Intervención psicoeducativa para potenciar la rehabilitación cardiovascular integral en pacientes convalecientes de infarto agudo de miocardio / A psychoeducational intervention to enhance comprehensive cardiovascular rehabilitation in patients convalescent from acute myocardial infarction

Introducción: La rehabilitación cardiovascular integral del paciente con infarto agudo de miocardio resulta fundamental para el logro de su bienestar físico y psicológico, y su reinserción a la vida social. Objetivo: Elaborar una estrategia de intervención psicoeducativa para potenciar la rehabilitación cardiovascular integral en pacientes convalecientes de infarto agudo de miocardio, con la visión de especialistas consultados. Métodos: Se realizó un estudio observacional, descriptivo y de corte transversal en el Hospital Universitario «Dr. Celestino Hernández Robau», de Santa Clara, entre octubre de 2019 y enero de 2021. La muestra estuvo conformada por 27 pacientes que asistieron a la consulta de Cardiología, y 7 especialistas según criterios de inclusión. Las técnicas aplicadas fueron: la revisión de historia clínica, entrevistas semiestructuradas a pacientes y especialistas, la encuesta sobre el conocimiento de la enfermedad, un autorreporte vivencial y la evaluación del estilo vida. Se utilizaron estadísticos descriptivos acorde a la medición de las variables, análisis de contenido y triangulación de la información. Resultados: En los pacientes diagnosticados con estilo de vida poco saludable, predominó un conocimiento medianamente suficiente de la enfermedad; la hipertensión arterial fue el principal factor de riesgo asociado. Se elaboró la estrategia de intervención según las necesidades psicoeducativas identificadas por los pacientes con la visión de especialistas consultados. Se constató que presentan carencia de habilidades para autocontrolar las reacciones emocionales posteriores al suceso cardiovascular. Conclusiones: La estrategia elaborada fue valorada satisfactoriamente por juicio de profesionales, indicándose la posibilidad de ser aplicada en los usuarios a los que está dirigida.

Introduction: comprehensive cardiovascular rehabilitation of patients with acute myocardial infarction is essential to achieve their physical and psychological well-being, and their reintegration into social life. Objective: to develop a psychoeducational intervention strategy to enhance comprehensive cardiovascular rehabilitation in patients convalescent from acute myocardial infarction, with the vision of consulted specialists. Methods: an observational, descriptive and cross-sectional study was carried out at "Dr. Celestino Hernández Robau" University Hospital, in Santa Clara, between October 2019 and January 2021. The sample consisted of 27 patients who come to the Cardiology consultation, and 7 specialists according to inclusion criteria. Medical history review, semi-structured interviews with patients and specialists, a survey on knowledge of the disease, an experiential self-report, and a lifestyle evaluation were the techniques applied. Descriptive statistics were used according to the measurement of the variables as well as content analysis and triangulation of the information. Results: a moderately sufficient knowledge of the disease prevailed in patients diagnosed with an unhealthy lifestyle; arterial hypertension was the main associated risk factor. The intervention strategy was developed according to the psychoeducational needs identified by the patients with the vision of the consulted specialists. We verified that they have a lack of abilities to self-control their emotional reactions after the cardiovascular event. Conclusions: the elaborated strategy was satisfactorily valued by professional judgment, which indicates the possibility of being applied to the users to whom it is directed.

Programa de entrenamiento en potencial de aprendizaje para niños colombianos con dificultades de aprendizaje en Matemáticas / Dynamic assessment program for Colombian children with learning disabilities in Mathematics (LDM)

Resumen Las dificultades de aprendizaje en Matemáticas (DAM) han sido estudiadas por parte de los investigadores en los últimos años. La literatura sobre su clasificación y su identificación en niños ha sido relevante; sin embargo, es poca la bibliografía actual acerca de cómo superar dichas dificultades en niños. El presente estudio tuvo como objetivo la validación de un protocolo para mejorar habilidades en el campo de las matemáticas. La muestra se componía de 59 niños con esta característica, además del bajo rendimiento en dicha área. Los participantes tenían entre 7 y 10 años y estaban cursando entre segundo y cuarto año de primaria. El diseño es cuasiexperimental con medidas pretest-postest y grupo control en lista de espera. El programa constó de cinco semanas, con una sesión semanal de forma grupal con una duración de 50 minutos aproximadamente. Los instrumentos de evaluación fueron: TEDI-MATH para la identificación de las DAM y tres subpruebas de la WISC-IV, dígitos, conceptos y claves. Los resultados de la investigación arrojaron diferencias significativas entre el grupo control y experimental para todas las pruebas de la TEDI-MATH y para la subprueba de conceptos en WISC-IV. Los resultados son coherentes con otras investigaciones relacionadas con la comorbilidad entre los campos del lenguaje y las matemáticas. Se concluye que, al entrenar aspectos relacionados con la adquisición del lenguaje mejora la comprensión y el manejo de las competencias en matemáticas en los niños.

