Research progress on commonly used visual acuity charts for preschool children / 国际眼科杂志(Guoji Yanke Zazhi)

Preschool age(3-6 years old)is a critical period for visual development, and it is crucial to detect and treat visual problems in preschool children as early as possible. Visual acuity charts are important tools for screening visual issues in children. In China, the commonly used charts are the standard logarithmic visual acuity chart and the pediatric optotype chart, while overseas, the Lea, HOTV, and ETDRS visual acuity charts are frequently employed. Numerous studies have reported the measurability, repeatability, and sensitivity of these three charts in diagnosing visual-related problems in children. However, the application of these three charts is relatively limited in China. This article provides a comprehensive review of the design principles, clinical applications, and characteristics of these three visual acuity charts, so as to better understand their applicability and limitations in preschool children, and provide reference for the selection and improvement of vision examination methods in the future.

A permanência dos símbolos teriomórficos na arte e na psique / The permanence of sybols in artand in the psyque / La permanencia de los simlolos del teriomorfismo en elarte yen la psique

O artigo trata de símbolos teriomórficos­referidos a animais. A importância que exercem pode ser atestada pela permanência na arte (pinturas parietais até os grafites contemporâneos) e na psique. A perpetuação de símbolos e temas é tratada por estudos como os de Aby Warburg em história da arte, com as noções de Kulturgeschichte, Pathosformele Mnemosyne: a recorrência de temas, emoções e comportamentos revela a perpetuação de símbolos interligados à cultura. Essa recorrência simbólica, em termos psíquicos é entendida por C.G. Jung mediante as noções de arquétipo e inconsciente coletivo. Autores contemporâneos a Warburg e a Jung e seus respectivos conceitos, bem como a apresentação de algumas obras de arte, ilustram a importância dos símbolos teriomórficos .Aventa-se a hipótese de que seja uma necessidade psíquica de reunir a natureza biológica, sua força desejante instintiva com a esfera da mente e do sentido de ser constantemente renovada (AU).

Teriomorphicsymbols refer to animals. The importance they exercise can be demonstrated by the permanence of these symbols both in art (parietal paintings to contemporary graffiti) and in the psyche. The perpetuation of symbols and themes is dealt with by studies suchas those by Aby Warburg in art history: Kulturgeschichte, Pathosformel and Mnemosyne. The recurrence of themes, emotions and behaviors reveals the perpetuation of symbols intertwined with culture. This symbolic recurrence, in psychic terms, is understood by C.G. Jung through the notions of archetype and collective unconscious. Contemporary authors of Warburg and Jungand their respective concepts, as well as the presentation of some works of artillustratethe importance of teriomorphic symbols. It is hypothesized that it is a psychic need to unite the biological nature, its instinctive desiring force with the sphere of the mind and the sense of being constantly renewed (AU).

Los símbolos teriomorfosse refieren a los animales. La importancia que ejercen puede ser atestiguada por su permanencia en el arte (pinturas parietales hasta grafitis contemporáneos) y en la psiquis. La perpetuación de símbolos y temas es abordada por estudios como los de Aby Warburg en historia del arte: Kulturgeschichte, Pathosformel y Mnemosyne: la recurrencia de temas, emociones y comportamientos revela la perpetuación de símbolos entrelazados con la cultura. Esta recurrencia simbólica, en términos psíquicos, es comprendida por C.G. por Jung a través de las nociones de arquetipo e inconsciente colectivo. Autores contemporáneos de Warburg y Jungy sus respectivos conceptos,así como la presentación de algunas obras de arte, ilustran la importancia de los símbolos teriomorfos. Se plantea la hipótesis de que se trata de una necesidad psíquica de unir la naturaleza biológica, su fuerza instintiva deseante con la esfera de la mente y el sentido de renovarse constantemente (AU).

A permanência dos símbolos teriomórficos na arte e na psique / The permanence of teriomorphic symbols in art and in the psyche / La permanencia de los simbolos del teriomorfismo en el arte y en la psique

O artigo trata de símbolos teriomórficos referidos a animais. A importância que exercem pode ser atestada pela permanência na arte (pinturas parietais até os grafites contemporâneos) e na psique. A perpetuação de símbolos e temas é tratada por estudos como os de Aby Warburg em história da arte, com as noções de Kulturgeschichte, Pathosformele Mnemosyne: a recorrência de temas, emoções e comportamentos revela a perpetuação de símbolos interligados à cultura. Essa recorrência simbólica, em termos psíquicos é entendida por C.G. Jung mediante as noções de arquétipo e inconsciente coletivo. Autores contemporâneos a Warburg e a Jung e seus respectivos conceitos, bem como a apresentação de algumas obras de arte, ilustram a importância dos símbolos teriomórficos.Aventa-se a hipótese de que seja uma necessidade psíquica de reunir a natureza biológica, sua força desejante instintiva com a esfera da mente e do sentido de ser constantemente renovada (AU).

Teriomorphicsymbols refer to animals. The importance they exercise can be demonstrated by the permanence of these symbols both in art (parietal paintings to contemporary graffiti) and in the psyche. The perpetuation of symbols and themes is dealt with by studies suchas those by Aby Warburg in art history: Kulturgeschichte, Pathosformel and Mnemosyne. The recurrence of themes, emotions and behaviors reveals the perpetuation of symbols intertwined with culture. This symbolic recurrence, in psychic terms, is understood by C.G. Jung through the notions of archetype and collective unconscious. Contemporary authors of Warburg and Jungand their respective concepts, as well as the presentation of some works of artillustratethe importance of teriomorphic symbols. It is hypothesized that it is a psychic need to unite the biological nature, its instinctive desiring force with the sphere of the mind and the sense of being constantly renewed (AU).

