Patient safety climate research in primary care dentistry: A systematic scoping review.

BACKGROUND: Patient safety climate constitutes an important element for quality improvement. Its current evidence base has been generated in hospital settings in developed countries. Studies in dentistry are limited. OBJECTIVE: To systematically explore the evidence regarding assessing patient safety climate in dentistry. METHODS: We developed a search strategy to explore MEDLINE, SCOPUS, and Web of Science databases from January 1st, 2002, to December 31st, 2022, to include observational studies on patient safety culture or patient safety climate assessment. Methodological features and item data concerning the dimensions employed for assessment were extracted and thematically analyzed. Reported scores were also collected. RESULTS: Nine articles out of 5584 were included in this study. Most studies were generated from high-income economies. Our analysis revealed methodological variations. Non-randomized samples were employed (ranging from 139 to 656 participants), and response rates varied from 28% to 93.7%. Three types of measurement instruments have been adapted to assess patient safety climate. These mainly consisted of replacing words or rewording sentences. Only one study employed an instrument previously validated through psychometric methods. In general, patient safety climate levels were either low or neutral. Only one study reported scores equal to or greater than 75. DISCUSSION: Despite diverse assessment tools, our two-decade analysis reveals a lag compared with medicine, resulting in methodological variations for assessing patient safety climate. Collaboration is vital to elevate standards, prioritize patient safety across oral healthcare services, and advocate for integrating safety climate into local and national quality and patient safety strategies.

Intra-urban variability of long-term exposure to PM2.5 and NO2 in five cities in Colombia.

Rapidly urbanizing cities in Latin America experience high levels of air pollution which are known risk factors for population health. However, the estimates of long-term exposure to air pollution are scarce in the region. We developed intraurban land use regression (LUR) models to map long-term exposure to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) in the five largest cities in Colombia. We conducted air pollution measurement campaigns using gravimetric PM2.5 and passive NO2 sensors for 2 weeks during both the dry and rainy seasons in 2021 in the cities of Barranquilla, Bucaramanga, Bogotá, Cali, and Medellín, and combined these data with geospatial and meteorological variables. Annual models were developed using multivariable spatial regression models. The city annual PM2.5 mean concentrations measured ranged between 12.32 and 15.99 µg/m3 while NO2 concentrations ranged between 24.92 and 49.15 µg/m3. The PM2.5 annual models explained 82% of the variance (R2) in Medellín, 77% in Bucaramanga, 73% in Barranquilla, 70% in Cali, and 44% in Bogotá. The NO2 models explained 65% of the variance in Bucaramanga, 57% in Medellín, 44% in Cali, 40% in Bogotá, and 30% in Barranquilla. Most of the predictor variables included in the models were a combination of specific land use characteristics and roadway variables. Cross-validation suggests that PM2.5 outperformed NO2 models. The developed models can be used as exposure estimate in epidemiological studies, as input in hybrid models to improve personal exposure assessment, and for policy evaluation.

Oxaliplatin-Associated Takotsubo Cardiomyopathy in a Patient with Metastatic Gastric Cancer: A Case Report.

We present the case of a 64-year-old female with stage IV gastric adenocarcinoma, pulmonary, and abdominal wall metastases, and no history of cardiovascular disease. In palliative care, she received systemic cytotoxic treatment with fluorouracil, leucovorin, oxaliplatin, and docetaxel protocol, which was well tolerated over five cycles. During cycle 6, she presented with cardiovascular symptoms with hemodynamic consequences while receiving oxaliplatin injection without docetaxel or 5-fluorouracil. She was transferred to the emergency department and then to the intensive care unit. She developed no complications during the hospital stay and was discharged after 10 days with preserved systolic function and no structural changes at the myocardial level. The electrocardiogram, echocardiogram, cardiac catheterization, and magnetic resonance imaging findings indicated an oxaliplatin-associated Takotsubo syndrome. The immunochemistry analysis showed PD-L1 expression level TPS: 40% and the foundation one genomic profiling revealed high mutation load, microsatellite instability, and HER2 not found. The patient is currently asymptomatic and on pembrolizumab monotherapy with good tolerance and partial treatment response.

