Comparative study of physical-chemical properties of bioactive glass ionomer cement.

This study analyzed the physical-chemical properties of bioactive ionomer materials. Cention N bioactive materials were evaluated chemically activated (CN) and light-cured (CN-LC), Equia Forte Fill (EQUI); conventional resin composite Filtek Z350 XT (Z350); resin glass ionomer cement Riva light Cure (RIVA) and flowable resin composite Filtek Bulk Fill Flow (BULK-F) were evaluated. Sixty specimens (n=10) were prepared for sorption (SR), solubility (SL), flexural strength (FS), shrinkage stress (SS), conversion degree (CD), microhardness (MI), and surface roughness (SR) tests. Non-cured and light-cured materials were assessed on FTIR. 30 human molar teeth were used in the bond strength test (BS). Data were subjected to ANOVA and post-hoc Tukey's test (5% of significance). EQUI showed more sorption in SR and no statistical difference from RIVA and CN-LC. CN group showed more solubility and EQUI presented less (p<0.05). BULK-F showed higher FS (MPa), without differences from CN and Z350, whereas EQUI presented the lowest FS not differing from RIVA. BULK-F and CN-LC showed more shrinkage stress differing from EQUI. CN-LC and CN showed higher CD differing from the other which showed no differences (p>0.05) between them. EQUI showed the highest hardness (p<0.05) in MI. There were no differences (p>0.05) in SR (µm). Z350 and BULK-F presented higher BS, whereas CN-LC showed the lowest, although not differing from EQUI and RIVA. Equia Forte's solubility and microhardness make it a good alternative as a restorative material. Cention N degree of conversion and flexural strength making it an esthetic option to amalgam.

Development of a Multiplatform Tool for the Prevention of Prevalent Mental Health Pathologies in Adults: Protocol for a Randomized Control Trial.

BACKGROUND: The prevalence of depression and anxiety has increased in recent years, with many individuals having trouble accessing mental health support. Smartphones have become an integral part of modern life, with apps offering new ways to deliver evidence-based self-help strategies to cope with common mental health symptoms. However, most of them do not have empirical evidence of their overall effectiveness or the effectiveness of their components, which could pose a risk for users. OBJECTIVE: The aim of this study is to evaluate the effectiveness of the modules of evaluation, psychoeducation, and emotional regulation strategies in a multiplatform self-help mental health mobile app in the Maule region of Chile. METHODS: A sample of 196 adults will be selected, who will be randomly assigned to different components of the app for a fixed period to assess its ability to reduce symptomatology. RESULTS: The trial is not yet recruiting and is expected to end in October 2024. The first results are expected in April 2024. CONCLUSIONS: This is the first study in Chile to develop and test the effectiveness of a mobile app to manage anxiety and depression symptoms in adults. The intervention proposed is based on evidence suggesting that the internet or remote intervention tools and self-management of prevalent symptomatology could be the future of mental health care systems in the digital era. If the effects of the intervention are positive, wide implementation in Chile and other Spanish-speaking countries could be possible in the future. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/52324.

Comparative study of physical-chemical properties of bioactive glass ionomer cement

Abstract This study analyzed the physical-chemical properties of bioactive ionomer materials. Cention N bioactive materials were evaluated chemically activated (CN) and light-cured (CN-LC), Equia Forte Fill (EQUI); conventional resin composite Filtek Z350 XT (Z350); resin glass ionomer cement Riva light Cure (RIVA) and flowable resin composite Filtek Bulk Fill Flow (BULK-F) were evaluated. Sixty specimens (n=10) were prepared for sorption (SR), solubility (SL), flexural strength (FS), shrinkage stress (SS), conversion degree (CD), microhardness (MI), and surface roughness (SR) tests. Non-cured and light-cured materials were assessed on FTIR. 30 human molar teeth were used in the bond strength test (BS). Data were subjected to ANOVA and post-hoc Tukey's test (5% of significance). EQUI showed more sorption in SR and no statistical difference from RIVA and CN-LC. CN group showed more solubility and EQUI presented less (p<0.05). BULK-F showed higher FS (MPa), without differences from CN and Z350, whereas EQUI presented the lowest FS not differing from RIVA. BULK-F and CN-LC showed more shrinkage stress differing from EQUI. CN-LC and CN showed higher CD differing from the other which showed no differences (p>0.05) between them. EQUI showed the highest hardness (p<0.05) in MI. There were no differences (p>0.05) in SR (µm). Z350 and BULK-F presented higher BS, whereas CN-LC showed the lowest, although not differing from EQUI and RIVA. Equia Forte's solubility and microhardness make it a good alternative as a restorative material. Cention N degree of conversion and flexural strength making it an esthetic option to amalgam.

