Confiabilidad y validez de una escala de identidad organizacional en servicios de salud

Objetivo Validar la Escala de Identidad Organizacional (IDN) de algunas instituciones mexicanas de servicios de salud a través de análisis confirmatorio. Métodos Se utilizó una escala de identidad de quince ítems aplicados a una muestra de 214 trabajadores pertenecientes a seis clínicas de servicios de salud en el Estado de Hidalgo, México. Resultados El análisis de fiabilidad indicó que la IDN posee consistencia interna adecuada. Los análisis factorial exploratorio y confirmatorio permitieron identificar una estructura de tres factores (orgullo, pertenencia y significado). El factor orgullo muestra cargas estimadas más elevadas. Conclusión La versión final del instrumento presenta confiabilidad y validez adecuadas para la medición de la identidad organizacional.

Objective To validate the Organizational Identity Scale (IDN) for Mexican health service institutions through confirmatory analysis. Methodology We applied a fifteen-item identity scale to a sample of 214 workers from six health service clinics in Hidalgo, Mexico. Results The reliability analysis indicated that the IDN has adequate internal consistency. The exploratory and confirmatory factor analyses allowed us to identify a struc-ture of three factors (pride, belonging, and meaning). The pride factor shows higher estimated loads. Conclusion The final version of the instrument presents adequate reliability and validity for the measurement of organizational identity.

Path-Tracking of a WMR Fed by Inverter-DC/DC Buck Power Electronic Converter Systems.

This paper is concerned with path-tracking control of a wheeled mobile robot. This robot is equipped with two permanent magnet brushed DC-motors which are fed by two inverter-DC/DC Buck power converter systems as power amplifiers. By taking into account the dynamics of all the subsystems we present, for the first time, a formal stability proof for this control problem. Our control scheme is simple, in the sense that it is composed by four internal classical proportional-integral loops and one external classical proportional-derivative loop for path-tracking purposes. This is the third paper of a series of papers devoted to control different nonlinear systems, which proves that the proposed methodology is a rather general approach for controlling electromechanical systems when actuated by power electronic converters.

Trastorno de excoriación en una mujer con panarteritis nudosa. Reporte de caso / Skin Picking Disorder in a Woman with Polyarteritis Nodosa. Case Report

RESUMEN Introducción: El trastorno por excoriación está incluido en el DSM - 5 dentro de la categoría Recibido el 4 de abril de 2017 de trastorno obsesivo compulsivo y trastornos relacionados. Se define como la urgencia Aceptado el 18 de marzo de 2018 de tocar, rascar, frotar, restregar, friccionar, apretar, morder o excavar la piel de forma On-line el 7 de mayo de 2018 recurrente hasta producirse lesiones cutáneas. Es un trastorno poco frecuente (1.4 - 5.4% de la población) y se presenta principalmente en mujeres. Presentación de caso: Se presenta el caso de una mujer de 31 años quien fue valorada por dermatología y ortopedia por presencia de lesiones ulceradas e infectadas en miembros inferiores, junto con otras lesiones superficiales por rascado en tórax, brazos, antebrazos, espalda y cabeza; además reportando síntomas ansiosos, razón por la cual es valorada por el servicio de Psiquiatría de enlace Discusión: El rascado cutáneo, conducta normal en los mamíferos, cobra valor patológico desde el punto de vista psiquiátrico al ser un acto repetitivo y persistente, como la conducta que se presenta en el trastorno por excoriación. Dada la relación descrita con el espectro obsesivo - compulsivo, se recomienda el uso de inhibidores selectivos de la recaptación de serotonina y la terapia cognitivo conductual.

ABSTRACT Introduction: Excoriation (skin picking) disorder is included in the DSM-5 in the obsessive compulsive and related disorders category. It is defined as the recurrent urge to touch, scratch, scrape, scrub, rub, squeeze, bite or dig in the skin, leading to skin lesions. It is a rare disorder (1.4-5.4% of the population) and occurs mainly in women. Case report: this article reports the case of a 31-year-old female patient, initially assessed by dermatology and orthopaedics for the presence of infected ulcerated lesions on her lower limbs, with other superficial lesions from scratching on her chest, arms, forearms, back and head. The patient also reported symptoms of anxiety, so was assessed by consultation-liaison psychiatry. Discussion: skin picking, normal behaviour in mammals, becomes pathological from a psychiatric point of view when it is repetitive and persistent, as in the case of excoriation disorder. In view of the reported relationship with the obsessive-compulsive spectrum, use of selective serotonin reuptake inhibitors and cognitive behavioural therapy are recommended.

