A study on the job preferences and heterogeneity of medical students from different birthplaces:A discrete choice experiment based on six hospitals in Beijing / 中国卫生政策研究

Objective:To analysis the job preference and heterogeneity of medical students by distinguishing their birthplaces,and to provide reference for optimizing the management of primary health care resources.Methods:Using a cluster sampling method,an online survey of discrete choice experiment was conducted with 925 medical students from six teaching hospitals in Beijing,741 valid questionnaires were obtained,the effective recovery rate was 80.1%.The mixed logit model was used to perform regression analysis on six job attributes and estimate the willingness to pay.Results:There were significant differences in the choice of work location among medical students from different birthplaces.The subgroup results showed that compared to medical students from city,undergraduates from rural and county district preferred a work with sufficient career development opportunities.The results of undergraduate subgroup showed that undergraduates from rural district preferred a work with good environment than those from other birthplaces.Conclusion:There is heterogeneity in job preferences of medical students from different birthplaces.Policy makers should pay attention to the medical students'birthplace,also take the educational level into account to optimize the diversified job attributes,formulating targeted intervention to attract primary health care talents.

Investigation of patients’preferences regarding therapeutic drug monitoring of mycophenolic acid in solid organ transplantation / 中国药房

OBJECTIVE To investigate the preferences of patients who underwent solid organ transplantation regarding therapeutic drug monitoring （TDM） of mycophenolic acid （MPA） and explore the factors influencing patients’ decision-making process， so as to provide support for the development of individualized medication guidelines for MPA and improvement of clinical decision-making. METHODS The cross-sectional study was used to design the questionnaire on the patients’ preferences to accept MPA TDM， and involved patients who underwent solid organ transplantation and received MPA treatment at two tertiary hospitals in Beijing from April 14， 2022， to June 27， 2022. The Likert 5-level scoring method was used to score the patients’ preferences to accept MPA TDM， the influencing factors and their correlation of the patients’ preferences to accept MPA TDM were analyzed by Pearson correlation analysis and binary Logistic regression analysis， and the nonparametric test and chi-square test were used to rank and analyze the consistency of the factors affecting patients’ preference decision. RESULTS A total of 140 questionnaires were collected， and the effective recovery rate was 77.35%. The average preference score of 140 patients to receive MPA TDM was （4.01±0.65）， and the overall preference value was high. There were 116 （82.86%） patients agreed or strongly agreed with MPA TDM. Significant differences were observed in preference scores between patients who had previously undergone MPA TDM and those who had never undergone it （[ 4.30±0.53） scores vs. （3.80±0.65） scores， P＜0.001]. Additionally， patients’ preference scores were significantly influenced by their understanding level and attention level （P＜0.001）. The ranking of factors contributing to decision-making exhibited consistency （P＜0.001）. The factors were ranked in descending order of clinical efficacy， safety， comfortability， economy and time cost. CONCLUSIONS The patients who underwent solid organ transplantation hold high preferences towards MPA TDM. The primary factors influencing their decisions are their prior experience， understanding level， and attention level.

Prognostic awareness and prognostic information preferences among advanced cancer patients in Kenya

Background: Cancer is the third leading cause of death in Kenya. Yet, little is known about prognostic awareness and preferences for prognostic information. Aim: To assess the prevalence of prognostic awareness and preference for prognostic information among advanced cancer patients in Kenya. Setting: Outpatient medical oncology and palliative care clinics and inpatient medical and surgical wards of Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya. Methods: The authors surveyed 207 adults with advanced solid cancers. The survey comprised validated measures developed for a multi-site study of end-of-life care in advanced cancer patients. Outcome variables included prognostic awareness and preference for prognostic information. Results: More than one-third of participants (36%) were unaware of their prognosis and most (67%) preferred not to receive prognostic information. Increased age (OR = 1.04, 95% CI: 1.02, 1.07) and education level (OR: 1.18, CI: 1.08, 1.30) were associated with a higher likelihood of preference to receive prognostic information, while increased symptom burden (OR= 0.94, CI: 0.90, 0.99) and higher perceived household income levels (lower-middle vs low: OR= 0.19; CI: 0.09, 0.44; and upper middle- or high vs low: OR= 0.22, CI: 0.09, 0.56) were associated with lower odds of preferring prognostic information. Conclusion: Results reveal low levels of prognostic awareness and little interest in receiving prognostic information among advanced cancer patients in Kenya. Contribution: Given the important role of prognostic awareness in providing patient-centred care, efforts to educate patients in Kenya on the value of this information should be a priority, especially among younger patients.

Alimentación exigente en niños; signos y síntomas, evaluación e intervención multiprofesional / Pick eating in Children; signs and symptoms, assessment and multiprofessional intervention

Los trastornos por evitación/restricción de la ingesta, han sido ampliamente descritos por la similitud en sus características y las consecuencias que estas traen sobre el desarrollo crecimiento de los niños que lo experimentan. La alimentación exigente es un trastorno de tipo multifactorial, en donde los niños muestran comportamientos negativos frente a la comida o tienen preferencia por un grupo de alimentos. Esta revisión narrativa de la literatura tiene como objetivo presentar las últimas investigaciones relacionadas con la alimentación exigente, ofreciendo una guía sobre signos y síntomas, evaluación e intervención en los niños con alimentación exigente realizada por el equipo multiprofesional. La revisión de literatura fue conducida en las bases de datos PubMed y Scopus, aplicando como principal criterio de inclusión artículos en inglés, español y portugués, sobre alimentación exigente en niños entre el nacimiento y los 5 años. Los resultados de esta revisión apuntan que la alimentación exigente estaría determinada por tres estadios importantes en la vida del niño; la gestación, la fase temprana de alimentación y las experiencias durante su segundo año de vida, por lo tanto, se requiere reconocer las señales de alerta (rechazo a comer determinados alimentos, falta de habilidades para alimentarse, duración excesiva durante los tiempo de alimentación etc.,), lo que permite realizar una evaluación temprana, que guie la intervención terapéutica, favoreciendo así una alimentación segura y eficaz para la nutrición y calidad de vida del niño.