Resumo Este estudo analisou as propriedades físico-químicas dos materiais de ionômero bioativo. Os materiais bioativos Cention N quimicamente ativados (CN) e fotopolimerizados (CN-LC), Equia Forte Fill (EQUI); resina composta convencional Filtek Z350 XT (Z350); resina de ionômero de vidro Riva light Cure (RIVA) e resina composta fluida Filtek Bulk Fill Flow (BULK-F) foram avaliados. Sessenta espécimes (n=10) foram preparados para testes de sorção (SR), solubilidade (SL), resistência à flexão (FS), tensão de contração (SS), grau de conversão (CD), microdureza (MI) e rugosidade da superfície (SR). Os materiais não curados e curados com luz foram avaliados por FTIR. 30 dentes molares humanos foram usados no teste de resistência de união (BS). Os dados foram submetidos a ANOVA e teste de post-hoc Tukey (5% de significância). O EQUI apresentou maior sorção no SR e não mostrou diferença estatística em relação aos grupos RIVA e CN-LC. O grupo CN apresentou maior solubilidade e o EQUI apresentou menor (p<0,05). O BULK-F apresentou maior FS (MPa), sem diferir do CN e do Z350, enquanto o EQUI apresentou o menor FS, não diferindo do RIVA. O BULK-F e o CN-LC apresentaram maior estresse de contração, diferindo do EQUI. O CN-LC e o CN apresentaram maior CD (%), diferindo dos demais, que não apresentaram diferenças (p>0,05) entre si. A EQUI apresentou a maior dureza (p<0,05) no MI. Não houve diferenças (p>0,05) na SR (µm). Z350 and BULK-F apresentaram BS, enquanto a CN-LC apresentou a menor, embora não diferindo da EQUI e da RIVA. A solubilidade e a microdureza do Equia Forte o tornam uma boa alternativa como material restaurador. O grau de conversão e a resistência à flexão do Cention N o tornam uma opção estética ao amálgama.

Assessing the bleaching effect of an experimental stabilized chlorine dioxide agent used for internal bleaching purposes

Aim Assessing the intracoronal bleaching effectiveness of an experimental chlorine dioxide product, based on the walking bleach technique. Methods Extracted bovine incisors were artificially stained with bovine blood and filled with zinc phosphate cement at cementoenamel junction level. Teeth were divided into 3 groups (n=10): (SP) sodium perborate added with distilled water, (CD) chlorine dioxide and (C) control - dry cotton inserted into the pulp chamber. Bleaching agents were used at 0, 7 and 14 days. VITA Easyshadetm (∆Eab) was used to analyze tooth color at the 7th, 14th and 21st days, based on the CIE2000 system. Data were analyzed through ANOVA and Tukey's test. Results There were no statistically significant differences in Δb, ΔE, ΔE00 and ΔWID between CD and the control group. These parameters have shown significant differences between CD and SP, which differed from the control. However, they did not show significant differences either in the control group or in CD at the 7th, 14th and 21st days. Values recorded for SP at the 7th day differed from those recorded at the 14th and 21st days. Δa has shown differences within the same group at the 7th, 14th and 21st days. There was no difference between groups, when they were compared at the same day (7th and 14th). The control group differed from SP at the 21st day. CD did not differ from the other two groups. ΔL did not show differences between groups and times. Conclusion Stabilized chlorine dioxide (0.07%, at pH 3.5) should not be used as intracoronal bleaching agent along with the walking bleach technique.

Rede de assistência integral à saúde do idoso: experiência de enfermeiros gerentes na atenção primária / Comprehensive care network for older adults: the experience of nurse-managers in primary care / Red de asistencia integral para la salud de la tercera edad: la experiencia de enfermeros gerentes en servicios de atención primaria

RESUMO Objetivo: compreender a concepção de rede de atenção integral ao idoso segundo experiências de enfermeiros gerentes de serviços de Atenção Primária à Saúde. Métodos: pesquisa qualitativa, realizada em municípios sede de cinco regiões de saúde do estado de São Paulo, Brasil, em 2019. Entrevistas audiogravadas, transcritas e analisadas conforme Teoria Fundamentada nos Dados, com saturação teórica a partir da quinta entrevista. Resultados: emergiram três subprocessos: reconhecendo potenciais para a constituição da rede de atenção integral ao idoso no contexto do sistema público de saúde; desencorajando-se por não vislumbrar a Rede de Atenção ao Idoso, perante os desafios organizacionais e culturais para fortalecimento da Atenção Primária à Saúde; desmotivando a movimentar-se para a construção da rede de atenção integral ao idoso. Considerações Finais: este estudo contribui para a equipe dos serviços de Atenção Primária à Saúde reavaliar suas práticas em saúde, buscando avançar na constituição da rede de atenção integral ao idoso.