Autoimmune Hemolytic Anemia Caused by Cold Agglutinin Antibodies in Systemic Lupus erythematosus-a Rare Association: Case Report.

Autoimmune hemolytic anemias (AIHAs) are rare and heterogeneous disorders characterized by the destruction of red blood cells by warm or cold antibodies. Hemolytic anemia associated with warm antibodies is the most common, whereas cold antibodies are rare and infrequent in cases published in the scientific literature. Herein, we present the case of a young patient with systemic lupus erythematosus (SLE) and autoimmune hemolytic anemia caused by cold antibodies. Initially, infectious etiology and hematological malignancy were considered, which were ruled out. She required management in the intensive care unit due to severe hematological involvement and responded well to immunomodulatory therapy. This case illustrates the importance of a strong clinical suspicion of AIHA due to cold agglutinins associated with SLE when faced with similar clinical symptoms in order to achieve a timely diagnosis and provide optimal therapy.

First case report of tumor lysis syndrome after third line systemic therapy with gemcitabine and pazopanib in a patient with lower extremity soft tissue sarcoma.

BACKGROUND: Tumor lysis syndrome (TLS) is recognized as an oncologic disorder with a variable incidence. TLS can cause the rapid destruction of tumor cells in response to oncologic therapy and is characterized by multiple electrolyte disturbances as well as its secondary complications, including death. This disease is common among patients with hematologic neoplasms, but very rare among those with solid tumors, as is the case with sarcomas. Such patients have a poor prognosis and increased risk of mortality. In the patient's particular case, this occurred after initiating third-line systemic therapy with gemcitabine associated with pazopanib, an event not previously described in the literature. CASE DESCRIPTION: We report the case of a patient with a history of high-grade sarcoma of the left lower limb T4N1M0 stage IIIB undergoing surgical management and exhibiting tumor progression with the need for third-line systemic therapy with pazopanib and gemcitabine. The patient presented with pain at the amputation site, inflammatory changes, and a tumor mass of large components on admission. They later developed electrolyte imbalance and acute renal injury compatible with TLS after systemic therapy was initiated. Pharmacological therapy, including rasburicase, was initiated based on the clinical and laboratory findings. Due to the progression of renal involvement, it was necessary to initiate haemodialysis, and during her hospital stay, the patient presented febrile syndrome associated with pancytopenia. The patient showed a favourable clinical response to the proposed antibiotic therapy and recovery of renal function, for which reason therapy was restarted with pazopanib and gemcitabine, the latter with a 20% reduction for the following cycles. Outpatient follow-up continued, completing eight cycles of treatment with good tolerance and partial clinical response; the patient died of respiratory complications eight months after discharge. CONCLUSIONS: There is limited evidence for TLS in patients with high-grade sarcoma in the literature related to the oncologic therapy used; this indicates that early risk evaluation along with prompt initiation of effective therapies is required to prevent the appearance of this type of complications in the short and long term.

Pulmonary Thromboembolism in Pregnancy: A Case Report and Literature Review.

Data on the optimal diagnostic management of pregnant women with suspected pulmonary embolism are limited. Despite a lack of compelling evidence in some practices, clinical practice guidelines focus on the management of these patients. We present the case of a 24-year-old patient at 36 weeks of pregnancy in whom pulmonary thromboembolism (PTE) was diagnosed in a timely manner also with hemodynamic instability and echocardiographic images with clear involvement of the right cavities. She received thrombolytic therapy with alteplase 100 mg intravenously over 2 hours, which resulted in excellent outcomes for both the pregnant woman and fetus. Understanding the acute approach and management of these patients will improve our clinical practice; therefore, we reviewed a case report of a pregnant patient with high-risk PTE and compared it with current evidence. In conclusion, PE is a common disease with a high mortality rate during pregnancy. Therefore, having made a timely diagnosis using the relevant diagnostic aids and performing thrombolysis with rtPA increase the probability of survival in our patient, leading to successful results for both her and the fetus.

