoreceu os processos terapêuticos, na medida em que intensificou a atividade dialógica entre paciente e terapeuta e configurou-se como recurso lúdico efetivo para a adesão dos pacientes ao tratamento.

INTRODUCTION: More and more, the use of technological communication tools is increasing. In this context, the theme of this research is the use of these technologies in speech therapy interventions in children with speech disorders (SD). OBJECTIVE: To describe the use of interactional technology tools with tablets in speech therapy of children with speech disorders. METHOD: Descriptive study with four children of both genders, aged 5.3 to 5.11 years old with SD. Individual assessment and reassessment were carried out through the ABFW test. Selected participants went to speech therapy weekly, for 30 minutes, in an adequate space. The tablet was used as an auxiliary tool. Statements were obtained from the teacher and the coordinator about the evolution of the cases. Data were analyzed quantitatively and qualitatively from categories defined later. RESULTS: The tablet was used in 92.68% of the sessions, and during 64.55% of the total time. Therapist / patient interaction games (43.57%) were the most used, followed by individual games (33.12%) and games with camera (23.29%). It was observed that the tablet worked as a motivating tool for the therapeutic process, although in different degrees and it was not overriding to the progress of the subjects. CONCLUSION: With the study the use of interactional technology tools improved the therapeutic process, as it intensified the dialogic activity between patient and therapist and was configured as an effective playful resource for patient adherence to the treatment.

INTRODUCCIÓN: Cada vez más, se proliferan herramientas tecnológicas de comunicación. El tema de esta investigación es la utilización de esas tecnologías en las intervenciones fonoaudiológicas con niños trastorno del habla. OBJETIVO: Describir la utilización de herramientas tecnológicas de interacción en tabletas en la atención fonoaudiológica de niños con trastorno del habla. MÉTODO: investigación descriptiva con cuatro niños de ambos sexos, en el grupo de edad de 5,3 a 5,11 años. Se realizó una evaluación y reavaloración individual de los sujetos por medio de la prueba de fonología del examen de lenguaje infantil - ABFW. Atendimiento semanal, durante 30 minutos. La tableta, se utilizó como dispositivo auxiliar. Fueron recolectados testimonios libres sobre la evolución de los casos. Los datos fueron analizados cuantitativa y cualitativamente a partir de categorías definidas a posteriori. RESULTADOS: La tableta fue utilizada en el 92,68% de las sesiones, y en promedio por el 64,55% del tiempo total. Se prevalecían los juegos de interacción terapeuta / paciente (43,57%), seguidos por aplicaciones de juegos individuales (33,12%) y cámara en (23,29%). Al analizar el conjunto de los casos estudiados, se verificó la siguiente tendencia: la tableta funcionó como recurso motivador para el proceso terapéutico, aunque en diferentes grados y de manera no decisiva para la evolución de los casos. CONCLUSIÓN: En los sujetos aquí estudiados la utilización de herramientas tecnológicas de interacción favoreció los procesos terapéuticos, en la medida en que intensificó la actividad dialógica entre paciente y terapeuta y se configuró como recurso lúdico efectivo para la adhesión de los pacientes al tratamiento.