ABSTRACT Objective: to understand the conception of the comprehensive care network for older adults according to the experiences of nurse-managers working in Primary Health Care services. Methods: a qualitative research study conducted in 2019 in a number of host municipalities from five health regions of the state of São Paulo, Brazil. The interviews were audio-recorded, transcribed and analyzed according to the Grounded Theory, with theoretical saturation from the fifth interview. Results: three sub-processes emerged, namely: recognizing potential for the constitution of a comprehensive care network for older adults in the context of the public health system; getting discouraged for not visualizing the Care Network for Older Adults, given the organizational and cultural challenges to strengthen Primary Health Care; and discouragement to mobilize towards the constitution of the comprehensive care network for older adults. Final Considerations: this study contributes for the teams working in the Primary Health Care services to reassess their health practices, seeking to advance in the constitution of the comprehensive care network for older adults.

RESUMEN Objetivo: comprender la concepción de la red de atención integral para la salud de la tercera edad de acuerdo con experiencias de enfermeros gerentes de servicios de Atención Primaria de la Salud. Métodos: investigación cualitativa realizada en el año 2019 en diversos municipios sede de cinco regiones de salud del estado de San Pablo, Brasil. Las entrevistas se grabaron en un medio de audio, transcribieron y analizaron conforme a la Teoría Fundamentada en los Datos, con saturación teórica a partir de la quinta entrevista. Resultados: surgieron tres subprocesos, a saber: reconocer potencialidades para establecer la red de atención integral para la tercera edad en el contexto del sistema público de salud; desánimo al no vislumbrar la Red de Atención para la Tercera Edad, ante los retos organizacionales y culturales para fortalecer la Atención Primaria de la Salud; y desmotivación para movilizarse en pos de establecer la red de atención integral para la tercera edad. Consideraciones Finales: este estudio sirve de apoyo para que los equipos de los servicios de Atención Primaria de la Salud reevalúen sus prácticas en materia de salud, procurando avanzar en la constitución de la red de atención integral para la tercera edad.

Identity-based hate and violence as trauma: Current research, clinical implications, and advocacy in a globally connected world.

Hate-based violence is increasingly recognized as an urgent social justice and human rights issue that is pervasive across geographical and socioeconomic boundaries. There is a growing body of research that demonstrates the traumatic impact of hate-based violence on the victim's mental and physical health. This review focuses on examining scientific knowledge and prevalence data on identity-based hate and violence exposure. A framework for conceptualizing hate-based violence as a traumatic event or series of traumatic events is offered as a means to understand research findings and intervention approaches. The importance of research, advocacy, and human rights training is highlighted in the efforts to address the traumatic impact of identity-based hate and violence.

Rede de assistência integral à saúde do idoso: experiência de enfermeiros gerentes na atenção primária / Comprehensive care network for older adults: the experience of nurse-managers in primary care / Red de asistencia integral para la salud de la tercera edad: la experiencia de enfermeros gerentes en servicios de atención primaria

RESUMO Objetivo: compreender a concepção de rede de atenção integral ao idoso segundo experiências de enfermeiros gerentes de serviços de Atenção Primária à Saúde. Métodos: pesquisa qualitativa, realizada em municípios sede de cinco regiões de saúde do estado de São Paulo, Brasil, em 2019. Entrevistas audiogravadas, transcritas e analisadas conforme Teoria Fundamentada nos Dados, com saturação teórica a partir da quinta entrevista. Resultados: emergiram três subprocessos: reconhecendo potenciais para a constituição da rede de atenção integral ao idoso no contexto do sistema público de saúde; desencorajando-se por não vislumbrar a Rede de Atenção ao Idoso, perante os desafios organizacionais e culturais para fortalecimento da Atenção Primária à Saúde; desmotivando a movimentar-se para a construção da rede de atenção integral ao idoso. Considerações Finais: este estudo contribui para a equipe dos serviços de Atenção Primária à Saúde reavaliar suas práticas em saúde, buscando avançar na constituição da rede de atenção integral ao idoso.

