Caracterización de pacientes con síndrome de Burnout en tratamiento con realidad virtual y retroalimentación neural en Pandemia por SarsCov2 en personal de salud, reporte de casos / Burnout management with virtual reality and neural feedback during pandemic for sarscov2 in health care workers, case report

Antecedentes: el Burnout es común entre los profesionales de la salud, un problema importante de agotamiento y angustia profesional, que puede afectar seriamente el estado emocional, la salud, y la calidad de la atención funcionario-paciente. Sin embargo, solo algunos estudios han investigado la mejora del estado de agotamiento de los profesionales en el marco de una terapia para la prevención y reducción sistemática del Burnout, basado en Realidad Virtual (RV) y Retroalimentación Neural. El objetivo de este estudio fue evaluar el nivel de agotamiento y mejoras obtenidas en funcionarios de la salud en el contexto de la pandemia por SarsCov2, producto de la aplicación de una terapia de relajación basada en RV asistida por Neurofeedback. Material y Método: Estudio transversal, en hospital público de la ciudad de Santiago de Chile. Se utilizó Maslach Burnout Inventory para evaluar el burnout en profesionales de la salud y se asoció a una terapia que facilita el aprendizaje de técnicas de respiración y relajación utilizando RV y retroalimentación neural. Resultados: De un total de 50 funcionarios de salud, 4 fueron seleccionados para el presente estudio de casos, obteniéndo, 3 funcionarios con un nivel de burnout alto en tanto que 1 presentó burnout medio. Conclusiones: Los profesionales de la salud que atienden a pacientes en el marco de la Pandemia por COVID19 experimentaron altos niveles de burnout. En nuestro estudio se presentaron niveles altos con respuesta a la terapia positiva a la terapia neural. (AU)

Objectives: Burnout is common among health professionals, an important problem of exhaustion and professional angst, that can severely affect the mental state, health, and the quality of personnel-patient care. Nonetheless, only a few studies have researched the improvement in the state of exhaustion of the professionals in the framework of a prevention and systematic reduction therapy for burnout, based on Virtual Reality (VR) and neural feedback. The objective of this study was to evaluate the level of exhaustion and the improvements obtained in health care workers in the context of pandemic for SarsCov 2, product of the application of relaxation therapy based on VR assisted by Neurofeedback. Material and Method: Transversal study, in a public hospital in the city of Santiago de Chile. Maslach Burnout Inventory was used to evaluate burnout in health professionals and a therapy was applied to facilitate the learning of breathing techniques and relaxation utilizing VR and neural feedback. Results: Out of 50 health care workers 4 were selected for the present study of case report, all obtaining a high level of burnout. Conclusion: The health professionals that take care of patients in the framework of the pandemic for COVID19 experimented high levels of burnout. In our study it was observed an improvement in the parameters of improvement in response to neural therapy. (AU)

Perceived Collective School Efficacy Mediates the Organizational Justice Effect in Teachers' Subjective Well-Being.

Trust and team communication are central aspects for the achievement of both individual and common goals, which affect not only work efficiency but also the well-being of its members. In addition, organizational justice could affect these indicators, as well as the perception of collective efficacy within organizations, in this case, schools. The purpose of this study was to analyze the effect of organizational justice on teachers' subjective well-being, and how this is affected/mediated by collective efficacy. We worked with a sample of 693 teachers across Chile. Multiple mediation analysis was carried out, where the latent variables of the study were estimated (subjective well-being, organizational justice, and two dimensions of collective efficacy). The results indicate that there is full mediation of the collective efficacy dimensions between the predictor-criterion relationship. Our findings allow us to hypothesize that perceptions of collective efficacy are central to explaining well-being as an intrinsic factor.

Comparison of the Effects of Different Skin-to-Skin Contact Onset Times on Breastfeeding Behavior.

