Nailing precision: a systematic review and meta-analysis of randomized controlled trials comparing piriformis and trochanteric entry points for femoral antegrade nailing.

INTRODUCTION: Entry point selection, a crucial aspect of femoral antegrade nailing, can impact nail fit and consequently fracture reduction. In adults, the standard entry portals used are the piriformis fossa and the tip of the greater trochanter. Previous systematic reviews comparing the two techniques have not been limited to Randomized Controlled Trials (RCTs) and have not consistently included the same available RCTs. MATERIALS AND METHODS: A systematic search of comparative studies regarding entry portal selection in femoral antegrade nailing was conducted on seven databases. Only Prospective RCTs comparing trochanteric and piriformis entry in the management of trochanteric or diaphyseal femur fractures were eligible for inclusion. RESULTS: Ultimately, only 6 RCTs were found eligible for inclusion. Five of the six included studies reported on operative time. The resulting mean difference (MD) illustrated a significant decrease in operative time by approximately 21.26 min (95% CI - 28.60 to - 13.92, p < 0.001) using trochanteric entry. Fluoroscopy exposure was reported on by four studies, however, only two studies were included in the analysis due to different reporting methods. Trochanteric entry used significantly less fluoroscopy than piriformis entry (MD -50.33 s, 95% CI - 84.441 to - 16.22, p = 0. 004). No significant difference in malalignment rates, delayed union rates, nonunion rates, pain scores, or complication rates was found. CONCLUSION: The significant differences found in operating time and fluoroscopy time align with those in other studies. While we were not able to pool the data on functional outcome scores, none of the included studies found a significant difference in scores by their last follow-up. Both approaches demonstrate comparable functional outcomes and safety profiles, indicating the choice of entry point should be at the discretion of the surgeon based on technique familiarity and fracture characteristics.

The Impact of the City of Miami's Decision to Revoke Electric Scooter Company Permits on Orthopedic Trauma at a Level I Trauma Center.

BACKGROUND: Since the introduction of electric-scooter (e-scooter) mobile applications, there has been a marked increase in e-scooter-related injury. On January 19, 2022, the City of Miami revoked permits to five major mobile applications for violation of safety protocols. OBJECTIVES: The purpose of our study was to assess the effects of this notice on the orthopedic patients seen at our corresponding Level I trauma center. METHODS: Institutional Review Board approval was obtained for this study. A retrospective chart review was performed including all patients with orthopedic injuries at our Level I trauma center between July 19, 2021 and July 19, 2022. These dates include 6 months prior to and after the major e-scooter operators ceased use in Miami. SPSS statistical software version 28.0.0 (SPSS, IBM, Armonk, NY) was utilized for all statistical analysis. RESULTS: There were 2558 patients in the prenotice cohort, and 2492 patients in the postnotice cohort. After the notice, there was a significant decrease in the number of patients that presented to our institution due to injuries caused by e-scooters (2.8% vs. 1.8% patients; p = 0.021). Patients with injuries caused by e-scooters had a significantly lower age (38 vs. 42, respectively; p = 0.034) and were more likely to be male (79.3% vs. 67.4% male, respectively; p = 0.007) than patients with other orthopedic injuries. CONCLUSION: This study demonstrates that the 2022 notice revoking the major mobile application operators from the City of Miami resulted in a significant decrease in the number of orthopedic cases due to e-scooter-related injury at the corresponding Level I trauma center.

USO DE RÚBRICAS PARA LA EVALUACIÓN DE TEXTOS ACADÉMICOS: UN DESAFÍO EN LA ENSEÑANZA DE ENFERMERÍA / USE OF RUBRICS FOR THE EVALUATION OF ACADEMIC TEXTS: A CHALLENGE IN NURSING EDUCATION