Avoidant/Restrictive Food Intake Disorders have been widely described due to the similarity in their characteristics and the consequences they have on the development and growth of children who experience them. Picky eating is a multifactorial disorder where children exhibit negative behaviors towards food or show preference for a specific group of foods. This narrative literature review aims to present the latest research related to picky eating, offering guidance on signs and symptoms, assessment, and intervention in children with picky eating conducted by a multidisciplinary team. The literature review was conducted using the PubMed and Scopus databases, with the main inclusion criterion being articles in English, Spanish, and Portuguese, on picky eating in children from birth to 5 years old. The results of this review suggest that picky eating is determined by three important stages in a child's life; gestation, the early phase of feeding, and experiences during their second year of life. Therefore, it is necessary to recognize warning signs (refusal to eat certain foods, lack of feeding skills, excessive duration during feeding times, etc.), which allows for an early assessment that guides therapeutic intervention, thus promoting safe and effective feeding for the nutrition and quality of life of the child.

Validity and reliability of Turkish pregnant women's preferences for mode of delivery questionnaire

SUMMARY OBJECTIVE: The aim of this study was to determine whether Pregnant Women's Preferences for Mode of Delivery Questionnaire, created by Zamani-Alavijeh et al., is a valid and reliable measurement tool for Turkish pregnant women. METHODS: This study has a methodological research design and was conducted with 139 pregnant women who were randomly selected from those aged 18-35 years, who applied to obstetric clinic,.who had no previous prenatal losses and no systemic diseases, and who had conceived naturally. The data for this study were collected with the Personal Information Form and the Pregnant Women's Preferences for Mode of Delivery Questionnaire. To test the reliability and validity of Pregnant Women's Preferences for Mode of Delivery Questionnaire, Cronbach's α, split-half method, item analysis, Kendall's coefficient of agreement (W), explanatory factor analysis, and confirmatory factor were used. RESULTS: The study found that Cronbach's α was 0.94, the Spearman-Brown reliability coefficient was 0.883, and the Guttman split-half was 0.880. Explanatory factor analysis revealed an 18-item structure with three factors having an eigenvalue exceeding 1, explaining 67.593% of the total variability, and factor loading between 0.40 and 0.64. CONCLUSION: Based on the scientific recommendations, the Turkish version of the Pregnant Women's Preferences for Mode of Delivery Questionnaire has adequate psychometric properties.

Percepción de la calidad de vida en pacientes con trasplante renal / Perception of quality of life in renal transplant patients / Percepção da qualidade de vida em pacientes transplantados renais

La enfermedad renal crónica (ERC) es un problema sanitario mundial que afecta al 10% de la población. Su prevalencia ha ido en aumento debido a factores relacionados con el estilo de vida y el envejecimiento de la población. Objetivo. Analizar la percepción de los pacientes receptores de trasplantes renales sobre su calidad de vida, y evaluar los factores que influyen en la calidad de vida post-trasplante renal. Metodología. Para ello, se llevó cabo un estudio bibliográfico considerando fuentes de bases de datos académicas como PubMed, Scopus, Web of Science, entre otras. Donde se usaron como descriptores de búsqueda "trasplante renal", "calidad de vida", "percepción del paciente", "resultados post-trasplante". Además, la búsqueda se amplió en revistas especializadas, tesis, libros y conferencias relacionadas con el tema. como criterios de inclusión fueron considerados estudios originales, revisiones sistemáticas, metaanálisis, publicaciones en los últimos 10 años, etc. Y como exclusión fueron considerados estudios no relacionados, artículos de opinión, publicaciones en idiomas no accesibles. En cuanto al proceso extracción de la información, se usó la matriz de registro y las técnicas de observación y análisis documental, la matriz quedo constituida por Autor(es), año de publicación, país de origen, objetivos del estudio, metodología utilizada, variables analizadas, resultados principales, y conclusiones relevantes. Conclusión. Es esencial reconocer que la calidad de vida post-trasplante renal es una experiencia subjetiva que varía significativamente entre los pacientes y que está influenciada por una amplia gama de factores, que van desde la gestión de síntomas físicos hasta el manejo de desafíos psicológicos y sociales.