Los símbolos teriomorfosse refieren a los animales. La importancia que ejercen puede ser atestiguada por su permanencia en el arte (pinturas parietales hasta grafitis contemporáneos) y en la psiquis. La perpetuación de símbolos y temas es abordada por estudios como los de Aby Warburg en historia del arte: Kulturgeschichte, Pathosformel y Mnemosyne: la recurrencia de temas, emociones y comportamientos revela la perpetuación de símbolos entrelazados con la cultura. Esta recurrencia simbólica, en términos psíquicos, es comprendida por C.G. por Jung a través de las nociones de arquetipo e inconsciente colectivo. Autores contemporáneos de Warburg y Jungy sus respectivos conceptos,así como la presentación de algunas obras de arte, ilustran la importancia de los símbolos teriomorfos. Se plantea la hipótesis de que se trata de una necesidad psíquica de unir la naturaleza biológica, su fuerza instintiva deseante con la esfera de la mente y el sentido de renovarse constantemente (AU).

Survey Regarding the Actual Use of Two-Dimensional Symbols Containing Prescription Information in Fukui Prefecture / 医薬品情報学

Objective: Two types of symbols have been established as industry standards in terms of two-dimensional (2D) symbols with prescription information: one for objects to be printed on prescriptions and the other for electronic versions of medication diaries. However, no studies have investigated the system for using 2D symbols in pharmacies and hospitals/clinics as well as the quality of the information actually stored in these 2D symbols. Therefore, we conducted a survey to clarify the current status and problems pertaining to prescription information sharing via 2D symbols.Methods: We distributed questionnaires to community pharmacies through the Fukui Pharmaceutical Association and asked them to cooperate with us during the survey. The list of items in the survey　included the installation status of devices necessary for reading 2D symbols at each pharmacy, receipt computer in use, and status of the support issued by hospitals/clinics for reading 2D symbols. At the same time, we received 2D symbols created by community pharmacies and conducted reading tests to examine issues related to the collection of prescription information via 2D symbols at medical institutions.Results: The response rate for the survey was 21.8%. Among the 57 stores that responded to the survey, 26 (45.6%) answered that they could read prescription symbols, and 22 of them had actually used the system till date. In addition, 38 community pharmacies were able to provide the 2D symbols for medication diaries. Of the 30 provided symbols for medication diaries, 16 (53.3%) could be read as Japanese data by the barcode reader used.Conclusions: It has become clear that the 2D symbols with stored prescription information are not being completely utilized at present, as both community pharmacies and hospitals/clinics face several issues such as hardware maintenance, software updates, and time and effort required for the usage.

Simbología gráfica anatómica en el proceso de comunicación / Anatomical graphic symbolism in the communication process

RESUMEN: Las ciencias de la comunicación mejoran la organización de la vida en sociedad. En la interdisciplinaridad que la caracteriza se nutre también de la anatomía. La simbología gráfica anatómica, por ejemplo, la calavera o cabeza ósea, por su carácter universal, facilita el proceso de comunicación y advierte sobre potenciales daños de la salud, a veces de consideraciones mortales. Este artículo destaca la participación de la anatomía en los procesos de comunicación.

SUMMARY: Communication sciences improve the organization of life in society. In the interdisciplinarity that characterizes it, it also draws on anatomy. The anatomical graphic symbology, for example, the skull or bony head, due to its universal nature, facilitates the communication process and warns of potential health damages, sometimes of mortal considerations. This article highlights the participation of anatomy in communication processes.

Ensinando Conceitos sobre a Pandemia com Símbolos Tangíveis / Teaching Pandemic Concepts with Tangible Symbols

RESUMO: Crianças com deficiência múltipla sensorial visual enfrentam desafios diários para comunicar seus interesses e necessidades e para compreender adequadamente conceitos. Um dos grandes obstáculos para iniciar uma intervenção eficaz com essas crianças consiste em identificar suas preferências e fornecer estratégias de ensino e oportunidades de aprendizagem específicas que valorizem os seus pontos fortes. Nesse sentido, o objetivo deste estudo foi apresentar cinco cartões de símbolos tangíveis como recurso para ensinar conceitos sobre a pandemia da COVID-19 para crianças que apresentam deficiência múltipla sensorial visual. Pensando nisso, este ensaio teórico coloca em evidência a importância dos símbolos tangíveis como valiosos recursos da comunicação alternativa tátil, capazes de favorecer a comunicação, a antecipação de atividades, a compreensão de conceitos, e como opções de escolhas a serem feitas por estas crianças. Destaca-se a importância das interações táteis exploratórias por meio da modalidade háptica e do distanciamento entre o eu, os outros, os objetos e as representações. Por tratar-se de um assunto pouco explorado no cenário nacional, considera-se relevante apresentá-lo para que outros professores e pesquisadores o conheçam e o utilizem com seus alunos.

ABSTRACT: Children with multi-sensory impairment face daily challenges to communicate their interests and needs and properly understand concepts. One of the major obstacles to start an effective intervention with these children is to identify their preferences and provide specific teaching strategies and learning opportunities that value their strengths. In this sense, the objective of this study was to present five cards of tangible symbols as a resource to teach concepts about the COVID-19 pandemic to children who have multi-sensory impairment. With this in mind, this theoretical essay highlights the importance of tangible symbols as valuable resources for alternative tactile communication, capable of favoring communication, anticipating activities, understanding concepts, and as options for choices to be made by these children. It highlights the importance of exploratory tactile interactions through haptic modality and distance between the self, others, objects and representations. As it is a subject little explored in the national scenario, it is considered relevant to present it so that other professors and researchers can get to know it and use it with their students.