INTRODUCCIÓN: Tanto la enseñanza de la escritura como la forma en que se evalúa constituyen un desafío importante en educación superior. La utilización de estrategias evaluativas permite remediar las carencias en habilidades de escritura, al ser no solo un recurso de evaluación exhaustivo y didáctico, sino que también, una guía para el desarrollo del texto en sí mismo. OBJETIVO: Desarrollar metodologías evaluativas para mejorar los aspectos de forma y contenido en la escritura de textos académicos en Enfermería. METODOLOGÍA: el proyecto contó de tres fases que contemplaron la construcción de dos instrumentos (fase 1), su aplicación en un texto académico y respectivos ajustes (fase 2), y la evaluación de dicha aplicación (fase 3). RESULTADOS: se obtuvieron dos rúbricas de tipo analíticas conformadas por los ítems de FORMA (aspectos de escritura) y CONTENIDO (aspectos de investigación), las que fueron aplicadas tres veces al texto para evaluar su progreso, observándose mejoras en la calificación global, en coherencia y cohesión en FORMA, y marco teórico, resultados y metodología, en CONTENIDO. DISCUSIÓN: el uso de rúbricas analíticas son una herramienta muy útil a la hora de evaluar textos académicos. Son instrumentos sumamente completos pues miran el proceso como un todo, actuando no solo como una instancia evaluativa, sino que también formadora para el estudiantado, a la vez que se configuran como una guía para el desarrollo de la escritura.

INTRODUCTION: Both the teaching of writing and the way it is evaluated constitute major challenges in higher education. The use of evaluative strategies can help remediate deficiencies in writing skills by being not only an exhaustive and didactic evaluation resource, but also a guide for the development of the text itself. OBJECTIVE: Develop evaluative methodologies to improve aspects of form and content in the writing of academic texts in Nursing. METHODOLOGY: The project had three phases that considered the construction of two instruments (phase 1), their application in an academic text (thesis report) and respective adjustments (phase 2), and, finally, the evaluation of said application. RESULTS: Two analytical headings were obtained (quantitative methodology and qualitative methodology), consisting of the items of FORM (writing aspects) and CONTENT (research aspects), respectively, which were applied three times to the text to evaluate its progress. Improvements were observed in the overall rating, in the areas of coherence and cohesion in FORM, and in the theoretical framework, results, and methodology in CONTENT. DISCUSSION: Analytical rubrics are a very useful tool when evaluating academic texts. They are extremely comprehensive instruments because they look at the process as a whole, serving not only as an evaluative tool, but also as a training opportunity for students, providing a guide for the development of academic writing skills.

The Synthesis of Novel aza-Steroids and α, ß-Unsaturated-Cyanoketone from Diosgenin.

Recent studies have demonstrated the antiproliferative and cytotoxic effects of aza-steroids and steroidal sapogenins on human cancer cell lines. The scientific community has shown a growing interest in these compounds as drug candidates for cancer treatment. In the current work, we report the synthesis of new diosgenin oxime derivatives as potential antiproliferative agents. From (25 R)-5α-spirost-3,5,6-triol (1), a diosgenin derivative, ketones 2, 3, 4, and 9 were obtained and used as precursors of the new oximes. A condensation reaction was carried out between the steroidal ketones (2, 3, 4, and 9) with hydroxylamine hydrochloride in 2,4,6-trimethylpyridine to produce five spirostanic oximes (four of them are not reported before) with a 42-96% yield. Also, a new spirostanic α, ß-unsaturated cyanoketone was synthesized via Beckmann fragmentation using thionyl chloride with a 62% yield. Furthermore, we proposed a reaction mechanism with the aim of explaining such transformation.

The impacts of anxiety and depression on outcomes in orthopaedic trauma surgery: a narrative review.

Introduction: The impact of anxiety and depression on outcomes in orthopaedic trauma surgery is a topic of growing research interest. Patients and methods: Orthopaedic trauma patients often experience high rates of psychiatric disorders, with anxiety and depression being the most prevalent. Mental health disorders have been shown to increase the risk of negative surgical outcomes and morbidity. This narrative review seeks to summarize the current literature surrounding the impacts of anxiety and depression on orthopaedic trauma surgery outcomes. Discussion: There is a bidirectional relationship between chronic pain and mental health disorders, involving overlapping brain regions and neurotransmitter pathways. Anxiety and depression have been identified as predictors of negative surgical outcomes in orthopaedic trauma patients. Screening tools like the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Screener-7 (GAD-7), and Medical Outcomes Study 36-item Short Form (SF-36) can assess mental health status and help tailor interventions. Psychological distress, chronic pain, and traumatic limb amputation are factors that contribute to adverse mental health outcomes in orthopaedic trauma patients. Opioid use for pain management is common in orthopaedic surgery, but it can worsen symptoms of depression and lead to dependency. Non-opioid pain management strategies may improve postoperative outcomes by reducing the impact of opioid-exacerbated depression. Conclusion: Mental health interventions, both preoperative and postoperative, are crucial in optimizing surgical outcomes and improving patient quality of life. Multidisciplinary approaches that address both physical and mental health are recommended for orthopaedic trauma patients. Further research is needed to develop effective interventions for improving mental health outcomes in this patient population.