Chronic kidney disease (CKD) is a worldwide health problem affecting 10% of the population. Its prevalence has been increasing due to factors related to lifestyle and population aging. Objective. To analyze the perception of renal transplant recipients on their quality of life, and to evaluate the factors that influence post renal transplant quality of life. Methodology. For this purpose, a bibliographic study was carried out considering sources of academic databases such as PubMed, Scopus, Web of Science, among others. The search descriptors used were "renal transplant", "quality of life", "patient perception", "post-transplant results". In addition, the search was extended to specialized journals, theses, books and conferences related to the subject. Inclusion criteria included original studies, systematic reviews, meta-analysis, publications in the last 10 years, etc. Unrelated studies, opinion articles, publications in non-accessible languages were considered as exclusion criteria. As for the information extraction process, the registration matrix and the techniques of observation and documentary analysis were used, the matrix was made up of author(s), year of publication, country of origin, objectives of the study, methodology used, variables analyzed, main results, and relevant conclusions. Conclusion. It is essential to recognize that post-renal transplant quality of life is a subjective experience that varies significantly among patients and is influenced by a wide range of factors, ranging from the management of physical symptoms to the management of psychological and social challenges.

A doença renal crônica (DRC) é um problema de saúde global que afeta 10% da população. Sua prevalência tem aumentado devido a fatores de estilo de vida e ao envelhecimento da população. Objetivo. Analisar a percepção dos receptores de transplante renal sobre sua qualidade de vida e avaliar os fatores que influenciam a qualidade de vida pós-transplante renal. Metodologia. Para isso, foi realizado um estudo bibliográfico considerando fontes de bancos de dados acadêmicos como PubMed, Scopus, Web of Science, entre outros. Os descritores de busca utilizados foram "transplante renal", "qualidade de vida", "percepção do paciente", "resultados pós-transplante" Além disso, a busca foi estendida a periódicos especializados, teses, livros e congressos relacionados ao tema. Os critérios de inclusão incluíram estudos originais, revisões sistemáticas, meta-análises, publicações nos últimos 10 anos, etc. Estudos não relacionados, artigos de opinião e publicações em idiomas não acessíveis foram considerados como critérios de exclusão. Quanto ao processo de extração de informações, foram utilizadas a matriz de registro e as técnicas de observação e análise documental. A matriz foi composta por autor(es), ano de publicação, país de origem, objetivos do estudo, metodologia utilizada, variáveis analisadas, principais resultados e conclusões relevantes. Conclusões. É essencial reconhecer que a qualidade de vida pós-transplante renal é uma experiência subjetiva que varia significativamente entre os pacientes e é influenciada por uma ampla gama de fatores, que vão desde o controle dos sintomas físicos até o enfrentamento de desafios psicológicos e sociais.

ESTILOS DE APRENDIZAJE EN ESTUDIANTES DE LA LICENCIATURA EN ENFEMERIA DE TRES INSTITUCIONES DE EDUCACIÓN SUPERIOR EN MÉXICO / LEARNING STYLES IN NURSING DEGREE STUDENTS FROM THREE HIGHER EDUCATION INSTITUTIONS IN MEXICO

INTRODUCCIÓN. La sociedad actual demanda de enfermeros que desarrollen la autonomía necesaria para la resolución de problemas, la planificación, el seguimiento y la evaluación de su propio desempeño. Esta autonomía proviene del aprendizaje permanente. OBJETIVO. Determinar los Estilos de Aprendizaje predominantes entre los estudiantes de primer año matriculados en tres instituciones de educación superior en México para cursar la carrera de enfermería. METODOLOGÍA: Estudio cuantitativo y multicéntrico con un diseño descriptivo, y una muestra no probabilística. Para identificar los Estilos de aprendizaje de los estudiantes se utilizó el cuestionario VARK, con coeficiente alfa de Cronbach osciló entre 0.77 y 0.85. La escala fue digitalizada y programada mediante la herramienta Formulario de Google Drive. Se obtuvo un dictamen favorable por el comité de ética de las instituciones. Los resultados se procesaron en el programa estadístico SPSS versión 25.0. RESULTADOS: Se aplicaron 305 cuestionarios, donde 88,63 % fueron mujeres. El estilo de aprendizaje más preponderante fue el Quinestésico (30.39 %), seguido por el Lectura/Escritura (27.42 %), auditivo (26,58 %) y visual (15.61 %). De acuerdo con el estilo modal más del 50 % son multimodales. CONCLUSIÓN: Los resultados muestran que es fundamental contar con datos tanto individuales como grupales de los estudiantes para pensar estrategias de enseñanza y aprendizaje que tengan en cuenta las preferencias de aprendizaje de los estudiantes y la orientación temática del orden disciplinario, desde su ingreso a la universidad.

INTRODUCTION. Today's society demands that nurses develop the necessary autonomy to solve problems, plan, monitor and evaluate their own performance. This autonomy comes from lifelong learning. AIM. To determine the predominant learning styles among first-year nursing students enrolled in three higher education institutions in Mexico. METHODOLOGY: Quantitative and multicenter study with a descriptive designand a non-probabilistic sample. To identify the learning styles of the students, the VARK questionnaire was used, with Cronbach's alpha coefficient ranging between 0.77 and 0.85. The scale was digitized and programmed using the Google Drive Form tool. A favorable opinion was obtained by the ethics committee of each institution. The results were processed in the statistical program SPSS, version 25.0. RESULTS: 305 questionnaires were completed by respondents, 88.63% of which were women. The most predominant learning style was kinesthetic (30.39%), followed by reading/writing (27.42%), auditory (26.58%) and visual (15.61%). As to the modal style, more than 50% were multimodal. CONCLUSION: The results show that it is essential to have both individual and group data related to students so that teaching and learning strategies can take into account their learning preferences, as well as the thematic orientation of the discipline of nursing, from the time of their admission to the university.