Frequent Cardiovascular Manifestations Associated With SARS Cov-2 Infection: Experience at a Tertiary Hospital In Cali, Colombia

Abstract Background: Coronavirus disease 2019 (COVID-19) mainly affects the respiratory system, while the most common extrapulmonary complication of COVID-19 is cardiovascular involvement. Objective: To identify the frequency of electrocardiographic changes and cardiac arrhythmias in patients hospitalized with COVID-19 infection. Methods: This was a cross-sectional study, including patients aged >18 years with diagnosis of severe acute respiratory syndrome coronavirus 2 infection in a high-complexity hospital in Santiago de Cali, Colombia, from March to September 2020. A descriptive analysis with an analytical component and multiple logistic regression analysis were performed; all estimates were established with a 95% confidence level (CI) and a 5% significance level. Results: This study included 183 individuals; of whom 160 were considered for electrocardiographic analysis, 63% of which evidenced significant findings, the most frequent being sinus tachycardia (29.4%). The frequency of myocardial injury was 21.9% and was more common among non-survivors than among survivors (41.7% vs. 12.2%, p < 0.001). Myocardial injury was also significantly more common in patients who presented electrocardiographic findings than those who did not (26.5% vs. 12.1%, p = 0.032) and in those who required intensive care admission (31.8% vs 10.5%, p < 0.001). The strongest mortality-associated factor was the need for mechanical ventilation — odds ratio (OR), 9.14; 95% confidence interval, 3.4-24.5. Conclusions: Electrocardiographic findings in patients with COVID 19 are frequent, including newly diagnosed arrhythmias, justifying the use of cost-effective tools for the initial approach and follow-up of this affected population. Worse outcomes depend on factors such as invasive mechanical ventilation, comorbidities, age, and superinfection.

Effects of Posttraumatic Stress Disorder and Mental Disorders on the Labor Market Integration of Young Syrian Refugees.

Civil war experience in the Syrian home country, insecurity and critical life events during migration, or adverse events in the receiving country might affect refugees' mental health. This paper addresses the effects of psychological distress and mental disorders on refugees' labor market integration in Germany between 2016 and 2021. We employ survey data from about 2700 young Syrians, delivering information on individuals' experience of migration and arrival in Germany in 2016. The survey data were successfully merged with register data, delivering detailed information regarding individuals' process of labor market integration and employment status from 2016 to 2021. Overall, the labor market integration of young refugees improved remarkably over time. In 2021, about 69% of the study population was integrated in a wider sense, and 30% was employed in fulltime contracts in 2021. However, the results indicate long-lasting effects of PTSD and mental disorders on individuals' labor market integration, whilst individuals' characteristics related to migration and arrival lose relevance over time and hardly affect labor market integration around five years after arrival. High PTSD scores in 2016 indicate a significantly reduced full-time employment probability in 2021. Anxiety and depression show significant negative effects on individuals' labor market integration, but with a less severe impact compared to a PTSD diagnosis.

Representações Sociais da Mulher na Literatura Científica: uma Revisão Sistemática / Social Representations of Women in Scientific Literature: a Systematic Review / Representaciones Sociales de la Mujer en la Literatura Científica: una Revisión Sistemática