ABSTRACT Objective: to understand the conception of the comprehensive care network for older adults according to the experiences of nurse-managers working in Primary Health Care services. Methods: a qualitative research study conducted in 2019 in a number of host municipalities from five health regions of the state of São Paulo, Brazil. The interviews were audio-recorded, transcribed and analyzed according to the Grounded Theory, with theoretical saturation from the fifth interview. Results: three sub-processes emerged, namely: recognizing potential for the constitution of a comprehensive care network for older adults in the context of the public health system; getting discouraged for not visualizing the Care Network for Older Adults, given the organizational and cultural challenges to strengthen Primary Health Care; and discouragement to mobilize towards the constitution of the comprehensive care network for older adults. Final Considerations: this study contributes for the teams working in the Primary Health Care services to reassess their health practices, seeking to advance in the constitution of the comprehensive care network for older adults.

RESUMEN Objetivo: comprender la concepción de la red de atención integral para la salud de la tercera edad de acuerdo con experiencias de enfermeros gerentes de servicios de Atención Primaria de la Salud. Métodos: investigación cualitativa realizada en el año 2019 en diversos municipios sede de cinco regiones de salud del estado de San Pablo, Brasil. Las entrevistas se grabaron en un medio de audio, transcribieron y analizaron conforme a la Teoría Fundamentada en los Datos, con saturación teórica a partir de la quinta entrevista. Resultados: surgieron tres subprocesos, a saber: reconocer potencialidades para establecer la red de atención integral para la tercera edad en el contexto del sistema público de salud; desánimo al no vislumbrar la Red de Atención para la Tercera Edad, ante los retos organizacionales y culturales para fortalecer la Atención Primaria de la Salud; y desmotivación para movilizarse en pos de establecer la red de atención integral para la tercera edad. Consideraciones Finales: este estudio sirve de apoyo para que los equipos de los servicios de Atención Primaria de la Salud reevalúen sus prácticas en materia de salud, procurando avanzar en la constitución de la red de atención integral para la tercera edad.

The role of renin angiotensin system in the pathophysiology of rheumatoid arthritis.

BACKGROUND: In rheumatoid arthritis (RA) and osteoarthritis (OA), chronic inflammatory processes lead to progresive joint destruction. The renin-angiotensin system (RAS) is involved in the pathogenesis of RA and OA. The aim of this mini-review article is to summarize evidence on the role of RAS in RA and OA. METHODS: A non-systematic search in Pubmed included terms as "rheumatoid arthritis", "renin angiotensin system", "osteopenia", "RANKL", "DKK-1", "MMP", "inflammation", "angiogenesis", "local renin-angiotensin system", "angiotensin converting enzyme", "AT2 receptor", "Ang-(1-7)", "VEGF", "angiotensine receptor blocker", "angiotensin converting enzyme inhibitors", "renin inhibitors". RESULTS: Both RAS axes, the classical one, formed by angiotensin converting enzyme (ACE), angiotensin (Ang) II and AT1 receptor (AT1R) and the counter-regulatory one, composed by ACE2, Ang-(1-7) and the Mas receptor, modulate inflammation and tissue damage. Ang II activates pro-inflammatory mediators and oxidative stress. Conversely, Ang-(1-7) exerts anti-inflammatory actions, decreasing cytokine release, leukocyte attraction, density of vessels, tissue damage and fibrosis. Angiogenesis facilitates inflammatory cells invasion, while osteopenia causes joint dysfunction. Up-regulated osteoclastogenisis and down-regulated osteoblastogeneses were associaed with the activation of the classical RAS axis. Three different pathways, RANKL, DKK-1 and MMPs are enhanced by classical RAS activation. The treatment of RA included methotrexate and corticosteroids, which can cause side effects. Studies with angiotensin receptor blockers (ARBs), angiotensin converting enzyme inhibitors (ACEi) and renin inhibitors have been conducted in experimental and clinical RA with promising results. CONCLUSION: The classical RAS activation is an important mechanism in RA pathogenesis and the benefit of ARB and ACEi administration should be further investigated.

Manejo de los hábitos orales en odontopediatría: Revisión de literatura

Los hábitos orales son responsables de gran cantidad de alteraciones dentoalveolares y de tejidos blandos. El conocimiento del manejo de estos es de vital importancia para el clínico. El propósito de esta revisión es buscar en la literatura científica, el manejo de los hábitos orales más comunes, para así, crear una guía de tratamiento que ayude al clínico en su manejo. Metodología: Se revisaron 121 artículos de las bases Pubmed, Cochrane Library, Ebsco, Scielo y Google Scholar. Se priorizaron los artículos del tipo revisiones sistemáticas, metaanálisis, ensayos clínicos aleatorizados y guías clínicas, con una antigüedad no mayor a 5 años. Luego de la revisión y selección final, se utilizaron 45 artículos. La búsqueda se realizó en inglés y español, utilizando las palabras claves para los temas: succión no nutritiva, deglución atípica, respiración bucal, bruxismo y succión o mordedura labial. Conclusiones: el manejo de los hábitos orales es de carácter multidisciplinario. Existen distintos tipos de terapias y aparatología para cada uno de ellos, por lo que es importante realizar un adecuado diagnóstico y plan de tratamiento de acuerdo a las condiciones y necesidades particulares de cada paciente.