"Sawbones": A pilot study assessing simulation-based orthopedic training for medical students.

Intro: Simulation-based training has become a valuable new tool in medical education across the country. The Orthopedic Surgery Interest Group (OSIG) at the University of Miami Miller School of Medicine organized a benchtop training workshop known as "Sawbones" to give medical students essential exposure to basic techniques and instruments commonly used in orthopedic surgery. This pilot study seeks to investigate the participating students' perceptions of this workshop as part of a potential longitudinal intervention. Methods: A total of 30 medical students (MS1-MS4) with a documented interest in orthopedic surgery were randomly selected via email invitation to participate in this workshop. Students first had a lecture-based training session with faculty on an overview of screw fixation. Participants then formed groups that were headed by an orthopedic resident or attending and took turns fixing fractures on model bones made of synthetic material. Following the session, students were sent an anonymous Qualtrics survey to assess their satisfaction with the workshop. Results: A total of 22 students (73%), responded to the survey. On a ten-point scale, the average reported interest in orthopedics was 9.2 (SD 0.4). All students (n = 22, 100%) reported that they would like more hands-on orthopedic experiences as a component of their medical education. Nineteen students (86.4%) reported that this training increased their interest in pursuing a career in orthopedic surgery and twenty-one (95.5%) further stated that they would recommend this training to other students. Discussion: Based on the results of this pilot study, Sawbones was promising at engaging students in orthopedics, providing a team environment, and introducing students to orthopedic skills and instrumentation. Providing these sessions in a longitudinal manner could provide opportunities for mentorship and better prepare students for a residency in orthopedics. We recommend a program like Sawbones to better address the lack of Orthopedic exposure in medical school.

Enhanced glycerol assimilation and lipid production in Rhodotorula toruloides CBS14 upon addition of hemicellulose primarily correlates with early transcription of energy-metabolism-related genes.

BACKGROUND: Lipid formation from glycerol was previously found to be activated in Rhodotorula toruloides when the yeast was cultivated in a mixture of crude glycerol (CG) and hemicellulose hydrolysate (CGHH) compared to CG as the only carbon source. RNA samples from R. toruloides CBS14 cell cultures grown on either CG or CGHH were collected at different timepoints of cultivation, and a differential gene expression analysis was performed between cells grown at a similar physiological situation. RESULTS: We observed enhanced transcription of genes involved in oxidative phosphorylation and enzymes localized in mitochondria in CGHH compared to CG. Genes involved in protein turnover, including those encoding ribosomal proteins, translation elongation factors, and genes involved in building the proteasome also showed an enhanced transcription in CGHH compared to CG. At 10 h cultivation, another group of activated genes in CGHH was involved in ß-oxidation, handling oxidative stress and degradation of xylose and aromatic compounds. Potential bypasses of the standard GUT1 and GUT2-glycerol assimilation pathway were also expressed and upregulated in CGHH 10 h. When the additional carbon sources from HH were completely consumed, at CGHH 36 h, their transcription decreased and NAD+-dependent glycerol-3-phosphate dehydrogenase was upregulated compared to CG 60 h, generating NADH instead of NADPH with glycerol catabolism. TPI1 was upregulated in CGHH compared to cells grown on CG in all physiological situations, potentially channeling the DHAP formed through glycerol catabolism into glycolysis. The highest number of upregulated genes encoding glycolytic enzymes was found after 36 h in CGHH, when all additional carbon sources were already consumed. CONCLUSIONS: We suspect that the physiological reason for the accelerated glycerol assimilation and faster lipid production, was primarily the activation of enzymes that provide energy.

Oleaginous yeasts for biochemicals, biofuels and food from lignocellulose-hydrolysate and crude glycerol.