Simbolismos do coração: a relação entre conteúdo onírico e a espera pela cirurgia cardíaca / Heart symbolisms: the relationship between dream content and waiting for cardiac surgery

A espera pela cirurgia cardíaca pode vir a ser prolongada, provocando vulnerabilidade psicológica aos pacientes. A análise dos sonhos facilita o acesso à linguagem simbólica e temáticas que se relacionam ao adoecimento cardíaco, internação e tratamento. O objetivo deste estudo é compreender a relação entre o conteúdo onírico e a espera pela cirurgia cardíaca, a partir do referencial teórico da Psicologia Analítica. Foi realizado um estudo qualitativo e exploratório em pacientes internados em uma Unidade de Internação de Cirurgia Cardíaca. Participaram da pesquisa seis pacientes internados na unidade. Para coleta de dados, foi utilizado o prontuário multiprofissional, assim como um formulário de Registro de Sonhos e Associações. A análise dos dados aconteceu em duas etapas: análise categorial de conteúdo e ampliação simbólica. Os sonhos analisados proporcionaram um aprofundamento na vivência psíquica dos pacientes participantes e uma maior conexão com temáticas que são latentes durante o processo de hospitalização: medo da morte, fuga e transformação. Foi possível perceber a conexão dos pacientes com a possibilidade de finitude, diante da fragilidade do corpo e do coração. A falta de autonomia e controle das situações durante o processo de hospitalização fortalecem o medo da morte e a vontade de retomar a vida segura, estável, fluída, que era supostamente mais viável antes da internação, através da fuga da realidade. Entretanto, os pacientes se defrontam com o chamado da transformação em suas vidas, para além dos cortes e ajustes carnais, uma mudança de perspectiva, atitude, o que provoca mais uma vez o medo.

The wait for cardiac surgery may be prolonged, causing psychological vulnerability to patients. The analysis of dreams facilitates access to symbolic language and themes related to heart disease, hospitalization and treatment. The aim of this study is to understand the relationship between dream content and waiting for cardiac surgery, based on the theoretical framework of Analytical Psychology. A qualitative and exploratory study was performed on patients admitted to a Cardiac Surgery Inpatient Unit. Six patients in the unit participated in the research. For data collection, a multidisciplinary medical record was used, as well as a Dream and Associations Record form. Data analysis took place in two stages: categorical content analysis and symbolic expansion. The analyzed dreams provided a deepening in the psychic experience of the participating patients and a greater connection with themes that are latent during the hospitalization process: fear of death, escape and transformation. It was possible to perceive the connection of patients with the possibility of finitude, given the fragility of the body and the heart. The lack of autonomy and control of situations during the hospitalization process strengthens the fear of death and the desire to resume a safe, stable, fluid life, which was supposedly more viable before hospitalization, through the escape from reality. However, patients are faced with the call of transformation in their lives, in addition to cuts and carnal adjustments, a change in perspective, attitude, which again causes fear.

Eros na constituição do objeto estético: fragmentos de uma escuta a fim de entender melhor o que eu quero dizer / Eros in constitution of the aesthetical object: fragments from a listening to better understand what I want to say / Eros en la constitución del objeto estético: fragmentos de una escucha para mejor entender lo que quiero decir / Eros dans la constitution de l'objet esthétique: fragments de l'écoute pour mieux comprendre ce que je veux dire

Neste trabalho faço uma exploração sobre o objeto estético, descrito por Meg Harris Williams como um processo da mentalidade estética. Tecendo associações entre poemas, experiências emocionais e sonhos, vou construindo um texto, em que as ideias nascidas são compreendidas como função dos objetos internos que, no recolhimento de sua câmera nupcial, criam símbolos, pensamentos oníricos e pensamentos de cuja matéria se fazem pensamentos.

In this paper I explore the aesthetic object described by Meg Harris Williams as a process of the aesthetic mindset. Weaving associations among poems, emotional experiences and dreams I build a text where the born ideas are understood as a function of the internal objects that, in the recollection of their "bridal camera", create symbols, dream thoughts and thoughts from whose matter thoughts are made.

En este artículo exploro el objeto estético descrito por Meg Harris Williams como un proceso de mentalidad estética. Tejiendo asociaciones entre poemas, experiencias emocionales y sueños construyo un texto donde las ideas nacidas se entienden como una función de los objetos internos que, en el recuerdo de su "cámara nupcial", crean símbolos, pensamientos y pensamientos de los sueños de los cuales están hechos los pensamientos.

Dans cet article, j'explore l'objet esthétique décrit par Meg Harris Williams en tant que processus de la mentalité esthétique. Tissant des associations entre poèmes, expériences émotionnelles et rêves, je construis un texte dans lequel les idées nées sont comprises comme une fonction des objets internes qui, dans le souvenir de leur "chambre nupciale", créent des symboles, des pensées de rêve et des pensées à partir desquelles des pensées sont créées.

Comparative analysis of Lea Symbols chart and ETDRS chart in Chinese preschool children's vision examination / 中华实验眼科杂志