Using Exploratory Structural Equation Modeling (ESEM) to Examine the Internal Structure of Posttraumatic Stress Disorder Symptoms.

Several studies have reported the factor structure of posttraumatic stress disorder (PTSD) using confirmatory factor analysis (CFA). The results show models with different number of factors, high correlations between factors, and symptoms that belong to different factors in different models without affecting the fit index. These elements could suppose the existence of considerable item cross-loading, the overlap of different factors or even the presence of a general factor that explains the items common source of variance. The aim is to provide new evidence regarding the factor structure of PTSD using CFA and exploratory structural equation modeling (ESEM). In a sample of 1,372 undergraduate students, we tested six different models using CFA and two models using ESEM and ESEM bifactor analysis. Trauma event and past-month PTSD symptoms were assessed with Life Events Checklist for DSM-5 (LEC-5) and PTSD Checklist for DSM-5 (PCL-5). All six tested CFA models showed good fit indexes (RMSEA = .051-.056, CFI = .969-.977, TLI = .965-.970), with high correlations between factors (M = .77, SD = .09 to M = .80, SD = .09). The ESEM models showed good fit indexes (RMSEA = .027-.036, CFI = .991-.996, TLI = .985-.992). These models confirmed the presence of cross-loadings on several items as well as loads on a general factor that explained 76.3% of the common variance. The results showed that most of the items do not meet the assumption of dimensional exclusivity, showing the need to expand the analysis strategies to study the symptomatic organization of PTSD.

Experience of nurse entrepreneurs in long term institutions for elderly people.

OBJECTIVE: To understand the nurse entrepreneur experience in long term institutions for elderly (LTIE) and to elaborate a theorical model regarding that experience process. METHODS: Qualitative research with theorical saturation, through analysis of the 10th nondirective interview, audio-recorded and transcribed, according to the Grounded Theory, with nurses in activity and those who had to quit the business. RESULTS: Three subprocesses emerged: (A) looking at the LTIE as a promising business to offer to the aging population; (B) discovering herself/himself without entrepreneur training/experience to carry on a social enterprise; (C) changing from preservation, expansion, and finally business discontinuance. The core category (process) was abstracted from the realignment of those subprocesses components: From the dream to expansion, preservation, and business abandonment: nurse training/experience for social enterprise as an intervening component. FINAL CONSIDERATIONS: In light of the Business Model Canvas, it showed the experiential process little instrumented by the fundamentals of business management, to support the proposal, overview and altering business.

Using Exploratory Structural Equation Modeling (ESEM) to examine the internal structure of posttraumatic stress disorder symptoms

Several studies have reported the factor structure of posttraumatic stress disorder (PTSD) using confirmatory factor analysis (CFA). The results show models with different number of factors, high correlations between factors, and symptoms that belong to different factors in different models without affecting the fit index. These elements could suppose the existence of considerable item cross-loading, the overlap of different factors or even the presence of a general factor that explains the items common source of variance. The aim is to provide new evidence regarding the factor structure of PTSD using CFA and exploratory structural equation modeling (ESEM). In a sample of 1,372 undergraduate students, we tested six different models using CFA and two models using ESEM and ESEM bifactor analysis. Trauma event and past-month PTSD symptoms were assessed with Life Events Checklist for DSM-5 (LEC-5) and PTSD Checklist for DSM-5 (PCL-5). All six tested CFA models showed good fit indexes (RMSEA = .051-.056, CFI = .969-.977, TLI = .965-.970), with high correlations between factors (M = .77, SD = .09 to M = .80, SD = .09). The ESEM models showed good fit indexes (RMSEA = .027-.036, CFI = .991-.996, TLI = .985-.992). These models confirmed the presence of cross-loadings on several items as well as loads on a general factor that explained 76.3% of the common variance. The results showed that most of the items do not meet the assumption of dimensional exclusivity, showing the need to expand the analysis strategies to study the symptomatic organization of PTSD

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Experience of nurse entrepreneurs in long term institutions for elderly people / Experiencia de enfermeros emprendedores con instituciones de larga permanencia para ancianos / Experiência de enfermeiros empreendedores com instituições de longa permanência para idosos

ABSTRACT Objective: To understand the nurse entrepreneur experience in long term institutions for elderly (LTIE) and to elaborate a theorical model regarding that experience process. Methods: Qualitative research with theorical saturation, through analysis of the 10th nondirective interview, audio-recorded and transcribed, according to the Grounded Theory, with nurses in activity and those who had to quit the business. Results: Three subprocesses emerged: (A) looking at the LTIE as a promising business to offer to the aging population; (B) discovering herself/himself without entrepreneur training/experience to carry on a social enterprise; (C) changing from preservation, expansion, and finally business discontinuance. The core category (process) was abstracted from the realignment of those subprocesses components: From the dream to expansion, preservation, and business abandonment: nurse training/experience for social enterprise as an intervening component. Final considerations: In light of the Business Model Canvas, it showed the experiential process little instrumented by the fundamentals of business management, to support the proposal, overview and altering business.