Skin Picking Disorder in a Woman with Polyarteritis Nodosa. Case Report. / Trastorno de excoriación en una mujer con panarteritis nudosa. Reporte de caso.

INTRODUCTION: Excoriation (skin picking) disorder is included in the DSM-5 in the obsessive compulsive and related disorders category. It is defined as the recurrent urge to touch, scratch, scrape, scrub, rub, squeeze, bite or dig in the skin, leading to skin lesions. It is a rare disorder (1.4-5.4% of the population) and occurs mainly in women. CASE REPORT: this article reports the case of a 31-year-old female patient, initially assessed by dermatology and orthopaedics for the presence of infected ulcerated lesions on her lower limbs, with other superficial lesions from scratching on her chest, arms, forearms, back and head. The patient also reported symptoms of anxiety, so was assessed by consultation-liaison psychiatry. DISCUSSION: skin picking, normal behaviour in mammals, becomes pathological from a psychiatric point of view when it is repetitive and persistent, as in the case of excoriation disorder. In view of the reported relationship with the obsessive-compulsive spectrum, use of selective serotonin reuptake inhibitors and cognitive behavioural therapy are recommended.

Robust Switched Tracking Control for Wheeled Mobile Robots Considering the Actuators and Drivers.

By using the hierarchical controller approach, a new solution for the control problem related to trajectory tracking in a differential drive wheeled mobile robot (DDWMR) is presented in this paper. For this aim, the dynamics of the three subsystems composing a DDWMR, i.e., the mechanical structure (differential drive type), the actuators (DC motors), and the power stage (DC/DC Buck power converters), are taken into account. The proposed hierarchical switched controller has three levels: the high level corresponds to a kinematic control for the mechanical structure; the medium level includes two controls based on differential flatness for the actuators; and the low level is linked to two cascade switched controls based on sliding modes and PI control for the power stage. The hierarchical switched controller was experimentally implemented on a DDWMR prototype via MATLAB-Simulink along with a DS1104 board. With the intention of assessing the performance of the switched controller, experimental results associated with a hierarchical average controller recently reported in literature are also presented here. The experimental results show the robustness of both controllers when parametric uncertainties are applied. However, the performance achieved with the switched controller introduced in the present paper is better than, or at least similar to, performance achieved with the average controller reported in literature.

Psychotherapies for the treatment of phantom limb pain / Uso de psicoterapias como tratamiento del dolor de miembro fantasma

Abstract Introduction: The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42-90% of amputees. Regular drug treatment of phantom limb pain is almost never effective. Methods: A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items. After reviewing the abstracts, 25 articles were excluded for not being related to the objective of the research. Additionally cross references of included articles and literature were reviewed. Objectives: To describe the psychotherapies used in the management of phantom limb pain, their effectiveness and clinical application reported in the literature. Aims: The mechanisms underlying phantom limb pain were initially explained, as were the published studies on the usefulness of some psychotherapies such as mirror visual feedback and immersive virtual reality, visual imagery, desensitisation and reprocessing eye movements and hypnosis. Conclusions: The phantom limb pain is a complex syndrome that requires pharmacological and psychotherapeutic intervention. The psychotherapies that have been used the most as adjuvants in the treatment of phantom limb pain are mirror visual feedback, desensitisation and reprocessing eye movements, imagery and hypnosis. Studies with more representative samples, specifically randomised trials are required.