Abstract Learning Disabilities Mathematical LDM, have been the subject of study since the decade of the 70`s, advances in this field have allowed a correct identification and classification through the design of various instruments for this objective. The number of investigations that address intervention protocols to improve this type of difficulties in children is even more limited. On this way, comorbidities have also been found different researches with the Language Learning Disabilities LLD, and as well as their relationship with the neurological development of children. It is estimated that in countries like Germany, USA, and Spain, the percentage of children with LDM is between 3% and 8%. In particular, in Colombia at the moment, there is very little research that allows identifying these difficulties in children, as well as very little research on the different types of intervention to improve these difficulties in Math. In General, there are little current literature on how to overcome such difficulties in children. An intervention based on the perspective of dynamic assessment would be useful for children who have these difficulties. The dynamic assessment implies two important concepts: activity and modifiability. The tester and the inquired assume an active role, where the tester intervenes and modifies the interaction with the inquired with the purpose of successfully inducing learning. The inquired is directed and reinforced to assume an active role in searching and organizing information. The product of the assessment is modifiability or change in cognitive functioning. This study presents the validation of a protocol based on dynamic assessment to improve skills in the field of mathematics. The sample was 59 Colombian children from public schools in the city of Bogotá. Participants were between 7 to 10 years old and from second to fourth grade. They had Mathematics Learning Difficulties in evaluated with TEDI-MATH on short version. They were distributed in 28 boys and 31 girls with this characteristic. And children who were undergoing psychological, medicated and/or clinical treatment processes were excluded. The design used was quasi-experimental with pretest-posttest measures and control group on the waiting list. The program considered five weeks, with one weekly session of group with a duration of approximately 50 minutes. The evaluation instruments were: TEDI-MATH which was used for the identification of the MLD; 3 sub tests of the WISC-IV, digits, concepts and keys. And PAMATH-C protocol was used for the intervention with children with the aforementioned difficulties. The results of the investigation showed significant differences between the control and experimental group for all the TEDI-MATH tests and for the subtest of concepts in WISC-IV. The results are consistent with other research related to comorbidity between the fields of language and mathematics. The results showed that like other research based interventions with Learning Potential training programs are effective in improving the different metacognitive abilities among the participants. and has a significant effect on the decrease in Mathematical Learning Disabilities. This research leaves projections for an application to a larger population in Colombia and in South America of the TEDYMATH test on short version, since good discrimination was observed for children with LDM. The application of the PAMATH-C protocol in other types of rural and urban population throughout the territories will improve the identification of children with difficulties. In addition, the contribution for the design of new tests based on dynamic evaluation and its form of application to improve other types of difficulties in both children and adults. Therefore, an immense methodological field to develop future protocols based on the Learning Potential. It is concluded that when training aspects related to language acquisition, it improves the understanding and management of mathematics in children.

Caracterización del balance redox en personas expuestas a una actividad psicofísica intensa / Characterization of redox balance in persons exponed to intensive psychophysical activity

Se realizó un estudio prospectivo longitudinal, en el que se tuvo en cuenta marcadores de estrés oxidativo en situación psicofísica intensa. La muestra estuvo constituida por 31 expuestos del sexo masculino, quienes realizaron un ejercicio especial de graduación. La investigación se dividió en dos etapas, basal y experimental, donde los individuos objeto de estudio fueron su propio control. Tanto en la etapa basal como en la experimental (durante e inmediatamente después), fueron evaluados desde el punto de vista clínico y bioquímico. En la muestra objeto de estudio se observó un aumento significativo de la concentración plasmática de malonildialdehído en la etapa después (441,65 nmol/L) en relación con la etapa antes (347,61 nmol/L). La catalasa se incrementó significativamente y no se encuentraron cambios significativos en las concentraciones séricas de superóxido dimutasa y peróxido de hidrógeno. Se encontró una correlación negativa, estadísticamente significativa entre malonildialdehido y vitamina C (r= -0,410; p= 0,025) y entre superóxido dimutasa y vitamina C (r= -0,467; p= 0,011). También el oligoelemento zinc correlacionó positivamente con la catalasa (r= 0,524; p= 0,004). Se estableció un desbalance redox como consecuencia de una actividad psicofísica intensa que se expresó mediante la aparición de peroxidación lipídica. Hubo respuesta antioxidante favorable para el tiempo de duración del ejercicio, que de prolongarse pudo haber depletado esta respuesta. Las variaciones encontradas pueden constituir factores de riesgo de enfermedad cardiovascular aterosclerótica en edades tempranas y limitar la vida útil del personal expuesto.

A longitudinal prospective study was made in which oxidative stress markers in an intensive psychophysical condition were taken into consideration. The sample was made up of 31 exposed male subjects, who had performed a special graduation exercise. The research was divided into two stages, that is, basal and experimental, in which these individuals under study were their own controls at the same time. Both in the basal and the experimental phases (during and immediately afterwards) the subjects were evaluated from the clinical and biochemical viewpoints. The sample under study showed significant increase in plasma malonylaldehyde concentration in the posterior phase (441.65 nmol/L) in relation to the previous phase (347.61 nmol/L). Catalase significantly increased but no remarkable changes were found in serum superoxide dismutase and hydrogen peroxide concentrations. Statistically significant negative correlation was found between malonylaldehyde and vitamin C (r= -0.410; p= 0.025) and between superoxide dismutase and vitamin C (r= -0.467; p= 0.011). Additionally, zinc oligoelement positively correlated with catalase (r= 0.524; p= 0.004). Redox imbalance occurred as a result of intensive psychophysical activity, which expressed in occurrence of lipid peroxidation. There was a favourable antioxidant response to the duration of exercise, but if this had been longer, it could have depleted this response. The variations found may represent risk factors for atherosclerotic cardiovascular disease at younger ages and limit the useful life of the exposed staff.