RESUMEN Objetivos: Comprender la experiencia del enfermero emprendedor con institución de larga permanencia de ancianos (ILPI) y elaborar modelo teórico de eso proceso de vivencia. Métodos: Investigación cualitativa con saturación teórica, mediante el análisis de la 10ª entrevista no directiva, audiograbada y transcripta, segundo la Teoría Fundamentada en los Datos, con enfermeros en actividades y renunciantes del negocio. Resultados: Emergieron tres subprocesos: (A) vislumbrando en la ILPI negocio prometedor con el envejecimiento poblacional; (B) descubriéndose sin formación/experiencia empresarial para el emprendimiento social; (C) moviéndose entre la manutención, la ampliación y la desistencia del negocio. Del realineamiento de los componentes de esos subprocesos, se abstrajo la categoría central (proceso): Del sueño a la ampliación, manutención y desistencia del negocio ILPI: formación/experiencia empresarial del enfermero para emprendimiento social como componente intermedio. Consideraciones finales: A la luz del Modelo de Negocios Canvas, se mostró proceso experiencial poco instrumentalizado por los fundamentos de la gestión empresarial, para apoyar en la proposición, visualización y alteración de negocios.

RESUMO Objetivos: Compreender a experiência do enfermeiro empreendedor com instituição de longa permanência de idosos (ILPI) e elaborar modelo teórico desse processo de vivência. Métodos: Pesquisa qualitativa com saturação teórica, mediante a análise da 10ª entrevista não diretiva, audiogravada e transcrita, segundo a Teoria Fundamentada nos Dados, com enfermeiros em atividades e desistentes do negócio. Resultados: Emergiram três subprocessos: (A) vislumbrando na ILPI negócio promissor com o envelhecimento populacional; (B) descobrindo-se sem formação/experiência empresarial para o empreendimento social; (C) movendo-se entre a manutenção, a ampliação e a desistência do negócio. Do realinhamento dos componentes desses subprocessos, abstraiu-se a categoria central (processo): Do sonho à ampliação, manutenção e desistência do negócio ILPI: formação/experiência empresarial do enfermeiro para empreendimento social como componente interveniente. Considerações finais: À luz do Modelo de Negócios Canvas, mostrou-se processo experiencial pouco instrumentalizado pelos fundamentos da gestão empresarial, para apoiar na proposição, visualização e alteração de negócios.

An Emergent Entity: Indolent Mucormycosis of the Paranasal Sinuses. A Multicenter Study

Abstract Introduction Indolent or chronic mucormycosis is a rare entity that affects both immunosuppressed and immunocompetent individuals. Additionally, its clinical evolution is nonspecific and there is no standardized treatment for this condition. Objective To describe the clinical characteristics and management of patients with indolent mucormycosis. Methods In the project of study with chart review in the Interinstitutional secondary care centers, patients with evidence of indolentmucormycosis, defined as pathological confirmation of nasal/paranasal sinus mucormycosis for more than 1 month, were included. All patients underwent complete laboratory workup, imaging studies, surgical treatment and adequate follow-up. No evidence of disease status was defined when patient had subsequent biopsies with no evidence of mucormycosis. Results We included seven patients, three female and four male subjects. The mean age was 53.14 years. Four patients were immunosuppressed and three immunocompetent. Among the immunosuppressed patients three had diabetes and one had dermatomyositis. The symptomswere nonspecific: facial pain/headache, mucoid discharge and cacosmiawere the ones most frequently reported. Maxillary sinus involvement was present in all patients. Two immunosuppressed subjects received amphotericin. Posaconazole was the only treatmentinoneimmunosuppressedpatient. Allimmunocompetent patientshadsingleparanasal sinus disease and received only surgical treatment. All patients are alive and free of disease. Conclusion Indolent mucormycosis is a new and emerging clinical entity in immunosuppressed and immunocompetent patients. Single paranasal sinus disease is a frequent presentation and should not be overlooked as a differential diagnosis in these patients. Immunocompetent patients should only be treated surgically. (AU)

An Emergent Entity: Indolent Mucormycosis of the Paranasal Sinuses. A Multicenter Study.