Adaptación al español del Ideal Partner and Relationship Scale (IPRS): evidencias sobre propiedades psicométricas

Introducción: Los estudios de preferencias de pareja han crecido ampliamente alrededor del mundo en los últimos años; no obstante, las pruebas psicológicas utilizadas en esta área no han sido adecuadamente adaptadas a contextos hispanohablantes. En esta investigación se adaptó al español una de las pruebas más frecuentemente usadas en el campo de la selección sexual humana: Ideal Partner and Relationship Scale (IPRS). Método: Se implementaron los siguientes procedimientos: (1) Traducción por pares, (2) Evaluación por expertos, (3) Aplicación inicial/validación (149 participantes), (4) Análisis de propiedades psicométricas, (5) Análisis confirmatorios con una muestra independiente (247 participantes). Resultados: Los análisis de las propiedades psicométricas de la prueba IPRS (español), indican que el instrumento conserva una estabilidad similar a la versión inglesa. En la estructura interna se conserva una solución factorial de cinco dimensiones de preferencia: atractivo físico, calidez y confianza, estatus y recursos, inteligencia y habilidades sociales. Además, los indicadores de confiabilidad demuestran una consistencia interna y estabilidad temporal sobresaliente. Por último, los patrones de preferencia de los participantes revelan similitudes con lo reportado en investigaciones transculturales semejantes. Conclusiones: Las sobresalientes propiedades referidas a la evidencia reportada en este estudio, llevan a considerar que la adaptación de la prueba IPRS al español fue exitosa, como resultado del seguimiento de protocolos estrictos de validación.

Introduction: Mate preference studies have been growing worldwide in recent years; however, the psychological tests used in this area have not been adequately adapted to Spanish-speaking contexts. This study aims to adapt to Spanish one of the most frequently used tests in human sexual selection: Ideal Partner and Relationship Scale (IPRS). Method: The adaptation included the following procedures: (1) Translation by peers; (2) Evaluation by experts; (3) Initial application / Validation (149 participants); (4) Analysis of psychometric properties; and (5) Confirmatory analysis from an independent sample (247 participants). Results: We proceeded to create the final version of the test in Spanish through the information collected. The analysis of the psychometric properties of the IPRS test indicates that the instrument retains stability and consistency similar to the original English version. This new version conserved the factorial structure, which includes five preference dimensions (physical attractiveness, warmth and trust, status and resources, intelligence, and social skills). Similarly, reliability indicators demonstrate good internal and temporal stability. Finally, the participant's preference patterns are equivalent to what has been reported in cross-cultural mate research. Conclusions: The good properties of the collected evidence led to the conclusion that the adaptation of the Spanish IPRS test was successful, as a result of strict validation protocols.

Educación en pacientes adultos mayores sometidos a endoprótesis total de cadera: Un enfoque centrado en las preferencias de los pacientes / Education in older patients undergoing total hip endoprosthesis: An approach focused on patient preferences

Propósito del estudio: Explorar las preferencias educativas de los beneficiarios adultos de las Garantías Explicitas en Salud (GES) sometidos a una cirugía de endoprótesis total de cadera. Material y método: Estudio descriptivo de carácter mixto. Se diseñó una encuesta que exploró las preferencias educativas referentes a cada etapa del proceso quirúrgico de adultos mayores sometidos electivamente a endoprótesis total de cadera en un centro hospitalario universitario. La encuesta se aplicó retrospectivamente de manera telefónica por un encuestador entrenado. El tiempo transcurrido entre la aplicación de la encuesta y la cirugía fue entre 2 y 14 meses. Resultados: Se incluyeron 63 pacientes, cuya edad promedio fue 72,5 años y el 69,8% correspondía al sexo femenino. Con respecto a su previsión de salud el 57,2% era beneficiario de FONASA y el 42,7% de ISAPRE. Las preferencias de información descritas en nuestra muestra con respecto al proceso quirúrgico desde su inicio a fin, señalan a la cirugía propiamente tal (40,4%) y los cuidados post operatorios (29,3%) como los temas de más interés. Los temas de menor interés fueron los relacionados con cuidados preoperatorios (45,2%) y al proceso de hospitalización (31,7%). Los pacientes encuestados valoraron la información entregada previa a su cirugía como adecuada, útil y fácil de entender. Conclusiones: Los adultos mayores sometidos a endoprótesis señalaron la información específica referente a la cirugía y los cuidados post operatorios como los temas educativos de mayor interés. La información estándar entregada por los médicos tratantes fue bien recibida por los pacientes.

Purpose of the study: To explore the educational preferences of adults aged 65 years and older with hip osteoarthritis undergoing total hip replacement (THA). Methods: Mixed descriptive study. A survey was designed to explore the educational preferences regarding each stage of the surgical process in elderly patients undergoing electively THA for osteoarthritis in a university-affiliated hospital. The survey was applied retrospectively and telephonically by a trained interviewer between 2 and 14 months after the surgery.Results: Sixty-three patients were surveyed, whose average age was 72.5 years, and 69.8% corresponded to females. Regarding their health coverage, 57.2% were beneficiaries of FONASA and 42.7% of ISAPRE. The educational preferences described in our sample regarding the surgical process from its beginning to the end indicate that surgery (40.4%) and post-operative care (29.3%) as the most relevant topics. The topics of least interest were preoperative care (45.2%) and information related to hospitalization (31.7%). The surveyed pa-tients rated their treating physician's education as adequate, helpful, and easy to understand before their surgery. Conclusions: Elderly patients undergoing THA indicated that specific surgery and post-operative care information are the most relevant educational topics.