Resumen Introducción: El dolor de miembro fantasma ha sido descrito como una condición en la que los pacientes experimentan una sensación de prurito, espasmo o dolor en un miembro o parte del cuerpo previamente amputado. Dicho dolor puede ser inducido por un conflicto entre la representación de la retroalimentación visual y propioceptiva del miembro previamente sano. El dolor de miembro fantasma ocurre en al menos 42 al 90% de los amputados. El tratamiento farmacológico regular del dolor del miembro fantasma casi nunca es efectivo. Método: Se realizó una revisión sistemática en las bases de datos Medline y Cochrane usando palabras MESH "phantom limb pain" y "psychotherapy", publicados en los últimos 10 anos, en español e inglés, encontrando 49 artículos. Al revisar los resúmenes, se excluyeron 25 artículos por no ser afines con el objetivo de la investigación. Adicionalmente se revisaron referencias cruzadas de los artículos incluidos y literatura médica. Objetivos: Describir las psicoterapias usadas en el manejo del dolor de miembro fantasma, su efectividad y aplicación clínica reportada en la literatura. Desarrollo: Se explican inicialmente los mecanismos subyacentes al dolor de miembro fantasma y se describen los estudios publicados sobre la utilidad del uso de algunas psicoterapias como la retroalimentación visual con espejo y con realidad virtual inmersiva, imaginería visual, reprocesamiento y desensibilización por movimientos oculares e hipnoterapia. Conclusiones: El dolor de miembro fantasma es un síndrome complejo que requiere intervención farmacológica y psicoterapéutica. Las psicoterapias que más se han usado como coadyuvantes en el tratamiento del dolor de miembro fantasma son la retroalimentación visual con espejo, la desensibilización y reprocesamiento por movimientos oculares, la imaginería y la hipnosis. Se requieren estudios con muestras más significativas, específicamente estudios clínicos aleatorizados.

[Psychotherapies for the Treatment of Phantom Limb Pain]. / Uso de psicoterapias como tratamiento del dolor de miembro fantasma.

INTRODUCTION: The phantom limb pain has been described as a condition in which patients experience a feeling of itching, spasm or pain in a limb or body part that has been previously amputated. Such pain can be induced by a conflict between the representation of the visual and proprioceptive feedback of the previously healthy limb. The phantom limb pain occurs in at least 42 to 90% of amputees. Regular drug treatment of phantom limb pain is almost never effective. METHODS: A systematic review of the literature was conducted in Medline and Cochrane using the MESH terms "phantom limb pain" and "psychotherapy", published in the last 10 years, in English and Spanish, finding 49 items. After reviewing the abstracts, 25 articles were excluded for not being related to the objective of the research. Additionally cross references of included articles and literature were reviewed. OBJECTIVES: To describe the psychotherapies used in the management of phantom limb pain, their effectiveness and clinical application reported in the literature. AIMS: The mechanisms underlying phantom limb pain were initially explained, as were the published studies on the usefulness of some psychotherapies such as mirror visual feedback and immersive virtual reality, visual imagery, desensitization and reprocessing eye movements and hypnosis. CONCLUSIONS: The phantom limb pain is a complex syndrome that requires pharmacological and psychotherapeutic intervention. The psychotherapies that have been used the most as adjuvants in the treatment of phantom limb pain are mirror visual feedback, desensitization and reprocessing eye movements, imagery and hypnosis. Studies with more representative samples, specifically randomized trials are required.

Wavefronts, caustic, ronchigram, and null ronchigrating of a plane wave refracted by an axicon lens.

The aim of this work is threefold: first we obtain analytical expressions for the wavefront train and the caustic associated with the refraction of a plane wavefront by an axicon lens, second we describe the structure of the ronchigram when the ronchiruling is placed at the flat surface of the axicon and the screen is placed at different relative positions to the caustic region, and third we describe in detail the structure of the null ronchigrating for this system; that is, we obtain the grating such that when it is placed at the flat surface of the axicon its associated pattern, at a given plane perpendicular to the optical axis, is a set of parallel fringes. We find that the caustic has only one branch, which is a segment of a line along the optical axis; the ronchigram exhibits self-intersecting fringes when the screen is placed at the caustic region, and the null ronchigrating exhibits closed loop rulings if we want to obtain its associated pattern at the caustic region.

Wavefronts, caustics, and ronchigrams of a spherical wave reflected by a spherical mirror.

The aim of the present work is twofold: first we obtain analytical expressions for both the wavefronts and the caustic associated with the light rays reflected by a spherical mirror after being emitted by a point light source located at an arbitrary position in free space, and second, we describe, in detail, the structure of the ronchigrams when the grating or Ronchi ruling is placed at different relative positions to the caustic region and the point light source is located on and off the optical axis. We find that, in general, the caustic has two branches: one is a segment of a line, and the other is a two-dimensional surface. The wavefronts, at the caustic region, have self intersections and singularities. The ronchigrams exhibit closed-loop fringes when the grating is placed at the caustic region.