Introduction Indolent or chronic mucormycosis is a rare entity that affects both immunosuppressed and immunocompetent individuals. Additionally, its clinical evolution is nonspecific and there is no standardized treatment for this condition. Objective To describe the clinical characteristics and management of patients with indolent mucormycosis. Methods In the project of study with chart review in the Interinstitutional secondary care centers, patients with evidence of indolent mucormycosis, defined as pathological confirmation of nasal/paranasal sinus mucormycosis for more than 1 month, were included. All patients underwent complete laboratory workup, imaging studies, surgical treatment and adequate follow-up. No evidence of disease status was defined when patient had subsequent biopsies with no evidence of mucormycosis. Results We included seven patients, three female and four male subjects. The mean age was 53.14 years. Four patients were immunosuppressed and three immunocompetent. Among the immunosuppressed patients three had diabetes and one had dermatomyositis. The symptoms were nonspecific: facial pain/headache, mucoid discharge and cacosmia were the ones most frequently reported. Maxillary sinus involvement was present in all patients. Two immunosuppressed subjects received amphotericin. Posaconazole was the only treatment in one immunosuppressed patient. All immunocompetent patients had single paranasal sinus disease and received only surgical treatment. All patients are alive and free of disease. Conclusion Indolent mucormycosis is a new and emerging clinical entity in immunosuppressed and immunocompetent patients. Single paranasal sinus disease is a frequent presentation and should not be overlooked as a differential diagnosis in these patients. Immunocompetent patients should only be treated surgically.

The effect of sexual abuse on children's attachment representations in Chile.

Child sexual abuse is associated with problems in children's emotional development, particularly increased insecurity of attachment. However, few studies have examined its effect on the organization of attachment representations in preschoolers, and the findings of those that have been conducted have not been entirely consistent. Therefore, this study aims to analyze the effect of child sexual abuse on attachment representation quality in a sample of children 3 to 7 years old in Chile. The results indicate child sexual abuse does affect children's attachment representation quality. The attachment narratives of child sexual abuse victims scored significantly higher than nonvictims on the hyperactivity and disorganization dimensions of attachment. These results are discussed in terms of attachment theory, clinical findings on child sexual abuse, and clinical implications.

Validación chilena del cuestionario de evaluación del apego romántico experiences in close relationships (ECR): análisis de la validez de criterio / A Chilean validation of the romantic attachment questionnaire experiences in close relationships (ECR): analysis of criterion validity

El objetivo de esta investigación fue analizar la validez de criterio del cuestionario de apego romántico Experiences in Close Relationships (ECR, Brennan, Clark y Shaver, 1998) para la población chilena de adultos. Este cuestionario evalúa las dos dimensiones del apego romántico adulto: la evitación (de la intimidad) y la ansiedad (acerca de las relaciones). Los participantes fueron 549 adultos, quienes completaron el cuestionario ECR y el cuestionario de apego adulto CaMir. Se evaluó las propiedades psicométricas del cuestionario, mostrando que es un instrumento con una adecuada validez de criterio y con una estructura factorial que representa las dos dimensiones teóricas propuestas por los autores originales. Se concluye que la versión chilena del ECR es válida para examinar el apego romántico en la adultez.

The aim of this study was to analyze the criterion validity of the Chilean version of the Experiences in Close Relationships (ECR; Brennan, Clark y Shaver 1998) questionnaire in a sample of Chilean adults. This self-report questionnaire assesses two dimensions of romantic attachment: avoidance (of intimacy) and anxiety (about relationships). 549 Chilean adults completed the ECR and the Chilean version of the adult attachment questionnaire CaMir. Data analyses evaluated psychometric properties of the Chilean ECR, and showed adequate evidence of reliability, criterion validity, and a bifactorial structure similar to the original instrument. We can conclude that the Chilean version of the ECR is a reliable and valid measure to assess the romantic attachment in this population.

Lesões musculoesqueléticas em atletas de luta olímpica / Musculoskeletal injuries in wrestling athletes

OBJETIVO: Avaliar as lesões musculoesqueléticas em atletas de elite da luta olímpica. MÉTODOS: Avaliação retrospectiva de 95 atletas por meio de um questionário estruturado contendo informações sobre lesões prévias e dados clínicos e epidemiológicos. RESULTADOS: Foram relatadas 145 lesões em 81 (85,3 por cento) atletas. As regiões anatômicas mais freqüentemente acometidas foram o joelho (25,5 por cento), o ombro (20 por cento), a coxa (15,2 por cento) e o tornozelo (14,5 por cento). As entorses e as lesões musculares foram as lesões mais comumente relatadas com 34,5 por cento e 30,4 por cento, respectivamente. O tratamento cirúrgico foi necessário em 9 por cento das lesões e a maioria destas lesões (61,5 por cento) localizavam-se nos membros.inferiores. CONCLUSÕES: Lesões do aparelho locomotor são frequentes nos praticantes de luta olímpica e os membros inferiores são o segmento mais acometido.