Objective@#To compare cooperation degree and visual acuity difference between Lea Symbols chart and ETDRS chart in Chinese preschool children.@*Methods@#A prospective self-control study design was performed.Two hundred and forty-one children aged from 42 months to 78 months in Quanzhou Quangang Experimental Kindergarten were enrolled and the mean age was (61.9±10.3) months.Among them, 132 pre-school children had normal refractive index.All children completed comprehensive ophthalmological examinations and measurement of monocular visual acuity using Lea Symbols chart and ETDRS chart.All monocular visual acuity scores were recorded in LogMAR form.This study followed the Declaration of Helsinki and this study protocol was approved by Medical Ethics Committee of The Second Affiliated Hospital of Fujian Medical University (No.2017[62]). Written informed consent was obtained from all guardians before entering the study.@*Results@#The cooperation degrees of Lea Symbols chart and ETDRS chart were 96.7% and 95.0% in 42-78 months of children, respectively, with no significant difference between the two visual acuity tables (χ2=1.669, P>0.05). The visual acuity measured by Lea Symbols chart was positively correlated with that measured by ETDRS chart (rs=0.726, P<0.001). The measurement consistency of the two chart was good (Kappa=0.531). Among 132 normal refractive children, the visual acuity level measured by Lea Symbols chart was higher than that measured by ETDRS chart (W=-7.461, P<0.001); the measurement consistency of the two visual acuity chart was good (Kappa=0.467). There was no significant difference between the two charts in measuring the binocular vision difference (W=-0.889, P=0.374); the visual acuity levels of boys measured by Lea Symbols chart and ETDRS chart were higher than those of girls, and the difference was statistically significant (U=-3.352, -4.679; both at P<0.001); the visual acuity values measured by Lea Symbols chart and ETDRS chart were negatively correlated with age (rs=-0.423, -0.437; both at P<0.001); the visual acuity measured by Lea Symbols chart was higher than that measured by ETDRS chart in different age groups, and the differences were statistically significant (all at P<0.001).@*Conclusions@#The measurement of visual acuity by Lea Symbols chart and ETDRS chart can be achieved with a high cooperation degree in 42 months and older children.The visual acuity measured by Lea Symbols chart is higher than that measured by ETDRS chart.In the preschool children's vision screening, we should pay attention to the difference between the two kinds of visual charts, and be careful to judge the abnormal vision.

Comparative analysis of Lea Symbols chart and ETDRS chart in Chinese preschool children ' s vision examination / 中华实验眼科杂志

Objective To compare cooperation degree and visual acuity difference between Lea Symbols chart and ETDRS chart in Chinese preschool children. Methods A prospective self-control study design was performed. Two hundred and forty-one children aged from 42 months to 78 months in Quanzhou Quangang Experimental Kindergarten were enrolled and the mean age was (61. 9±10. 3) months. Among them,132 pre-school children had normal refractive index. All children completed comprehensive ophthalmological examinations and measurement of monocular visual acuity using Lea Symbols chart and ETDRS chart. All monocular visual acuity scores were recorded in LogMAR form. This study followed the Declaration of Helsinki and this study protocol was approved by Medical Ethics Committee of The Second Affiliated Hospital of Fujian Medical University ( No. 2017 [ 62 ] ) . Written informed consent was obtained from all guardians before entering the study. Results The cooperation degrees of Lea Symbols chart and ETDRS chart were 96. 7％ and 95. 0％ in 42-78 months of children,respectively, with no significant difference between the two visual acuity tables (χ2=1. 669,P>0. 05). The visual acuity measured by Lea Symbols chart was positively correlated with that measured by ETDRS chart (rs=0. 726,P<0. 001). The measurement consistency of the two chart was good ( Kappa=0. 531 ) . Among 132 normal refractive children, the visual acuity level measured by Lea Symbols chart was higher than that measured by ETDRS chart (W=-7. 461,P<0. 001);the measurement consistency of the two visual acuity chart was good (Kappa=0. 467). There was no significant difference between the two charts in measuring the binocular vision difference (W=-0. 889,P=0. 374);the visual acuity levels of boys measured by Lea Symbols chart and ETDRS chart were higher than those of girls,and the difference was statistically significant (U=-3. 352,-4. 679;both at P<0. 001);the visual acuity values measured by Lea Symbols chart and ETDRS chart were negatively correlated with age ( rs =-0. 423,-0. 437;both at P<0. 001 );the visual acuity measured by Lea Symbols chart was higher than that measured by ETDRS chart in different age groups,and the differences were statistically significant (all at P<0. 001). Conclusions The measurement of visual acuity by Lea Symbols chart and ETDRS chart can be achieved with a high cooperation degree in 42 months and older children. The visual acuity measured by Lea Symbols chart is higher than that measured by ETDRS chart. In the preschool children's vision screening,we should pay attention to the difference between the two kinds of visual charts, and be careful to judge the abnormal vision.

Os sentidos como funções estruturantes da Consciência: Um Estudo da Psicologia Simbólica / The senses as structuring functions of consciousness: A contribution of symbolic psychology / Los sentidos como funciones estructurantes de la conciencia: Un estudio de la psicología simbólica

O autor estuda os órgãos dos sentidos como funções estruturantes da Consciência e da Sombra Individual e Coletiva. Comparando o cérebro a um computador, o autor argumenta que as funções fisiológicas são equivalentes aos hardware e as funções estruturantes aos software. Com esta comparação, o autor pretende chamar a atenção para a extraordinária transformação da Consciência operada pela Civilização, fato que tem sido pouco considerado pela Psiquiatria moderna, devido ao seu justificável, mas lamentável fascínio atual pela neuropsicofarmacologia. A seguir, o autor tece considerações resumidas sobre cada órgão dos sentidos percebido como função estruturante e cita a expressividade da visão pela pintura, do olfato pelos perfumes, do paladar pelo vinho, da audição pela música e do tato pela cosmetologia. Considera que, enquanto a cultura aumentou o poder da visão e da audição, o mesmo não aconteceu com o olfato, o paladar e o tato. Finalmente, à guisa de ilustrar o desenvolvimento cultural dos órgãos dos sentidos como funções estruturantes da Consciência Individual e Coletiva, o autor aplica sua Teoria Arquetípica da História à História da Arte Moderna. ■