Esta revisão sistemática analisa publicações científicas sobre representações sociais da mulher no Brasil e América Latina, considerando para essa análise os objetivos de estudos embasados na Teoria das Representações Sociais (TRS) a fim de identificar os principais temas e contextos nos quais eles têm sido realizados. Foram conduzidas buscas nas bases Lilacs, PePSIC e SciELO, utilizando-se os descritores: "feminino" ou "mulher" combinados com "representação social". Foram analisados 114 artigos, publicados entre 1999 e 2020. A análise foi realizada com auxílio do software Iramuteq, gerando quatro classes temáticas: "Relação com o corpo"; "Gestação e maternidade"; "Feminino contranormativo" e "Violência de gênero". Nos resultados, observou-se dois núcleos principais: por um lado, temas tipicamente associados ao feminino, como maternidade, por outro, contextos não aprovados socialmente ou contranormativos, como a prostituição. Assim, há nas publicações uma representação ambivalente que parece espelhar a realidade social, tratando do que deve ser ou não "lugar de mulher". Além disso, percebe-se a ausência de estudos embasados pela TRS sobre a mulher em espaços importantes, como os de liderança política. Com isso, discutimos a relação entre representações sociais da mulher e práticas sociais, bem como o papel da ciência no combate às desigualdades de gênero.

This systematic review analyzes scientific publications on social representations of women in Brazil and Latin America, considering for this analysis the objectives of studies based on the Theory of Social Representations (TSR) in order to identify their main themes and contexts. Searches were conducted in the Lilacs, PePSIC and SciELO databases, using the descriptors: "female" or "woman" combined with "social representation". We analyzed 114 articles, published between 1999 and 2020. The analysis was performed with the help of the Iramuteq software, generating four thematic classes: "Relationship with the body"; "Gestation and maternity"; "Female counter-normative"; "Gender-based violence". In the results, two main focuses were observed: themes typically associated with the feminine, such as motherhood, and contexts not socially approved or counter-normative, such as prostitution. There is an ambivalent representation in publications that seems to mirror the social reality, dealing with what should or should not be the "woman's place". In addition, there is a lack of studies supported by the TSR on women in important spaces, such as those of political leadership. Finally, we discussed the relationship between social representations of women and social practices, as well as the role of science in combating gender inequalities.

Esta revisión sistemática tuvo como objetivo analizar las publicaciones científicas sobre las representaciones sociales de las mujeres en Brasil y América Latina, considerando los objetivos de los estudios basados en la Teoría de las Representaciones Sociales (TRS) a fin de identificar sus principales temas y contextos. Las búsquedas se realizaron en las bases Lilacs, PePSIC y SciELO, utilizando los descriptores: "femenino" o "mujer" combinados con "representación social". Se analizaron 114 artículos, publicados entre 1999 y 2020. El análisis con el software Iramuteq, generó cuatro clases: "Relación con el cuerpo"; "Gestación y maternidad"; "Contranormativa femenina" y "Violencia de género". En los resultados se observaron dos enfoques principales: temas típicamente asociados con el femenino, como la maternidad, y contextos no aprobados socialmente, como la prostitución. Así, existe una representación ambivalente en las publicaciones que parece reflejar la realidad social, abordando lo que debería o no ser un "lugar de mujeres". Además, faltan estudios apoyados por la TRS sobre mujeres en áreas importantes, como las del liderazgo político. Con esto, discutimos la relación entre las representaciones sociales de las mujeres y las prácticas sociales, así como el papel de la ciencia en la lucha contra las desigualdades de género.

Morphea mimicking facial capillary malformations: Two new cases and review of the literature.

Morphea and facial capillary malformations (port-wine stains) are distinct conditions that can affect the pediatric population. Early localized morphea mimicking a capillary malformation is an uncommon clinical presentation. We present two new cases of girls, aged 2 and 3 years, who presented with erythematous patches, initially diagnosed as capillary malformations, which were later diagnosed as morphea. We also performed a literature review, yielding 12 additional cases that underscore that the unusual presentation of morphea may delay correct diagnosis. Although early management of morphea reduces long-term sequelae, it is important to delay laser treatment for selected acquired vascular malformations, until the diagnosis of morphea is excluded.

Dermoscopic features of actinomycetoma: a case series.

Dermoscopy of mycetoma has white structures as the predominant feature, while white scale and yellowish structures were also consistent in our findings with available literature.

LQG Control for Dynamic Positioning of Floating Caissons Based on the Kalman Filter.