Objective: Skin-to-skin contact (SSC) between mother and child improves the rates of exclusive breastfeeding (EBF) in the neonatal period. This study evaluated the effects of two SSC onset times on breastfeeding behavior in the neonatal period. Materials and Methods: A multicenter clinical trial was conducted, with random allocation of participants to two different SSC onset times: immediate (at birth) and early (at 60 minutes of life). Low-risk neonates at birth were included. The researchers responsible for analyzing the data were blinded. The outcomes evaluated were early breastfeeding; EBF in the hospital, in the first week of life, and in the first month; and breastfeeding effectiveness in the neonatal period. Bivariate analyses were performed to evaluate the effect of the onset of SSC on breastfeeding indicators. The relative risk (RR) was reported as an effect measure. Results: A total of 297 neonates were included (immediate SSC, n = 148; and early SSC, n = 149). No differences were found in early breastfeeding (93.6% versus 90.6%; RR 1.6, 95% confidence interval 0.07-3.82), breastfeeding effectiveness, or EBF in the neonatal period. There was an earlier initiation of breastfeeding in the immediate SSC group (22 versus 27 minutes, p < 0.001). Conclusions: No differences in breastfeeding indicators in the neonatal period were observed between groups with different onset times of SSC (immediate versus early) in the neonatal sensitive period among low-risk neonates at birth. Clinical Trial Registration Number: NCT02687685.

UVB Inhibits Proliferation, Cell Cycle and Induces Apoptosis via p53, E2F1 and Microtubules System in Cervical Cancer Cell Lines.

Ultraviolet (UV) exposure has been linked to skin damage and carcinogenesis, but recently UVB has been proposed as a therapeutic approach for cancer. Herein, we investigated the cellular and molecular effects of UVB in immortal and tumorigenic HPV positive and negative cells. Cells were irradiated with 220.5 to 1102.5 J/m2 of UVB and cell proliferation was evaluated by crystal violet, while cell cycle arrest and apoptosis analysis were performed through flow cytometry. UVB effect on cells was recorded at 661.5 J/m2 and it was exacerbated at 1102.5 J/m2. All cell lines were affected by proliferation inhibition, cell cycle ablation and apoptosis induction, with different degrees depending on tumorigenesis level or HPV type. Analysis of the well-known UV-responsive p53, E2F1 and microtubules system proteins was performed in SiHa cells in response to UVB through Western-blotting assays. E2F1 and the Microtubule-associated protein 2 (MAP2) expression decrease correlated with cellular processes alteration while p53 and Microtubule-associated Protein 1S (MAP1S) expression switch was observed since 882 J/m2, suggesting they were required under more severe cellular damage. However, expression transition of α-Tubulin3C and ß-Tubulin was abruptly noticed until 1102.5 J/m2 and particularly, γ-Tubulin protein expression remained without alteration. This study provides insights into the effect of UVB in cervical cancer cell lines.

Randomized clinical trial of the effect of the onset time of skin-to-skin contact at birth, immediate compared to early, on the duration of breastfeeding in full term newborns.

BACKGROUND: Skin-to-skin contact (SSC) compared to separation at birth has a positive effect on breastfeeding. However, separation at birth is common with negative impact on breastfeeding. The aim was to determine the effect of immediate SSC compared to early SSC on the duration of exclusive breastfeeding. METHODS: A randomized multicentre parallel clinical trial was conducted in two hospitals in Cundinamarca (Colombia) between November 2018 and January 2020. Low-risk full term newborns at birth were included. Neonates were assigned to immediate (in the first minute after birth) or early onset (start exactly at 60 min of life) skin to skin contact. Monthly follow-up was performed until 6 months of age. The primary outcome was the percentage of exclusively breastfed infants at 6 months (time in months with human milk as the only source of food). Secondary outcomes were the percentage of infants with exclusive breastfeeding at 3 months, duration in months of exclusive breastfeeding, neonate's breastfeeding ability, percentage of weight change between birth and the first week of life and hospitalization in the neonatal unit in the first week. A bivariate analysis was performed to determine the variables associated with exclusive breastfeeding at 6 months. A survival analysis was performed to evaluate the effect of the onset of SSC on exclusive breastfeeding duration. RESULTS: A total of 297 newborns were included: 49.8% (n = 148) in the immediate SSC group, and 50.2% (n = 149) in the early SSC group. The mean duration of exclusive breastfeeding in both groups was 5 months. There were no differences between the groups in the percentage of exclusive breastfeeding at 6 months (relative risk [RR] 1.06, 95% CI 0.72, 1.58) or in the duration of exclusive breastfeeding (hazard ratio [HR] 0.98, 95% CI 0.74, 1.28). CONCLUSIONS: The percentage of infants and the duration of exclusive breastfeeding in the first 6 months of age were the same between the two groups of SSC interventions. Given the current barriers to its implementation, the results of this study could positively impact the use of SSC at birth and standardize the intervention and improve breastfeeding indicators. TRIAL REGISTRATION: ClinicalTrials.gov NCT02687685 .