The author studies the sense organs as structuring functions of individual and collective consciousness and shadow. Comparing the brain to a computer, he argues that physiological functions are equivalent to hardware and structuring functions to software. With this comparison, the author intends to call attention to the extraordinary transformation of consciousness brought about by civilization, a fact which modern psychiatry fails to consider due to its comprehensible fascination for neuro-psycho-pharmacology. Then, the author briefly considers each sense organ when seen as a structuring function and considers the expression of sight through painting, hearing through music, smell through perfumes, taste through wine, and touch through skin creams. He remarks that while the power of vision and hearing were enhanced by culture, the same did not happen to smell, taste and touch. Finally, the author applies his Archetypal Theory of History to the history of modern art to illustrate the cultural development of the senses seen as structuring functions of individual and collective consciousness and shadow. ■

El autor estudia los órganos de los sentidos como funciones estructurantes de la Conciencia y de la Sombra Individual y Colectiva. Comparando el cerebro a una computadora, el autor argumenta que las funciones fisiológicas son equivalentes a los hardwares y las funciones estructurantes a los softwares. Con esta comparación, el autor pretende llamar la atención sobre la extraordinaria transformación de la Conciencia operada por la Civilización, hecho que ha sido poco considerado por la Psiquiatría moderna, debido a su justificable pero lamentable fascinación actual por la neuropsicofarmacología. A continuación, el autor hace consideraciones resumidas sobre cada órgano de los sentidos percibido como función estructurante y cita la expresividad de la visión por la pintura, el olfato por los perfumes, el paladar por el vino, la audición por la música y el tacto por la cosmetología. Considera que mientras que la cultura aumentó el poder de la visión y de la audición, lo mismo no ocurrió con el olfato, el paladar y el tacto. Finalmente, a la luz de ilustrar el desarrollo cultural de los órganos de los sentidos como funciones estructurantes de la Conciencia Individual y Colectiva, el autor aplica su Teoría Arquetípica de la Historia a la Historia del Arte Moderno. ■

Review on visual acuity charts for preschool children / 中华实验眼科杂志

The preschool age is an important stage for the development of children's vision.Visual problems can affect visual development of children,so it is necessary for preschool children to have vision examination.As an important method of preschool vision screening,visual acuity charts can be used for early screening of eye diseases in children.The benefits of screening before school entry have been demonstrated in practice.There are many kinds of visual acuity charts that can be used to test the vision acuity of preschool children aged 3 to 6 years.This review introduced the design of visual acuity charts and lists several types of charts for screening of preschool children.Simultaneously,we have analyzed a number of papers that compared preschool vision screening methods.The vision examination on children aged 3 to 6 years was necessary to discover various visual impairments.Choosing an appropriate visual acuity chart is the focus of low vision rehabilitation research.

Tablas de normalidad de la población en Cuba para las pruebas psicométricas utilizadas en el diagnóstico de la encefalopatía hepática mínima / Cuban Normality Tables for Psychometric Tests Used for Diagnosis of Minimal Hepatic Encephalopathy

Objetivos: la encefalopatía hepática mínima constituye el estadio subclínico previo al desarrollo de encefalopatía hepática clínica en el paciente cirrótico, además de asociarse con un deterioro de la calidad de vida de estos pacientes y con un riesgo incrementado de accidentes laborales e incapacidad de conducción de vehículos. El Psychometric Hepatic Encephalopathy Score es considerado actualmente el método diagnóstico de elección en el diagnóstico de la EHM. El objetivo de este trabajo fue diseñar las tablas de normalidad del PHES para la población cubana. Población y métodos: se estudió una muestra conformada por 520 personas sanas de las provincias de Villa Clara, Sancti Spíritus y Cienfuegos. Las mismas realizaron las 5 pruebas incluidas en el PHES. Se analizaron las variables edad, sexo, años de escolarización, procedencia y consumo diario de alcohol. Mediante la prueba de la t de Student, ANOVA y el coeficiente de correlación de Pearson, se realizó el análisis univariante. Se efectuó un análisis de regresión lineal múltiple para cada prueba, y se construyeron las tablas de normalidad. Resultados: en el análisis multivariante (regresión lineal múltiple) la edad y los años de escolarización fueron las 2 variables independientes relacionadas con el rendimiento en cada una de las cinco pruebas. Conclusión: la disponibilidad de las tablas de normalidad del PHES permitirá contar con un método diagnóstico de referencia aplicable a los pacientes cubanos con cirrosis hepática, sin la necesidad de configurar grupos controlados por la edad y el nivel de escolaridad regionalmente

Objectives: Minimal hepatic encephalopathy (MHE) is the subclinical stage prior to the development of clinical hepatic encephalopathy in cirrhotic patients. For these patients, it is associated with impaired quality of life, increased risk of accidents, and incapacity for driving vehicles. The Psychometric Hepatic Encephalopathy Score (PHES) is currently considered to be the diagnostic method of choice for diagnosis of MHE. The aim of this work was to design PHES normality tables for the Cuban population. Population and Methods: The study sample consisted of 520 healthy people from the provinces of Villa Clara, Sancti Spiritus and Cienfuegos who all took the 5 tests included in the PHES. Variables of age, sex, years of schooling, place of origin, and daily alcohol consumption were analyzed. Univariate analysis with the Student’s t test, ANOVA and Pearson correlation coefficient was performed. Multivariable linear regression for each test was performed and normality tables were constructed. Results: Multivariate analysis used multiple linear regression with age and years of schooling as the independent variables related to performance for each of the 5 tests. Conclusions: The availability of normality tables provides a diagnostic reference method for PHES which is applicable to Cuban patients with liver cirrhosis without requiring control groups for age and regional education level

Uma pele-pergaminho: memória e publicação / Parchment-skin: memory and publication

A autora reflete acerca do papel do corpo como ancoradouro e objeto de inscrição de um enredo traumático a ser publicado. Acompanhada pelas ideias de Freud e Bion, que são ampliadas com as aproximações utilizadas por Gabriel García Márquez em Cem anos de solidão, experimento a incursão num universo que demanda subjetivação em um nível de linguagem das sensações representadas por tatuagens que ganham significado através de uma pele-pergaminho. Quando compartilho com o paciente a experiência emocional, na sala de análise, o sofrimento publicado passa a pertencer a um campo acessível à percepção e à digestão.