HR Must Study Personal Economics - A Behavioral Economics Approach

Organizations in both the public and private sectors are increasingly using behavioural economics techniques to address a range of problems, including mechanism design and incentive architecture. Yet, there hasn't been much attention paid to how behavioural economics' experimental techniques might assist businesses in learning more about their (current or potential) workforce, and particularly about the preferences and tendencies of their employees. This has significant ramifications for overall organisational performance because certain designs or incentives may only influence people who share a certain disposition (such as those who are risk-averse or fairness-oriented), but not others, or they may even have the opposite effect on people who have different sets of preferences. In this post, we highlight a variety of intriguing directions for using a behavioural economics lens to comprehend and control employees. Also, a thorough case study is given.

Gusto dulce: Percepción, fuentes alimentarias y preferencias

El dulzor es un atributo característico de alimentos y bebidas que contienen azúcares u otros edulcorantes. El uso de azú-cares ha sido reemplazado por otros edulcorantes, a fin de disminuir los efectos nocivos de éstos en diferentes resultados de salud. Sin embargo, se ha sugerido que el gusto dulce, independiente de su origen, podría tener efectos indeseados en la salud. En este artículo se revisan diversos aspectos relacionados con el gusto dulce, desde su percepción, su presencia en alimentos y líquidos, las preferencias innatas y adquiridas por este gusto y los productos que lo aportan. Se analiza además la importancia de estudiar el rol del gusto dulce en la dieta y salud.

Sweetness is a characteristic of foods and beverages that contain sugars or other sweeteners. Sugars have been replaced by other sweeteners to reduce their harmful effects on different health outcomes. However, it has been suggested that the sweet taste, regardless of its origin, could have unwanted effects on health. This article reviews various aspects of sweet taste, from its perception, presence in foods and liquids, innate and acquired preferences for this taste, and the products that provide it. We also analyzed the importance of studying the role of sweet taste in diet and health.

Experience and enlightenment of generic drug substitution promotion policy in drug use in typical foreign countries / 中国卫生政策研究

Objective:From the link of drug use to improve China's generic drug substitution promotion policy to provide suggestions.Methods:Literature research method was used to explore the ideas and typical measures of promoting generic drug substitution in Europe,the United States,Japan and other countries.Combined with the existing problems in the process of generic drug substitution in China,specific suggestions were put forward to improve the promotion policy of generic drug substitution in the process of drug use in China.Results and conclusions:Through the experience research of Europe,the United States,Japan and other countries,it is found that typical countries outside the region have formed the idea of"accepting generic drugs-scientific and reasonable substitution-continuous feedback and improvement"in the process of promoting generic drug substitution.It is suggested that China incorporate the opinions of doctors and patients into the generic drug substitution decision-making,establish generic drug substitution rules based on risk,strengthen the real-world data research and monitoring and evaluation of generic drug substitution,strengthen the disclosure of generic drug information and policy publicity,further improve the promotion policy of generic drug substitution in the drug use process in China,and promote the alternative use of generic drugs.

Importance of Values and Preferences of Acupuncture Patients in the Field / 世界科学技术-中医药现代化

With the development of patient-centered medical model,patient values and preferences have become a hot research topic.This paper starts from the concept of patients'values and preferences,analyzes the important importance of patients'values and preferences;Based on the published literature,the importance of patients'values and preferences in the development of acupuncture clinical guidelines,the positive role in doctor-patient co-decision,the value of patients'cognition and value promotion in acupuncture"Deqi"were sorted out,and the influencing factors of patients'values and preferences and acupuncture compliance were summarized.According to the influencing factors,the corresponding solutions were proposed to help patients establish correct values,and thus improve patients'acupuncture compliance.

Burial or cremation? Factors associated with preferences among patients with cancer in Brazil: a cross-sectional study

ABSTRACT BACKGROUND: People living with life-limiting illnesses and their family caregivers consistently emphasize the importance of preparing for imminent death, with planned funerals being a common aspect of this preparation. Few studies have described the funeral rituals or post-mortem preferences of patients with cancer. OBJECTIVE: To evaluate the percentage of patients with cancer who wish to be cremated and to identify the factors associated with this preference. DESIGN AND SETTING: Cross-sectional study conducted at Barretos Cancer Hospital. METHODS: A total of 220 patients with cancer completed a Sociodemographic and Clinical Questionnaire, the Duke University Religiosity Index, and burial or cremation preferences. Binary Logistic Regression was performed to identify independent variables associated with cremation. RESULTS: Of the 220 patients, 25.0% preferred cremation and 71.4% preferred burial. Talks about death with family or close friends in their daily life (odds ratio, OR = 2.89; P = 0.021), patients that answered "other" (unsure, tends not be true and not true) for religious beliefs are what really lie behind my whole approach to life (OR = 20.34; P = 0.005), and education 9 to 11 years (OR = 3.15; P = 0.019) or ≥ 12 years (OR = 3.18; P = 0.024) were associated with cremation preference. CONCLUSION: Most patients with Cancer in Brazil prefer burial after death. Discussions about death, religious beliefs and involvement, and educational level seem to influence the preference for cremation. A deeper understanding of ritual funeral preferences and their associated factors may guide policies, services, and health teams in promoting the quality of dying and death.