Effect of skin-to-skin contact at birth on early neonatal hospitalization.

BACKGROUND: Skin-to-skin contact (SCC) at birth has a positive impact on breastfeeding indicators and physiological stabilization at birth. On the other hand, globally and in Colombia, morbidity and mortality have increased in intermediate- and low-risk infants. The aim of the study was to assess the effect of immediate skin-to-skin contact, compared to separation at birth, on the risk of hospitalization of intermediate- and low-risk infants prior to discharge from the maternity ward. METHODOLOGY: A retrospective cohort study of newborn who underwent a SCC compared to habitual management was conducted. Intermediate- and low-risk neonates with spontaneous neonatal adaptation and cardiorespiratory stability at birth were included. Main outcome measure was hospital admission prior to the discharge from the maternity ward. RESULT: A total of 816 infants were included, 672 (82.3%) in the skin-to-skin contact group and 144 (17.6%) in the habitual management group. The main causes of hospital admission were jaundice and feeding/sucking related issues. Significantly lower admission to the neonatal unit was found for infants in the contact group compared to infants who did not receive skin-to-skin contact (13.8% vs. 26.4%; OR 0.46, 95% CI 0.29-0.71, p = 0.001). CONCLUSION: Skin-to-skin contact in newborns of intermediate and low risk has protective effects on the risk of hospital admission within the first few hours of life. SSC is proposed as a prevention strategy in second-level care scenarios.

Dosis y Factores Gamma de una paciente con 131I / Doses and Gamma factors in a patient with 131I

Mediante métodos Monte Carlo se calcularon las dosis en los órganos internos de una mujer, con tres meses de embarazo, debidas al radioiodo captado por su tiroides, así como a 1 metro de la glándula. Se utilizó un modelo tridimensional del cuerpo de la mujer y mediante Monte Carlo, los fotones de radioiodo se transportaron isotrópicamente desde la tiroides hacia todo el cuerpo y se calculó la dosis absorbida por sus órganos internos. También se determinó el Kerma en aire (K) y la dosis equivalente ambiental (H*(10)) a 1 m de la glándula. Se determinaron dos factores de actividad a dosis, también llamados Factores Gamma, que permiten estimar la dosis que la paciente produce a personas a su alrededor. De la radiación gamma que emite el 131I en la tiroides se encontró que el timo recibe la mayor dosis mientras que el útero es el órgano que menor dosis recibe. Los factores gamma determinados fueron: ΓKAire = 52.06 μGy-m2-h-1-GBq-1, y ΓH*(10) = 67.72 μSv-m2-h-1-GBq-1. La distribución de la dosis absorbida por los órganos internos se atribuye a la distancia relativa entre la tiroides y los otros órganos, al blindaje inter-órganos, su tamaño y a su composición elemental. Los factores ΓKAire y ΓH*(10) permiten estimar la exposición que la paciente produce sobre el personal a su alrededor. Con esto, el médico nuclear, el físico médico o el responsable de la seguridad radiológica en el hospital pueden dar indicaciones mas precisas sobre el comportamiento de las personas en torno al paciente.