A meaningful psychoanalytical experience allows the author to think about the role played by the body both as an anchorage and an object of inscription of a traumatic event that is about to be published. Along with the ideas of Freud and Bion and broadening her gaze, with the help of Gabriel Garcia Marquez in One Hundred Years of Solitude, she experiments the entrance in a universe that demands subjectivation in a sensation language level, represented by tattoos that have their meanings revealed through a parchment-skin.

Country Differences in the History of Use of Health Claims and Symbols.

Health-related claims and symbols are intended as aids to help consumers make informed and healthier food choices but they can also stimulate the food industry to develop food that goes hand in hand with a healthier lifestyle. In order to better understand the role that health claims and symbols currently have and in the future potentially can have, the objective of the CLYMBOL project (“Role of health-related claims and symbols in consumer behaviour”, Grant no 311963) is to investigate consumers’ understanding of health claims and symbols, and how they affect purchasing and consumption [1]. As part of this endeavour, it is important to understand the history of use of claims and symbols in Europe. What have consumers been exposed to and how were these health-related messages used and discussed among the public? In this study, we interviewed key stakeholders across Europe about how health claims have been regulated in their country, how health symbols have been and currently are being treated, what form of monitoring there is or should be and how both health claims and symbols have been debated in the public opinion. In 26 European Union (EU) Member States, opinions from 53 key informants from up to three different stakeholder groups were gathered: national food authorities, representatives of the food industry, and consumer organisations. While 14 Member States reported (at least partial) regulation of the use of health claims and/or symbols before the introduction of the EU Regulation (EC 1924/2006) on nutrition and health claims made on foods [2], mandatory reporting of use had only been in place in three EU Member States. A number of voluntary codes of practice for health claims and/or symbols (i.e. pre-approval or justification when challenged) was said to be in use in 15 Member States. There are only a few national databases on health claims and symbols available, the data for which is often incomplete. Only eight Member States reported having some form of database from which information about health claims and symbols could be extracted. The stakeholders interviewed expressed a strong interest in measuring the impact of health claims and symbols, particularly research into the effects on consumer behaviour (e.g. awareness and understanding, attitudes towards products carrying claims and symbols and purchase/consumption effects), public health (health outcomes and changes in national health status due to the introduction of claims and symbols on food products) and economic aspects including sales, return on investment and reputation measurements. Public debates were said to have evolved around the topics of consumer understanding of claims, acceptance as well as trust in the information presented but also the effects on vulnerable groups such as children and elderly consumers. Another field of debate was said to have been the question of the effectiveness of health claims and symbols. Lastly, stakeholders reported that public debates focussed mainly on the legislative aspects, i.e. how to apply the EU Regulation (No 1924/2006) with regards to wording issues, the evaluation process at the European Food Safety Authority (EFSA), the status of various claims and the nutrient profile modelling to be introduced in Europe.

La cultura organizacional desde sus paradigmas de estudio: una aproximación a la perspectiva interpretativa-simbólica

La perspectiva interpretativa-simbólica es una forma de analizar las dinámicas culturales presentes en las organizaciones. La revisión de literatura en bases de datos especializadas muestra que el principal postulado de esta perspectiva es la interpretación de segundo orden realizada a los símbolos de la organización para identificar el excedente de significado, o lo que comúnmente es conocido como el sentido de los elementos simbólicos. Sobrepasa los postulados de otros paradigmas de estudio, relacionados con la forma como son materializados los valores; y la interpretación de primer orden que les damos a los supuestos básicos compartidos dentro de las organizaciones o lo que comúnmente es conocido como el significado literal de los elementos simbólicos. La finalidad del artículo es abarcar los postulados y conceptos acerca del paradigma interpretativo-simbólico y exponer un modelo que reúne los elementos trabajados sobre el tema, para facilitar la comprensión y la aplicación de esta perspectiva en investigaciones y análisis organizacionales.

The interpretative-symbolic perspective is one among many ways to interpret the cultural dynamics present within organizations. The literature reviewed in specialized data bases shows that this perspective's main postulate is the interpretation of second order performed on organizational symbols in order to identify the surplus of meaning or what is commonly known as the sense of symbolic elements. It surpases the postulates of other paradigms of study related to the way in whoch values are materialized; and the interpretation of first order we give to basic postulations shared within organizations or what is commonly known as the literal meaning of symbolic elements. The end pursued by this paper is to embark the postulates and concepts about the interpretative-symbolic paradigm and present a model which gathers the elements regarded on the subject, thus facilitating the understanding and application of this perspective to future research and organizational analysis.

A perspectiva interpretativa-simbólica é uma forma de analisar as dinâmicas culturais presentes nas organizações. A revisão da literatura nas bases de dados especializadas mostra que a principal postulado desta perspectiva é a interpretação de segunda ordem feita aos símbolos da organização para identificar o excedente de sentido, ou o que é comumente conhecido como o sentido dos elementos simbólicos . Excede os dogmas de outros paradigmas de estudo, relatou como os valores são incorporados; ea interpretação de primeira ordem damos compartilhada pressupostos básicos dentro das organizações ou o que é comumente conhecido como o significado literal dos elementos simbólicos. O objetivo do artigo é abraçar os princípios e conceitos de paradigma interpretativo-simbólica e expor um modelo que atenda aos elementos trabalharam sobre o assunto, para facilitar a compreensão e aplicação dessa perspectiva em pesquisa e análise organizacional.