Scurvy and food selectivity in childhood: a case report

ABSTRACT Despite its rarity, symptomatic micronutrient deficiency remains a public health problem. Scurvy is the differential diagnosis for bleeding disorders and hematological and rheumatological diseases, especially in patients with eating disorders. However, it is unrelated to autism spectrum disorders or other neurodevelopmental disorders. A previously healthy 10-year-old boy living in São Paulo, Brazil, had a history of significant food selectivity unrelated to autism spectrum disorder, resulting in symptomatic ascorbic acid deficiency (scurvy). This resulted in pain and purpuric lesions on the lower limbs, gingival edema, bleeding during tooth brushing, asthenia, weakness, malaise, and sadness. Therefore, dietary anamnesis is important for routine monitoring of child growth and development. This process helps prevent nutritional deficiencies, facilitates early diagnosis of eating disorders, and enables multidisciplinary follow-up for these patients.

A política social e o conservadorismo econômico: o que revela o período recente? / Social policy and economic conservatism: what do recent years reveal? / Política social y conservadurismo económico: ¿qué revela el período reciente?

O objetivo do artigo é averiguar se os brasileiros ficaram mais conservadores em termos econômicos, em especial, pós-2013, a despeito dos ganhos das gestões de centro-esquerda no campo social. Como metodologia, se apresenta uma análise descritiva de dados de diversas fontes, bem como a revisão da literatura sobre os protestos de 2013. Os resultados, com contribuição à literatura devido à amplitude de informações e de abordagem, apontam o avanço da política social com reflexos na queda da pobreza e da desigualdade, porém, com retrocessos se consubstanciando na Emenda Constitucional 95 e nas reformas trabalhista e previdenciária. Em meio à inflexão iniciada com as manifestações de 2013, a conclusão a que se chega é que parece ter havido uma onda de conservadorismo econômico, que teria atingido seu pico em algum momento no quinquênio posterior a 2013

The purpose of the paper is to investigate whether Brazilians have become more conservative in economic terms, especially after 2013, despite the gains of the center-left administrations in the social field. As a methodology, a descriptive analysis of data from different sources is presented, as well as a literature review on the 2013 protests. With contribution to the literature due to the breadth of data and approaches, the results point to the progress of social policy with repercussions on the fall of poverty and inequality, however, with setbacks materializing in the Constitutional Amendment 95 and in labor and social security reforms. Amid the inflection that started with the 2013 demonstrations, the conclusion is that there seems to have been a wave of economic conservatism, which would have reached its peak at some point in the five years after 2013

El objetivo del artículo es investigar si, a pesar de los avances logrados por las administraciones de centro-izquierda en el campo social, los brasileños se volvieron más conservadores en términos económicos, especialmente des-pués de 2013. Como metodología, se presenta un análisis descriptivo de datos de diferentes fuentes, y una revisión de la literatura sobre las protestas de 2013. Se identifica un avance de la política social con consecuencias en términos de reducción de la pobreza y de la desigualdad, sin embargo, con retrocesos, consustanciados en la Enmienda Constitucional 95 y en reformas laboral y previsional. Se concluye que parece haber habido una ola de conservadurismo económico, que habría alcanzado su pico en algún momento del quinquenio posterior a 2013

Características de los pacientes con artritis reumatoidea que impactan en la satisfacción y la adherencia al tratamiento: subanálisis de los datos de Argentina, Chile y Uruguay del estudio SENSE / Characteristics of patients with rheumatoid arthritis that impact treatment satisfaction and adherence: subanalysis of data from Argentina, Chile and Uruguay from the SENSE study

Introducción: las necesidades y perspectivas de los pacientes son determinantes para tratar la artritis reumatoidea (AR). Objetivos: evaluar el impacto de la respuesta inadecuada a los fármacos antirreumáticos modificadores de la enfermedad (DMARD) sobre la satisfacción con el tratamiento, los resultados y las perspectivas de pacientes adultos con control inadecuado de la AR de actividad moderada/alta. Materiales y métodos: se evaluó la satisfacción mediante el cuestionario Treatment Satisfaction Questionnaire for Medication (TSQM) v1.4. Se recolectaron datos sobre la calidad de vida, la adherencia y las estrategias de manejo. Se presentan los resultados para Argentina, Chile y Uruguay (n=202). Resultados: el promedio de la escala de satisfacción global TSQM fue de 62,3±21,8. El 83% informó buena adherencia. Las principales expectativas del tratamiento fueron "alivio duradero de los síntomas" y "menos dolor articular". El 53,47% prefirió tratamiento oral y el 75,74% eligió un rápido inicio de acción. El efecto secundario menos aceptado fue "mayor riesgo de neoplasias". Se planificó rotar el DMARD en el 55% de los casos. De estos, el 84,7% se consideraron terapias avanzadas. La mayoría estaba abierto a un esquema combinado, pero el 25,2% prefirió no utilizarlo. Conclusiones: los resultados reafirman el compromiso con las estrategias treat-to-target, considerando la individualización de las decisiones terapéuticas en el contexto regional.

