Impact of intimate partner violence on quality of life and disease activity in women with systemic lupus erythematosus.

OBJECTIVE: Stress and trauma are psychosocial factors with an impact on the course of systemic lupus erythematosus (SLE). The influence of violence on SLE has not been entirely explored, even though women (including patients with rheumatic diseases) are a vulnerable population to any form of violence. This study aims to assess the prevalence and impact of intimate partner violence (IPV) on health-related quality of life in women with SLE. METHODS: An observational, cross-sectional, and analytical study was conducted at a rheumatology clinic of a university hospital from September 2022 and September 2023. We evaluated the presence of IPV in 85 women with SLE with the Hurt, Insulted, Threatened with Harm and Screamed at (HITS) questionnaire and the Index of Spouse Abuse (ISA), and quality of life with LupusQoL. RESULTS: The prevalence by HITS score of past-year IPV was 24.4% and of lifetime IPV was 36.5%. Past-year non-physical violence was present in 17.1% of patients by ISA, and 27.1% were victims in their lifetime. While in physical violence, 7.3% were victims in the previous year and 21.2% in their lifetime. The total quality of life and the emotional domain by LupusQoL were diminished in victims of past-year IPV, compared to those who weren't exposed (p = .018 and p = .036, respectively). Past-year HITS score correlated with the Physician Global Assessment (PGA) (rho = 0.301, p = .006), while lifetime HITS score correlated with PGA (rho = 0.329, p = .002) and SLEDAI-2K (rho = 0.277, p = .010). CONCLUSION: We found that one in four women suffered IPV in the previous year, and those who were exposed had diminished quality of life. Also, the severity of the abuse correlated with disease activity. Our findings emphasize the importance of comprehensive care for patients with SLE.

Quality indicators and satisfaction with care in patients with systemic lupus erythematosus.

Grading the quality of care in patients with systemic lupus erythematosus and determining its relationship with care satisfaction may recognize gaps that could lead to better clinical practice. Eighteen quality indicators (QIs) were recently developed and validated for patients with SLE based on the 2019 EULAR management recommendations. Few studies have analyzed the relationship between quality of care and care satisfaction in patients with lupus. This was a cross-sectional study. We included patients at least 18 years old who met the EULAR/ACR 2019 classification criteria for SLE. We interviewed patients and retrieved data from medical records to assess their compliance with a set of 18 EULAR-based QIs. We calculated each QI fulfillment as the proportion of fulfilled QI divided by the number of eligible patients for each indicator. Care satisfaction was evaluated with the satisfaction domain of LupusPRO version 1.7. Spearman correlation coefficient was used to determine the relationship between quality of care and care satisfaction. Seventy patients with a median age of 33 (IQR 23-48) were included, 90% were women. Overall adherence was 62.29%. The median care satisfaction was 100. Global adherence to the 18-QIs and the care satisfaction score revealed no correlation (r = 0.064, p = 0.599). Higher QI fulfillment was found in the group with remission versus the moderate-high activity group (p = 0.008). In our study, SLE patients in remission had higher fulfillment of quality indicators. We found no correlation between the quality of care and satisfaction with care.

Assisted reality device to guide cardiac implantable device programming in distant rural areas.