Microbial lipids produced from lignocellulose and crude glycerol (CG) can serve as sustainable alternatives to vegetable oils, whose production is, in many cases, accompanied by monocultures, land use changes or rain forest clearings. Our projects aim to understand the physiology of microbial lipid production by oleaginous yeasts, optimise the production and establish novel applications of microbial lipid compounds. We have established methods for fermentation and intracellular lipid quantification. Following the kinetics of lipid accumulation in different strains, we found high variability in lipid formation even between very closely related oleaginous yeast strains on both, wheat straw hydrolysate and CG. For example, on complete wheat straw hydrolysate, we saw that one Rhodotorula glutinis strain, when starting assimilating D-xylosealso assimilated the accumulated lipids, while a Rhodotorula babjevae strain could accumulate lipids on D-xylose. Two strains (Rhodotorula toruloides CBS 14 and R. glutinis CBS 3044) were found to be the best out of 27 tested to accumulate lipids on CG. Interestingly, the presence of hemicellulose hydrolysate stimulated glycerol assimilation in both strains. Apart from microbial oil, R. toruloides also produces carotenoids. The first attempts of extraction using the classical acetone-based method showed that ß-carotene is the major carotenoid. However, there are indications that there are also substantial amounts of torulene and torularhodin, which have a very high potential as antioxidants.

Supplemental musculoskeletal anatomy education in a shortened medical school curriculum.

To address anatomy knowledge gaps exacerbated by the education constraints of a new shortened medical school curriculum and the COVID-19 pandemic, the Orthopedic Surgery Interest Group (OSIG) created a novel hybrid anatomy curriculum for students interested in orthopedic surgery. The main objectives were to determine (1) Does this elective supplement to the curriculum improve students' perceived confidence with regard to orthopedic anatomy? (2) What are the students' preferred formats for receiving this elective supplement to the curriculum? To determine this, we used a prospective study design to determine the impact of the OSIG's student-led hybrid anatomy sessions. A survey with a five-point Likert scale (1) Strongly disagree; (2) Disagree; (3) Neither agree nor disagree; (4) Agree; (5) Strongly agree; was used to quantify responses. Chi-squared tests, Fisher's exact tests and T-tests were used when appropriate. Our results show that participants without prior anatomy experience rated the course higher on average when compared with those with prior anatomy experience (4.27 vs. 3.67, respectively; p = 0.168). Most students (88.2%) prefer for anatomy sessions to be held more frequently and 76.4% enjoyed having virtual components. 82.4% of participants reported that this course improved their self-confidence regarding orthopedic anatomy, and 100% would recommend it to other students. Most students enjoyed the course and reported improved self-perceived anatomy knowledge after participating. Medical schools that have a shortened anatomy curriculum can consider using the present study as a model for an optional musculoskeletal anatomy supplement at their institution.

The Choice between Intravenous and Subcutaneous Immunoglobulins: Aspects for Consideration.

BACKGROUND: Intravenous immunoglobulin and subcutaneous immunoglobulin preparations are used to treat primary and secondary immunodeficiencies, as well as autoimmune and inflammatory conditions. SUMMARY: For certain indications, only defined formulations or routes of administration are approved by health authorities. However, for other diseases, there are more options, and treatment decisions may be based on different aspects, such as patient conditions and preferences, pharmacokinetics, or pharmacoeconomic considerations. KEY MESSAGES: Understanding the two different treatment modalities may support the decision-making for the optimal therapeutic option for individual patients. This review summarizes the latest insights into the direct and indirect comparison between the two types of products.

Prophylactic Radiotherapy for Prevention of Heterotopic Ossification After Periacetabular Fractures: A Review of Efficacy and Associated Conditions.

Prophylactic radiotherapy (XRT) is a commonly used treatment to decrease heterotopic ossification (HO) in patients with traumatic hip injuries. We conducted a retrospective review of patients at risk for HO who underwent XRT. Of the patients reviewed, 27.3% developed radiographic HO, 11.2% developed symptoms, and 2.0% required resection surgery. Patients were divided into primary (n = 71) and secondary prophylaxis (n = 27) cohorts. In the primary group, 25.0% developed radiographic HO, 5.6% developed symptoms, and 0 required surgery. In the secondary cohort, 33.3% of patients developed new radiographic HO, and 25.9% were symptomatic: four had a Brooker score of 3, and three had a score of 4 (p = 0.03), and 7.4% required surgical resection. (Journal of Surgical Orthopaedic Advances 31(2):113-118, 2022).

Post-Pandemic Telehealth Policy for Primary Care: An Equity Perspective.