This paper presents the application of an linear quadratic gaussian (LQG) control strategy for concrete caisson deployment for marine structures. Currently these maneuvers are carried out manually with the risk that this entails. Control systems for these operations with classical regulators have begun to be implemented. They try to reduce risks, but they still need to be optimized due to the complexity of the dynamics involved during the sinking process and the contact with the sea bed. A linear approximation of the dynamic model of the caisson is obtained and an LQG control strategy is implemented based on the Kalman filter (KF). The results of the proposed LQG control strategy are compared to the ones given by a classic controller. It is noted that the proposed system is positioned with greater precision and accuracy, as shown in the different simulations and in the Monte Carlo study. Furthermore, the control efforts are less than with classical regulators. For all the reasons cited above, it is concluded that there is a clear improvement in performance with the control system proposed.

PSON: A Serialization Format for IoT Sensor Networks.

In many Internet of Things (IoT) environments, the lifetime of a sensor is linked to its power supply. Sensor devices capture external information and transmit it. They also receive messages with control commands, which means that one of the largest computational overheads of sensor devices is spent on data serialization and deserialization tasks, as well as data transmission. The simpler the serialization/deserialization and the smaller the size of the information to be transmitted, the longer the lifetime of the sensor device and, consequently, the longer the service life. This paper presents a new serialization format (PSON) for these environments, which simplifies the serialization/deserialization tasks and minimizes the messages to be sent/received. The paper presents evaluation results with the most popular serialization formats, demonstrating the improvement obtained with the new PSON format.

Egalitarian men: stereotypes and discrimination / Hombres igualitarios: estereotipos y discriminación en el mercado laboral

Abstract This article aimed to analyze the stereotypes attributed to "egalitarian men", understood here as men who support gender equality in relation to domestic and family responsibilities as well as inclusion in the workforce. To do so, two studies were carried out. The first study investigated the attribution of stereotypes to egalitarian men through a single open question. A total of 250 university students participated in this study, of which 51.1% were male, and their average age was 21.5 years (SD = 4.39). The second study analyzed the attribution of stereotypes to egalitarian or traditional men and women in a work context considered masculine. Participants included 221 university students with a mean age of 21.9 years (SD = 4.19), the majority (54.3%) being male. Taken together, the results of the two studies indicate that the egalitarian man is perceived as fragile and possibly homosexual. On the other hand, he is also seen as being more competent than traditional men.

Resumen El presente estudio tuvo por objetivo analizar los estereotipos atribuidos a los "hombres igualitarios", aquí entendidos como hombres que defienden la igualdad de género en lo que refiere a las responsabilidades domésticas y familiares, así como en la inserción laboral. Para ello, se realizaron dos estudios: el primero para investigar la atribución de estereotipos sobre los hombres igualitarios por medio de una única pregunta abierta, en el que participaron 250 estudiantes universitarios con edad media de 21.5 años (DE = 4.39), de los cuales el 51.1 % era del sexo masculino; y el segundo para analizar la atribución de estereotipos a hombres y mujeres igualitarios o tradicionales en un contexto laboral considerado masculino, que contó con la participación de 221 universitarios con edad media de 21.9 años (DE = 4.19), siendo la mayoría (54.3 %) del sexo masculino. En conjunto, los resultados de los dos estudios indican que el hombre igualitario es percibido como frágil y posiblemente homosexual; aunque, por otro lado, también es visto como más competente que los hombres tradicionales

Relaciones entre valores humanos y síndrome de burnout: una revisión sistemática / The relationship between human values and the burnout syndrome: a systematic review