OBJECTIVE: The present study aimed to retrospectively evaluate musculoskeletal injuries in elite Brazilian wrestlers. METHODS: Ninety-five wrestlers completed a structured questionnaire to asses wrestling injury history and clinical and demographic data. RESULTS: Eighty one athletes (85,3 percent) informed 145 lesions. The most commonly injured body regions were knee (25,5 percent), shoulder (20 percent), thigh (15,2 percent) and ankle (14,5 percent). Sprains (34,5 percent) and muscle lesions (30,4 percent) were the most common injuries. Surgical treatment was performed in 9 percent of the lesions and the majority of these lesions (61,5 percent) were located in the lower limbs. CONCLUSIONS: Musculoskeletal lesions are common in wrestling athletes and the lower limbs are the most frequently injured site.

Mapa exploratorio de intervenciones psicosociales frente al terremoto del 27 de febrero de 2010 en la zona centro-sur de Chile / Exploratory map of psychosocial interventions after the February 27 2010 earthquake in the South-Central Zone of Chile

La presente exploración tiene por objetivo elaborar un mapa de caracterización de las primeras intervenciones psicosociales realizadas en la Región del Maule en ocasión del terremoto del 27 de febrero de 2010 en Chile. Se solicitó información a 40 organizaciones que eventualmente realizaron intervenciones en la Región del Maule y a 7 informantes claves. Fueron reportadas un total de 67 intervenciones de las que un 76,4 por ciento fueron realizadas en las comunas de Talca, Curicó y Constitución, y mayoritariamente por instituciones públicas (50,7 por ciento) y dirigidas a todo tipo de público (46,2 por ciento). Los tipos de intervención más comunes son las atenciones grupales (26,8 por ciento) y talleres (22,3 por ciento). Una de las principales dificultades fue obtener la información desde las organizaciones contactadas. La precariedad de las organizaciones para hacer frente a la catástrofe quedó evidenciada. No obstante, el relativamente reducido número de muertos indicaría que el trabajo educativo pre-catástrofe parece haber sido eficaz.

This exploratory work is intended to generate a characterization map of psychosocial interventions conducted in the Maule Region after earthquake occurred in Chile in February 27 2010. Information was requested from 40 organizations and seven key informants that eventually made interventions in the Maule Region. A total of 67 interventions were reported, of which 76.4 percent were made in the cities of Talca, Curicó and Constitución, mostly by public institutions (50.7 percent), and aimed at all audiences (46.2 percent). The most common types of intervention were care groups (26.8 percent) and workshops (22.3 percent). A major difficulty was to obtain relevant information from the contacted organizations. The precariousness of the organizations to cope with the disaster became evident. However, the relatively small number of deaths indicates that the educational work previous to the disaster seems to have been effective.

La competencia didáctica de los profesores de ciencias básicas de la facultad de Tecnología de la Salud: Teoría, métodos e instrumentos / Didactic competence of the basic science teachers in the health tecnology faculty: Theory, methods and instruments

Perfeccionar la formación de los docentes de forma tal que puedan identificar los problemas profesionales de su contexto, proyectando y ejecutando acciones que eleven la calidad del egresado es hoy un imperativo de la Educación Superior. Especial importancia adquiere dicha preparación en el sector de la Salud Pública donde se operan acelerados cambios en la formación profesional que responden al nuevo modelo pedagógico. En el presente trabajo se proponen los fundamentos teóricos para la definición de la competencia didáctica del profesor de Ciencias Básicas de Tecnología de la Salud. A partir de la misma se determinan las dimensiones, indicadores y se ejemplifica con la presentación de algunos instrumentos para la evaluación de la misma en el contexto de dicha institución. A partir de la propuesta teórica que se presenta en el trabajo se pueden elaborar alternativas que potencien el desarrollo de dicha competencia. Las dimensiones, indicadores e instrumentos que se diseñan pueden contribuir con efectividad a la evaluación del nivel de desarrollo de la misma, permitiendo el adecuado ajuste del trabajo metodológico y la superación del claustro a los objetivos sociales de la institución para la formación de profesionales de la salud en condiciones de cambio educativo(AU)