Malestar en organizaciones chilenas: historias de trabajadores / Discontent in Chilean organizations: stories of workers

En el trabajo se analizan experiencias de malestar en organizaciones chilenas post industriales según cuatro historias escritas por trabajadores. Se utiliza el concepto psicoanalítico organización-en la mente-para el estudio de las historias. El documento aporta al entendimiento de condiciones laborales en el Chile actual y sus efectos en la salud mental de individuos, grupos y organizaciones.

This paper considers the analysis of discomfort and uneasy experiences in post-industrial Chilean organizations taking into account stories written by workers. It is used the psychoanalytical approach organization-in the mind-to understand the stories. The paper is a contribution to know about working conditions in Chile today and their effects on mental health on the realm of individuals, groups and organizations.

[Lead levels in high-risk populations and the surrounding environment in San Ignacio, Fresnillo, Zacatecas, México]. / Niveles de plomo en la población de alto riesgo y su entorno en San Ignacio, Fresnillo, Zacatecas, México.

OBJECTIVE: To determine the lead concentration in the blood of children and nursing or pregnant women from San Ignacio, Fresnillo, in Zacatecas, Mexico as well as in soil, plants, ash and lead-glazed pottery, in order to determine exposure due to a metal-recycling facility. MATERIAL AND METHODS: The study was carried out from December 2004 to April 2005. Lead in blood was measured with anodic stripping voltammetry, while dispersive energy X-ray fluorescence was used in the other matrices. RESULTS: Based upon the criteria outlined in the Official Mexican Standards, 90% of the children was identified as category 1, 5% as category II and another 5% as category III. The soil in the land near the facility contained from 73 to 84,238 microg/g, with an average of 4940 microg/g. Larger lead concentrations were found on sites located closer to the facility. San Ignacio's soil contained, on average, 109 microg/g. High lead levels were found in glazed pottery and the concentration in agricultural crops was greater than 300 microg/g. CONCLUSIONS: Although the majority of children in San Ignacio have blood lead concentrations considered to be acceptable according to the Official Mexican Standards, several studies indicate that deleterious effects on children's health exist even at low concentrations. The land around the metal recycling facility is contaminated with lead, and to that extent, the crops that are produced there, once ingested, are a source of contamination, which is compounded by the use of glazed pottery.

Niveles de plomo en la población de alto riesgo y su entorno en San Ignacio, Fresnillo, Zacatecas, México / Lead levels in high-risk populations and the surrounding environment in San Ignacio, Fresnillo, Zacatecas, México

OBJETIVO: Determinar la concentración de plomo en la sangre de niños y mujeres, en periodo de lactancia o embarazadas, de la comunidad de San Ignacio, Fresnillo, en Zacatecas, así como en matrices de suelo, plantas, ceniza y barro vidriado, para determinar la exposición que genera una empresa recicladora de metales. MATERIAL Y MÉTODOS: El estudio se realizó de diciembre de 2004 al mes de abril de 2005. El Pb en sangre se midió por voltamperometría de redisolución anódica, mientras que se utilizó energía dispersa de fluorescencia por rayos X para las otras matrices. RESULTADOS: Con base en los criterios de la Norma Oficial Mexicana (NOM) se encontró que 90 por ciento de los menores está en la categoría I, 5 por ciento se encuentra en la categoría II y el otro 5 por ciento se ubica en la categoría III. El suelo de los terrenos aledaños a la recicladora tiene en promedio 4 940 µg/g, en un intervalo de 73 a 84 238 µg/g. Las mayores concentraciones se localizan en los puntos más cercanos a la empresa. El suelo de San Ignacio tiene en promedio 109 µg/g. Se encontraron valores altos en el barro vidriado y la concentración del Pb en las plantas es superior a los 300 µg/g. CONCLUSIONES: A pesar de que la mayoría de los niños analizados presenta niveles de plomo en sangre que la Norma Mexicana señala como aceptables, varios estudios indican que existen efectos nocivos aun a concentraciones bajas. Los terrenos aledaños a la empresa están contaminados, y en esa medida los alimentos que ahí se producen, al ser consumidos, son una fuente de contaminación, que se agudiza con el uso de barro vidriado.