OBJETIVOS: Revisión sistemática de las relaciones entre valores humanos y síndrome de burnout, analizando también aquellas estrategias de afrontamiento frente a esta enfermedad. Material y MÉTODOS: Se realizó una revisión sistemática en las bases de datos MEDLINE (PUBMED), SCIELO, LILACS, CISNE/UCM, Periódicos CAPES y BVS. RESULTADOS: Los 9 artículos seleccionados mostraron un mayor número de asociaciones positivas entre los valores de autopromoción y el burnout, principalmente en la despersonalización, mientras que los valores de autotrascendencia y conservación se relacionaron negativamente con la despersonalización. Las estrategias de afrontamiento más indicadas son aquellas que se dirigen a la evitación del conflicto entre valores personales y profesionales. CONCLUSIÓN: Se encontraron asociaciones significativas entre el burnout y sus dimensiones (despersonalización, agotamiento emocional y baja realización) y los valores. Dada la relevancia de la relación entre valores y burnout se señala la necesidad de realizar nuevos estudios que puedan confirmar y explicar mejor estos resultados

OBJECTIVES: Systematic review of the relationship between human values and the burnout syndrome, also analyzing coping strategies towards this mental health disorder. MATERIALS AND METHODS: A systematic review was carried out on the MEDLINE (PUBMED), SCIELO, LILACS, CISNE / UCM, CAPES and VHL journal databases. RESULTS: The 9 selected articles showed a higher number of positive associations between self-promotion values and burnout, mainly in depersonalization, while self-transcendence and conservation values were negatively related to depersonalization. The most indicated coping strategies were those that address conflict avoidance between personal and professional values. CONCLUSIONS: Significant associations were found between burnout and its dimensions (depersonalization, emotional exhaustion and low performance) and values. Given the relevance of the relationship between values and burnout, it is pointed out the need to carry out new studies that can confirm and explain these results better

Valores y principios bioéticos que identifican las comunidades en los servicios ecosistémicos que prestan los ríos y quebradas / Values and bioethical principles identified by communities in ecosystem services provided by rivers and streams / Valores e princípios da bioética que identificam as comunidades nos serviços de ecossistema fornecidos pelos rios e ribeiros

Propósito/Contexto. Este artículo tiene como propósito analizar los valores y principios bioéticos que identifican las comunidades sobre los servicios ecosistémicos que prestan los ríos y quebradas en los municipios de la cuenca del Río Apulo, en el Departamento de Cundinamarca, Colombia. Se trabaja alrededor de la idea de la coexistencia armoniosa de los seres humanos y los ríos, como fundamento para lograr un uso sostenible de los servicios que nos prestan estos ecosistemas. Metodología/Enfoque. Metodológicamente consta de dos partes: en la primera se trabajó desde el paradigma positivista, a través de metodologías cuantitativas de campo y de laboratorio; en la segunda parte se trabajó desde el paradigma interpretativo, a través de talleres de cartografía social. Resultados. Por el análisis de los datos cuantitativos, se encontró que las aguas de los ríos de la cuenca estaban contaminadas en todas las estaciones de muestreo, principalmente, con materia fecal. La identificación de los valores de los servicios ecosistémicos que prestan estos ríos y quebradas mostraron una fuerte influencia de la concepción productivista, localista y antropocéntrica. Discusión/Conclusiones/Contribuciones. Debido a que la contaminación afecta al ambiente, tanto presente como futuro, es necesario acudir a los principios de precaución, de responsabilidad y de justicia.

Purpose/Context. This article intends to analyze the bioethical values and prin-ciples communities identify in ecosystem services provided by rivers and streams to municipalities in the Apulo River basin, in the Department of Cundinamarca, Colombia. It builds on the idea of harmonious coexistence between human beings and rivers for achieving the sustainable use of such services. Method/Approach. The project has two parts. The first one is based on the positivist paradigm of research through field and laboratory quantitative methods. The second part employs the interpretive paradigm of research through social mapping workshops. Results/Findings.In analyzing the quantitative data, it was found that the river basin waters are polluted at all sample sites, especially by feces. The identification of the values of ecosystem services provided by rivers and streams was strongly influenced by a productivist, localist, and anthropocentric conception. Discussion/Conclusions/Contributions. Since pollution affects the environment, both now and in the future, it is necessary to adhere to the principles of precaution, responsibility, and justice.