BACKGROUND: Patients with cardiac implantable electronic devices (CIEDs) living in rural areas have difficulty obtaining follow-up visits for device interrogation and programming in specialized healthcare facilities. OBJECTIVE: To describe the use of an assisted reality device designed to provide front-line workers with real-time online support from a remotely located specialist (Realwear HTM-1; Realwear) during CIED assistance in distant rural areas. METHODS: This is a prospective study of patients requiring CIED interrogation using the Realwear HMT-1 in a remote rural population in Colombia between April 2021 and June 2022. CIED interrogation and device programming were performed by a general practitioner and guided by a cardiac electrophysiologist. Non-CIED-related medical interventions were allowed and analyzed. The primary objective was to determine the incidence of clinically significant CIED alerts. Secondary objectives were the changes medical interventions used to treat the events found in the device interrogations regarding non-CIED related conditions. RESULTS: A total of 205 CIED interrogations were performed on 139 patients (age 69 ± 14 years; 54% female). Clinically significant CIED alerts were reported in 42% of CIED interrogations, consisting of the detection of significant arrhythmias (35%), lead malfunction (3%), and device in elective replacement interval (3.9%). Oral anticoagulation was initiated in 8% of patients and general medical/cardiac interventions unrelated to the CIED were performed in 52% of CIED encounters. CONCLUSION: Remote assistance using a commercially available assisted reality device has the potential to provide specialized healthcare to patients in difficult-to-reach areas, overcoming current difficulties associated with RM, including the inability to change device programming. Additionally, these interactions provided care beyond CIED-related interventions, thus delivering significant social and clinical impact to remote rural populations.

Competencias genéricas de/la profesional psicopedagogo/a*: Análisis transmetodológico para la actualización del perfil profesional por medio de una experiencia de investigación acción participativa / Generic competences of the professional psychopedagogue: Transmethodological analysis to update the professional profile through an experience of Participatory Action Research

El presente artículo da cuenta de los principales hallazgos generados a partir del proyecto de investigación denominado "Perfil del profesional psicopedagogo/a: Aportes desde una revisión epistemológica a la praxis en Chile. Concepto, ámbitos de acción y roles actuales" realizado por la Agrupación de profesionales Psicopedagogos/as de Chile en el período 2019-2020. En esta primera etapa, por medio de una transmetodología de la investigación con enfoque de Investigación Acción Participativa (IAP), se establece un constructo teórico fundamentado en la empiria, que categoriza las competencias genéricas de los/as profesionales psicopedagogos/as en cuatro áreas principales: investigación, evaluación, acompañamiento y orientación y/o asesoramiento psicopedagógico. Las categorías elaboradas se fundamentan en la triangulación hermenéutica entre datos, teoría y experiencias de diversos actores/as de la Psicopedagogía chilena (académicos/as, trabajadores/as y estudiantes) e invitan a la reflexión en torno a la ruptura paradigmática emergente, la identidad disciplinar, la transmetodología de la investigación y las aportaciones desde la complejidad en la práctica profesional.

This reports the main findings generated from the research project called "Profile of the Psychopedagogue Professional: Contributions from an epistemological review of praxis in Chile. Concept, fields of action and current roles" carried out by the Psychopedagogue Professional Association in Chile in the period 2019-2020. In this first stage, through a transmethodology of research with a Participatory Action Research (IAP) focus, an empirical-based theoretical construct is established, which categorizes the generic competences of professional psychopedagogue in four main areas: research, evaluation, accompaniment and counseling and / or psycho-pedagogical advice. The elaborated categories are based on the hermeneutic triangulation between data, theory and experiences of various actors of the Chilean Psychopedagogy (academics, workers and students) and invite reflection on the emerging paradigmatic rupture, identity discipline, the transmethodology of research and contributions from complexity in professional practice.

Estructuración de la personalidad en niños y niñas abandonados por sus progenitores / Personality structuring in children abandoned by their parents