Neutron source design for boron neutron capture synovectomy

Se diseñó una fuente de neutrones para la Sinovectomía por Captura de Neutrones en Boro. La fuente utiliza una fuente isotópica de 239PuBe que se inserta en el centro de contenedor cilindrico con un arreglo heterogéneo de dos moderadores. Los moderadores estudiados son agua ligera/agua pesada, grafito/agua pesada, lucita/agua pesada y polietileno/agua pesada. La fluencia total y la de los neutrones térmicos producidas se emplearon para seleccionar el mejor embalaje. Así, el espectro que produce una fuente de 239PuBe dentro del moderador con polietileno/agua pesada se utilizó como término fuente para calcular los espectros de neutrones dentro de un modelo de rodilla. La composición elemental utilizada para modelar el saco y el líquido sinovial fue la del agua, la del tejido sanguíneo y la de este último con dos concentraciones de boro. Encontramos que cuando la composición elemental del saco sinovial se asume igual a la del tejido sanguíneo con 0.278 por ciento en peso de boro el kerma debido a los neutrones es 7351 veces mayor al que se obtiene cuando la composición del saco sinovial es la del agua.

Evaluación práctica de anatomía: rendimiento de los alumnos de primer año de medicina ante distintas formas de preguntar / Practical evaluation in anatomy: performance of first year medical students in relation to different ways of asking questions

Los anatomistas hemos debido hacer innovaciones para mantener una enseñanza de alto nivel, enfrentando factores como la disminución del horario lectivo, aumento del número de alumnos, falta de material cadavérico y de docentes. Los cambios incluyen el uso de disecciones preparadas con anticipación, desarrollo de una página Web con fotos animadas y el uso de imágenes clínicas (RX, TAC, RNM). Las pruebas prácticas del curso han incluido preguntas en este material, disponible en los pabellones de disección y en el sistema computacional. En este trabajo analizamos el rendimiento de los alumnos ante nuevas formas de evaluar el conocimiento práctico de Anatomía. Se compararon los puntajes obtenidos por los estudiantes en seis tipos de preguntas de reconocimiento en: 1.- Preparaciones cadavéricas que han visto con anterioridad. 2.- Fotos animadas de la página Web del curso. 3.- Imágenes de resonancia nuclear. 4.- Preparaciones anatómicas nuevas. 5.-Secciones anatómicas. 6.- Radiografías. El análisis estadístico de los resultados demostró que los alumnos reconocen con facilidad estructuras anatómicas en planos bidimensionales como la pantalla del computador o RX, presentando una complejidad mayor la identificación de elementos en las preparaciones cadavéricas o secciones de segmentos corporales; diferencias que son estadísticamente significativas. La utilización de imágenes anatómicas computacionales representan un apoyo importante a las actividades prácticas. Sin embargo, subsiste el problema de la concepción tridimensional de la estructura anatómica, que no alcanza a ser resuelta por el uso de las imágenes; resaltando el valor de las disecciones anatómicas en este tipo de cursos.

Neutron and gamma-ray spectra of 239PuBe and 241AmBe.

Neutron and gamma-ray spectra of 239PuBe and 241AmBe were measured and their dosimetric features were calculated. Neutron spectra were measured using a multisphere neutron spectrometer with a 6LiI(Eu) scintillator. The 239PuBe neutron spectrum was measured in an open environment, while the 241AmBe neutron spectrum was measured in a closed environment. Gamma-ray spectra were measured using a NaI(Tl) scintillator using the same experimental conditions for both sources. The effect of measuring conditions for the 241AmBe neutron spectrum indicates the presence of epithermal and thermal neutrons. The low-resolution neutron spectra obtained with the multisphere spectrometer allows one to calculate the dosimetric features of neutron sources. At 100 cm both sources produce approximately the same count rate as that of the 4.4 MeV gamma-ray per unit of alpha emitter activity.