Objetivo/Contexto. O presente artigo tem como objetivo analisar os valores e princípios bioéticos identificados pelas comunidades sobre os serviços ecossistêmicos que fornecem rios e córregos nos municípios da bacia do rio Apulo, no Estado de Cundinamarca, Colômbia. Trabalha-se ao redor da ideia da coexistência harmoniosa dos seres humanos e rios, como base para alcançar um uso sustentável dos serviços prestados por esses ecossistemas. Metodologia/Abordagem. Metodologicamente, o projeto consiste em duas partes: na primeira, o trabalho foi realizado a partir do paradigma positivista da pesquisa, por meio de metodologias quantitativas de campo e laboratório; na segunda parte, o trabalho foi realizado a partir do paradigma interpretativo da pesquisa, através de oficinas sobre mapeamento social. Resultados/Descobertas. Para a análise dos dados quantitativos, verificou-se que as águas dos rios da bacia estavam contaminadas em todos os pontos de amostragem, principalmente com matéria fecal. A identificação dos valores dos serviços ecossistêmicos que apresentam estes rios e córregos mostraram uma forte influência da concepção produtivista, localista e antropocêntrica. Discussão/Conclusões/Contribuições. Como a poluição afeta o meio ambiente, no presente e no futuro, é necessário nos aderir aos princípios de precaução, de responsabilidade e de justiça.

Violence and burnout in health care emergency workers in Santiago, Chile: A survey-based cross-sectional study.

Shortage of quantitative studies regarding health risks for emergency services workers is a concern for Chilean's occupational health organizations. OBJECTIVE: To explore the incidence of violence and burnout in emergency services of the Metropolitan Region of Chile, and associations with workers' characteristics and workplace conditions. METHODS: A cross-sectional study was carried out from January to August 2016. A self-reported questionnaire explored about frequency and seriousness of violence episodes and about symptoms of burnout with the Maslach Burnout Inventory. RESULTS: Of the 565 workers participating, 71% (95% CI 66.7-74.5) said violence episodes occurred at least once a week; 71.3% (95% CI 67.3-75.0) were victims of some aggression in the previous 12 months. Patients companions, relatives or friends arose as the main aggressors and the severity of the episodes was considered slight or moderate by more than 50% of participants. Fifty-seven respondents (10.5%, CI 95% 8.1-13.5) classified as having a burnout syndrome. Having been a victim of violence was associated to high emotional exhaustion (ORadj = 1.7, 95% CI: 1.1-2.8) and depersonalization (ORadj = 2.0, 95% CI 1.3-3.3). CONCLUSIONS: Violence is a problem in the emergency departments of Chile's Metropolitan Region. Burnout is also present and independently associated to violence.

Influence of Group Membership, Moral Values and Belief in a Just World in Blaming the Victim / Influência da Pertença Grupal, Valores Morais e Crença no Mundo Justo na Culpabilização da Vítima / Influencia de la Pertenencia Grupal, Valores Morais y Creencia en el Mundo Justo en la Culpabilización de la Víctima

Abstract This study investigated the relationship between the victim's group membership and secondary victimization she suffers, moderated by Moral Values and Belief in a Just World (BJW). The victim of the ingroup was blamed more for the sexual violence she suffered (Study 1, N = 250). In turn, that relationship was moderated by binding values (Study 2, N = 117) and by BJW (Study 3, N = 258). Together, the results suggest that the victim blaming is greater when she belongs to the ingroup; and that this relationship is predicted by high adherence to binding values and low adherence to BJW. This research contributes to the extent that it demonstrates that the relationship between adherence to binding values and victim derogation does not occur exclusively at the cognitive level, as information processing in which high adherence to these values would produce greater secondary victimization regardless of group membership of the victim. Additionally, it highlights the importance of considering the psychosocial processes underlying violence against women in order to promote more effective discussions and actions.