Resumen Esta investigación expone cómo la ausencia de ambos padres afecta la estructuración de la personalidad en los niños y niñas que vivencian el abandono, tomando como aporte lo planteado por la teoría sistémica respecto a la familia, la cual la considera como el primer ente de contacto y el espacio en que se inicia el desarrollo psicológico y social de las personas; igualmente lo planteado por la teoría psicoanalítica en cuanto a la estructuración de la personalidad. La familia es considerada como una pieza fundamental en el desarrollo psicológico del niño; por lo tanto, la presencia de ambos padres cumple un papel significativo durante el crecimiento físico y psicológico. El objetivo principal fue analizar cómo se está estructurando la personalidad en los niños y niñas abandonados por sus progenitores. La investigación se ajusta al método cualitativo, y en ella participaron seis menores de uno y otro sexo, cuyas edades oscilaron entre los nueve y once años de edad; los participantes formaban parte del ICBF (Instituto Colombiano de Bienestar Familiar). Se aplicaron entrevistas abiertas en total dos pruebas proyectivas: el CAT (Test de Apercepción Temática para niños CATA) y Test del Dibujo de la Familia, estudio de caso, historia clínica y observaciones personalizadas. Se destaca que los niños y niñas actualmente no cuentan con la presencia de una figura masculina que pueda cumplir con las funciones de una figura paterna y que pueda dar paso a que el Edipo encuentre una salida adecuada; además las mujeres encargadas de los cuidados de los participantes cambian con frecuencia lo cual genera en ellos dificultades en el establecimiento de vínculos afectivos seguros, y presentan un yo y superyó débiles y con notables vacíos afectivos en sus relaciones vinculares primarias.

Abstract This exposes how the absence of both parents affects the structuring of the personality in the boys and girls who experience the abandonment, taking as contribution what was proposed by the systemic theory in front of the family, which considers it as the first entity of contact and the space in which the psychological and social development of people begins, likewise what is posed by psychoanalytic theory regarding the structuring of personality. The family is considered as a fundamental piece in the child's psychological development, therefore the presence of both parents plays a significant role during physical and psychological growth. The main objective was to analyze how the personality is being structured in children abandoned by their parents. The research is adjusted to the qualitative method, where six minors of both sexes participated, whose ages ranged from nine to eleven years of age; the participants were part of the ICBF (Colombian Institute of Family Welfare). Two projective tests were applied to open interviews: the CAT (Thematic Apperception Test for children CATA) and the Family Drawing Test, case study, medical history and personalized observations. It is highlighted that boys and girls currently do not they have the presence of a male figure who can fulfill the functions of a father figure and who can make way for the Oedipus to find a suitable outlet; furthermore, the women in charge of the care of the participants change frequently, generating difficulties in establishing secure affective bonds, presenting a weak self and superego and with notable affective gaps in their primary bonding relationships.

Prescripción del ejercicio físico y sus implicaciones en adultos que han sufrido quemaduras / Prescription of physical activity and its implications in adults who have experienced burns

Resumen Introducción. La prescripción del ejercicio físico y sus implicaciones en pacientes que han sufrido quemaduras es objeto de estudio en diferentes investigaciones debido al impacto físico, psicológico y social que tiene en las personas. Objetivo. Describir la prescripción de ejercicio físico y sus implicaciones en la población adulta que ha sufrido quemaduras. Materiales y métodos. Se realizó una revisión de tema por medio de exploración de artículos de manera electrónica con filtros de búsqueda en distintas bases de datos con términos DeCS y MeSH. Resultados. Se seleccionaron 11 artículos con intervención de ejercicio físico en fases aguda y crónica. Se incluyeron estrategias sobre la fuerza muscular en cinco de los artículos: tres de resistencia cardiovascular; dos de rango de movimiento, flexibilidad y características tróficas de la piel, y uno de dolor. Conclusiones. Las variables de la prescripción se determinan de acuerdo a las características propias que presenta la persona con quemadura, las cuales se resumen en esta revisión.

Abstract Introduction: The prescription of physical activity and its implications in patients who have suffered burns is the object of study of different investigations due to the physical, psychological and social impact they have on people. Objective: To describe the prescription of physical activity and its implications in adults with burn injury. Materials and methods: A review of the topic was carried out by scanning articles electronically and using search filters in different databases with DeCS and MeSH terms. Results: 11 articles about physical activity intervention in acute and chronic phases were selected. Strategies on muscle strength were included in six of the articles: three on cardiovascular resistance; two on range of motion, flexibility and trophic features of the skin; and one on pain. Conclusions: The variables of the prescription are determined according to the characteristics of the person with the burn, which are summarized in this review.