National telehealth policy thus far has focused on broadening access to service, specialties, and originating sites. Yet telehealth policy can further equity by providing system-level change needed to reduce structural determinants that hamper telehealth access in historically marginalized, low income, and limited English-speaking populations. The authors propose policy solutions for states and CMS to help address these structural determinants of telehealth care. A telehealth "ecosystem" grounded in the following core components would ensure equitable access to care: use of technology inclusive of economically marginalized patients, access to the technology and broadband for completing virtual visits, and concrete support for patients as they develop their digital and telehealth skills.

Near Chromosome-Level Genome Assembly and Annotation of Rhodotorula babjevae Strains Reveals High Intraspecific Divergence.

The genus Rhodotorula includes basidiomycetous oleaginous yeast species. Rhodotorula babjevae can produce compounds of biotechnological interest such as lipids, carotenoids, and biosurfactants from low value substrates such as lignocellulose hydrolysate. High-quality genome assemblies are needed to develop genetic tools and to understand fungal evolution and genetics. Here, we combined short- and long-read sequencing to resolve the genomes of two R. babjevae strains, CBS 7808 (type strain) and DBVPG 8058, at chromosomal level. Both genomes are 21 Mbp in size and have a GC content of 68.2%. Allele frequency analysis indicates that both strains are tetraploid. The genomes consist of a maximum of 21 chromosomes with a size of 0.4 to 2.4 Mbp. In both assemblies, the mitochondrial genome was recovered in a single contig, that shared 97% pairwise identity. Pairwise identity between most chromosomes ranges from 82 to 87%. We also found indications for strain-specific extrachromosomal endogenous DNA. A total of 7591 and 7481 protein-coding genes were annotated in CBS 7808 and DBVPG 8058, respectively. CBS 7808 accumulated a higher number of tandem duplications than DBVPG 8058. We identified large translocation events between putative chromosomes. Genome divergence values between the two strains indicate that they may belong to different species.

Experiencia de estudiantes universitarios de salud al publicar en una revista académica de pregrado / Experience of university health students when publishing in an undergraduate academic journal

Objetivo principal: Conocer la experiencia de estudiantes de carreras de la salud al publicar un artículo en una revista académica de pregrado, creada en el marco de los proyectos de innovación de una universidad chilena. Metodología: Investigación de diseño mixto, en la que se utilizó un cuestionario electrónico con preguntas abiertas, de selección y tipo Likert, previa firma de consentimiento informado. Se evaluaron las variables descritas como el proceso de publicación, las instrucciones a los autores, la comunicación con el equipo editor, la satisfacción con la publicación y el acceso electrónico a la revista. El cuestionario cualitativo contempló las dimensiones razones de publicar y aportes a los valores y competencias de la universidad. Se realizó análisis cuantitativo y análisis de contenido con enfoque cualitativo de una muestra de 54 estudiantes. Resultados principales: La comunicación con el equipo editor obtuvo la más alta calificación (83,33%). La calificación más baja (37%) fue obtenida en el acceso al número completo de la revista ya publicado. Los estudiantes reportaron que se fortaleció el valor de la “responsabilidad” y la competencia “visión analítica” luego de publicar. Conclusión principal: La experiencia de publicar fue muy bien evaluada por los estudiantes. La motivación de publicar fortalece competencias y valores y se consolida como una experiencia positiva. Los estudiantes se sienten parte de una comunidad del conocimiento colaborativa entre pares. Se debe mejorar algunos procesos editoriales que fortalezcan la comunicación con los estudiantes que son autores.(AU)

Objective: Know the experience of health career students by publishing an article in an undergraduate academic journal, created within the framework of innovation projects of a Chilean university. Methods: Mixed design research in which an electronic questionnaire with open-ended, selection and Likert questions was used, prior signature of informed consent. The variables described as the publication process, instructions to the authors, communication with the editorial team, satisfaction with the publication and electronic access to the journal were evaluated. The qualitative questionnaire contemplated the dimensions reasons for publishing and contributions to the values ​​and competencies of the university. Quantitative analysis and content analysis were performed with a qualitative approach from a sample of 54 students. Results: Communication with the editorial team obtained the highest rating (83.33%). The lowest rating (37%) was obtained in access to the full issue of the journal already published. Students reported that the value of "responsibility" and competence "analytical vision" was strengthened after publishing. Conclusions: The publishing experience was very well evaluated by the students. The motivation to publish strengthens skills and values and is consolidated as a positive experience. Students feel part of a collaborative peer-to-peer knowledge community. Some editorial processes that strengthen communication with students who are authors must be improved.(AU)

Chromosome-level genome assembly and transcriptome-based annotation of the oleaginous yeast Rhodotorula toruloides CBS 14.