Introduction: patients' needs and perspectives are determinants for the treatment of rheumatoid arthritis (RA). Objectives: to evaluate the impact of inadequate response to disease-modifying antirheumatic drugs (DMARDs) on treatment satisfaction, outcomes and perspectives of adult patients with inadequate control of moderate/high activity RA. Materials and methods: satisfaction was assessed using the TSQM v1.4 questionnaire. Data on quality of life, adherence and management strategies were collected. Results are presented for Argentina, Chile and Uruguay (n=202). Results: the mean of the TSQM global satisfaction score was 62.3±21.8. Eighty-three percent reported good adherence. The main expectations of treatment were "lasting relief of symptoms" and "less joint pain". The 53.47% of patients preferred an oral treatment; 75.74% chose a rapid onset of action. The least accepted side effect was "increased risk of malignant neoplasms". Fifty-five percent planned to rotate DMARD. Of these, advanced therapies were considered in only 84.7%. Most were open to a combination treatment, but 25.2% preferred not to use it. Conclusions: the results reaffirm the commitment to treat-to-target strategies, considering the individualization of therapeutic decisions in the regional context.

Preferências de carreira entre graduandos de medicina no sudoeste da Nigéria / Career preferences of final-year medical students in south-west Nigeria

Resumo Estudantes de medicina possuem diferentes opções de trajetórias acadêmicas ou profissionais após a graduação. Este estudo busca determinar as preferências de carreira entre graduandos de medicina e os fatores que contribuem para tal decisão. Pesquisa descritiva e transversal foi realizada com graduandos de medicina da Afe Babalola University, localizada em Ekiti State, Nigéria. Dados foram coletados por um questionário bem estruturado e analisados usando SPSS versão 21.0. A estatística descritiva inclui tabelas de frequência, gráficos, médias e desvios padrão. Um total de 100 graduandos participaram do estudo, dos quais 29 (29,0%) homens e 71 (71,0%) mulheres, com relação homem/mulher de 0,4 para 1. A faixa etária dos participantes foi de 21 a 30 anos, com média (±SD) de 23,5 (±1,4). Do total de participantes, 72% planejavam ingressar na pós-graduação após a faculdade de medicina, a maioria no Reino Unido, sendo o mestrado em Saúde Pública a qualificação de maior interesse. Da mesma forma, 76% dos entrevistados planejavam buscar uma bolsa de pós-graduação após a faculdade, também em sua maioria no Reino Unido. A especialidade mais procurada é Obstetrícia e Ginecologia (43%), seguida por Cirurgia (40%), Medicina de Família (34%), Medicina Comunitária (33%), Pediatria (25%) e Medicina Interna (23%), enquanto a especialidade menos procurada é Patologia Química (28%), seguida por Microbiologia Médica (27%) e Anatomia Mórbida (24%). O principal fator considerado para esta escolha é o interesse pessoal pela especialidade, seguido por perspectivas financeiras, estilo de vida confortável e horário de trabalho flexível. Mestrado em Saúde Pública e especialização em Obstetrícia e Ginecologia são as carreiras mais buscadas por graduandos de medicina, escolha majoritariamente pautada em seus interesses pessoais.

Abstract Medical students have many different options of academic and professional undertakings after graduation. The aim of this study is to determine the career preferences of students in their final year of medical school and to determine the factors that contributed for such decision. This is a descriptive cross-sectional study involving the final-year medical students of Afe Babalola University, Ekiti State, Nigeria. A well-structured questionnaire was used for data collection. The data was analysed using the Statistical Package for the Social Sciences (SPSS) version 21.0. Descriptive statistics included frequency tables, charts, means and standard deviations. A total number of 100 final-year medical students participated in the study, out of which 29 (29.0%) were males and 71 (71.0%) were females, with a male to female ratio of 0.4 to 1. The age range of the respondents was 21 to 30 years, with a mean(±SD) of 23.5(±1.4). 72% of the respondents planned to pursue a postgraduate academic qualification after graduating from medical school, mostly in the United Kingdom, and a Master of Public Health was the most sought qualification. Similarly, 76% of the respondents planned to pursue a postgraduate medical fellowship after medical school, also mostly in the United Kingdom. The specialty most sought-after is Obstetrics and Gynaecology (43%), followed by Surgery (40%), Family Medicine (34%), Community Medicine (33%), Paediatrics (25%), and Internal Medicine (23%) while the least sought-after specialty is Chemical pathology (28%), followed by Medical Microbiology (27%) and Morbid Anatomy (24%). The most important factor considered by the respondents in choosing a particular specialty is their personal interest in that specialty, followed by financial prospects, comfortable lifestyle, and flexible working hours. Master of Public Health degree and postgraduate fellowship in Obstetrics and Gynaecology specialty are the career preferences for most of the final-year medical students in this study, and this is largely informed by their personal interest in these fields.