Indicadores de adquisición de la función simbólica en el nivel de acciones materializadas en preescolares / Indicators of Symbolic Function Acquisition in the Level of Materialization of Actions in Preschoolers / Indicadores de aquisição da função simbólica no nível de ações materializadas em pré-escolares

Objetivo. Determinar cuáles son los indicadores de adquisición de la función simbólica en la zona del desarrollo próximo y actual, para el nivel de desarrollo de las acciones materializadas en niños preescolares entre los 5 y 6 años. Método. Participaron 180 preescolares de Bogotá a los que se les aplicó el protocolo de evaluación de la función simbólica (99 niños de instituciones educativas públicas y 81 niños de instituciones educativas privadas). Resultados. El nivel de desarrollo simbólico se determinó por medio de indicadores que se refieren a: (a) la posibilidad de sustitución de un objeto por otro realizando las acciones características del objeto que se sustituye; (b) la generalización de rasgos simbólicos; (c) la esquematización; y (d) la explicación reflexiva de la situación simbólica. Se discute la importancia de la evaluación de la adquisición de la función simbólica para precisar su nivel de desarrollo al final de la edad preescolar. Conclusión. La evidencia de la presencia de la función simbólica en el plano materializado es que el niño puede utilizar un objeto como un sustituto de otro, denomina tanto el objeto como la acción y reflexiona respecto la situación de sustitución que realiza.

Objective. The objective of this study is to identify the indicators of symbolic function acquisition within the proximal and actual development zone on the level of development of materialized actions in preschool children between 5 and 6 years. Method. The study included 180 preschoolers from Bogota to whom the Protocol for assessment of symbolic function on materialized level was applied (99 children in public educational institutions and 81 children in private schools). Results. The level of symbolic development was determined by indicators referring to: (a) the possibility of substitution of one object for another one performing characteristic actions of the replaced object, (b) the generalization of symbolic features, (c) the schematization, and (d) the reflective explanation of the symbolic situation. The importance of evaluating the acquisition of symbolic function to determine their level of development at the end of the preschool years is discussed. Conclusion. The evidence of the presence of symbolic function manifested on materialized level is that the child is able to substitute an object, name both the object and the action and ponder on the action of substitution.

Escopo. Determinar quais são os indicadores de aquisição da função simbólica na zona de desenvolvimento próximo e na zona de desenvolvimento atual para o nível de desenvolvimento das ações materializadas em crianças pré-escolares entre os 5 e os 6 anos de idade. Metodologia. Participaram 180 pré-escolares de Bogotá aos que foi aplicado o protocolo de avaliação da função simbólica (99 crianças de instituições educativas públicas e 81 crianças de intuições educativas privadas). Resultados. O nível de desenvolvimento simbólico foi determinado por meio de indicadores que estão referido a: (a) a possibilidade de substituição de um objeto por um outro fazendo as ações características do objeto substituído; (b) a generalização de rasgos simbólicos; (c) a esquematização, e (d) a explicação reflexiva da situação simbólica. É discutida a importância da avaliação da aquisição da função simbólica para determinar seu nível de desenvolvimento ao final da idade pré-escolar. Conclusão. A evidencia da presencia da função simbólica no plano materializado é que a criança pode utilizar um objeto como um substituto de outro, denomina tanto o objeto como a ação e reflexiona respeito a situação de substituição que faz.

Esclepios (Esculapio) y su familia en la mitología y la medicina occidental / Esclepios (Aesculapius) and his family in mythology and Western medicine.

La práctica médica en el imaginario de la mitología ha formulado las características que encontramos todavía hoy día en la práctica médica científica de la medicina occidental. Además del famoso y conocido Asclepios, llamado por los romanos Esculapio, y de las deidades primigenias mitológicas de la medicina (Apolo y Quirón), tenemos a los descendientes del dios Asclepios y su esposa mortal Epione, cinco (5) hijas inmortales: Higia, Aceso, Yaso, Eglee y Panacea; y dos (2) hijos mortales Macaón y Podalirio. A través de la adoración que los padecientes de enfermedades (suplicantes) hacían en los distintos santuarios de los dioses Asclepíades, templos de Asclepio y sus hijos, se cantaban himnos corales (peanes) dedicados a estas deidades, para poder realizar las solicitudes de curación. Ya, desde el ámbito de lo mitológico, se esboza la forma organizativa de la práctica médica occidental actual, de carácter naturalista, donde los griegos consideraban como dioses protectores de las áreas quirúrgicas a Aceso, Asclepios y Podalirio; a Yaso y Macaon como las deidades bajo cuya égida están el trabajo de los médicos clínicos; la importante área de los cuidados humanos (enfermería), prácticas de programas sanitarios e higiene, y áreas de apoyo al diagnóstico y tratamiento (radiología, técnicos biomédicos, etc.) a la más famosa hija de Asclepios, Higia. Los romanos le llamaban Salus; de su nombre derivan los términos de Salud e Higiene. Eglee es la diosa que confiere el prestigio social de los médicos y el derecho a los honorarios; y Panacea, “es la que todo lo cura”. Queda claro que siempre lo mitológico guarda una esencia de tipo filosófico, y lo filosófico de lo mitológico.

Medical practice in the imagination of Greek mythology developed characteristics that still can be found today in the scientific medical practice of Western medicine. In addition to the famous Asclepius, called by the Romans Aesculapius, and the mythological primordial deities of Medicine (Apollo and Chiron), we have the descendants of the God Asclepius and his mortal wife Epione, five (5) immortal daughters: Hygeia, Aceso, Yaso, Eglee and Panacea; and two (2) mortal sons, Machaon and Podalirius. Through the worship practiced by the sick (supplicants) in the different shrines of the gods Asclepiads, temples of Asclepius and his children, choral hymns were sung (peanes), dedicated to these deities, to make healing pleas. From the mythologic realm, the outlines of the organizational form of current Western medical practice could already be appreciated, with a naturalistic character, where the Greeks considered Aceso, Asclepius and Podalirius as the gods protectors of surgical domains; Yaso and Machaon, under whose aegis is the work of clinicians; the important area of human care (nursing), practices of health programs and hygiene, and areas supporting diagnosis and treatment (radiology, biomedical technicians, etc.) were attributed to Hygeia, the most famous daughter of Asclepius; the Romans called her Salus. From her name the terms health and hygiene derive. Eglee, is the goddess who gives doctors the social prestige and the right to charge fees; And Panacea, the one “who heals everything”. It is clear that mythology contains an essence of philosophy, and philosophy of mythology.