Rhodotorula toruloides is an oleaginous yeast with high biotechnological potential. In order to understand the molecular physiology of lipid synthesis in R. toruloides and to advance metabolic engineering, a high-resolution genome is required. We constructed a genome draft of R. toruloides CBS 14, using a hybrid assembly approach, consisting of short and long reads generated by Illumina and Nanopore sequencing, respectively. The genome draft consists of 23 contigs and 3 scaffolds, with a N50 length of 1,529,952 bp, thus largely representing chromosomal organization. The total size of the genome is 20,534,857 bp and the overall GC content is 61.83%. Transcriptomic data from different growth conditions was used to aid species-specific gene annotation. We annotated 9464 genes and identified 11,691 transcripts. Furthermore, we demonstrated the presence of a potential plasmid, an extrachromosomal circular structure of about 11 kb with a copy number about three times as high as the other chromosomes.

Conversaciones sobre brigadas médicas cubanas en contexto de COVID-19 desde el ambiente info-comunicativo de Twitter / Conversations on Cuban medical delegations in the context of COVID-19 from the info-communicative environment on Twitter

Introducción: La pandemia de COVID-19 modifica el ambiente info-comunicativo de los ciberusuarios. Cuba, en particular, presenta un nivel considerable de desarrollo tecnológico insertado en la plataforma social de Internet, Twitter. Este soporte desempeña un rol vertebral para el debate sobre temas relacionados a las brigadas médicas cubanas, por su enfrentamiento al virus en el ámbito internacional, que coadyuva a la conformación de una opinión global favorable. Lo planteado con anterioridad se expresa desde las conversaciones online y sus discursos en este sitio. Objetivo: Caracterizar el ambiente info-comunicativo de Twitter durante las conversaciones online sobre brigadas médicas cubanas, entre el 31 de diciembre de 2020 y el 18 de enero de 2021. Material y Métodos: Se emplea el método teórico hermenéutico, para la descripción de los resultados del procesamiento estadístico de contenido, estructura y uso en la web, correspondiente a un enfoque transdisciplinar, mediante la técnica de minería de datos y la aplicación como instrumento del algoritmo no supervisado SSA-UO para el análisis de sentimientos en Twitter. Resultados: Las características del ambiente info-comunicativo de Twitter durante las conversaciones online sobre brigadas médicas cubanas evidencian un predominio de la polaridad positiva. Conclusiones: Los retuits, las menciones y la publicación de enlaces condicionan las particularidades del debate sobre el tema en la esfera de microblogging(AU)

Introduction: The COVID-19 pandemic modifies the info-communicative environment of cyber users. Cuba, in particular, presents a remarkable level of technological development inserted in the Internet social platform, Twitter. This support plays a key role in the debate about issues related to the Cuban medical delegations due to their confrontation with the virus at the international level, which contributes to the formation of a favorable global opinion. The aforementioned point is expressed from the online conversations and their speeches in this site. Objective: To characterize the info-communicative environment on Twitter during the online conversations about Cuban medical brigades between December 31, 2020 and January 18, 2021. Material and Methods: The hermeneutic theoretical method is used for the description of the results of the statistical processing of content, structure and use on the Web, corresponding to a transdisciplinary approach through the application of Data Mining Technique as an instrument of the unsupervised algorithm SSA-UO for sentiment analysis on Twitter. Results: The characteristics of the info-communicative environment on Twitter during the online conversations about Cuban medical delegations evidence a predominance of positive polarity. Conclusions: Retweets, mentions and the publication of links influence the particularities of the debate on the topic in the microblogging sphere(AU)

Meeting them where they are on the web: addressing structural barriers for Latinos in telehealth care.