Resumo Este trabalho investigou a relação entre pertença grupal da vítima (endogrupo vs. exogrupo) e vitimização secundária por ela sofrida moderada pelos valores morais e Crença em um Mundo Justo (CMJ). Em consonância com estudos anteriores, a vítima do endogrupo foi mais responsabilizada pela violência sexual por ela sofrida (Estudo 1, N = 250). Por sua vez, essa relação foi moderada pelos valores vinculativos (Estudo 2, N = 117) e pela CMJ (Estudo 3, N = 258). Em conjunto, os resultados sugerem que a responsabilização da vítima de violência sexual é maior quando ela pertence ao endogrupo; e que esta relação é predita pela alta adesão aos valores vinculativos e baixa adesão à Crença em um Mundo Justo (CMJ). Esta investigação traz contribuições na medida em que demonstra que a relação entre adesão aos valores vinculativos e a derrogação da vítima não ocorre exclusivamente ao nível cognitivo, como um processamento de informação no qual a alta adesão a esses valores produziria maior vitimização secundária independente da pertença grupal da vítima. Adicionalmente, sinaliza a importância de considerar os processos psicossociais subjacentes à violência contra as mulheres com a finalidade de promover discussões e ações mais efetivas.

Resumen Este estudio investigó la relación entre la pertenencia a un grupo de la víctima y la victimización secundaria que sufre, moderada por los valores morales y la creencia en un mundo justo (BJW). Se culpó más a la víctima del ingroup por la violencia sexual que sufrió (Estudio 1, N = 250). A su vez, esa relación fue moderada por los valores de enlace (Estudio 2, N = 117) y por BJW (Estudio 3, N = 258). Juntos, los resultados sugieren que la culpa de la víctima es mayor cuando pertenece al ingroup; y que esta relación se predice por una alta adherencia a los valores de unión y una baja adherencia a BJW. Esta investigación contribuye en la medida en que demuestra que la relación entre la adherencia a los valores vinculantes y la derogación de la víctima no se produce exclusivamente a nivel cognitivo, ya que el procesamiento de la información en el que la alta adherencia a estos valores produciría una mayor victimización secundaria independientemente de la pertenencia al grupo de la victima. Además, destaca la importancia de considerar los procesos psicosociales subyacentes a la violencia contra las mujeres para promover debates y acciones más efectivas.

Protocol for mandibular reconstruction with zygomatic implants (zygomatic mandibular implant).

INTRODUCTION: This study describes a modified protocol using transmandibular zygomatic implants with immediate occlusal loading for the comprehensive dental rehabilitation of previously reconstructed mandibular defects and reports preliminary results of this modified protocol. MATERIALS AND METHODS: Fifteen patients (6 female and 9 male), with a mean of age 40.26 years (range 12 to 68 years), had previously undergone immediate mandibular reconstruction using either autologous bone grafting, bone transport, or microvascular free-flap reconstruction for a variety of diagnoses. Transmandibular zygomatic implants were subsequently placed, depending on the type of defect. Implant stability was evaluated by insertion torque, percussion testing, and the implant stability quotient (ISQ). The patients were rehabilitated with an immediate provisional prosthesis. All patients' records included pre and postoperative clinical examination, radiographs, CT scan, and photographic analysis. All patients were followed for a minimum of 36 months. RESULTS: All patients were dentally rehabilitated immediately with functional and esthetic hybrid dentures based on either acrylic or porcelain on a metal framework. Among all cases of transmandibular zygomatic implants, the ISQ was greater than 75, which allowed immediate prosthetic loading. The zygomatic implants were considered to be successful if they were asymptomatic with no clinical mobility and no sign of infection. We have also added new indications for placement of transmandibular implants in cases of sequelae of gunshot trauma, dentoalveolar defects, and complications of orthognathic surgery, partially edentulous and/or failure of prior mandibular reconstruction. CONCLUSIONS: The zygomatic implant is an excellent immediate loading option for mandibular dental rehabilitation among patients with mandibular defects. According to our observation, immediate occlusal loading of transmandibular zygomatic implants has a very good potential for success.