O papel das identidades culturais e dos serviços públicos de saúde no processo de municipalização ocorrido nas últimas décadas em pequenas localidades do Rio Grande do Sul, Brasil / The role of cultural identities and public health services in the municipalization process taken place in recent decades on small towns of Rio Grande do Sul, Brazil

O artigo mostra os resultados preliminares de uma pesquisa etnográfica na qual observamos como é vivenciado socialmente o processo de municipalização em seis municípios da Bacia Hidrográfica do Forqueta, no Rio Grande do Sul, onde a fragmentação de municípios tem se disseminado como estratégia administrativa desde a década de 1990. Discorremos acerca de elementos culturais e de ações sociais que dão suporte às identidades construídas e/ou reconstruídas na definição das fronteiras dos territórios-município. Teorias sociológicas e antropológicas foram utilizadas para pensar as identidades e o pressuposto de que a integração de espaços sociais num território cria a necessidade social de produção de uma identidade territorial estreitamente vinculada a um contexto sociopolítico e a uma configuração cultural. Percebemos que o processo de municipalização em pequenos municípios ajuda a conter o êxodo rural, sendo os serviços de saúde determinantes na contenção do fluxo migratório que caracterizava a realidade destas localidades, nas últimas décadas, em consequência do crescimento da agroindústria. Na atualidade, nesses mesmos locais, os serviços de saúde representam o principal suporte da identidade coletiva com o território-município e, no lugar da emigração, estimulam a imigração.

The paper presents a preliminary results of an ethnographic study in which we observe how is socially experienced the municipality process in six counties of the Forqueta Watershed in Rio Grande do Sul, where the municipal fragmentation has been used as an administrative strategy since the 1990s. Deal about cultural elements and social actions that support construction and/or reconstruction identities to define territories-county's borders. Sociological and anthropological theories have been used to think the identities and the assumption that the integration of social spaces into a territory creates the social necessity to produce a territorial identity, closely linked to a socio-political context and cultural setting. We realize that the decentralization process in small municipalities helps stem the rural exodus, being health services determinant in curbing the migratory flow that characterized these locations reality in recent decades as a result of the agribusiness growth. Today, in these same places, health services represent the main support of collective identity with the territory-county and, instead of emigration, stimulate the immigration.

Mitología y Medicina I: Dioses griegos primigenios de la Medicina Occidental / Mythology and medicine I: Original greek gods of Western Medicine

La práctica médica en la antigua Grecia se llevó a cabo en dos vertientes: una medicina de carácter místico religioso, enraizada en las creencias politeístas, donde dioses sanadores acudían a los santuarios (asclespiades) para ayudar a los enfermos; y una concepción médica, de carácter naturalistico, empírico y racional, ejecutada por médicos entrenados en las escuelas de medicina. Estas dos prácticas no están reñidas entre sí, la primera da paso a la segunda forma de enfrentar el proceso salud-enfermedad, ya que está basada más en prácticas de suturas de heridas superficiales, espolvoreo de sustancias naturales cicatrizantes y/o analgésicas, y aplicación de brebajes de hierbas medicinales, pero es una medicina, cuya narración mitológica ya se encuentra lejos de las prácticas mágica religiosa o milagros de curación espontánea; mientras que la actitud de los médicos científicos es de respeto de las prácticas religiosas de restitución de la salud, aunque ellos ofrezcan servicios limitados al pronóstico del paciente y de carácter laico y sin rituales religiosos. El presente artículo pretende explorar las deidades primigenias de la salud (Quirón, Apolo y Asclepios) y cómo los rituales, símbolos y significados religiosos asignados en sus ceremonias religiosas, representaciones artísticas, y concepciones teológicas, siguen influyendo en la concepción y expresión sociocultural y ética de la práctica médica científica del mundo occidental actual. La concepción mitológica de la medicina impregna las prácticas modernas de la misma, en su expresión sociocultural, simbólica y ética, pero conservando el respeto a la acción autónoma, laica, apolítica y racional.

Medical practice in the ancient Greece was carried out in two ways: a mystical religious medicine, rooted in the polytheistic beliefs, where healing gods flocked to shrines (asclepiads) to help the sick; and a medical concept of naturalistic, empirical and rational character, performed by physicians trained in medical schools. These two practices are not at odds with themselves, the first opens the door to the second way of confronting the health-disease process, since it is based more on practices of sutures of superficial wounds, sprinkling of natural substances healing the analgesic, and application of herbal concoctions, but is a medicine, whose mythological narrative is already away from religious magic practices or miracles of spontaneous healing; while the attitude of the scientific physicians is one of respect for the religious restoration of health practices, even though they offer limited services to the prognosis of the patient and secular nature and without religious rituals. This article aims to explore the primordial deities of health (Chiron, Apollo and Asclepius) and how the rituals, the symbols and religious meanings assigned to their religious ceremonies, artistic depictions, and theological concepts, are still influencing the conception, socio-cultural expression and ethical practice of the medical science in the Western world today. The mythological conception of medicine permeates modern practices, in its socio-cultural, symbolic and ethical expressions, while retaining respect for the autonomous, secular, apolitical and rational action.