As we enter an era of health care that incorporates telehealth for routine provision of care, we can build a system that consciously and proactively includes vulnerable patients, thereby avoiding further exacerbation of health disparities. A practical way to reach out to Latino patients is to use media they already widely use. Rather than expect patients to adapt to suboptimal systems of telehealth care, we can improve telehealth for Latinos by using platforms already familiar to them and thereby refocus telehealth delivery systems to provide patient-centered care. Such care is responsive to patients' needs and preferences; for Latinos, this includes using digital devices that they actually own (ie, smartphones). Equity-centered telehealth is accessible for all, regardless of linguistic, literacy, and socioeconomic barriers.

Significado de la experiencia del embarazo, parto y puerperio en la mujer migrante en Chile / Meaning of the experience of pregnancy, birth and postpartum in immigrant women in Chile

OBJETIVO: Conocer el significado de la experiencia del proceso de embarazo, parto y puerperio en mujeres inmigrantes afiliadas a centros de salud familiar de una comuna de la zona sur de la ciudad de Santiago de Chile. METODOLOGÍA: Estudio con metodología cualitativa con muestreo por avalancha o bola de nieve. Se aplicaron entrevistas semiestructuradas a 8 mujeres inmigrantes, que fueron transcritas verbatim. Se realizó un análisis de contenido, detallándose aspectos del fenómeno de estudio y buscando las categorías de significado que dieran respuesta a los objetivos de la investigación. RESULTADOS: Emergieron 4 unidades de significado: 1) necesidades percibidas durante el proceso de embarazo, parto y puerperio en condición de inmigrante; 2) barreras o dificultades vividas durante este proceso; 3) facilitadores percibidos, y 4) percepción de red de apoyo en su condición de migrante. CONCLUSIONES: La mujer inmigrante presenta grandes desafíos durante el proceso de embarazo, parto y puerperio en el país receptor. Vivir esta etapa en un país desconocido produce importantes diferencias en las condiciones de vida y riesgo de vulnerabilidad, determinando la forma en que la mujer lo experimenta, planteando, por ende, nuevos desafíos para los profesionales de la salud

OBJECTIVE: To know the meaning of the experience of the pregnancy, childbirth and postpartum process in immigrant women affiliated to family health centers of a commune of the south zone of the city of Santiago (Chile). METHODOLOGY: Qualitative case study with sampling like snowball. Semistructured interview was applied to 8 immigrant women, which were transcribed verbatim. Content analysis was carried out, detailing aspects of the study phenomenon and looking for categories of meaning that would respond to the research objectives. RESULTS: Four units of meaning emerged to respond to the phenomenon under study, these were: 1) perceived needs during the pregnancy, childbirth and postpartum process in immigrant status; 2) barriers or difficulties experienced during the pregnancy, childbirth and postpartum in immigrant status; 3) facilitators perceived, and 4) perception of support network in their migrant status. CONCLUSIONS: The immigrant woman presents great challenges during the process of pregnancy, childbirth and puerperium in the receiving country. Living this stage in an unknown country produces important differences in the living conditions and risk of vulnerability, determining the way in which the woman experiences this stage of her life, and posing, therefore, new challenges for health professionals

Bruxismo y estrés académico en estudiantes de las ciencias médicas / Bruxism and academic stress in students of the medical sciences

RESUMEN Fundamento: Los estudiantes de las carreras de las ciencias médicas, especialmente los de nuevo ingreso, se desarrollan en un ambiente estresante, debido al desequilibrio emocional provocado por las exigencias del proceso enseñanza-aprendizaje; situación que, de no ser atendida de manera adecuada, puede desencadenar en la aparición del bruxismo. Objetivo: Describir el comportamiento del bruxismo relacionado con el estrés académico en los estudiantes del primer año de Medicina, Estomatología y Enfermería de la Universidad de Ciencias Médicas de Camagüey. Método: Se realizó un estudio descriptivo y transversal durante el período comprendido entre octubre de 2018 y marzo de 2020. El universo estuvo constituido por 748 estudiantes de primer año de las carreras mencionadas, de los cursos académicos 2018-2019 y 2019-2020. La muestra seleccionada de forma aleatoria, estuvo integrada por 90 estudiantes. Resultados: Más de la mitad de los examinados se diagnosticó como bruxópatas, con predominio del bruxismo céntrico. Los estudiantes de Medicina resultaron los de mayor afectación. Los síntomas más frecuentes fueron el dolor muscular, el apretamiento dentario referido, así como el dolor articular y los signos, la hipertrofia muscular y las facetas de desgaste parafuncional a nivel de esmalte. Discusión: Se constató el predominio de casos con niveles de estrés académico moderado seguido por niveles de estrés leve. Casi la totalidad de estos pacientes presentaron bruxismo, con prevalencia del tipo céntrico.