Disponibilidad y utilización de los recursos poliníferos por Apis mellifera (Hymenoptera: Apidae) en el este de las Yungas de Jujuy (Argentina) / Availability and use of polliniferous resources by Apis mellifera (Hymenoptera: Apidae) in the Eastern Yungas of Jujuy (Argentina)

Resumen Introducción: El conocimiento de la riqueza vegetal y la estacionalidad alrededor de los apiarios de Apis mellifera es una herramienta de planificación indispensable para los apicultores. Debe incluir la disponibilidad de recursos, las preferencias alimenticias y el comportamiento de búsqueda de alimento. Dicha información no está disponible para las Yungas argentinas, uno de los ecosistemas forestales más estacionales de América del Sur. Objetivo: Evaluar la disponibilidad de recursos tróficos a través de un calendario de floración y su relación con las cargas de polen de A. mellifera en las Yungas. Métodos: En El Fuerte, Jujuy, recolectamos muestras mensuales de septiembre a marzo (2014-2015 y 2015-2016) utilizando trampas de polen. Utilizamos técnicas estandarizadas para los análisis palinológicos e índices de asociación para el uso de recursos. Las fenofases fueron Inicio de floración, Plena floración y Fin de floración. Resultados: Se identificaron 47 especímenes botánicos a nivel de especie y 9 a nivel de género. En ambos períodos hubo una oferta moderada de flores al inicio de la primavera, representada igualmente por plantas arbustivas y herbáceas, con un pico de floración en noviembre. Posteriormente, hubo una caída en la disponibilidad, con un pico de floración nuevamente al final de la temporada. En cinco especies de plantas hubo una asociación de media a alta entre la especie vegetal disponible y la presencia de ésta en el espectro polínico de la muestra de polen corbicular recolectada (Vachellia aroma, Blepharocalyx salicifolius, Cantinoa sp., Vernonanthura sp. y Zanthoxylum coco). Conclusión: En esta región hay una oferta moderada de flores de plantas arbustivas y herbáceas a principios de la primavera, con un pico de floración en noviembre y al final de la temporada. Solo cinco, de casi 50 especies de plantas, muestran una asociación de disponibilidad y uso por parte de las abejas.

Abstract Introduction: Knowledge of vegetation richness and seasonality around Apis mellifera apiaries is an indispensable planning tool for beekeepers. It must include resource availability, food preferences and foraging behaviour. Such information is unavailable for the Argentinian Yungas, one of the most seasonal forest ecosystems in South America. Objective: To assess the availability of trophic resources through a flowering calendar and its relationship with A. mellifera pollen loads in the Yungas. Methods: In El Fuerte, Jujuy, we collected monthly samples from September to March (2014-2015 and 2015-2016) using pollen traps. We used standardized techniques for palynological analyses, and association indices for resource use. The phenophases were Beginning of flowering, Full flowering, and End of flowering. Results: We identified 47 botanical specimens to species level and 9 only to genus. In both periods there was a moderate supply of flowers at the beginning of spring, represented equally by shrub and herbaceous plants, with peak flowering in November. Subsequently, there was a drop in availability, with peak flowering again at the end of the season. In five plant species, there was a medium to high association between the plant species available and their presence in the pollen spectrum of the corbicular pollen samples collected (Vachellia aroma, Blepharocalyx salicifolius, Cantinoa sp., Vernonanthura sp. And Zanthoxylum coco). Conclusion: In this region, there is a moderate supply of shrub and herbaceous plant flowers at the beginning of spring, with peak flowering in November and at the end of the season. Only five, out of nearly 50 plant species, show an association of availability and use by bees.

Percepciones del paciente en realimentación tras cirugía colorrectal. Un estudio cualitativo

Introducción: El conocimiento obtenido a partir de las experiencias de los pacientes favorece una atención de calidad. El objetivo de este estudio cualitativo es conocer la percepción de los pacientes sobre su realimentación tras una cirugía colorrectal, y los factores condicionantes en relación con dicho proceso. Material y Método: En base a la directriz de Standards for Reporting Qualitative Research, se realiza un estudio cualitativo a partir de una entrevista de 8 preguntas de término abierto realizada a 20 pacientes seleccionados por un método de variación máxima de muestreo. Se realizó análisis temático. Resultados: Se identificaron cuatro dimensiones principales (con subtemas respectivos) que condicionan la alimentación en el postoperatorio: 1. propósitos del paciente tras la alimentación (búsqueda de alta, hidratación, búsqueda de salud, finalizar ayuno, deambulación); 2. propiedades y características de los alimentos (sazón, presentación, temperatura, porciones, consistencia, favoritos); 3. factores del paciente (físicos, psicológicos); y 4. relación equipo de salud-paciente (confianza, complacencia, información, agradecimiento). Conclusión: El proceso de ingesta de alimentos en este contexto está condicionado por las cuatro dimensiones mencionadas. Sería importante considerarlas al momento de crear y ejecutar pautas y guías de alimentación adaptadas a los pacientes.

Introduction: Knowledge obtained from the experiences of patients favors quality care. The aim of this study is to know the perception of patients regarding refeeding after colorectal surgery, and particular factors that condition postoperative intake from their perspective. Materials and Method: Based on the guideline of Standards for reporting qualitative Research, a qualitative study was constructed from an interview with 8 open-ended questions to 20 patients selected by a maximum sampling variation method. Thematic analysis was carried out. Results: Four main dimensions were identified that determine feeding in the postoperative period: 1. patient's goals after feeding (search for discharge, hydration, search for health, end fasting, ambulation); 2. properties and characteristics of food (seasoning, presentation, temperature, portions, consistency, favorites); 3 patient factors (physical, psychological); and 4. health team-patient relationship (trust, complacency, information, gratitude). Conclusion: The process of food intake in this context is conditioned by the four dimensions mentioned. It would be important to consider them when creating and executing feeding guidelines adapted to patients.