ABSTRACT Introduction: The students of the specialties of the medical sciences, especially those of 1st year, develop themselves in a stressful ambience, due to the emotional imbalance provoked by the requirements of the teaching - learning process; situation that, of not being attended in a suitable way, can unleash in the appearance of the bruxism. That´s why, the present work takes as objective to describe the behavior of the bruxism related to the academic stress in the students of the first year of Medicine, Dentistry and Infirmary of the University of Medical Sciences of Camagüey. Method: A descriptive and cross-sectional study was carried out during the period understood between October, 2018 and March, 2020. The universe was constituted by 748 students of the first year of the mentioned specialties, of the academic courses 2018-2019 and 2019-2020. The chosen sample of random form was integrated by 90 students. Results: More than half of the examined students were diagnosed with bruxism, with predominance of the central bruxism. The Medicine students resulted to be those of major affectation. The most frequent symptoms were the muscular pain, the above-mentioned dental grinding, as well as the pain to articulate and the signs, the muscular hypertrophy and the facets of parafunctional wear at enamel level. Discussion: The cases predominance was stated at levels of moderate academic stress continued by levels of light stress. Almost the totality of these patients presented bruxism, with predominance of the central type.

Percepción de los estudiantes y docentes de Enfermería con respecto a la pertinencia de la rúbrica de evaluación clínica / Perception of nursing students and teachers regarding the relevance of the clinical evaluation rubric

Introducción: La reflexión conjunta de estudiantes y docentes acerca de los procesos y factores involucrados tanto en el aprendizaje como en la enseñanza y evaluación, logrará mayores niveles de entendimiento a partir del intercambio de ideas, valoraciones y percepciones que se generan entre los distintos actores del proceso formativo. Objetivo: Conocer la percepción de los estudiantes y docentes de enfermería con respecto a la pertinencia de la rúbrica de evaluación clínica utilizada en la asignatura de enfermería médico quirúrgica, de tercer año de la carrera, en una universidad privada de Chile. Métodos: Investigación cualitativa con muestreo opinático. Se aplicaron encuestas semiestructuradas a un grupo de 16 participantes entre docentes y estudiantes de enfermería, las que fueron trascritas verbatim. Se realizó análisis de contenido, detallándose aspectos del fenómeno de estudio y buscando las categorías de significado que dieran respuesta al objetivo de la investigación. Resultados: El fenómeno de estudio emergió en tres grandes unidades de significado: impresión global de la utilidad del instrumento; dimensiones deficitarias de la rúbrica de evaluación y propuestas de mejora. Conclusiones: Es importante considerar la opinión de docentes y estudiantes sobre la rúbrica de evaluación a ser utilizada, ya que son un insumo para monitorizar de manera cualitativa el comportamiento del instrumento, considerando su carácter flexible, abierto y dinámico, que requiere de una permanente revisión, a fin de asegurar su calidad, para ser finalmente, un verdadero aporte al proceso de enseñanza-aprendizaje(AU)

Introduction: Joint reflection of students and teachers about the processes and factors involved in both learning and teaching and evaluation will achieve higher levels of understanding from the exchange of ideas, assessments and perceptions that are generated among the different participants in the training process. Objective: To know the Nursing students' and teachers' perception about the relevance of the clinical evaluation method used in the subject Surgical-Medical Nursing during the third academic year of the major, at a private university in Chile. Methods: Qualitative research with opinion sampling. Semi-structured surveys were applied to a group of 16 participants among teachers and nursing students, which were transcribed verbatim. Content analysis was carried out, detailing aspects of the studied phenomenon and looking for the categories of meaning that would answer the objective of the research. Results: The studied phenomenon emerged in three large units of meaning: global impression about the usefulness of the instrument; deficit dimensions of the evaluation method, and improvement proposals. Conclusions: It is important to consider the professors' and students' opinion about the evaluation method to be used, since they are an input to monitor qualitatively the behavior of the instrument, considering its flexible, open and dynamic nature, which requires a permanent revision, in order to ensure its quality, to be finally a true contribution to the teaching-learning process(AU)